Assessing the physical environment in adult day program for persons with dementia
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Date
2012
Authors
Brown, Thea
Journal Title
Journal ISSN
Volume Title
Publisher
Mount Saint Vincent University
Abstract
This research assesses physical environments in adult day programs in Nova
Scotia in terms of their appropriateness for persons with dementia. Researchers have
found that when physical environments are well designed, they can significantly
compensate for decreased cognitive ability and can impact the behaviour and well being
of people with dementia. The Personal Environment Fit Model (Lawton & Nahemow,
1973) is used in this study as it recognizes that behaviour and affect are outcomes of a
person’s level of competence interacting with an environment’s level of press.
This study reports the reliability and validity tests of an adult day program
physical environment assessment tool (ADPPEAT) designed by the author. Additionally,
an assessment of the extent to which adult day program environments in Nova Scotia
implement the key physical environment design principles follows. All adult day
programs (N=27) were included in the cross-sectional design of this study. A sub-sample
of four centres were re-assessed for reliability purposes. Descriptive information is
presented on characteristics of the programs: type and number of clientele, hours and
days of operation, services offered, funding sources and information on support networks.
The results of this research indicated significant relationships between different
categories of adult day programs and their implementation of the physical environment
design principles. Adult day programs that were supported with District Health Authority
(DHA) and/or Department of Health and Wellness (DHW) funding were found to have
significantly more design features that provide safety and security, opportunity for meaningful activities, opportunity to function independently and space for the staff, than
adult day programs that were not supported with DHA/ DHW funding. Adult day
programs that were open for a full day and operating 2+ days a week were found to have
significantly more design features that provide safety and security and opportunity for
meaningful activities, good ‘visual access’ and functional independence within the
program for persons with dementia than adult day programs operating 1 day a week;
40.7% of adult day programs operate 1 day a week.
The relative importance of the design in creating a dementia friendly physical
environment in community-based services is demonstrated in the findings of the research.
Nevertheless, it is acknowledged that people with dementia do not experience themselves
and their physical and social environments as separate. Each element, the personal,
physical and social, comprise an integral piece to understanding the experience of the
person with dementia. Future research would benefit from incorporating an assessment of
the supportive environment (programming, staff-client-family- relationships) in adult day
programs to capture a more holistic approach.
Description
Keywords
Adult day programs , Dementia , Health services - Nova Scotia