The Therapeutic Environment Screening Survey for Nursing Homes (TESS-NH): An Observational Instrument for Assessing the Physical Environment of Institutional Settings for Persons With Dementia

Sloane, Philip D.; Mitchell, C. Madeline; Weisman, Gerald D.; Zimmerman, Sheryl; Foley, K.; Lynn, Mary R.; Calkins, Margaret P.; Lawton, M. Powell; Teresi, Jeanne A.; Grant, Leslie; Lindeman, David; Montgomery, Rhonda J. V.

doi:10.1093/geronb/57.2.s69

Cited by 150 publications

(162 citation statements)

References 33 publications

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“…Chenoweth et al [42], using a PCC staff training program or the DCM method as two alternative interventions, found significantly lower agitation measured by the CMAI in the patients of both intervention groups than in the patients of a common control group. The study population in the study of Chenoweth et al [42] was selected on a criterion of persistent need-driven behaviour, and the participating nursing homes were screened before the start of the study using the Therapeutic Environment Screening Survey for Nursing Homes (TESS-NH) [56] to be able to select nursing homes characterized as having a task-focused, not person-centred care system. In our study, there was no screening of the nursing homes' care system or the patients' behaviour after they met the inclusion criterion of dementia in all stages.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Person-Centred Dementia Care to Prevent Agitation and Other Neuropsychiatric Symptoms and Enhance Quality of Life in Nursing Home Patients: A 10-Month Randomized Controlled Trial

Rokstad

Røsvik

Kirkevold³

et al. 2013

Dement Geriatr Cogn Disord

104

147

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Aims: We examined whether Dementia Care Mapping (DCM) or the VIPS practice model (VPM) is more effective than education of the nursing home staff about dementia (control group) in reducing agitation and other neuropsychiatric symptoms as well as in enhancing the quality of life among nursing home patients. Methods: A 10-month three-armed cluster-randomized controlled trial compared DCM and VPM with control. Of 624 nursing home patients with dementia, 446 completed follow-up assessments. The primary outcome was the change on the Brief Agitation Rating Scale (BARS). Secondary outcomes were changes on the 10-item version of the Neuropsychiatric Inventory Questionnaire (NPI-Q), the Cornell Scale for Depression in Dementia (CSDD) and the Quality of Life in Late-Stage Dementia (QUALID) scale. Results: Changes in the BARS score did not differ significantly between the DCM and the control group or between the VPM and the control group after 10 months. Positive differences were found for changes in the secondary outcomes: the NPI-Q sum score as well as the subscales NPI-Q agitation and NPI-Q psychosis were in favour of both interventions versus control, the QUALID score was in favour of DCM versus control and the CSDD score was in favour of VPM versus control. Conclusions: This study failed to find a significant effect of both interventions on the primary outcome. Positive effects on the secondary outcomes indicate that the methods merit further investigation.

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Section: Discussionmentioning

confidence: 99%

The Effect of Person-Centred Dementia Care to Prevent Agitation and Other Neuropsychiatric Symptoms and Enhance Quality of Life in Nursing Home Patients: A 10-Month Randomized Controlled Trial

Rokstad

Røsvik

Kirkevold³

et al. 2013

Dement Geriatr Cogn Disord

104

147

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“…Seven care homes in South East England (51 0 N) participated in the study. Each care home was assessed using the modified Therapeutic Environment Screening Survey for nursing homes (TESS-NH) [45], to ensure the environments were comparable.…”

Section: Methodsmentioning

confidence: 99%

Blue-Enriched Lighting for Older People Living in Care Homes: Effect on Activity, Actigraphic Sleep, Mood and Alertness

Hopkins

Morgan

Schlangen

et al. 2017

CAR

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Environmental (little outdoor light; low indoor lighting) and age-related physiological factors (reduced light transmission through the ocular lens, reduced mobility) contribute to a light-deprived environment for older people living in care homes. This study investigates the effect of increasing indoor light levels with blueenriched white lighting on objective (rest-activity rhythms, performance) and self-reported (mood, sleep, alertness) measures in older people. Eighty residents (69 female), aged 86 ± 8 yrs (mean ± SD), participated (MMSE 19 ± 6). Overhead fluorescent lighting was installed in communal rooms (n=20) of seven care homes.Four weeks of blue-enriched white lighting (17000 K  900 lux) were compared with four weeks of control white lighting (4000 K  200 lux), separated by three weeks wash-out. Participants completed validated mood and sleep questionnaires, psychomotor vigilance task (PVT) and wore activity and light monitors (AWL). Restactivity rhythms were assessed by cosinor, non-parametric circadian rhythm (NPCRA) and actigraphic sleep analysis. Blue-enriched (17000 K) light increased wake time and activity during sleep decreasing actual sleep time, sleep percentage and sleep efficiency (p < 0.05) (actigraphic sleep). Compared to 4000 K lighting, blueenriched 17000 K lighting significantly (p < 0.05) advanced the timing of participants' rest-activity rhythm (cosinor), increased daytime and night-time activity (NPCRA), reduced subjective anxiety (HADA) and sleep quality (PSQI). There was no difference between the two light conditions in daytime alertness and performance (PVT). Blue-enriched lighting produced some positive (increased daytime activity, reduced anxiety) and negative (increased night-time activity, reduced sleep efficiency and quality) effects in older people.Keywords: care home, light therapy; mood; elderly; rest-activity; sleep. 3 Graphical AbstractThe effect of blue-enriched 17000 K lighting (right) on the rest-activity, sleep and mood of older people living in care homes has been investigated compared to control 4000 K lighting (middle) (left, original lighting) 4

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“…Most of the earlier studies of the physical environment took place primarily in nursing homes (Brawley, 2001;Sloane et al, 2002;Zeisel et al, 2003). Two more recent studies (Keane & Cislo, 2003;Samus et al, 2005) focused on the impact of the physical environment on dementia residents in assisted living settings.…”

Section: Physical Environmentmentioning

confidence: 99%

Dementia and Assisted Living

Hyde¹,

Pérez²,

Forester³

2007

The Gerontologist

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Purpose: This article presents an overview of what is known about dementia services in assisted living settings and suggests areas for future research. Design and Methods: We undertook a search of Medline, the Journals of Gerontology, and The Gerontologist. We then organized publications dealing with the target subject into 10 topic areas and reviewed them. Results: The article describes the demographic characteristics of cognitively impaired residents in assisted living and related residential settings in the United States, the services they receive, and process and structural elements both in specialized dementia units and in integrated assisted living settings. Finally, we review the literature on methodological issues regarding research in this area. Implications: It is important to generate research on processes as well as outcomes, such as dignity, individualized and pleasurable experiences, and freedom from pain and discomfort. We make recommendations for both content areas that would benefit from further research as well as methodological approaches that will yield important information in this field.Key Words: Long-term care, Alzheimer's disease, Cognitively impaired, Aging in place, Residential careThis article outlines what is known about dementia services in assisted living settings and explores the many questions that remain unanswered. Ultimately, research is needed that will offer specific information regarding how assisted living processes and structure result in specific outcomes in the various subpopulations of cognitively impaired residents. The variability of assisted living and its philosophy of customizing services to the wishes and needs of each individual resident provide a rich environment for research as researchers attempt to discover what works best for whom (Feldman & Kane, 2003). We also discuss the range of processes and outcomes that one should consider in evaluating the effectiveness of assisted living services and environments, including the central role of quality of life in the assisted living philosophy of dementia care.Assisted living, as an industry, is less than 20 years old. Early research sought to enumerate how many people with dementia lived in assisted living, how many were in special care units (SCUs) or in general assisted living settings, and what kinds of services they received. However, even these simple facts have been elusive as basic data such as the prevalence of dementia can be difficult to determine in these non-health-care settings. In fact, determining which settings meet the criteria to be considered assisted living can, in itself, be less than straightforward.Central to the assisted living philosophy is a respect for the individuals who live in this setting and their continued rights as citizens and human beings. However, this philosophy is challenged when the people served have cognitive impairments that compromise their ability to make or communicate decisions regarding their care and lifestyle choices.Not all regulators, providers, family members, co...

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The Therapeutic Environment Screening Survey for Nursing Homes (TESS-NH): An Observational Instrument for Assessing the Physical Environment of Institutional Settings for Persons With Dementia

Abstract: The TESS-NH efficiently assesses discrete elements of the physical environment and has strong reliability and validity. The SCUEQS provides a quantitative measure of environmental quality in institutional settings.

Cited by 150 publications

References 33 publications

The Effect of Person-Centred Dementia Care to Prevent Agitation and Other Neuropsychiatric Symptoms and Enhance Quality of Life in Nursing Home Patients: A 10-Month Randomized Controlled Trial

The Effect of Person-Centred Dementia Care to Prevent Agitation and Other Neuropsychiatric Symptoms and Enhance Quality of Life in Nursing Home Patients: A 10-Month Randomized Controlled Trial

Blue-Enriched Lighting for Older People Living in Care Homes: Effect on Activity, Actigraphic Sleep, Mood and Alertness

Dementia and Assisted Living

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