Abstract
Concerns about negative outcomes associated with relocating residents are common. Fifty-five residents of a traditional high-care nursing home moved to new, purpose-built, dementia-specific cottages; 35 additional residents moved into the cottages within the first 8 months of operation. Direct-care staff participated in workshops on engaging residents in life-skill activities. Resident behavior was observed using a time sampling and a de-identified behavior mapping procedure. Results showed increases in resident engagement following the move and further increases after staff training. Staff engagement in resident interactive tasks similarly increased both after the move and again after staff training. The newly built cottages scored higher across all domains of 3 different types of environmental assessment, and family satisfaction ratings also improved. These results suggest that relocation need not negatively affect residents with dementia and that this environment provides an attractive model of care for dementia facilities.
Keywords: dementia, environment, engagement, distress, relocation
Full Text
The Full Text of this article is available as a PDF (491.0 KB).
Contributor Information
Ronald Smith, University of Sydney, Sydney, Australia.
R. Mark Mathews, University of Sydney, Sydney, Australia.
Meredith Gresham, Hammond Care, Sydney, Australia.
References
- World Health Organization. Active Ageing: Towards Age-friendly Primary Health Care. France World Health Organization; 2004. :40. [Google Scholar]
- Australian Government Department of Health and Ageing. A New Strategy for Community Care-The Way Forward. Canberra: , Australia: Australian Government; 2008:44. [Google Scholar]
- Hogan WP Review of Pricing Arrangements in Residential Aged Care. Canberra, Australia: Australian Government; 2004:397. [Google Scholar]
- Brodaty H., Draper B., Saab D., et al. Psychosis, depression and behavioural disturbances in Sydney nursing home residents: prevalence and predictors. Int J Ger Psych. 2001;16(5):504-512. [DOI] [PubMed] [Google Scholar]
- Fleming R., Forbes I., Bennet K. Adapting the Ward for People With Dementia. Sydney, Australia: New South Wales Department of Health; 2003:121. [Google Scholar]
- Fleming R., Crookes P., Sum S. A Review of the Empirical Literature on the Design of Physical Environments for People With Dementia. Sydney, Australia: Primary Dementia Collaborative Research Centre, UNSW; 2008. . [Google Scholar]
- Australian Government Department of Health and Ageing. Building Quality for Residential Care Services. Canberra: , Australia: Australian Government; 2005. [Google Scholar]
- Aldrich C., Mendkoff E. Relocation of the aged and disability: a mortality study. J Am Geriatr Soc. 1963;11:185-194. [DOI] [PubMed] [Google Scholar]
- Borup J., Gallego D., Heffernan P. Relocation and its effects on mortality. Gerontologist. 1979;19(2):135-140. [DOI] [PubMed] [Google Scholar]
- Gutman G., Herbert C. Mortality rates among extended-care patients. J Gerontol. 1976;31(3):352-357. [DOI] [PubMed] [Google Scholar]
- Nirenberg TD Relocation of institutionalized elderly. J Consult Clin Psychol. 1983;51(5):693-701. [DOI] [PubMed] [Google Scholar]
- Anthony K., Procter A., Silverman A., Murphy E. Mood and behavior problems following the relocation of elderly patients with mental illness. Age Ageing. 1987;16(6):355-365. [DOI] [PubMed] [Google Scholar]
- McAuslane L. , Sperlinger D. The effects of relocation on elderly people with dementia and their nursing staff. Int J Geriatr Psychiatry . 1994;9(12):981-984. [Google Scholar]
- Schwarz B., Chaundry H., Tofle RB Effect of design interventions on a dementia care setting. Am J Alzheimers Dis Other Demen. 2004;9(3):172-176. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith A., Crome P. Relocation mosaic-a review of 40 years of resettlement literature. Rev Clin Gerontol. 2000;10(1): 81-95. [Google Scholar]
- Aneshensel CS, Pearlin LI, Levy-Storms L., Schuler RH The transition from home to nursing home mortality among people with dementia. J Gerontol. 2000. ;55(3):S152-S162. [DOI] [PubMed] [Google Scholar]
- Meehan T., Robertson S., Vermeer C. The impact of relocation on elderly patents with mental illness. Aust New Zeal J Ment Health Nurs. 2001;10(4):236-242. [DOI] [PubMed] [Google Scholar]
- Mirotznik J. Does cognitive status moderate the health effects of single person room transfers on nursing home residents? Gerontologist. 2002;42(5):634-642. [DOI] [PubMed] [Google Scholar]
- Folstein MF , Robins LN, Helzer JE The Mini-Mental State Examination. Arch Gen Psychiatry. 1983;40(7):812. [DOI] [PubMed] [Google Scholar]
- Reisberg B. Functional assessment staging (FAST). Psychopharmacol Bulletin. 1988;24(4):653-659. [PubMed] [Google Scholar]
- 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]
- Sloane P., Mitchell C., Weisman G., et al. The Therapeutic Environment Screening Scale 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]