The Physical Environment of Special Care Units: Needs of Residents with Dementia from the Perspective of Staff and Family Caregivers

To manage the care of increasing numbers of residents with dementia, many long-term care facilities have created special care units (SCUs) designed to meet the unique needs of this group. This article describes results of the qualitative component of a larger research project examining environment-behavior relationships in dementia care settings. Eighteen in-depth interviews were conducted with 9 staff and 9 family members of SCU residents. Thematic analysis was conducted using grounded theory techniques. Participants described residents’ needs in relation to both the physical and social environments. This article focuses on the five areas of need identified by participants in relation to the physical environment: safety, homelike setting, optimal stimulation, cues, and options for privacy and social interaction.

[1]  D. Gold,et al.  Predictors and consequences of aggressive behavior by community-based dementia patients. , 1990, The Gerontologist.

[2]  K. Knafl,et al.  Interpreting and reporting qualitative research. , 1984, Research in nursing & health.

[3]  M. Aronson Reshaping dementia care : practice and policy in long-term care , 1994 .

[4]  K. Buckwalter,et al.  Progressively lowered stress threshold: a conceptual model for care of adults with Alzheimer's disease. , 1987, Archives of psychiatric nursing.

[5]  K. Buckwalter,et al.  Residential care for persons with dementia. Are codes and regulations protective or counter-productive? , 1996, Journal of gerontological nursing.

[6]  S. Gauthier,et al.  Spatial disorientation in persons with early senile dementia of the Alzheimer type. , 1991, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[7]  J Nelson,et al.  The influence of environmental factors in incidents of disruptive behavior. , 1995, Journal of gerontological nursing.

[8]  A. Strauss,et al.  The discovery of grounded theory: strategies for qualitative research aldine de gruyter , 1968 .

[9]  S. Berent,et al.  Need-driven dementia-compromised behavior: An alternative view of disruptive behavior , 1996 .

[10]  Debra Morgan,et al.  The Importance of the Social Environment in Dementia Care , 1997 .

[11]  Anselm L. Strauss,et al.  Qualitative Analysis For Social Scientists , 1987 .

[12]  J M Morse,et al.  Approaches to qualitative-quantitative methodological triangulation. , 1991, Nursing research.

[13]  G. Bucht,et al.  Behavioural symptoms in the institutionalized elderly—relationship to dementia , 1993 .

[14]  A. Strauss,et al.  Basics of qualitative research: Grounded theory procedures and techniques. , 1992 .

[15]  M. Powell Lawton,et al.  Ecology and the aging process. , 1973 .

[16]  N. Stewart,et al.  High versus Low Density Special Care Units: Impact on the Behaviour of Elderly Residents with Dementia , 1998, Canadian Journal on Aging / La Revue canadienne du vieillissement.

[17]  K. Buckwalter,et al.  Catastrophic reactions and other behaviors of Alzheimer's residents: special unit compared with traditional units. , 1993, Archives of psychiatric nursing.

[18]  N. Denzin The research act: A theoretical introduction to sociological methods , 1977 .

[19]  K. H. Namazi,et al.  Environmental modifications in a specially designed unit for the care of patients with Alzheimer's disease: An overview and introduction , 1991 .

[20]  E. Guba Criteria for assessing the trustworthiness of naturalistic inquiries , 1981 .

[21]  J. Lindsay Patterns of Caring for People with Dementia in Canada The Canadian Study of Health and Aging , 1994, Canadian Journal on Aging / La Revue canadienne du vieillissement.

[22]  L. Taft,et al.  Dementia care creating a therapeutic milieu. , 1993, Journal of gerontological nursing.

[23]  Rudolf H. Moos,et al.  Person-environment congruence in work, school, and health care settings☆ , 1987 .

[24]  K. Knafl,et al.  Triangulation in qualitative research: evaluation of completeness and confirmation purposes. , 1993, Image--the journal of nursing scholarship.

[25]  W. Spector,et al.  Prevalence and Correlates of Disruptive Behavior in the Nursing Home , 1989 .

[26]  T. Cleary,et al.  A reduced stimulation unit: effects on patients with Alzheimer's disease and related disorders. , 1988, The Gerontologist.

[27]  D R Royall,et al.  Precis of executive dyscontrol as a cause of problem behavior in dementia. , 1994, Experimental aging research.