Date Presented 04/05/19
The number of individuals living with dementia is rapidly increasing. Individuals with dementia often have difficulty interacting with the environment, thus affecting their quality of life. This research analyzed the most recent research evidence to determine environmental factors that impact quality of life among individuals with dementia. OTs may use this research to further their own practice or to take on a consultative role in designing or modifying facilities.
Primary Author and Speaker: Danielle Jecklin
PURPOSE: According to the World Health Organization (2017), the estimated number of individuals living with Dementia is 47 million. The World Health Organization expects this number to grow to 75 million by the year 2030 and almost triple by the year 2050. Dementia is best described as a set of symptoms affecting one’s memory, cognition, and social functions severely enough to interfere with participation in everyday occupations (Alzheimer's Association, n.d.). These symptoms make individuals with dementia more vulnerable to decreased quality of life and increased difficulties interacting with the environment (Mazzei, Gillan, & Cloutier, 2013). It is within occupational therapy’s line of practice to make changes to an individual’s environment so that it meets his or her unique needs and improves quality of life. There is a vast amount of research on the effects of the environment, but there is limited research directed toward the effects of the environment specifically on quality of life of individuals with dementia. The purpose of this research is to determine physical and social environmental factors and designs that are conducive to increased quality of life among individuals with dementia residing in a long term care facility.
DESIGN: The research conducted was a critically appraised topic. Article inclusion criteria were those published within the past 10 years; written in English; within the scope of dementia and the environment; and level I, II, III, or IV evidence. Exclusion criteria included articles that focused on conditions other than dementia, articles published more than 10 years ago, non-peer-reviewed literature, dissertations, and articles that were level V evidence or qualitative studies.
METHOD: Search terms were identified and then used to search databases for articles. Databases searched included CINAHL, Medline, PubMed, PsycARTICLES, PsycINFO. Articles meeting inclusion criteria were appraised and organized into an evidence table. Following completion of the evidence table, a critically appraised topic was completed.
RESULTS: Database search resulted in two level I studies, one level II study, five level III studies, and nine level IV studies. Article appraisal resulted in environmental factor and design themes that were most conducive to quality of life, including lighting, noise level, temperature, color and contrast, multisensory environments, small-scale and homelike environments, architecture and building design, environmental cues and visual barriers, promotion of occupational performance, and social environment.
CONCLUSION: There is substantial evidence indicating the positive effects of proper design, adaptation, and modification of the environment on the quality of life of older adults with dementia. This provides a variety of implications for occupational therapy. Occupational therapists may use this information to modify the environment when providing therapy interventions, take on a consultative role with facilities looking to redesign or make changes to the environment to better accommodate individuals with dementia, assist in the planning and design of new long-term or memory care facilities, and advocate for the use of dementia-friendly environments and the importance of occupational therapy’s role in creating these environments.
References
Alzheimer's Association. (n.d.). What is dementia? Retrieved from https://www.alz.org/what-is-dementia.asp
Mazzei, F., Gillan, R., & Cloutier, D. (2013). Exploring the influence of environment on the spatial behavior of older adults in a purpose-built acute care dementia unit. American Journal of Alzheimers Disease & Other Dementiasr, 29(4), 311-319. doi:10.1177/1533317513517033
World Health Organization. (2017, April). 10 facts on dementia. Retrieved September 20, 2017, from http://www.who.int/features/factfiles/dementia/en/
