Wayfinding in People with Alzheimer’s Disease: Perspective Taking and Architectural Cognition—A Vision Paper on Future Dementia Care Research Opportunities

Kuliga, Saskia; Berwig, Martin; Roes, Martina

doi:10.3390/su13031084

Cited by 19 publications

(12 citation statements)

References 98 publications

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“…In research initiatives, the role of the built environment is often discussed in connection to wayfinding [ 46 ] influencing residents’ safety and ability to perform activities of daily living, such as toileting or dressing [ 47 ]. The findings of the process evaluation indicate that a dementia-sensitive spatial design additionally has an impact on residents’ social life and their engagement in purposeful and leisure activities, as also shown by Lee et al [ 48 ] and Morgan-Brown et al [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Mechanisms of impact and contextual aspects of a dementia special care unit in long-term care: a process evaluation

2021

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Background In long-term care, persons with dementia are often cared for in specialised facilities, which are rather heterogeneous in regard to care concepts. Little information is available on how these facilities and care concepts bring about changes in the targeted outcomes. Such knowledge is needed to understand the effects of care concepts and to consciously shape further developments. This study aimed to explore the mechanisms of impact of a specific care concept from a dementia special care unit and the contextual aspects that influence its implementation or outcomes. Methods Using a qualitative approach to process evaluation of complex interventions, we conducted participating observations and focus groups with nurses and single interviews with ward and nursing home managers. Data were collected from two identical dementia special care units to enhance the contrasts in the analysis of two non-specialised nursing homes. We analysed the data thematically. We conducted 16 observations, three group interviews and eleven individual interviews. Results We identified seven themes in three domains related to mechanisms that lead to outcomes regarding residents’ and nurses’ behaviour and well-being. The themes include the development of nurses’ skills and knowledge, the promotion of a positive work climate, adjusted spatial structures, adjusted personnel deployment strategy “dedicated time for activities”, promotion of relaxation, of engagement in activities and of engagement in social interaction of residents. The implementation and outcomes of the care concept are influenced by contextual aspects relating to the (target) population and cultural, organisational and financial features. Conclusions The study found expected and unexpected mechanisms of impact and contextual aspects. The care concept of the dementia special care unit results in higher levels of relaxation, activities, and social interaction of residents. Its implementation highly depends on the shared understanding of nursing and the skills of the nursing team. Changes in residents’ characteristics result in altered effects of the concept. Trial registration DRKS00011513.

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Section: Discussionmentioning

confidence: 99%

Mechanisms of impact and contextual aspects of a dementia special care unit in long-term care: a process evaluation

2021

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“…In research initiatives, the role of the built environment is primarily discussed in connection to way nding [34] in uencing residents' safety and ability to perform activities of daily living, such as toileting or dressing [35]. The ndings of the process evaluation indicate that a dementia-sensitive spatial design additionally has an impact on residents' social life and their engagement in purposeful and leisure activities, as also shown by Lee et al…”

Section: Promotion Of Relaxation Engagement In Activities and Social Interactionmentioning

confidence: 95%

Mechanisms Of Impact And Contextual Aspects of A Care Concept From A Dementia Special Care Unit In Long-Term Care: Process Evaluation As Part of A Theory-Driven Evaluation

Adlbrecht

Bartholomeyczik

Mayer

2021

Preprint

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Background: In long-term care, persons with dementia are often cared for in specialised facilities, which are rather heterogeneous in regard to their design and care concepts. Little information is available on how these facilities and care concepts bring about changes in the targeted outcomes. Such knowledge is needed to understand the effects of care concepts and to consciously shape further developments. This study aimed to explore the mechanisms of impact of a specific care concept from a dementia special care unit and the contextual aspects that influence its implementation or outcomes.Methods: Using a qualitative approach to process evaluation of complex interventions, we conducted participating observations and focus groups with nurses and single interviews with ward and nursing home managers. Data were collected from two identical dementia special care units to enhance the contrasts in the analysis of two non-specialised nursing homes. We analysed the data thematically. We conducted 16 observations, three group interviews and eleven individual interviews.Results: We identified seven themes in three domains related to mechanisms that lead to outcomes regarding residents’ and nurses’ behaviour and well-being. The development of nurses' skills and knowledge changes team-level competence and leads to an altered understanding of nursing. The promotion of a positive work climate reduces distress and promotes the long-term implementation of the care concept. Adjusted spatial structures and personnel strategies facilitate the implementation of interventions for residents and promote the fulfilment of their needs. Personalised psychosocial interventions promote residents' relaxation, engagement in activities and social interaction and thereby empower them to become part of the social community, to spend their time purposefully, to have positive experiences and to experience belonging and affection. The implementation and outcomes of the care concept are influenced by contextual aspects relating to the (target) population and cultural, organisational and financial features.Conclusions: The care concept of the dementia special care unit results in higher levels of relaxation, activities, and social interaction of residents. Its implementation highly depends on the shared understanding of nursing and the skills of the nursing team. Changes in residents’ characteristics result in altered effects of the concept.Trial registration: DRKS00011513

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“…Findings from prior studies on the PtD seemed to agree that design for visibility should be part of architects' repertoire in the early stages of design to enhance building life-cycle, safety performance and occupants safety as proven by Eilouti, 2021;Hamzah, 2006;Kowaltowski et al, 2013;Kuliga et al, 2021). The topic addresses universal design consideration through adequate building signage, a design for people with disabilities, ergonomic safety building facilities, especially for maintenance work, fire prevention, and emergency escape.…”

Section: Design For Visibilitymentioning

confidence: 97%

The Sustainable Aspect of Safety in Architectural Early Design: An Introduction to Prevention through Design (PtD) Concept

Samsudin¹,

Khalil²,

Zainonabidin³

2022

IJSCET

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Architects must have an adequate and relevant understanding of Prevention through Design (PtD) to execute essential design decisions during the early design stage.The understanding of PtD as a proactive safety intervention throughout the design process has been supported in various studies, but there has been little research incorporatingPtDin design practices by the architectandprovisionalarchitectural safety design parameter on the Occupational Safety andHealth (OSH)matters, thus, leadingto the gap in this study.ConsideringthePtD concept as part of the sustainablestrategy into thearchitecturalearly design stages may significantly enhance the building's life cycle and safety performance, particularly during the operational and maintenance phase of the buildingprojects. Therefore, thesystematicreview was motivated by the belief that the early architectural design stage is one of the key factors improving safety performance in the practice of PtD.This review begins by analysing literature from 2011 to 2021 with relevant keywords related to the architectural design aspect that contributes to building safety performance, followed by characterising the safety aspect atthe early architectural design stage. The findings were identified and clustered into the following five categoriesof the architectural design parameters: 1) Site planning, 2) Space Planning, 3) Building envelope, 4) Design for Visibility, and 5) Environmental DesignParameters. This finding is hope to be able to providean architectural frame of reference on Occupational Safety and Health (OSH) matters, allowing future researchers and practitioners to addresssustainable aspectof safety in the early architectural design practicesof PtD while optimising building safety performance across the building life cycle projects.

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Wayfinding in People with Alzheimer’s Disease: Perspective Taking and Architectural Cognition—A Vision Paper on Future Dementia Care Research Opportunities

Cited by 19 publications

References 98 publications

Mechanisms of impact and contextual aspects of a dementia special care unit in long-term care: a process evaluation

Mechanisms of impact and contextual aspects of a dementia special care unit in long-term care: a process evaluation

Mechanisms Of Impact And Contextual Aspects of A Care Concept From A Dementia Special Care Unit In Long-Term Care: Process Evaluation As Part of A Theory-Driven Evaluation

The Sustainable Aspect of Safety in Architectural Early Design: An Introduction to Prevention through Design (PtD) Concept

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