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American Journal of Alzheimer's Disease and Other Dementias logoLink to American Journal of Alzheimer's Disease and Other Dementias
. 2010 May;25(3):202–232. doi: 10.1177/1533317509358885

Environmental Interventions and the Design of Homes for Older Adults With Dementia: An Overview

J van Hoof 1, HSM Kort 2, H van Waarde 3, MM Blom 4
PMCID: PMC10845627  PMID: 20150655

Abstract

In Western societies, the vast majority of people with dementia live at home and wish to remain doing so for as long as possible. Aging in place can be facilitated through a variety of environmental interventions, including home modifications. This article provides an overview of existing design principles and design goals, and environmental interventions implemented at home, based on literature study and additional focus group sessions. There is a multitude of design principles, design goals, and environmental interventions available to assist with activities of daily living and functions, although few systematic studies have been conducted on the efficacy of these goals and interventions. The own home seems to be a largely ignored territory in research and government policies, which implies that many problems concerning aging in place and environmental interventions for dementia are not adequately dealt with.

Keywords: dementia, Alzheimer's disease, environmental interventions, older adults, informal care, home modifications, architecture, interior design, assistive technology, aging in place

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Contributor Information

J. van Hoof, Hogeschool Utrecht University of Applied Sciences, Faculty of Health Care, Research Centre for Innovation in Health Care, Research Group Demand Driven Care, Utrecht, Netherlands, joost.vanhoof@hu.nl, Vilans, Utrecht, Netherlands.

H.S.M. Kort, Hogeschool Utrecht University of Applied Sciences, Faculty of Health Care, Research Centre for Innovation in Health Care, Research Group Demand Driven Care, Utrecht, Netherlands, Vilans, Utrecht, Netherlands.

H. van Waarde, Alzheimer Nederland, Bunnik, Netherlands.

M.M. Blom, Alzheimer Nederland, Bunnik, Netherlands.

References

  1. Krothe JS Giving voice to elderly people: community-based long-term care. Public Health Nurs. 1997;14(4):217-226. [DOI] [PubMed] [Google Scholar]
  2. Gitlin LN Next steps in home modification and assistive technology research . In: Charness N, Schaie KW, eds. Impact of Technology on Successful Aging. New York, NY: Springer; 2003:188-202. [Google Scholar]
  3. Duijnstee MSH. De belasting van familieleden van dementerenden. Dissertation. Nijmegen, the Netherlands Katholieke Universiteit; Nijmegen; 1992. [Google Scholar]
  4. Ferri CP, Prince M., Brayne C., et al, and for Alzheimer’s Disease International. Global prevalence of dementia: a Delphi consensus study. Lancet. 2005-2006;366(9503):2112-2117. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. van Hoof J., Kort HSM, van Waarde H. Housing and care for older adults with dementia. A European perspective . J Hous Built Environ. 2009;24(3):396-390. [Google Scholar]
  6. Rabins PV The caregiver’s role in Alzheimer’s disease. Dement Geriatr Cogn. 1998;9(suppl 3):25-28. [DOI] [PubMed] [Google Scholar]
  7. Valla P., Harrington T. Designing for older people with cognitive and affective disorders . Arch Gerontol Geriatr Disord. 1998;26(suppl 1):515-518. [Google Scholar]
  8. Health Council of the Netherlands. Dementia. Publication no. 2002/04. The Hague, the Netherlands: Health Council of the Netherlands; 2002. [Google Scholar]
  9. Wimo A., Winblad B., Jönsson L. An estimate of the total worldwide societal costs of dementia in 2005 . Alzheimers Dement. 2007;3(2):81-91. [DOI] [PubMed] [Google Scholar]
  10. Moise P., Schwarzinger M., Um M-Y., and the the Dementia Experts’ Group. OECD Health Working Papers No. 13. Dementia Care in 9 OECD Countries: A Comparative Analysis. Paris, France: OECD;; 2004. [Google Scholar]
  11. Pynoos J., Cohen E., Lucas C. Environmental coping strategies for Alzheimer’s caregivers. Am J Alzheimers Dis Other Demen. 1989;4(6):4-8. [Google Scholar]
  12. Alzheimer Europe. Who Cares? The State of Dementia Care in Europe. Luxembourg City, Luxemburg: Alzheimer Europe; 2006. [Google Scholar]
  13. van Hoof J. , Kort HSM. Supportive living environments: a first concept of a dwelling designed for older adults with dementia. Dementia. 2009;8(2):293-316. [Google Scholar]
  14. Desai AK, Grossberg GT Recognition and management of behavioral disturbances in dementia . Prim Care Companion J Clin Psychiatry. 2001;3(3):93-109. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Tilly J., Reed P. Literature review. Intervention research on caring for people with dementia in assisted living and nursing homes. Alzheimers Care Today . 2008;9(1):24-32. [Google Scholar]
  16. Marshall M. Therapeutic buildings for people with dementia . In: Judd S, Marshall M, Phippen P, eds. Design for Dementia. London: Journal of Dementia Care; 1998:11-14. [Google Scholar]
  17. WHO. International classification of functioning, disability and health. Resolution WHA54.21 of the fifty-fourth World Health Assembly, ninth plenary meeting, agenda item 13.9, 22 May 2001, A54/VR/9. Geneva , Switzerland: World Health Organization; 2001 . [Google Scholar]
  18. Schiff MR Designing environments for individuals with Alzheimer’s disease: some general principles. Am J Alzheimers Dis Other Demen. 1990;5(3):4-8. [Google Scholar]
  19. Lawton MP The elderly in context: perspectives from environmental psychology and gerontology . Environ Behav. 1985; 17(4):501-519. [Google Scholar]
  20. Gitlin LN, Corcoran M. Managing dementia at home: the role of home environmental modifications . Top Geriatr Rehabil. 1996; 12(2):28-39. [Google Scholar]
  21. Ministry of Community and Social Services. Dementia and Activities of Daily Living. A Report on Technologies and Environmental Design That Can Assist People With Alzheimer Disease and Related Dementias . Toronto, Ontario: Ministry of Community and Social Services; 1990. [Google Scholar]
  22. van Hoof J. , Kort HSM , Hensen JLM , Duijnstee MSH , Rutten PGS. Thermal comfort and integrated building design for older people with dementia . Build Environ. 2010;45(2):358-370. [Google Scholar]
  23. van Hoof J. , Kort HSM, Duijnstee MSH, Rutten PGS, Hensen JLM. The indoor environment and the integrated building design of homes for older people with dementia. Build Environ. 2010;45:doi: 10.1016/j.buildenv.2009.11.008. [Google Scholar]
  24. Diaz Moore K., Verhoef R. Special Care Units as places for social interaction: Evaluating an SCU’s social affordance. Am J Alzheimers Dis Other Demen. 1999;14(4):217-229. [Google Scholar]
  25. van Hoof J. , Kort HSM, Markopoulos P., Soede M. Ambient intelligence, ethics and privacy. Gerontechnology. 2007. ;6(3):155-163. [Google Scholar]
  26. Lauriks S., Reinersmann A., van der Roest HG, et al. Review of ICT-based services for identified unmet needs in people with dementia. Ageing Res Rev. 2007;6(3):223-246. [DOI] [PubMed] [Google Scholar]
  27. van Rijn H. , van Hoof J., Stappers PJ Designing leisure products for people with dementia: developing ‘the Chitchatters’ game. Am J Alzheimers Dis Other Demen. 2010:doi: 10.1177/ 1533317509333039. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Mitchell L. , Burton E., Raman S., Blackman T., Jenks M., Williams K. Making the outside world dementia-friendly: design issues and considerations. Environ Plann B. 2003;30(4): 605-632. [Google Scholar]
  29. Zgola J. Alzheimer’s disease and the home: issues in environmental design . Am J Alzheimers Dis Other Demen. 1990;5(3):15-22. [Google Scholar]
  30. Cohen U., Weisman GD Holding on to Home: Designing Environments for People With Dementia . Baltimore, MD: The Johns Hopkins University Press; 1991. [Google Scholar]
  31. Brawley E. Alzheimer’s disease: designing the physical environment. Am J Alzheimers Dis Other Demen. 1992;7(1):3-8. [Google Scholar]
  32. Fleming R., Forbes I., Bennett K. Adapting the Ward-for People With Dementia. Sydney: : NSW Department of Health; 2003. . [Google Scholar]
  33. Diaz Moore K. , Geboy LD, Weisman GD Designing a Better Day. Guidelines for Adults and Dementia Day Services Centers. Baltimore, MD: The Johns Hopkins University Press; 2006. . [Google Scholar]
  34. Burton E., Torrington J. Designing environments suitable for older people. CME J Geriatr Med. 2007;9(2):39-45. [Google Scholar]
  35. Marquardt G. , Schmieg P. Dementia-friendly architecture: environments that facilitate wayfinding in nursing homes. Am J Alzheimers Dis Other Demen. 2009;24(4):333-340. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Weisman G., Cohen U., Day K., Meyer G. Programming and Design for Dementia. Development of a 50 Person Residential Environment. 2nd print. Milwaukee, WI: University of Wisconsin-Milwaukee; 1992. [Google Scholar]
  37. Steeman E., Godderis J., Grypdonck M., De Bal N., Dierckx de Casterlé B. Living with dementia from the perspective of older people: Is it a positive story? Aging Ment Health. 2007; 11(2):119-130. [DOI] [PubMed] [Google Scholar]
  38. Namazi KH, DiNatale Johnson B. How familiar tasks can enhance concentration in Alzheimer’s disease patients. Am J Alzheimers Dis Other Demen. 1992;7(1):35-40. [Google Scholar]
  39. van Bronswijk Jemh, Koren LGH, Horst FAM, et al. Hoofdstuk 4. Gezond en duurzaam bouwen. GeDuBo. Report TU/e number BMGT99.083 [in Dutch]. Eindhoven, the Netherlands: Eindhoven University of Technology; 1999. [Google Scholar]
  40. Wackerbarth S., Johnson MMS. Predictors of driving cessation, independent living and power of attorney decisions by dementia patients and caregivers . Am J Alzheimers Dis Other Demen. 1999;14(5):283-288. [Google Scholar]
  41. Calkins MP Designing special care units: a systematic approach. Am J Alzheimers Dis Other Demen. 1987;2(2):16-22. [Google Scholar]
  42. Calkins MP Designing special care units: a systematic approach-part II. Am J Alzheimers Dis Other Demen. 1987;2(3):30-34. [Google Scholar]
  43. Thomas DW A case study on the effects of a retrofitted dementia special care unit on resident behaviors. Am J Alzheimers Dis Other Demen . 1996;11(3):8-14. [Google Scholar]
  44. Wilkinson TJ , Henschke PJ, Handscombe K. How should toilets be labelled for people with dementia? Aust J Ageing. 1994;13(4):163-165. [Google Scholar]
  45. Marshall M. Design for dementia. In: Tanner B, ed. Proceedings of RSAS One Day Symposium ‘‘Coping with the problems of dementia in old age’’. London, UK: Royal Surgical and Society; 1995:43-54. [Google Scholar]
  46. Calkins MP, Namazi KH Caregivers’ perceptions of the effectiveness of home modifications for community living adults with dementia. Am J Alzheimers Dis Other Demen. 1991;6(1):25-29. [Google Scholar]
  47. Day K., Carreon D., Stump C. The therapeutic design of environments for people with dementia. A review of the empirical research. Gerontologist. 2000;40(4):397-416. [DOI] [PubMed] [Google Scholar]
  48. Warner ML The Complete Guide to Alzheimer’s Proofing Your Home. West Lafayette, IN: Purdue University Press; 2000. [Google Scholar]
  49. Petersen R, editor-in-chief. Mayo Clinic on Alzheimer’s Disease. Practical Answers on Memory Loss, Aging, Research, Treatment and Caregiving. Rochester, MN: : Mayo Clinic Health Information; 2002. [Google Scholar]
  50. Silverstein NM, Hyde J., Ohta R. Home adaptation for Alzheimer’s households . Technol Disabil. 1993;2(4):58-68. [Google Scholar]
  51. Gitlin LN, Corcoran M. Expanding caregiver ability to use environmental solutions for problems of bathing and incontinence in the elderly with dementia. Technol Disabil. 1993;2(1):12-21. [Google Scholar]
  52. Gitlin LN, Kyung Chee Y. Use of adaptive equipment in caring for persons with dementia at home . Alzheimers Care Quart. 2006;7(1):32-40. [Google Scholar]
  53. Blom M., Tjadens F., Withagen P. Weten van vergeten [in Dutch]. Utrecht, the Netherlands: NIZW; 2000. [Google Scholar]
  54. Rodriguez JG , Baughman AL, Sattin RW, et al. A standardized instrument to assess hazards for falls in the home of older persons. Accident Anal Prev. 1995;27(5):625-631. [DOI] [PubMed] [Google Scholar]
  55. Mace NL, Rabins PV The 36-Hour Day. 4th edition. Baltimore, MD: The Johns Hopkins University Press; 2006. [Google Scholar]
  56. Gitlin LN, Corcoran M. Making homes safer: environmental adaptations for people with dementia . Alzheimers Care Quart. 2000;1(1):50-58. [Google Scholar]
  57. Gitlin L. Guidelines for environmental adaptations and safety at home. Alzheimers Care Today. 2007;8(3):278-281. [Google Scholar]
  58. Bowlby Sifton C. Setting up surroundings for success and safety . Alzheimers Care Today. 2007;8(3):286. [Google Scholar]
  59. Ponzetto M., Scarafiotti C., Ferrario E., Fabris F. Health Promotion for Family Caregivers of People With Alzheimer’s Disease and Related Disorders. Group Leader’s Manual. Module 5. Practical Consequences of the Increased Dependency of People With Alzheimer’s Disease. 1998. http://www.uni-koeln.de/ew-fak/Klein/ . Accessed December 29, 2009. [Google Scholar]
  60. Tilly J., Reed P. Dementia care practice recommendations for nursing homes and assisted living, Phase 2: falls, wandering, and physical restraints. Alzheimers Care Today. 2008;9(1):51-59. [Google Scholar]
  61. Brawley EC Design Innovations for Aging and Alzheimer’s. Creating Caring Environments . Hoboken, NJ: John Wiley & Sons, Inc; 2006. [Google Scholar]
  62. Strubel D., Jacquot JM, Martin-Hunyadi C. Démence et chutes. Ann Readapt Med Phys. 2001;44(1):4-12. [DOI] [PubMed] [Google Scholar]
  63. Lach HW, Reed AT, Smith LJ, Carr DB Alzheimer’s disease: assessing safety problems in the home. Geriatr Nurs. 1995;16(4):160-164. [DOI] [PubMed] [Google Scholar]
  64. Brawley EC Designing for Alzheimer’s Disease. Strategies for Creating Better Care Environments. New York, NY: John Wiley & Sons, Inc; 1997. [Google Scholar]
  65. Nouws H. Huiselijk en vertrouwd. Handreiking voor de bouw en inrichting van woonvoorzieningen voor dementerenden [in Dutch]. Utrecht: , the Netherlands: NIZW; 2001. [Google Scholar]
  66. Turner G. Decreasing stimulation in the environment of persons diagnosed with Alzheimer’s disease. Am J Alzheimers Dis Other Demen . 1991;6(4):26-28. [Google Scholar]
  67. Bakker R. Sensory loss, dementia and environments. Generations . 2003;27(1):46-51. [Google Scholar]
  68. Hyde J. The physical environment and the care of Alzheimer’s patients: an experiential survey of Massachusetts’ Alzheimer’s units. Am J Alzheimers Dis Other Demen. 1989;4(3):36-44. [Google Scholar]
  69. Namazi KH, DiNatale Johnson B. Dressing independently: a closet modification model for Alzheimer’s disease patients. Am J Alzheimers Dis Other Demen. 1992;7(1):22-28. [Google Scholar]
  70. Kinney JM, Kart CS, Murdoch LD, Ziemba TF Challenges in caregiving and creative solutions: using technology to facilitate caring for a relative with dementia. Ageing Int. 2003;28(3):295-314. [Google Scholar]
  71. Nygård L. The stove timer as a device for older adults with cognitive impairment or dementia: different professionals’ reasoning and actions. Technol Disabil. 2009;21(3):53-66. [Google Scholar]
  72. Nygård L., Starkhammar S., Lilja M. The provision of stove times to individuals with cognitive impairment. Scand J Occup Ther. 2007;15(1):4-12. [DOI] [PubMed] [Google Scholar]
  73. Frank R., Souques M., Himbert C., et al. Effects of 50 to 60 Hz and of 20 to 50 kHz magnetic fields on the operation of implanted cardiac pacemakers [in French]. Arch Mal Coeur Vaiss. 2003; 96(S3):35-41. [PubMed] [Google Scholar]
  74. Irnich W., Bernstein AD Do induction cooktops interfere with cardiac pacemakers? Europace. 2006;8(5):377-384. [DOI] [PubMed] [Google Scholar]
  75. Namazi KH, DiNatale Johnson B. Environmental issues related to visibility and consumption of food in an Alzheimer’s disease unit. Am J Alzheimers Dis Other Demen. 1992;7(1):30-34. [Google Scholar]
  76. Leikas J., Salo J., Poramo R. Security alarm system supports independent living of demented persons . In: Graafmans J, Taipale V, Charness N, eds. Gerontechnology: A Sustainable Investment in the Future. Amsterdam, the Netherlands: IOS Press; ; 1998:402-405. [PubMed] [Google Scholar]
  77. van Hoof J. , Schoutens AMC, Aarts MPJ High colour temperature lighting for institutionalised older people with dementia. Build Environ. 2009;44(9):1959-1969. [Google Scholar]
  78. van Hoof J. , Aarts MPJ, Rense CG, Schoutens AMC. Ambient bright light in dementia: Effects on behaviour and circadian rhythmicity. Build Environ. 2009;44(1):146-155. [Google Scholar]
  79. Carter SE, Campbell EM, Sanson-Fisher RW, Redman S. Environmental hazards in the homes of older people. Age Ageing . 1997;26(3):195-202. [DOI] [PubMed] [Google Scholar]
  80. Namazi KH, DiNatale Johnson B. The effects of environmental barriers on the attention span of Alzheimer’s disease patients. Am J Alzheimers Dis Other Demen. 1992;7(1):9-15. [Google Scholar]
  81. Marx L., Haschka B., Schnur P. Mehr Lux-mehr Wohlbefinden. Die richtige Beleuchtung hat positiven Einfluss auf demente Bewohner [in German]. Altenheim. 2002;41(5):57-58, 60-61. [Google Scholar]
  82. Sloane PD, Mitchell CM, Weisman G., et al. The Therapeutic Environment Screening Survey for Nursing Homes (TESS-NH): an observational instrument for assessing the physical environment of institutional settings for persons with dementia. J Gerontol B Psychol Sci Soc Sci. 2002;57(2):S69-S78. [DOI] [PubMed] [Google Scholar]
  83. Cohen E., Lyman K., Pynoos J. Adapting day care center settings for persons with Alzheimer’s disease: environmental design training for staff. Am J Alzheimers Dis Other Demen. 1991;6(2):25-32. [Google Scholar]
  84. Cohen U., Day K. Contemporary Environments for People With Dementia. Baltimore: , MD: The Johns Hopkins University Press; ; 1993. [Google Scholar]
  85. Weisman GD Chapter 11. Creating places for people with dementia: An action research perspective . In: Schaie KW, Wahl H-W, Mollenkopf H, Oswald F, eds. Aging Independently: Living Arrangements and Mobility. New York, NY: Springer; 2003:162-173. [Google Scholar]
  86. Castell L. Building access for the intellectually disabled. Facilities. 2008;26(3-4):117-130. [Google Scholar]
  87. Judd S. ‘We shape our buildings . . .thereafter they shape us.’ . Dementia. 2008;7(2):163-165. [Google Scholar]
  88. Zeisel J. Environment, neuroscience, and Alzheimer’s disease. Alzheimers Care Quart. 2005;6(4):273-279. [Google Scholar]
  89. Olsen RV, Hutchings BL, Ehrenkrantz E. The physical design of the home as a caregiving support: an environment for persons with dementia. J Long Term Home Health Care. 1999;1(2):125-131. [PubMed] [Google Scholar]
  90. Sloane PD, Mathew LJ The therapeutic environment screening scale: an observational screening instrument to assess the quality of nursing home environments for residents with dementia . Am J Alzheimers Dis Other Demen. 1990;5(6):22-26. [Google Scholar]
  91. Grant LA Assessing environments in Alzheimer special unit units. Nursing unit rating scale. Res Aging. 1996;18(3):275-291. [Google Scholar]
  92. Algase DL, Yao L., Son G.-R, Beattie ERA, Beck C., Whall AF Initial psychometrics of the ambiance scale: A tool to study person-environment interaction in dementia. Aging Ment Health. 2007;11(3):266-272. [DOI] [PubMed] [Google Scholar]
  93. de Courval LP , Gélinas I., Gauthier S., et al. Reliability and validity of the Safety Assessment Scale for people with dementia living at home. Can J Occup Ther. 2006;73(2):67-75. [DOI] [PubMed] [Google Scholar]
  94. Halliday G. , Snowdon J. The Environmental Cleanliness and Clutter Scale (ECCS). Int Psychogeriatr. 2009;21(6):1041-1050. [DOI] [PubMed] [Google Scholar]
  95. Parker C., Barnes S., McKee K., Morgan K., Torrington J., Tregenza P. Quality of life and building design in residential and nursing homes for older people. Ageing Soc. 2004; 24(6):941-962. [Google Scholar]
  96. Day K., Cohen U. The role of culture in designing environments for people with dementia: a study of Russian Jewish immigrants. Environ Behav. 2000;32(3):361-399. [Google Scholar]
  97. Olsen RV, Ehrenkrantz E., Hutchings BL Creating the movement-access continuum in home environments for dementia care . Top Geriatr Rehabil. 1996;12(2):1-8. [Google Scholar]
  98. Vroon PA Psychologische aspecten van ziekmakende gebouwen. Utrecht: , the Netherlands: Rijksuniversiteit Utrecht; ; 1990. [Google Scholar]
  99. Gitlin LN, Liebman J., Winter L. Are environmental interventions effective in the management of Alzheimer’s disease and related disorders? A synthesis of the evidence. Alzheimers Care Quart. 2003;4(2):85-107. [Google Scholar]
  100. Tilly J., Reed P. Falls, wandering, and physical restraints. A review of interventions for individuals with dementia in assisted living and nursing homes. Alzheimers Care Today. 2008;9(1):45-50. [Google Scholar]
  101. Perritt MR , McCune ED, McCune SL Empirical findings suggest recommendations for carpet pattern and texture. Alzheimers Care Quart. 2005;6(4):300-305. [Google Scholar]
  102. Calkins MP Learning from doing. Conducting a SAGE postoccupance evaluation. Alzheimers Care Quart. 2005;6(4):357-365. [Google Scholar]
  103. Gross J., Harmon ME, Myers RA, et al. Recognition of self among persons with dementia. Pictures versus names as environmental supports. Environ Behav. 2004;36(3):424-454. [Google Scholar]
  104. Price JD, Hermans DG, Grimley Evans J. Subjective barriers to prevent wandering of cognitively impaired people (Review) . Cochrane Database Syst Rev. 2007. ;3: CD001932. [DOI] [PMC free article] [PubMed] [Google Scholar]
  105. Namazi KH, DiNatale Johnson B. Pertinent autonomy for residents with dementias: modification of the physical environment to enhance independence. Am J Alzheimers Dis Other Demen. 1992;7(1):16-21. [Google Scholar]
  106. Calkins MP The physical and social environment of the person with Alzheimer’s disease. Aging Ment Health. 2001;5(suppl 1): S74-S78. [DOI] [PubMed] [Google Scholar]
  107. Lawton MP The physical environment of the person with Alzheimer’s disease . Aging Ment Health. 2001;5(suppl 1): S56-S64. [DOI] [PubMed] [Google Scholar]
  108. Charness N. , Holley P. Human factors and environmental support in Alzheimer’s disease. Aging Ment Health. 2001; 5(S1):S65-S73. [PubMed] [Google Scholar]
  109. Messecar DC , Archbold PG, Stewart BJ, Kirschling J. Home environmental modification strategies used by caregivers of elders. Res Nurs Health. 2002;25(5):357-370. [DOI] [PubMed] [Google Scholar]
  110. Braudy Harris P. The experience of living alone with early stage Alzheimer’s disease. What are the person’s concerns? Alzheimers Care Quart. 2006;7(2):84-94. [Google Scholar]
  111. Gitlin LN, Corcoran M., Winter L., Boyce A., Hauck WW A randomized, controlled trial of a home environmental intervention: effect on efficacy and upset in caregivers and on daily function of persons with dementia. Gerontologist. 2001;41(1):4-14. [DOI] [PubMed] [Google Scholar]
  112. Graff MJL , Adang EMM , Vernooij-Dassen MJM , et al. Community occupational therapy for older patients with dementia and their care givers: cost effectiveness study. Brit Med J. 2008;336(7636):134-138. [DOI] [PMC free article] [PubMed] [Google Scholar]
  113. Galasko D. , Bennett D., Sano M., et al. An inventory to assess activities of daily living for clinical trials in Alzheimer’s disease. Alzheimer Dis Assoc Disord. 1997. ;11(S2):S33-S39. [PubMed] [Google Scholar]
  114. Galasko D. An integrated approach to the management of Alzheimer’s disease: assessing cognition, function and behaviour. Eur J Neurol. 1998;5(suppl 4):S9-S17. [Google Scholar]

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