Abstract
It is well recognized that the physical environment is important for the well-being of people with dementia. This influences developments within the nursing home care sector where there is an increasing interest in supporting person-centered care by using the physical environment. Innovations in nursing home design often focus on small-scale and homelike care environments. This study investigated: (1) the physical environment of different types of nursing homes, comparing traditional nursing homes with small-scale living facilities and green care farms; and (2) how the physical environment was being used in practice in terms of the location, engagement and social interaction of residents. Two observational studies were carried out. Results indicate that the physical environment of small-scale living facilities for people with dementia has the potential to be beneficial for resident’s daily life. However, having a potentially beneficial physical environment did not automatically lead to an optimal use of this environment, as some areas of a nursing home (e.g., outdoor areas) were not utilized. This study emphasizes the importance of nursing staff that provides residents with meaningful activities and stimulates residents to be active and use the physical environment to its full extent.
Highlights
The importance of the physical environment for the well-being of people with dementia is well recognized
All types of small-scale, homelike care environments score better on environmental aspects compared with traditional nursing homes, especially green care farms
Results of the current study indicate that the physical environment of small-scale living facilities for people with dementia has more potential to be beneficial for residents’ daily life than the physical environment of traditional large-scale nursing homes
Summary
The importance of the physical environment for the well-being of people with dementia is well recognized. The ecological theory of aging and the environmental press model developed over 30 years ago stated that the fit between the environment and an individual’s cognitive and physical capacities is associated with the ability of people with dementia to age in place [1,2]. The built environment can avoid agitated or diffusing behavior, which might cause unnecessary harm [3,4]. It can support people with dementia to attain their full potential by positively influencing their autonomy, support their quality of life and well-being and attain the best possible potential of independence [4,5,6]
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