Susan E Slaughter1, Debra G Morgan. 1. Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alberta, Canada. susan.slaughter@ualberta.ca
Abstract
OBJECTIVES: The aim of this article was to examine associations between specific dimensions of nursing home environments and the functional ability (walking and eating) of residents with dementia, and to contribute to the ongoing psychometric development of the Professional Environmental Assessment Protocol (PEAP). DESIGN: One-year prospective cohort study. SETTING: Fifteen nursing homes in a western Canadian province. PARTICIPANTS: Convenience sample of 120 nursing home residents with middle-stage dementia. MEASUREMENTS: Every 2 weeks we observed residents' abilities to walk to the dining room and to feed themselves. At the end of a year of observation and immediately following a brief interview with the unit managers, we used the PEAP to measure the extent to which 9 specific dimensions of nursing home environments support the ability of residents with dementia to walk and to eat. Cox proportional hazards models were used to evaluate the effect of specific environmental features on residents' walking and eating disability. RESULTS: "Support of functional ability" was associated with a reduced hazard of both walking and eating disability. The environmental dimensions of "maximizing awareness and orientation" and better "quality of stimulation" were associated specifically with reduced hazard of walking disability, whereas the dimensions of the nursing home environment specifically associated with a reduced hazard of eating disability included improved "safety and security," "opportunities for personal control," and "regulation of stimulation." The Cox proportional hazards models using the 13-point PEAP scale were not significantly different from nested models using the 5-point PEAP scale, indicating that the 2 scales did not differ in their ability to discriminate between more and less supportive environments for residents with dementia. CONCLUSIONS: Specific dimensions of the nursing home environment reduced the hazard of walking disability, whereas others reduced the hazard of eating disability. Modifying specific features of nursing home environments may reduce disability in nursing home residents with dementia. The 5-point PEAP scale is able to discriminate between nursing home environments as well as the 13-point scale.
OBJECTIVES: The aim of this article was to examine associations between specific dimensions of nursing home environments and the functional ability (walking and eating) of residents with dementia, and to contribute to the ongoing psychometric development of the Professional Environmental Assessment Protocol (PEAP). DESIGN: One-year prospective cohort study. SETTING: Fifteen nursing homes in a western Canadian province. PARTICIPANTS: Convenience sample of 120 nursing home residents with middle-stage dementia. MEASUREMENTS: Every 2 weeks we observed residents' abilities to walk to the dining room and to feed themselves. At the end of a year of observation and immediately following a brief interview with the unit managers, we used the PEAP to measure the extent to which 9 specific dimensions of nursing home environments support the ability of residents with dementia to walk and to eat. Cox proportional hazards models were used to evaluate the effect of specific environmental features on residents' walking and eating disability. RESULTS: "Support of functional ability" was associated with a reduced hazard of both walking and eating disability. The environmental dimensions of "maximizing awareness and orientation" and better "quality of stimulation" were associated specifically with reduced hazard of walking disability, whereas the dimensions of the nursing home environment specifically associated with a reduced hazard of eating disability included improved "safety and security," "opportunities for personal control," and "regulation of stimulation." The Cox proportional hazards models using the 13-point PEAP scale were not significantly different from nested models using the 5-point PEAP scale, indicating that the 2 scales did not differ in their ability to discriminate between more and less supportive environments for residents with dementia. CONCLUSIONS: Specific dimensions of the nursing home environment reduced the hazard of walking disability, whereas others reduced the hazard of eating disability. Modifying specific features of nursing home environments may reduce disability in nursing home residents with dementia. The 5-point PEAP scale is able to discriminate between nursing home environments as well as the 13-point scale.
Authors: Barbara Resnick; Ann Kolanowski; Kimberly Van Haitsma; Elizabeth Galik; Marie Boltz; Shijun Zhu; Jeanette Ellis; Liza Behrens; Karen Eshraghi; Nicole Viviano; Ying-Ling Jao Journal: J Aging Environ Date: 2020-01-28
Authors: Heather Keller; Natalie Carrier; Lisa Duizer; Christina Lengyel; Susan Slaughter; Catriona Steele Journal: J Am Med Dir Assoc Date: 2014-03 Impact factor: 4.669
Authors: Heather H Keller; Natalie Carrier; Susan Slaughter; Christina Lengyel; Catriona M Steele; Lisa Duizer; K Steve Brown; Habib Chaudhury; Minn N Yoon; Alison M Duncan; Veronique M Boscart; George Heckman; Lita Villalon Journal: BMC Geriatr Date: 2017-01-13 Impact factor: 3.921