Effects of supporting facilities on memory loss among older people with dementia in care and attention homes

Abstract

Supporting facilities (SF) including handrails, signage, finishes, furniture and recreational facilities facilitate the daily life of older persons. Memory loss is one of the most common signs of dementia affecting the daily life of older persons. Therefore, they may need special SF in residential homes. In order to improve the quality of daily life of older people with dementia, this study aims to investigate the effects of SF on the memory loss of those living in care and attention (C&A) homes. A questionnaire survey was conducted among elderly C&A home residents aged 65 and above in Hong Kong. A Supporting Facilities-Memory Loss model was established based on correlation and regression analyses. The model confirmed the following: (1) none of the SF items affects long-term memory loss; (2) satisfaction with signage, finishes and furniture leads to a reduction of short-term memory loss; (3) satisfaction with handrails, signage and finishes enhances spatial memory and (4) satisfaction with the location of signage reduces time confusion. Practical recommendations are proposed, including using large and well-placed signage with pictograms and icons, avoiding the removal and modification of furniture, enhancing colour contrasts between different functional rooms, installing handrails with a consideration for orientation strategies, and so on.

Developing a Non-Pharmacological Intervention Programme for Wandering in People with Dementia: Recommendations for Healthcare Providers in Nursing Homes

“…In terms of the study design, we included one guideline [ 28 ], three systematic reviews [ 23 , 27 , 44 ], two cohort studies [ 46 , 47 ], two quasi-experimental studies [ 25 , 26 ], two analytical cross-sectional studies [ 30 , 45 ], three clinical decision-making studies [ 32 , 50 , 51 ], one evidence summary [ 49 ], one recommended practice [ 48 ], and seven articles from the Alzheimer’s Society [ 31 , 52 , 53 , 54 , 55 , 56 , 57 ].…”

“…Seven studies [ 25 , 28 , 31 , 45 , 48 , 51 , 55 ] centred on how to prevent excessive wandering, including three on managing sleep issues to prevent night-time wandering [ 45 , 51 , 55 ]. Among the 13 studies [ 23 , 26 , 27 , 28 , 30 , 31 , 44 , 48 , 49 , 50 , 53 , 55 , 57 ] on preventing patients from getting lost, low-tech strategies such as camouflaged doors and mirrors in front of exit doors, and high-tech solutions such as identification bracelets, boundary alarm systems, and GPS devices were involved, and one of them discussed ethical issues in the use of electronic tracking devices [ 23 ]. In addition, there were four studies on what to do if a person with dementia goes missing [ 31 , 50 , 52 , 56 ].…”

“…Providing a safe-as-possible environment for PwD could promote safe walking [ 48 ]. Environmental stressors, such as being cold at night, and changes in daily routines and furniture, should be minimised [ 28 , 30 ], and tripping hazards should be removed to reduce the risk of falls by PwD, such as throw rugs, extension cords, excessive clutter, and electric cords or wires [ 28 , 53 ]. A previous study found that home modifications and repairs were effective ways to reduce injuries and led to an estimated 31% reduction in the rate of fall-based injuries each year [ 63 ].…”

“…Wayfinding cues should be salient and straightforward, and the amount of irrelevant information should be minimised [ 71 ]. Handrails in hallways following installation strategies of orientation and continuity helped PwD find their way quickly and should be mounted not much higher than the eyes due to weak necks [ 30 ].…”

“…High-tech strategies, including global positioning systems (GPS), radiofrequency, and electronic tracking, can monitor a person’s exact location and alert responsible individuals [ 9 , 23 , 24 ]. Low-tech strategies, such as environment-based interventions [ 25 , 26 , 27 , 28 , 29 ] and supporting facilities [ 30 , 31 ], can effectively reduce wandering and night behaviours, help PwD in their wayfinding, and decrease the risk of falls. In addition, regular supervised exercise, such as gait and balance training, and strength training, can be effective in improving balance and decreasing the risk of falls [ 32 ].…”