The therapeutic environment screening scale

Abstract

As part of a study of care for patients with Alzheimer's disease and related disorders in 31 dementia units, (special care units) and 32 traditional units in five states, an observational screening checklist was designed and field tested. That checklist the Therapeutic Environment Screening Scale (TESS) uses 12 items to evaluate the appropriateness of a nursing home unit for residents with dementing disorders. The therapeutic principles evaluated by the instrument are: eliminating potentially noxious stimuli, enhancing mood and self image, promoting safety, accommodating a range of private and social activities, and providing access to the outdoors. Application of the instrument showed that the 63 settings studied did differ in the 12 environmental characteristics studied, and that as a whole, dementia units scored significantly better than traditional nursing home units.

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References

1. Lawton MP : Competence, environmental press and the adaptation of older people. In: Aging and the environment; MP Lawton , P Windley , T Byerts (eds.). New York, Springer, 1982

2. Coons DH : Residential care for persons with dementia. In: Dementia care: Patient, family, and community; N Mace (ed.). Baltimore, London, Johns Hopkins Press, 1990

3. Hiatt LG : Environment design and mentally impaired older people. In: Alzheimer's disease: Problems, prospects, and perspectives; H Altman (ed.). New York, Plenum Press, 1987

4. Cohen U , Weissman GD , Ray K , Steiner VL , Rand J , Toyne RM : Environments for people with dementia: Design guide. Milwaukee, Center for Architecture and Urban Planning Research, 1988

5. American Institute of Architects : Design for aging: An architect's guide. Washington DC, AIA Press, 1985

6. Byerts TO : The social and physical aspects of housing and aging: A U.S. perspective. In: Aging 2000: Our health care destiny; C Gaity , G Niederche , N Wilson (eds.). New York, Springer-Verlag, 1985

7. Staats DO : Physical environments. In: Geriatric medicine: Fundamentals of geriatric care; CK Cassel , JR Walsh (eds.). New York, Springer-Verlag, 1984

8. Lipman A , Slater R : Homes for old people: Towards a positive environment. In: Designing for therapeutic environments: A review of the research; D Canter , S Canter (eds.). New York, John Wiley & Sons, 1979

9. Golant S : A place to grow old. New York, Columbia University Press, 1984

10.

10. Green I , Fedewa BE , Johnson CA , et al: Housing for the elderly: The development and design process. New York, Van Nostrand Reinhold, 1975

11.

11. Pastalan LA , Pawlson LG : Importance of the physical environment for older people. J Am Geriatrics Soc 1985;33:874-874

12.

12. Thomas J , Bobrow ML : Targeting the elderly in facility design. Hospitals, February 16, 1984:83-88

13.

13. Hiatt LG : Supportive design for people with memory impairments. In: Confronting Alzheimer's disease; AC Kalicki (Ed.) Owings Mills, Maryland, National Health Publishing, 1987

14.

14. Calkins MP : Design for dementia: Planning environments for the elderly and the confused. Owings Mills, Maryland, National Health Publishing, 1988

15.

15. Peppard NR : Effective design of special care units. Provider, May, 1988:14-17

16.

16. Moos RH , Lemke S : Multiphasic environmental assessment procedure. Palo Alto, CA, Stanford University School of Medicine, 1979

17.

17. Mace N : Programs and services which specialize in the care of persons with dementing illness; Issues and options. Amer J of Alz Care & Research 1987;2:10-17

18.

18. Hall G , Kirschling MV , Todd S : Sheltered freedom An Alzheimer's unit in an ICF. Geriatric Nursing May/June, 1986:132-137

19.

19. Sloane PD , Mathew LJ (eds.): Specialized dementia units in nursing homes. Baltimore, MD, Johns Hopkins Press, to be published in 1991.