Get access

Measuring Physical and Social Environments in Nursing Homes for People with Middle- to Late-Stage Dementia

Authors

  • Susan Slaughter RN, MSc(A),

    1. From the Departments of *Community Health SciencesClinical Neurosciences, University of Calgary, Calgary, CanadaI.D.E.A.S. Inc., Kirtland, OhioFaculty of Nursing, University of Manitoba, Manitoba, Canada.
    Search for more papers by this author
  • Margaret Calkins PhD,

    1. From the Departments of *Community Health SciencesClinical Neurosciences, University of Calgary, Calgary, CanadaI.D.E.A.S. Inc., Kirtland, OhioFaculty of Nursing, University of Manitoba, Manitoba, Canada.
    Search for more papers by this author
  • Michael Eliasziw PhD,

    1. From the Departments of *Community Health SciencesClinical Neurosciences, University of Calgary, Calgary, CanadaI.D.E.A.S. Inc., Kirtland, OhioFaculty of Nursing, University of Manitoba, Manitoba, Canada.
    Search for more papers by this author
  • Marlene Reimer RN, PhD

    1. From the Departments of *Community Health SciencesClinical Neurosciences, University of Calgary, Calgary, CanadaI.D.E.A.S. Inc., Kirtland, OhioFaculty of Nursing, University of Manitoba, Manitoba, Canada.
    Search for more papers by this author

  • 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.

Address correspondence to Susan Slaughter, RN, MSc(A), Department of Community Health Sciences, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada. E-mail: sslaught@ucalgary.ca

Abstract

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.

Get access to the full text of this article

Ancillary