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Effective Use of the Built Environment to Manage Behavioural and Psychological Symptoms of Dementia: A Systematic Review

Originally Published:
2014
Key Point Summary
Key Point Summary Author(s):
Zborowsky, Terri
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Key Concepts/Context

There is a lack of valid and reliable research in the area of impact of built environment interventions in managing behavioral and psychological symptoms of dementia. 

Objectives

The objective of this study was to determine the effectiveness of built environment interventions in managing behavioral and psychological symptoms of dementia among residents in long-term care settings.

Methods

Authors conducted a systematic literature review of all articles published from 1995-2013. The authors were interested in finding valid and reliable published research in this area.

Design Implications
Design interventions of the studies are discussed in the findings. Practitioners should be encouraged to work with their clients to develop research studies based on design interventions. 
Findings

Five low- to moderate-quality studies were included. Three categories of interventions were identified as change/redesign of existing physical space, addition of physical objects to the environment, and type of living environment. The five studies discussed in this article included the following design interventions and resulting impact:

  1. Redesign of an existing corridor had no significant difference in overall resident behavior while in the corridor.
  2. Unlocked doors to a courtyard decreased agitation when doors were unlocked compared to when doors were locked.
  3. Two different multisensory environments and one control environment had no significant differences in affect states before and after intervention, among the three environments. The only significant difference was that more sadness was recorded in the control environment (a living room) versus the other two environments.
  4. In a move to a purpose-built specialized care facility for people with dementia the quality of life in the intervention group was similar or better compared to the control group.
  5. In a move to a special care unit for people with dementia there was a reduction of verbally agitated behavior in the intervention group compared to the control group.
Limitations

 The small number of research studies identified makes generalizability to a larger population difficult. The authors note that there is a lack of valid and reliable studies in this area of design.

Design Category
Room configuration and layout|Unit configuration and layout
Setting
Residential healthcare facilities
Outcome Category
Patient / resident health outcomes
Environmental Condition Category
Attractiveness of physical environment
Key Point Summary Author(s):
Zborowsky, Terri
Primary Author
Soril, L. J. J.
Paper Type