Gesine Marquardt

Dementia-friendly architecture: environments that facilitate wayfinding in nursing homes.

Spatial disorientation is a prime reason for institutionalization. The autonomy of the residents and their quality of life, however, is strongly linked with their ability to reach certain places within their nursing home. The physical environment has a great potential for supporting a resident’s wayfinding abilities. For this study, data were collected from 30 German nursing homes. Skilled nurses rated the resident’s ability to perform 5 wayfinding tasks. The architectural characteristics of the homes were analyzed and their impact on the resulting scores was tested for statistical significance using the Mann-Whitney U test (P < .05). Results confirm that people with advancing dementia are increasingly dependent on a compensating environment. The significant factors include a small number of residents per living area, the straight layout of the circulation system without any changes in direction, and the provision of only 1 living/dining room. These and additional results were transformed into architectural guidelines.

Impact of the Design of the Built Environment on People with Dementia: An Evidence-Based Review:

OBJECTIVE: In this review the impact of the design of the built environment on people with dementia in long-term care settings is systematically analyzed and summarized. Architects and designers will be provided with credible evidence on which they can confidently base their design decisions. Researchers will be able to determine which environmental aspects have been well investigated and where there are gaps in the current state of the research. BACKGROUND: A great number of studies have established a relationship between the design of the physical environment of long-term care settings and outcomes of people with dementia. However, the methods employed are heterogeneous and the results are often conflicting. Consequently, the process of integrating the best evidence available into architectural designs may be hindered. METHODS: A systematic literature search was conducted reviewing studies that meet certain inclusion criteria. Using an evidence-based approach, the methodical quality of the studies was rated. RESULTS: One hundred sixty-nine studies were found. They were thematically summarized into four main categories: basic design decisions, environmental attributes, ambience, and environmental information. The effectiveness of the interventions on the behavior, cognition, function, well being, social abilities, orientation, and care outcomes on people with dementia was illustrated by matrices. CONCLUSIONS: Results of this review indicate that, with the exception of cognition, specific design interventions are beneficial to the outcomes of people with dementia. Overall, the field of environmental design for people with dementia is well researched in many aspects and only few gaps in knowledge were identified.

How to Rate the Quality of a Research Paper: Introducing a Helpful Algorithm for Architects and Designers

KEYWORDS Decision-making, evidence-based design, methodology.

Environmental Cues in Double-Occupancy Rooms to Support Patients With Dementia.

Objective: The purpose of this study was to evaluate the effectiveness of different environmental cues in double-occupancy rooms of an acute care hospital to support patients’ abilities to identify their bed and wardrobe. Methods: The quasi-experiment was conducted on a geriatric ward of an acute care hospital. Patients with dementia were included (n = 42). To test the effectiveness of environmental cues, two rooms were enhanced with the environmental cue “color,” two rooms with the cue “number,” and two rooms with the cue “patient’s name”. Four rooms were not redesigned and were used as control rooms. For analysis, we pooled the intervention groups color and number (n = 14) and compared it with the control group (n = 22). Results: The environmental cues color and number were significantly effective to improve the identification of the wardrobe from the third to the fifth day after admission. However, for the 10th–12th day after admission, we found no difference in results. Furthermore, results indicate improvements in the ability to identify the bed by using the environmental cues color and number. Conclusions: As this study indicated, the environmental cues color and number are helpful for these patients to identify their bed and wardrobe. However, these cues were most effective from the third to the fifth day after admission. To sustain their effectiveness on patients’ identification abilities during their hospital stay, we discuss, whether verbal prompting and an ongoing mentioning of such cues, embedded in the daily work of nurses, could be beneficial.

Investigation of Eligible Picture Categories for Use as Environmental Cues in Dementia-Sensitive Environments.

Objectives: Environmental cues, such as pictures, could be helpful in improving room-finding and wayfinding abilities among older patients. The aim of this study was to identify picture categories that are preferred and easily remembered by older patients and cognitively impaired patients and which therefore might be suitable for use as environmental cues in acute care settings. Methods: Twelve pictures were presented to a sample of older patients (n = 37). The pictures represented different categories: familiarity (familiar vs. unfamiliar), type of shot (close-up vs. wide shot), and picture content (nature vs. animal vs. urban). We tested the patients’ votes of preference and abilities to identify and immediately recall pictures. Cognitively impaired patients (n = 14) were assessed by the abbreviated mental test and the mini mental state examination and were compared with patients without cognitive impairments (n = 23) using a repeated measures analysis of variance. Results: The results showed a main effect of familiarity on positive vote and recall of pictures. The absence of interaction effects of familiarity and group indicated an overall impact of familiarity on the sample. Within cognitively impaired patients, a significant difference in recall of picture content between urban (20%) and animal (9%) was found. Conclusions: Pictures, which patients were able to relate to in terms of familiarity and the characteristics urban and nature, seem to be suitable for use as environmental cues. Besides functioning as such, we assume, based on literature, that pictures could further enhance the ambiance or serve as prompts for communication and interaction.

There or not there? A multidisciplinary review and research agenda on the impact of transparent barriers on human perception, action, and social behavior

Through advances in production and treatment technologies, transparent glass has become an increasingly versatile material and a global hallmark of modern architecture. In the shape of invisible barriers, it defines spaces while simultaneously shaping their lighting, noise, and climate conditions. Despite these unique architectural qualities, little is known regarding the human experience with glass barriers. Is a material that has been described as being simultaneously there and not there from an architectural perspective, actually there and/or not there from perceptual, behavioral, and social points of view? In this article, we review systematic observations and experimental studies that explore the impact of transparent barriers on human cognition and action. In doing so, the importance of empirical and multidisciplinary approaches to inform the use of glass in contemporary architecture is highlighted and key questions for future inquiry are identified.

Mit Architektur den Alltag unterstützen

Fazit für die PflegeEin ganzheitliches Konzept demenzsensibler Gestaltung muss von Beginn an in die architektonische Planung von Einrichtungen des Gesundheitswesens integriert werden.In räumlicher Struktur und Ausgestaltung sollte eine Umgebung geschaffen werden, die Sicherheit und Orientierung bietet sowie Kommunikation, soziale Interaktion und Teilhabe fördert.Bei Bestandsgebäuden lassen sich schrittweise Maßnahmen auch im Rahmen von Sanierung und Instandhaltung umsetzen.Wichtig ist es, ein Gesamtkonzept des Umgangs mit Menschen mit Demenz zu haben, das nicht nur bauliche, sondern auch organisatorische und personelle Ansätze einbezieht.

Fostering Evidence-Based Design Towards Patient-Oriented and Knowledge-Driven Hospital Design

Medical knowledge spans over a large scope (e.g., from the single cell to the whole human body). Hence, finding orientation between science and daily practice in health care is not an easy task. There is a vast amount of literature regarding knowledge and its transfer. The article presents a framework in order to structure methods of knowledge exchange and transfer corresponding to different levels of the healthcare system—societal, organizational, and group level. This framework will support the selection of knowledge management methods, IT support, and architectural means discussed in order to support the transfer of knowledge in hospitals and in the healthcare system.

Architektur für Menschen mit Demenz

Die Zahl der Menschen mit Demenz wächst kontinuierlich. 2010 lebten nach Schätzungen weltweit etwa 35.6 Millionen mit einer Demenz. Diese Zahl wird sich alle 20 Jahre verdoppeln, sodass für das Jahr 2050 etwa 115 Menschen mit einer Demenz erwartet werden (Prince et al., 2013). Für die Betro enen selbst, ihre Angehörigen und insbesondere die P egeeinrichtungen und -anbieter stellt diese Entwicklung eine große Herausforderung dar. Menschen mit Demenz benötigen zunächst zwar nur Unterstützung bei ihrer Alltagsbewältigung, wer den aber mit Fortschreiten der Krankheit sehr schnell von umfassenden P egeleistungen abhängig.