Assessing the Physical Environment in Adult Day Programs for Persons with Dementia

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Brown, Thea
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Mount Saint Vincent University
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.
Environment , Adult , Day-programs , Dementia , Nova Scotia , Design principles , District Health Authority , Department of Health and Wellness