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Perceptions of family and staff on the role of the environment in long-term care homes for people with dementia

Published online by Cambridge University Press:  23 January 2012

Linda J. Garcia*
Affiliation:
Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada Élisabeth Bruyère Research Institute, Ottawa, Canada
Michèle Hébert
Affiliation:
Occupational Therapy Program, School of Rehabilitation, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
Jean Kozak
Affiliation:
Department of Family and Community Medicine, Centre for Healthy Aging, Providence Health Care, Vancouver, Canada
Isabelle Sénécal
Affiliation:
Social Sciences and Humanities Research Council of Canada, Ottawa, Canada
Susan E. Slaughter
Affiliation:
Faculty of Nursing, University of Alberta, Edmonton, Canada
Faranak Aminzadeh
Affiliation:
Élisabeth Bruyère Research Institute, Ottawa, Canada Regional Geriatric Program of Eastern Ontario, Ottawa, Canada
William Dalziel
Affiliation:
Regional Geriatric Program of Eastern Ontario, Ottawa, Canada Department of Medicine, University of Ottawa, Ottawa, Canada
Jocelyn Charles
Affiliation:
Veterans Centre, Sunnybrook Health Sciences Centre, Toronto, Canada Department of Family & Community Medicine, University of Toronto, Toronto, Canada
Misha Eliasziw
Affiliation:
Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, Massachusetts, USA
*
Correspondence should be addressed to: Linda J. Garcia, Professor, Interdisciplinary School of Health Sciences Faculty of Health Sciences, University of Ottawa, K1N 6X1, Ottawa, Ontario, Canada. Phone: +1-613-562-5254; Fax: +1-613-562-5632. Email: linda.garcia@uottawa.ca.

Abstract

Background: Disruptive behaviors are frequent and often the first predictor of institutionalization. The goal of this multi-center study was to explore the perceptions of family and staff members on the potential contribution of environmental factors that influence disruptive behaviors and quality of life of residents with dementia living in long-term care homes.

Methods: Data were collected using 15 nominal focus groups with 45 family and 59 staff members from eight care units. Groups discussed and created lists of factors that could either reduce disruptive behaviors and facilitate quality of life or encourage disruptive behaviors and impede the quality of life of residents. Then each participant individually selected the nine most important facilitators and obstacles. Themes were identified from the lists of data and operational categories and definitions were developed for independent coding by four researchers.

Results: Participants from both family and staff nominal focus groups highlighted facility, staffing, and resident factors to consider when creating optimal environments. Human environments were perceived to be more important than physical environments and flexibility was judged to be essential. Noise was identified as one of the most important factors influencing behavior and quality of life of residents.

Conclusion: Specialized physical design features can be useful for maintaining quality of life and reducing disruptive behaviors, but they are not sufficient. Although they can ease some of the anxieties and set the stage for social interactions, individuals who make up the human environment are just as important in promoting well-being among residents.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2012

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