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      Building design for people with dementia: a case study of a UK care home

      , , ,
      Facilities
      Emerald

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          Abstract

          Purpose

          This paper aims to investigate the impact that building design has upon the quality of life for residents of a care home who have dementia. To present a balanced perspective, carers within the care home also participate in the research.

          Design/methodology/approach

          A case study methodological approach was adopted using one care home, ten residents and five staff as a sample frame. During interviews conducted, participants were asked semi-structured questions on how building design features impact upon the quality of life of residents. Questions posed focussed upon key design principles that emerged from a detailed review of extant literature.

          Findings

          Building design for people with dementia must consider a complex array of features to provide a safe and habitable living space for residents and family members who visit. This living space must also be suitably utilitarian and provide a workable environment for staff. Hence, an appropriate balance between these two competing requirements must be attained, and often a tailor-made solution is required that fits the individual’s level of dementia. Three prominent areas that study participants expressed a desire for were a safe environment; support for wayfinding, orientation and navigation; and access to nature and the outdoors.

          Originality/value

          The work reports upon the rarely discussed issue of building design for people with dementia and could be used by policymakers and construction firms to enhance their knowledge capabilities in this area. The research concludes with direction for future research which should seek to provide more evidence-based research vis-a-vis perception enquiry and extend this seminal work to a larger sample of care homes or people with dementia living at home.

          Related collections

          Most cited references56

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          Dementia in Parkinson's disease.

          Dementia can occur in a substantial number of patients with Parkinson's disease with a point prevalence close to 30%. The cognitive profile is characterized by predominant deficits in executive, visuospatial functions, attention and memory. Behavioral symptoms are frequent such as apathy, visual hallucinations and delusions. The most prominent associated pathology is Lewy body-type and biochemical deficit is cholinergic. Placebo-controlled randomized trials with cholinesterase inhibitors demonstrated modest but significant benefits in cognition, behavioral symptoms and global functions.
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            • Abstract: found
            • Article: not found

            Environmental correlates to behavioral health outcomes in Alzheimer's special care units.

            We systematically measured the associations between environmental design features of nursing home special care units and the incidence of aggression, agitation, social withdrawal, depression, and psychotic problems among persons living there who have Alzheimer's disease or a related disorder. We developed and tested a model of critical health-related environmental design features in settings for people with Alzheimer's disease. We used hierarchical linear modeling statistical techniques to assess associations between seven environmental design features and behavioral health measures for 427 residents in 15 special care units. Behavioral health measures included the Cohen-Mansfield physical agitation, verbal agitation, and aggressive behavior scales, the Multidimensional Observation Scale for Elderly Subjects depression and social withdrawal scales, and BEHAVE-AD (psychotic symptom list) misidentification and paranoid delusions scales. Statistical controls were included for the influence of, among others, cognitive status, need for assistance with activities of daily living, prescription drug use, amount of Alzheimer's staff training, and staff-to-resident ratio. Although hierarchical linear modeling minimizes the risk of Type II-false positive-error, this exploratory study also pays special attention to avoiding Type I error-the failure to recognize possible relationships between behavioral health characteristics and independent variables. We found associations between each behavioral health measure and particular environmental design features, as well as between behavioral health measures and both resident and nonenvironmental facility variables. This research demonstrates the potential that environment has for contributing to the improvement of Alzheimer's symptoms. A balanced combination of pharmacologic, behavioral, and environmental approaches is likely to be most effective in improving the health, behavior, and quality of life of people with Alzheimer's disease.
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              • Record: found
              • Abstract: not found
              • Article: not found

              The impact of early dementia on outdoor life: A `shrinking world'?

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                Author and article information

                Journal
                Facilities
                F
                Emerald
                0263-2772
                May 08 2018
                May 08 2018
                : 36
                : 7/8
                : 349-368
                Article
                10.1108/F-06-2017-0062
                4448466d-abb8-46c1-ba00-f64966529495
                © 2018

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