The Physical Environment Influences Neuropsychiatric Symptoms and Other Outcomes in Assisted Living Residents

Overview

Journal Int J Geriatr Psychiatry

Specialties Geriatrics
Psychiatry

Date 2010 Jan 16

PMID 20077498

Citations 14

Authors

Mark C Bicket

Quincy M Samus

Mathew McNabney

Chiadi U Onyike

Lawrence S Mayer

Jason Brandt

Peter Rabins

Constantine Lyketsos

Adam Rosenblatt

Affiliations

Soon will be listed here.

Abstract

Objective: Although the number of elderly residents living in assisted living (AL) facilities is rising, few studies have examined the AL physical environment and its impact on resident well-being. We sought to quantify the relationship of AL physical environment with resident outcomes including neuropsychiatric symptoms (NPS), quality of life (QOL), and fall risk, and to compare the effects for demented and non-demented residents.

Methods: Prospective cohort study of a stratified random sample of 326 AL residents living in 21 AL facilities. Measures included the Therapeutic Environmental Screening Scale for Nursing Homes and Residential Care (TESS-NH/RC) to rate facilities and in-person assessment of residents for diagnosis (and assessment of treatment) of dementia, ratings on standardized clinical, cognitive, and QOL measures. Regression models compared environmental measures with outcomes. TESS-NH/RC is modified into a scale for rating the AL physical environment AL-EQS.

Results: The AL Environmental Quality Score (AL-EQS) was strongly negatively associated with Neuropsychiatric Inventory (NPI) total score (p < 0.001), positively associated with Alzheimer Disease Related Quality of Life (ADRQL) score (p = 0.010), and negatively correlated with fall risk (p = 0.042). Factor analysis revealed an excellent two-factor solution, Dignity and Sensory. Both were strongly associated with NPI and associated with ADRQL.

Conclusion: The physical environment of AL facilities likely affects NPS and QOL in AL residents, and the effect may be stronger for residents without dementia than for residents with dementia. Environmental manipulations that increase resident privacy, as well as implementing call buttons and telephones, may improve resident well-being.

Citing Articles

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Developing and Testing A Model of the Assisted Living Environment.

Holmes S, Resnick B, Galik E, Kusmaul N J Aging Environ. 2021; 35(1):62-76.

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Dementia Enlightened?! A Systematic Literature Review of the Influence of Indoor Environmental Light on the Health of Older Persons with Dementia in Long-Term Care Facilities.

Goudriaan I, van Boekel L, Verbiest M, van Hoof J, Luijkx K Clin Interv Aging. 2021; 16:909-937.

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