Comparing Communal Environments Using the Assessment Tool for Occupation and Social Engagement: Using Interactive Occupation and Social Engagement as Outcome Measures

Abstract

Introduction: Interactive occupation and social engagement are important components of quality of life for residents with dementia in nursing homes. Communal living spaces should be evaluated on these qualities. Two Irish nursing homes were compared pre and post conversion from a traditional to a household model unit using the Assessment Tool for Occupation and Social Engagement. This assessment uses interactive occupation and social engagement as positive outcome measures. Method: Residents, staff, and relatives were observed pre and post renovation over a 6-week period using a snapshot observational method over 4 hours on 7 different weekdays. Findings: Changing from a traditional to a household model nursing home increased the interactive occupation and social engagement of residents, staff, and visitors within the communal living areas. The role of a homemaker in the household unit was critical for maintaining residents' participation and engagement, including engaging in familiar everyday domestic tasks. Conclusion: Interactive occupation and social engagement were significantly increased in the household model unit over the traditional model unit, particularly for residents. In the household model unit, more residents initiated and maintained their own interactions within the communal environment and did not require prompting from staff to do this.

Engagement and social interaction in dementia care settings. A call for occupational and social justice

“…Closer proximity in the four other venues seemed to lead to more spontaneous interactions between the staff and the residents. However, while the physical characteristics of a room can affect staff and resident interaction, the organisational and relational care practices of a setting are also critical (Chaudhury, Cooke, Cowie, & Razaghi, ; Morgan‐Brown & Chard, ; Morgan‐Brown et al, ; Røen, et al, ) and further examination of these factors could explain the discrepancy in results. Social interaction, interactive occupation, informal group situations, and especially structured group situations depend on the facilitation of staff.…”

“…The resident, staffing and visitor groups do not need to be matched and the numbers within the room will naturally vary during the course of the observations. The development, reliability, and validity of the ATOSE have been described elsewhere (Morgan‐Brown, ; Morgan‐Brown & Brangan, ; Morgan‐Brown & Chard, ; Morgan‐Brown et al, ). Content validity was determined by adhering to the recommendations of Robson () for an observational assessment in order for it to be reliable, accurate, and straightforward to complete.…”

“…The ATOSE was developed for a PhD study which investigated the impact of changing the physical, operational, and social environments of two private traditional style Irish nursing homes to create more person‐centred and “homelike” environments. These planned interventions created statistically significant increases in resident interaction and engagement with their environments (Morgan‐Brown, ; Morgan‐Brown & Chard, ; Morgan‐Brown, Newton, & Ormerod, ).…”

Capturing Interactive Occupation and Social Engagement in a Residential Dementia and Mental Health Setting Using Quantitative and Narrative Data

“…Recommendations for change focus on the physical, social, and sensory environments as well as change in the culture of care throughout an organization [77]. Occupational and psychosocial interventions reduce the number and severity of neuropsychiatric symptoms and enhance physical ability and general well-being [78].…”

“…A willingness to address the occupational interaction and social engagement needs of residents can minimize occupational and social deprivation. However, this requires determination, resources, and imagination to allocate staff time, provide training, and create a new physical environment with flexible routines, spontaneity, choice, and interaction [40,77]. Changes need to be sustainable which require feedback schedules, accountability, and review.…”