[Dementia-friendly hospital wards : Expert recommendations for planning and design]

BACKGROUND

Hospitals face great challenges in the necessity of providing care for the rising number of elderly patients with dementia. The adaptation of the spatial environment represents an important component to improve the care situation of patients with dementia. For more than 30 years research results from long-term care have provided evidence on the therapeutic effect of numerous architectural features on people with dementia. Due to specific medical and organizational requirements in hospitals, the transferability of these findings is, however, limited.

MATERIAL AND METHODS

An interdisciplinary workshop with experts from the fields of medicine, nursing, gerontology, self-help and architecture was conducted in July 2015. Based on existing research findings and experiences from pilot projects, the spatial requirements for dementia-friendly hospital wards were collated, suggested solutions were discussed from different perspectives and finally design recommendations were derived.

RESULTS

The article gives a first comprehensive overview of architectural measures that are required for the design of dementia-friendly hospital wards. The recommendations provided range from architectural criteria, such as the size and spatial structure of hospital wards, to interior design elements, including orientation and navigation aids and the use of light and colors. Furthermore, information about the planning process are given.

[Post-traumatic stress disorder and delusions. A case report]

The present paper initially discusses the possible transitions existing between posttraumatic stress disorder (PTSD) and delusional disorder. With respect to the latter, the main focus is on the psychopathological concept of the so-called sensitive delusion of reference. A patient who developed a delusional disorder secondary to PTSD, which had been precipitated by his involvement in a serious auto accident, is then described. The details of this case seem to lend some support to the hypothesis of a clinical continuum provided that the "trauma" found in PTSD, on the one hand, and the "crucial experience" associated with the sensitive delusion of reference, on the other, positively correlate with the presence of prominent sensitive traits of personality.

[Psychotherapeutic group work with psychiatric patients--a clinical study (author's transl)]

This study investigates the effects of a highly structurized therapy programme made up of different elements of psychotherapy and sociotherapy, conducted in 42 inpatients of a psychiatric hospital. Random testing of the patients was differentiated in respect of the diagnosis of a psychosis, neurosis and disturbed personality. Whereas clearly positive effects were seen in the group of neurotics (measured by means of the Freiburg Personality Inventory test before and after the therapy programme), this did not seem to apply to the group of psychotics. This group, too, included the majority of patients who discontinued participation in the programme.