Occupational need in severe dementia: a descriptive study.

This project represents the first phase of a larger study, the whole of which is intended to demonstrate the occupational need of elderly persons, in hospital or residential settings, who have severe dementia and to identify those therapeutic approaches which serve to meet such need. One hundred and nine severely impaired persons in nine dementia care units were each observed over the course of a day, using the dementia care mapping instrument. Results indicate a severe dearth of occupational provision for this client group, most of whom spent the greater part of their day unoccupied. They also highlight the conditions of minimum well-being experienced by most residents for most of the time. The anomaly of those units whose dementia care mapping scores did not match the perceived quality of their social and physical environments is discussed. A hypothesis of an altered perception of environment in severely impaired persons is proposed.