Effect of Design Interventions on a Dementia Care Setting

This study examined the effects of particular design interventions in a long-term care facility on residents with dementia and staff perceptions of care delivery. Major renovations were carried out in a care facility in the Midwestern United States. Renovations included a new addition of a dementia care unit designed as a cluster of resident rooms around living and dining areas, and two renovated wings with decentralized dining areas. The research methods used in the study included environmental assessment with the Professional Environmental Assessment Protocol (PEAP), behavioral mapping, and focus-group interviews with staff members. The renovated environment scored higher in PEAP and was perceived by the staff members as a more homelike setting. Although behavioral observations indicate that there was more involvement in programmed activities by the residents, the decentralized neighborhood design did not meet all the behavioral expectations due to a lack of appropriate activities, high staff turnover, and family members' resistance to the relocation of their loved ones. Organizational commitment, advanced planning for appropriate staffing levels, and dementia-related training is crucial for fuller realization of the potential of a household design.