Some preliminary findings were presented at the Annual Dreambuilders Conference, October 2002, Calgary, Canada, and at the Designing for Diversity in Dementia Care Conference, May 2002, Toronto, Canada.
Measuring Physical and Social Environments in Nursing Homes for People with Middle- to Late-Stage Dementia
Article first published online: 24 JUL 2006
Journal of the American Geriatrics Society
Volume 54, Issue 9, pages 1436–1441, September 2006
How to Cite
Slaughter, S., Calkins, M., Eliasziw, M. and Reimer, M. (2006), Measuring Physical and Social Environments in Nursing Homes for People with Middle- to Late-Stage Dementia. Journal of the American Geriatrics Society, 54: 1436–1441. doi: 10.1111/j.1532-5415.2006.00851.x
- Issue published online: 7 SEP 2006
- Article first published online: 24 JUL 2006
- social environment;
- physical environment;
- long-term care;
- models of care instrument
OBJECTIVES: To evaluate measures of dementia care environments by comparing a special care facility (SCF) with traditional institutional facilities (TIFs).
DESIGN: A cross-sectional comparative study of nursing home environments conducted as part of a longitudinal study on quality of life for residents with dementia.
SETTING: Twenty-four traditional nursing homes and one special care facility.
PARTICIPANTS: One SCF with six distinct environments, 24 TIFs with 45 distinct environments, and 88 family members.
MEASUREMENTS: Therapeutic Environment Screening Scale—2+ (TESS-2+); Special Care Unit Environmental Quality Scale (SCUEQS), a subset of the TESS-2+ items; Composite Above Average Quality Score (CAAQS), a composite score of all items on the TESS-2+; and Models of Care Instrument (MOCI).
RESULTS: The SCUEQS did not detect a significant difference between the SCF and the TIFs (30.0 vs 27.2, P=.28). The CAAQS detected a significant difference between the SCF and the TIFs, whereby the SCF environments were rated as having above-average quality in 71.4% of the domains, compared with 57.3% for the TIF environments (95% confidence interval (CI) for difference=2.6–25.6%, P=.02). Using the MOCI, SCF families were 1.8 times as likely to rate the SCF as a home or resort versus a hospital as TIF families rating TIFs (95% CI for odds ratio=1.5–2.1, P<.001).
CONCLUSION: The TESS-2+ CAAQS differentiated between physical environments better than the more established SCUQES. The MOCI distinguished between environments using a more holistic approach to measurement. The availability of environmental measures that are able to discriminate between specialized and traditional long-term care settings will facilitate future outcome-based research.