Does the Design of Settings Where Acute Care Is Delivered Meet the Needs of Older People? Perspectives of Patients, Family Carers, and Staff

Measuring the Impact of Bedroom Privacy on Social Networks in a Long-Term Care Facility for Hong Kong Older Adults: A Spatio-Social Network Analysis Approach

This study aims to measure the impact of bedroom privacy on residents' social networks in a long-term care (LTC) facility for older adults. Little is known about how the architectural design of bedrooms affects residents' social networks in compact LTC facilities. Five design factors affecting privacy were examined: bedroom occupancy, visual privacy, visibility, bedroom adjacency, and transitional space. We present a spatio-social network analysis approach to analyse the social network structures of 48 residents. Results show that residents with the highest bedroom privacy had comparatively smaller yet stronger groups of network partners in their own bedrooms. Further, residents who lived along short corridors interacted frequently with non-roommates in one another's bedrooms. In contrast, residents who had the least privacy had relatively diverse network partners, however, with weak social ties. Clustering analyses also identified five distinct social clusters among residents of different bedrooms, ranging from diverse to restricted. Multiple regressions showed that these architectural factors are significantly associated with residents' network structures. The findings have methodological implications for the study of physical environment and social networks which are useful for LTC service providers. We argue that our findings could inform current policies to develop LTC facilities aimed at improving residents' well-being.

Understanding the knowledge and engagement of facilities management with dementia-friendly design in Irish hospitals: an exploratory study

Purpose

This exploratory study stems from research conducted between 2015–2018 focussing on dementia-friendly design (DFD) in hospitals (Grey T. et al. 2018). Specifically, this study focusses on facilities management (FM) staff in Irish hospitals to gain a preliminary understanding of the level of knowledge and engagement of FM in the implementation of dementia-friendly hospital (DFH) design.

Design/methodology/approach

A mixed-methods approach based on a series of ad hoc semi-structured interviews, and an online survey. The aims were, namely, assess the extent of FM engagement in hospital works; measure the level of awareness regarding DFD; and identify facilitators and barriers to DFD in hospital settings. Participants (74) comprised FM staff in 35 Irish acute care hospitals. The research findings are based on thematic analysis of ad hoc semi-structured interviews (participants, n = 4) and survey responses (participants, n = 13).

Findings

While FM staff reported to possess important knowledge for building DFH, they also mentioned a lack of engagement of FM in design processes and hospital works.

Practical implications

The research has gained insight into the role of FM in promoting a dementia-friendly approach. Lack of or poor engagement of FM in design processes and hospital works means not fully tapping into rich expertise that would be invaluable in the development, implementation and maintenance of DFH. Universal design is a key driver for facilitating their engagement in the design, implementation and maintenance of DFH environments.

Originality/value

This is the first study exploring the role of FM in supporting a DFD approach in acute care hospitals.

Dementia Friendly Hospital Design: Key Issues for Patients and Accompanying Persons in an Irish Acute Care Public Hospital

OBJECTIVES

Research was conducted to investigate the impact of the hospital environment on older people including patients with dementia and their accompanying persons (APs). The article presents key research findings in the case study hospital.

BACKGROUND

For many patients, the hospital is challenging due to the busy, unfamiliar, and stressful nature of the environment. For a person with dementia, the hospital experience can be exacerbated by cognitive impairment and behavioral or psychological symptoms and can therefore prove to be a frightening, distressing, and disorientating place.

METHOD

The findings are based on a stakeholder engagement process where the research team spent approximately 150 hr observing within the hospital, administered 95 questionnaires to patients and/or APs, and conducted 12 structured interviews with patients and APs. A thematic analysis was employed to analyze and generate key themes emerging from the process.

RESULTS

Themes were grouped into overarching issues and design issues across spatial scales.

CONCLUSION

This research confirms the negative impact of the acute hospital setting on older people with cognitive impairments including dementia and delirium. The multiple perspectives captured in this study, including most importantly people with dementia, ensure that stakeholder needs can be used to inform the design of the hospital environment. The research points to the value of understanding the lived experience of the person with dementia and APs. The voices of patients, particularly persons with dementia and their APs, are a crucial element in helping hospitals to fulfill their role as caregiving and healing facilities.