Browse > Article
http://dx.doi.org/10.5659/AIKAR.2021.23.2.19

Effects of Physical Environment on Quality of Life among Residents with Dementia in Long-Term Care Facilities in Canada and Sweden: A longitudinal study in a large-scale institutional setting versus a small-scale homelike setting  

Lee, Sook Young (Yonsei University)
Hung, Lillian (University of British Columbia)
Chaudhury, Habib (Simon Fraser University)
Morelli, Agneta (University of Gavle)
Publication Information
Architectural research / v.23, no.2, 2021 , pp. 19-28 More about this Journal
Abstract
Reduction in competence makes older adults with dementia more sensitive to the influence of the physical environment. The aim of the longitudinal study was to examine whether residents with dementia in long-term facilities with variability in physical environmental characteristics in Vancouver (N= 11), Canada and Stockholm (N=13), Sweden had a difference in their quality of life (QoL). QoL was assessed using Dementia Care Mapping tool three times over one year for the reliability of data. The results of the study demonstrated that the residents with dementia living in a homelike and positive stimulating setting showed less withdrawn behaviors and a higher level of well-being compared to those in a large-scale institutional setting. This study also found that the residents living in a large-scale institutional environment spent more monotonous times than the other groups, which may be to provision of fewer structured activity programs or less social interaction with neighbors or staff members. Residents living in a large-scale institutional setting in Canada showed so far as five times more agitated/ distressed behaviors and twice more withdrawal compared to the ones living in a small-scale homelike setting in Sweden. The study supports that the large-scale institutional environment was considerably associated with levels of lower quality of life among the residents with dementia.
Keywords
physical environment; residents with dementia; long-term care facility; quality of life; Canada; Sweden;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Chenoweth, L., Forbes, I., Fleming, R., & et al. (2014). PerCEN: a cluster randomized controlled trial of person-centered residential care and environment for people with dementia. International Psychogeriatrics, 26(7), 1147-1160.   DOI
2 University of Bradford. (2010). DCM 8 User's Manual. University of Bradford.
3 Verbeek, H., Zwakhalen, S.M.G., van Rossum, E., Kempen, G.I.J.M., & Hamers, J.P.H. (2012). Small-scale, homelike facilities in dementia care: a process evaluation into the experiences of family caregivers and nursing staff. International Journal of Nursing Studies, 49(1), 21-29.   DOI
4 Verbeek, H., Zwakhalen, S.M., van Rossum, E., Ambergen, T., Kempen, G.I., & Hamers, J.P. (2010). Dementia care redesigned: Effects of small-scale living facilities on residents, their family caregivers, and staff. Journal of the American Medical Directors Association, 11, 662-670. doi:10.1016/j.jamda.2010.08.001   DOI
5 Smit, D., de Lange, J., Willemse, B., & Pot ,A.M. (2012). The relationship between small-scale care and activity involvement of residents with dementia. International Psychogeriatrics / IPA, 24(5), 722-32. doi:10.1017/S1041610211002377   DOI
6 Vermeerbergen, L., van Hootegem, G., & Benders, J. (2017). A comparison of working in small-scale and large-scale nursing homes: A systematic review of quantitative and qualitative evidence. International Journal of Nursing Studies, 67, 59-70. http://doi.org/10.1016/j.ijnurstu.2016.11.006   DOI
7 Zimmerman, S., Anderson, W.L., Brode, S., & et al. (2013). Systematic review: Effective characteristics of nursing homes and other residential long-term care settings for people with dementia. Journal of the American Geriatrics Society, 61(8),1399-1409.   DOI
8 Husberg, L., & Ovesen, L. (2007). Gammal och Fri (Old and Free). Angsblomman:Sweden.
9 Kane, R.A., Lum, T.Y., Culter, L.J., Degenholtz, H.B., & Yu, T. (2007). Resident outcomes in small-house nursing homes: A longitudinal evaluation of the initial green house program. Journal of the American Geriatrics Society, 55(6), 832-839.   DOI
10 Lawton, M.P., & Nahemow, L. (1973). Ecology and the aging process. In The psychology of adult development and aging. Washington, DC: American Psychological Association, 619-674.
11 Brawley, E.C. (2005). Design Innovations for Aging and Alzheimer's: Creating Caring Environments. Hoboken, NJ: John Wiley & Sons.
12 Fleming, R., & Purandare, N. (2010). Long-term care for people with dementia: environmental design guidelines. International Psychogeriatrics, 22(7), 1084-1096.   DOI
13 Lee, S.Y., Hung, L., Chaudhury, H., & Morelli, A. (2021). Staff perspectives on the role of physical environment in long-term care facilities on dementia care in Canada and Sweden. Dementia, 0(0), 1-15. doi: 10.1177/14713012211003994   DOI
14 Pollock, A., & Fuggle, L. (2013). Designing for dementia: creating a therapeutic environment. Nursing and Residential Care, 15(6), 438-442. https://doi.org/10.12968/nrec.2013.15.6.438   DOI
15 Day, K., Carreon, D., & Stump, C. (2000). The therapeutic design of environments for people with dementia: A review of the empirical research. The Gerontologist, 40(4), 397-416.   DOI
16 Corrada, M.M., Brookmeyer, R., Paganini-Hill, A., Berlau, D., & Kawas, C.H. (2010). Dementia incidence continues to increase with age in the oldest old: the 90+ study. Ann Neurol, 67(1), 114-121.   DOI
17 Cutler, L.J. (2007). Physical environments of assisted living: Research needs and challenges. The Gerontologist, 47(3), 68-82.   DOI
18 Davis, S., Byers, S., Nay, R., & Koch, S. (2009). Guiding design of dementiafriendly environments inresidential care settings: Considering the living experiences. Dementia, 8(2), 185-203. http://www.sagepub.co.uk/journalspermissions.nav   DOI
19 Garre-Olme, J., Lopez-Pousa, S., Turon-Estrade, A., Juvinya, D., Ballester, D., & Vilalta-Franch, J. (2012). Environmental determinants of quality of life in nursing home residents with severe dementia. The Ameriacan Geriatrics Society, 60(7), 1230-1236.   DOI
20 Hall, G.R., & Buckwalter, K.C. (1987). Progressively lowered stress threshold: A conceptual model for care of adults with Alzheimer's disease. Archives of Psychiatric Nursing, 1(6), 399-406.
21 de Rooij, A.H.P.M., Luijkx, K.G., Schaafsma, J., Declercq, A.G., Emmerink, P.M.J., & Schols, J.M.G.A. (2012). Quality of life of residents with dementia in traditional versus small-scale long-term care settings: A quasi-experimental study. International Journal of Nursing Studies, 49(8), 931-940.   DOI
22 Hung, L., & Chaudhury, H. (2010). Exploring personhood in dining experiences of residents with dementia in long-term care facilities. Journal of Aging Studies, 25(1), 1-12. https://doi.org/10.1016/j.jaging.2010.08.007   DOI
23 Kovach, C.R., Noonan, P., Schilidt, A.M,, Reynolds, S., & Wells, T. (2006). The serial trial intervention: An innovative approach to meeting needs of individuals with dementia. Journal of Gerontological Nursing, 32(4), 18-25.   DOI
24 Jones, G.M.M., & van der Eerden, W.J. (2008). Designing care environments for persons withAlzheimer's disease: visuoperceptual considerations. Reviews in Clinical Gerontology, 18(1), 13-37. https://doi.org/10.1017/S0959259808002645   DOI
25 Joseph, A., Choi, Y., & Quan, X. (2016). Impact of the physical environment of residential health, care, and support facilities (RHCSF) on staff and residents: A systematic review of the literature. Environment and Behavior. 48(10),1203-1241.   DOI
26 Kok, J.S., Nielen, M.M.A., & Scherder, E.J.A. (2018). Quality of life in small-scaled homelike nursing homes: an 8-month controlled trial. Health and Quality of Life Outcomes, 16(38), 2-8.   DOI
27 Lee, S.Y., Chaudhury, H., & Hung, L. (2016a). Effects of physical environment on health and behaviors of residents with dementia in long-term care facilities: A longitudinal study. Research in Gerontological Nursing, 9(2), 81-91. doi:10.3928/19404921-20150709-01   DOI
28 Lee et al. (2007). Health supportive design in elderly care homes: Swedish examples and their implication to Korean counterparts. Architectual Research, 9(1), 9-18.
29 OECD. (2018). Care Needed: Improving the Lives of People with Dementia. OECD Health Policy Studies. OECD Publishing: Paris. http://dx.doi.org/10.1787/9789264085107-en
30 Reimer, M.A., Slaughter, S., Donaldson, C., Currie, G., & Eliasziw, M. (2004). Special care facility compared with traditional environments for dementia care: A longitudinal stuyd of quality of life. Journal of the American Geriatrics Society, 52(7), 1085-1092.   DOI
31 Chaudhury, H., Cooke, H., Cowie, H., & Razaghi, L. (2018). The influence of the physical environment on residents with dementia in long-term care settings: review of the empirical literature. The Gerontologist, 58(5), e325-e337. https://doi.org/10.1093/geront/ gnw259   DOI
32 Marquardt, M., Bueter, K., & Motzek, T. (2014). Impact of the design of the built environment on people with dementia: An evidence-based review. Health Environments Research & Design Journal, 8(1), 127-157.   DOI
33 Ausserhofer, D., Deschodt, M., Geest, S.D., van Achterberg, T., Meyer, G., & et al. (2016). "There's no place like home": A scoping review on the impact of homelike residential care models on resident-, family-, and staff-related outcomes. Journal of the American Medical Directors Association, 17(8), 685-693.   DOI
34 Calkins, M.P. (2009). Evidence-based long term care design. Neuro Rehabilitation, 25,145-154
35 Soril, L.J.J., Leggett, L.E., Lorenzetti, D.L., Silvius, J., Robertson, D., Mansell, L., Holroyd-Leduc, J., Noseworthy, T.W., & Clement, F.M. (2014). Effective use of the built environment to manage behavioural and psychological symptoms of dementia: A systematic review. PLoS ONE, 9(12), e115425. https://doi.org/10.1371/journal.pone.0115425   DOI
36 Verbeek, H. (2011). Redesigning dementia care: An Evaluation of Small-Scale Homelike Care Environments. Doctoral Thesis. Universiteit Maastricht.
37 Zeisel, J., Silverstein, N.M., Hyde, J., Levkoff, S., Lawton, M.P., & Holmes, W. (2003). Environmental correlates to behavioral health outcomes in Alzheimer's special care units. The Gerontologist, 43, 697-711. doi:10.1093/geront/43.5.697   DOI
38 Verbeek, H., Zwakhalen, S.M.G., van Rossum, E., Ambergen, T., Kempen, G.I.J.M., & Hamers, J.P.H. (2014). Effects of small-scale, home-like facilities in dementia care on residents' behavior, and use of physical restraints and psychotropic drugs: A quasi-experimental study. International Psychogeriatrics, 26(4), 657-68. doi:10.1017/ S1041610213002512   DOI
39 Campo, M., & Chaudhur y, H. (2012). Informal social interaction among residents with dementia in special care units: Exploring the role of the physical and social environments. Dementia, 11(3), 401-423. https//doi-org.focus.lib.kth.se/10.1177/ 1471301211421189   DOI
40 Harrison, S.L., Dyer, S.M,, Laver, K.E., Milte, R.K., Fleming, R., & Crotty, M. (2017). Physical environmental designs in residential care to improve quality of life of older people. Cochrane Database of Systematic Reviews, 12(CD012), 1-14. https://DOI:10.1002/14651858.CD012892   DOI
41 Sloane, P.D., Mitchell, M., Weisman, G., Zimmerman, S., Foley, K., Lynn, M., & et al. (2002). 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. Journal of Gerontology: Social Sciences, 57B(2), S69-S78.
42 Alzheimer's Disease International.(2018). World Alzheimer Report 2018: The state of the art of dementia research: New frontiers. https://www.alz.co.uk/research/WorldAlzheimerReport2018.pdf?2
43 Armstrong, P., Banerjee, A., Szebehely, M., Armstrong, H., Daly, T., & Lafrance, S. (2009). They Deserve Better: The Long-Term Care Experience in Canada and Scandinavia. Ottawa: Canadian Centre for Policy Alternatives.
44 Brooker, D., & Surr, C. (2010). Dementia are mapping: Principles and practice. Bradford, UK: University of Bradford.
45 Verbeek, H., van Rossum, E., Zwakhalen, S.M.G., Ambergen, T., Kempen, G.I.J.M., & Hamers, J.P.H. (2009). The effects of small-scale, homelike facilities for older people with dementia on residents, family caregivers and staff: design of a longitudinal quasi-experimental study. BMC Geriatrics. 9(1):3. Doi:10.1186/1471-2318-9-3   DOI
46 Lee, S.Y., Chaudhury, H., & Hung, L. (2016b). Exploring staff perceptions on the role of physical environment in dementia care setting. Dementia, 15(4), 743-75. doi:10.1177/1471301214536910   DOI
47 O'Connor, D., Phinney, A., Smith, A., Small, J., Purves, B., Perry, J., Drance, E., Donnelly, M., Chaudhury, H., & Beattie, L. (2007). Personhood in dementia care: Developing a research agenda for broadening the vision. Dementia:The International Journal of Social Research and Practice, 6(1), 121-142.   DOI
48 Rahman, S. (2017). Living well and promoting wellbeing. In Enhancing Health and Wellbeing in Dementia. Jessica Kingsley Publisher, 173-198.
49 United Nations. (2020). World Population Ageing 2019. The United Nations: New York.