Defining and assessing the characteristics of the built environment that contribute to the well‐being of people with dementia living in aged care facilities in Singapore

Abstract

AbstractBackgroundThe study uncovers the characteristics of the built environment that contribute to the well‐being of Singaporeans living with dementia. With the findings, the study plans to translate the knowledge into action by developing an acceptable, reliable, and culturally sensitive tool for Singapore.MethodThe study employed a sequential qualitative‐quantitative mixed method design. The study was structured into two phases. A scoping review was carried out in the first phase to understand the characteristics of nursing homes in East and Southeast Asia in relation to eight design principles. An investigation was carried out into the cultural characteristics and the acceptance of the principles of design through focus group discussions (FGD, n=150). Qualitative data and descriptive statistics were collected and analysed. The testing of the Singaporean Environmental Audit Tool (SEAT) made up the second phase and data via interviews on the barriers and facilitators and usability were obtained after participants (n=6) tested the tool in eight nursing homes.ResultThe scoping review found that the principles of design can be applied in nursing home environments in East and Southeast Asia when cultural sensitivities such as spaces for palliative care, technology, spirituality, and culturally familiar features were addressed. The successful outcome of the first phase of the study enabled research into the second phase of the study. Data echoed those of the scoping review, with the same cultural characteristics being identified as lacking in the Australian Environmental Assessment Tool High‐Care (EAT‐HC). The data indicated a high level of acceptance of the design principles. In the second phase, the tool was found to be culturally appropriate, reliable, and acceptable for use when undertaken by users with knowledge of dementia.ConclusionThis study maps the processes involved in the development of the SEAT and will aid researchers in the future to adapt the EAT to diverse cultures across countries. The tool will be able to provide a measure of the application of the relevant principles of design for an environment for a person with dementia in a Singaporean high care facility.