Title

Can't Judge a Place by its Looks: Environmental Dynamics, Occupation and Wellbeing in People with Dementia

Presenter Information

Wendy Wood

Start Time

16-10-2002 12:00 AM

End Time

18-10-2002 12:00 AM

Abstract

A recent interdisciplinary consensus statement on Alzheimer's disease and related disorders (AD) identified two critical outcomes of dementia care: optimal day-to-day functioning and quality of life (QOL). Needs for research into whether and how dementia care facilities support these outcomes were underscored. Findings of existing environmental research in dementia care are inclusive, a situation partly attributed to how inadequate caregiving practices undermine the potential of well-designed living environments to enhance functioning and QOL.

The purpose of the study reported here was to compare and contrast environmental correlates of how residents with dementia occupied time and experienced emotional well-being across two dementia care facilities. A naturalistic case study design was used with two study sites chosen on the basis of key environmental differences: one site was a traditional nursing home with 40 residents; the other was a homelike environment with 7 residents. Data were collected using a computer-assisted direct observational measure, the Activity in Context and Time Instrument (ACT). The ACT relies on time-sampling and Observer-Mobile software. Seven residents at each facility were each observed every ten minutes from 8 AM to 8 PM for four days. A total of 4032 observation sets were collected, with 185 matched sets used to assess inter-rater agreement. Observation sets consisted of entered codes across ten observational categories: Four environmental categories:(social interactions, interactions with physical environmental features, presence of formal activities, and location); four time-use categories (gaze, position, conversation, and complex occupational participation); and two wellbeing categories (apparent affect and distress).

Findings suggest residents were somewhat more likely to be alert, engaged in coherent conversation and complex activities, and evidenc ing apparent interest or pleasure in the traditional nursing home than homelike environment. Interactions between physical environmental features and people in the environment at specific daily periods, and hour by hour across the day, help explain findings. Findings also suggest processes by which living spaces that can support occupational engagement do so or fail to do so. Implications for occupational science are developed with respect to ecological dynamics of occupational engagement and QOL for people with AD.

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Oct 16th, 12:00 AM Oct 18th, 12:00 AM

Can't Judge a Place by its Looks: Environmental Dynamics, Occupation and Wellbeing in People with Dementia

A recent interdisciplinary consensus statement on Alzheimer's disease and related disorders (AD) identified two critical outcomes of dementia care: optimal day-to-day functioning and quality of life (QOL). Needs for research into whether and how dementia care facilities support these outcomes were underscored. Findings of existing environmental research in dementia care are inclusive, a situation partly attributed to how inadequate caregiving practices undermine the potential of well-designed living environments to enhance functioning and QOL.

The purpose of the study reported here was to compare and contrast environmental correlates of how residents with dementia occupied time and experienced emotional well-being across two dementia care facilities. A naturalistic case study design was used with two study sites chosen on the basis of key environmental differences: one site was a traditional nursing home with 40 residents; the other was a homelike environment with 7 residents. Data were collected using a computer-assisted direct observational measure, the Activity in Context and Time Instrument (ACT). The ACT relies on time-sampling and Observer-Mobile software. Seven residents at each facility were each observed every ten minutes from 8 AM to 8 PM for four days. A total of 4032 observation sets were collected, with 185 matched sets used to assess inter-rater agreement. Observation sets consisted of entered codes across ten observational categories: Four environmental categories:(social interactions, interactions with physical environmental features, presence of formal activities, and location); four time-use categories (gaze, position, conversation, and complex occupational participation); and two wellbeing categories (apparent affect and distress).

Findings suggest residents were somewhat more likely to be alert, engaged in coherent conversation and complex activities, and evidenc ing apparent interest or pleasure in the traditional nursing home than homelike environment. Interactions between physical environmental features and people in the environment at specific daily periods, and hour by hour across the day, help explain findings. Findings also suggest processes by which living spaces that can support occupational engagement do so or fail to do so. Implications for occupational science are developed with respect to ecological dynamics of occupational engagement and QOL for people with AD.