Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-27T21:34:48.079Z Has data issue: false hasContentIssue false

The use of common spaces in assisted living schemes for older persons: a comparison of somatic and dementia units

Published online by Cambridge University Press:  23 February 2015

MORGAN ANDERSSON*
Affiliation:
Department of Architecture, Chalmers University of Technology, Gothenburg, Sweden.
JAN PAULSSON
Affiliation:
Department of Architecture, Chalmers University of Technology, Gothenburg, Sweden.
INGA MALMQVIST
Affiliation:
Department of Architecture, Chalmers University of Technology, Gothenburg, Sweden.
GÖRAN LINDAHL
Affiliation:
Department of Construction Management, Chalmers University of Technology, Gothenburg, Sweden.
*
Address for correspondence: Morgan Andersson, Department of Architecture, Chalmers University of Technology, S-412 96 Gothenburg, Sweden E-mail: morgan.andersson@chalmers.se

Abstract

This study explores how common spaces in assisted living schemes for older persons are used by the residents. Observation studies, group interviews with staff and individual interviews with residents, relatives, architects and key stakeholders in the context of Swedish elder-care were conducted. Common spaces are the major location for in-house social interaction on the units. The results show a higher presence on the dementia units, compared to the somatic units. No significant correlation was found between the residents' mobility limitations and their degree of presence in the common spaces. The results also suggest a contradiction between the staff's intentions to provide a social context and the capabilities of the residents. Although common spaces are not used much between meals, the residents stress their importance for social interaction, suggesting that common spaces have important qualitative aspects, rather than quantitative. The results also show that few of the residents used the common spaces together with their relatives. The increasing use of assistive technology creates a shortage of space, suggesting a conflict between the efforts to create a home-like environment and the use of assistive technology.

Type
Articles
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Albert, S. M. 1992. The nature of wandering in dementia: a Guttman scaling analysis of an empirical classification scheme. International Journal of Geriatric Psychiatry, 7, 11, 783–7.Google Scholar
Alexander, C. 1979. The Timeless Way of Building. Oxford University Press, New York.Google Scholar
Alexander, K. 2006. The application of usability concepts in the built environment. Journal of Facilities Management, 4, 4, 262–70.Google Scholar
Algase, D. L., Beattie, E. R. A., Antonakos, C., Beel-Bates, C. A. and Lan, Y. 2010. Wandering and the physical environment. American Journal of Alzheimer's Disease and Other Dementias, 25, 4, 340–6.Google Scholar
Almberg, C. and Paulsson, J. 1991. Group homes and groups of homes. In Preiser, W. F. E., Vischer, J. and White, E. T. (eds), Design Intervention – Toward a More Humane Architecture. Van Nostrand Reinhold, New York, 223–37.Google Scholar
Andersson, J. E. 2011. Architecture and ageing. On the interaction between frail older people and the built environment. Doctoral dissertation, Royal Institute of Technology, Stockholm.Google Scholar
Andersson, M., Lindahl, G. and Malmqvist, I. 2011. Use and usability of assisted living facilities for the elderly: an observation study in Gothenburg, Sweden. Journal of Housing for the Elderly, 25, 4, 380400.Google Scholar
Ball, M. M., Lepore, M. L., Perkins, M. M., Hollingsworth, C. and Sweatman, M. 2009. They are the reason I come to work: the meaning of resident–staff relationships in assisted living. Journal of Aging Studies, 23, 1, 3747.Google Scholar
Barnes, S. 2006. Space, choice and control, and quality of life in care settings for older people. Environment and Behavior, 38, 5, 589604.Google Scholar
BBR 2012. Boverkets byggregler, Karlskrona: The Swedish National Board of Housing, Building and Planning.Google Scholar
Blakstad, S. H. 2001. A strategic approach to adaptability in office buildings. Dissertation, Norwegian University of Science and Technology, Trondheim, Norway.Google Scholar
Bland, R. 1999. Independence, privacy and risk: two contrasting approaches to residential care for older people. Ageing & Society, 19, 5, 539–60.Google Scholar
Blyth, A. and Worthington, J. 2001. Managing the Brief for Better Design. Spon Press, New York.Google Scholar
Briller, S. and Calkins, M. P. 2000. Conceptualizing care settings as home, resort or hospital. Alzheimer's Care Quarterly, 1, 1, 1723.Google Scholar
Bryman, A. 2008. Social Research Methods. Third edition, Oxford University Press, London.Google Scholar
Cristoforetti, A., Gennai, F. and Rodeschini, G. 2011. Home sweet home: the emotional construction of places. Journal of Aging Studies, 25, 3, 225–32.Google Scholar
Cutchin, M. P., Owen, S. V. and Chang, P.-F. 2003. Becoming ‘at home’ in assisted living residences: Exploring place intregration processes. The Journals of Gerontology, Series B, 58, 4, 234–43.Google Scholar
Day, K., Carreon, D. and Stump, C. 2000. The therapeutic design of environments for people with dementia: a review of the empirical research. The Gerontologist, 40, 4, 417–21.Google Scholar
Dementia Association 1992. Riktlinjer gällande gruppboende för människor med demens [Guidelines Concerning Group Living for Persons with Dementia]. Demensförbundet [The National Association for the Rights of the Demented Stockholm].Google Scholar
Denzin, N. K. 1978. The Research Act: A Theoretical Introduction to Sociological Methods. Second edition, McGraw Hill, New York.Google Scholar
Dewalt, K. and Dewalt, B. R. 2002. Participant Observation, a Guide for Fieldworkers. Rowman & Littlefield, Lanham, Maryland.Google Scholar
Dijkstra, K., Piterse, M. and Pruyn, A. 2006. Physical environmental stimuli that turn healthcare facilities into healing environments through psychologically mediated effects: systematic review. Journal of Advanced Nursing, 56, 2, 166–81.Google Scholar
Dobbs, D. 2004. The adjustment to a new home. Journal of Housing for the Elderly, 18, 1, 5171.Google Scholar
Fisher Box, J. 1987. Guinness, Gosset, Fisher, and small samples. Statistical Science, 2, 1, 4552.Google Scholar
Frankowski, A. C., Roth, E., Eckert, J. K. and Harris-Wallace, B. 2011. The dining room as the locus of ritual in assisted living. Generations, 35, 3, 41–6.Google Scholar
Gurney, C. and Means, R. 1993. The meaning of home in later life. In Arber, S. and Evandrou, M. (eds), Ageing, Independence and the Life Course. Jessica Kingsley, London, pp. 119131.Google Scholar
Heywood, F., Oldman, C. and Means, R. 2002. Housing and Home in Later Life. Open University Press, Buckingham, UK.Google Scholar
Ice, G. H. 2002. Daily life in a nursing home: has it changed in 25 years? Journal of Aging Studies, 16, 4, 345–59.Google Scholar
Imamoğlu, C. 2007. Assisted living as a new place schema: a comparison with homes and nursing homes. Environnment and Behavior, 39, 2, 246–68.Google Scholar
Kalymun, M. 1991. Toward a definition of assisted living. Journal of Housing for the Elderly, 7, 1, 97132.Google Scholar
Kaskie, B. and Storandt, M. 1995. Visuospatial deficit in dementia of the Alzheimer type. Archives of Neurology, 52, 4, 422–5.Google Scholar
Keen, J. 1989. Interiors: architecture in the lives of people with dementia. International Journal of Geriatric Psychiatry, 4, 5, 255–72.Google Scholar
Lai, C. K. Y. and Arthur, D. G. 2003. Wandering behaviour in people with dementia (review). Journal of Advanced Nursing, 44, 2, 173–82.Google Scholar
Lawrence, R. J. 1987. What makes a house a home? Environment and Behavior, 19, 2, 154–68.Google Scholar
Lawton, M. P. and Nahemow, L. 1973. Ecology and the aging process. In Eisdorfer, C. and Lawton, M. P. (eds), The Psychology of Adult Development and Aging. American Psychological Association, Washington DC, 619–74.Google Scholar
Leaman, A. 2000. Usability in buildings: the Cinderella subject. Building Research & Information, 28, 4, 296300.Google Scholar
Lee, G. and Ishii-Kuntz, M. 1987. Social interaction, loneliness and emotional well-being among the elderly. Research on Aging, 9, 4, 459–82.Google Scholar
Lindahl, G. and Ryd, N. 2007. Client's goals and the construction project management process. Facilities, 25, 3/4, 147–56.Google Scholar
Lorenz, S. G. 2007. The potential of the patient room to promote healing and well-being in patients and nurses. An integrative review of the research. Holistic Nursing Practice, 21, 5, 263–77.Google Scholar
Lu, Z., Rodiek, S. D., Shepley, M. M. and Duffy, M. 2010. Influences of physical environment on corridor walking among assisted living residents: findings from focus group discussions. Journal of Applied Gerontology, 30, 4, 463–84.Google Scholar
Lundgren, E. 2000. Homelike housing for elderly people – materialized ideology. Housing, Theory and Society, 17, 3, 109–20.Google Scholar
Lyman, S. M. and Scott, M. B. 1967. Territoriality: a neglected sociological dimension. Social Problems, 15, 2, 236–49.Google Scholar
McColgan, G. 2005. A place to sit – resistance strategies used to create privacy and home by people with dementia. Journal of Contemporary Ethnography, 34, 4, 410–33.Google Scholar
Miles, M. B., Huberman, A. M. 1994. Qualitative Data Analysis. Sage, Thousand Oaks, California.Google Scholar
Moore, K. D. 1999. Dissonance in the dining room: a study of social interaction in a special care unit. Quality Health Research, 9, 1, 133–55.Google Scholar
Morris, R. G. 1996. The Cognitive Neuropsychology of Alzheimer-type Dementia. Oxford University Press, Oxford.Google Scholar
National Board of Health and Welfare 2010. Nationella riktlinjer för vård och omsorg vid demenssjukdom 2010 [National Guidelines Concerning Dementia Care 2010]. Socialstyrelsen, Stockholm.Google Scholar
National Board of Health and Welfare 2012. Nyheter januari 2012 [News January 2012]. Socialstyrelsen. Available online at http://www.socialstyrelsen.se/nyheter/2012januari/farrealdreborisarskiltboende-menflerfarhemtjanst [Accessed 31 October 2012].Google Scholar
Nord, C. 2011 a. Individual care and personal space in assisted living in Sweden. Health and Place, 17, 1, 50–6.CrossRefGoogle ScholarPubMed
Nord, C. 2011 b. Architectural space as a moulding factor of care practices and resident privacy in assisted living. Ageing & Society, 31, 6, 934–52.Google Scholar
Patton, M. Q. 2002. Qualitative Research and Evaluation Methods. Sage, Thousand Oaks, California.Google Scholar
Paulsson, J. 2002. Det Nya Äldreboendet. Idéer och Begrepp, Byggnader och Rum. Svensk Byggtjänst, Stockholm.Google Scholar
Prop 1990/91:14. Regeringens proposition angående ansvaret för service och vård till äldre och handikappade, m.m. [Government Bill Concerning the Responsibility for Service and Care to Old and Disabled, etc.] Stockholm: The Swedish Government.Google Scholar
Raber, C. A., Teitelman, J. B., Watts, J. B. and Kielhofner, G. C. 2010. A phenomenological study of volition in everyday occupations of older people with dementia. British Journal of Occupational Therapy, 73, 11, 498506.Google Scholar
Rider, P. R. 1932. On the distribution of the correlation coefficient in small samples. Biometrika, 24, 3/4, 382403.Google Scholar
Ryvicker, M. 2011. Staff–resident interaction in the nursing home: an ethnographic study of socio-economic disparities and community contexts. Journal of Aging Studies, 25, 3, 295304.Google Scholar
SFS 1970:994. Hyreslagen [Lease and Tenancy Act]. Stockholm: The Riksdag.Google Scholar
SFS 1980:620. Socialtjänstlag [Social Services Act]. Stockholm: The Riksdag.Google Scholar
SFS 1990:1403. Lag om ändring i lagen, SFS 1980:620 [Law on Change in the Law, SFS 1980:620]. Stockholm: The Riksdag.Google Scholar
SFS 1991:900. Kommunallag [Municipal Government Act]. Stockholm: The Riksdag.Google Scholar
SFS 2001:453. Socialtjänstlag [Social Services Act]. Stockholm: The Riksdag.Google Scholar
Sloane, P. D., Mitchell, C. M., Weisman, G., Zimmerman, S., Foley, K. M. L., Lynn, M., Calkins, M., Lawton, M. P., Teresi, J., Grant, L., Lindeman, D. and Montgomery, R. 2001. The Therapeutic Environment Screening Survey for Nursing Homes (TESS-NH): an observational instrument for assessing the physical environment of institutional settings for persons with dementia. Journals of Gerontology: Psychological Sciences and Social Sciences, 57B, 2, 6978.Google Scholar
Snyder, L. H., Rupprecht, P., Pyrek, J., Brekhus, S. and Moss, T. 1978. Wandering. The Gerontologist, 18, 3, 272–80.Google Scholar
SOU 2008:113. Bo bra hela livet [Good Living All Life Long]. Swedish Government, Stockholm. Stockholm: Ministry of Health and Social Affairs.Google Scholar
Swedish Institute for Assistive Technology 2012. Långsam ökning av antalet bostäder för äldre [Slow Increase in Housing for the Elderly]. Hjälpmedelsinstitutet. Available online at http://www.hi.se/svse/Arbetsomraden/Projekt/bobrapaaldredar/Aktuellt-Bo-bra-pa-aldredar/langsam-okning-av-antalet-bostader-for-aldre-/ [Accessed 31 October 2012].Google Scholar
Swedish Work Environment Authority 2009. Arbetsmiljöverkets Författningssamling AFS 2009:2. Stockholm: The Swedish Work Environment Authority.Google Scholar
Tinker, A. 1987. A review of the contribution of housing to policies for the frail elderly. Journal of Geriatric Psychiatry, 2, 1, 317.Google Scholar
Trydegård, G. B. 2012. Vad hände med äldreomsorgen efter Ädel? Äldre i Centrum, 2, 12–4.Google Scholar
Twigg, J. 2002. Bathing – The Body and Community Care. Routledge, London.Google Scholar
Ulrich, R., Zimring, C., Zhu, X., DuBose, J., Seo, H.-B., Choi, Y.-S., Quan, X. and Joseph, A. 2008. A review of the research literature on evidence-based healthcare design. HERD, 1, 3, 61125.Google Scholar
van den Berg, A. 2005. Health Impacts of Healing Environments: A Review of the Benefits of Nature, Daylight, Fresh Air and Quiet in Healthcare Settings. Foundation 200 Years University Hospital, Groningen, The Netherlands.Google Scholar
Verbeek, H., van Rossum, E., Zwakhalen, S. M. G., Kempen, G. I. J. M. and Hamers, J. P. H. 2009. Small, homelike care environments for older people with dementia: a literature review. International Psychogeriatrics, 21, 2, 252–64.Google Scholar
Ward, L., Snodgrass, J., Chew, B. and Russell, J. 1988. The role of plans in cognitive and affective responses to places. Environmental Psychology, 8, 1, 18.Google Scholar
Williams, K. N. and Warren, C. A. B. 2009. Communication in assisted living. Journal of Aging Studies, 23, 1, 2436.Google Scholar
Yang, H. Y. and Stark, S. 2010. The role of environmental features in social engagement among residents living in assisted living facilities. Journal of Housing for the Elderly, 24, 1, 2843.Google Scholar
Zavotka, S. and Teaford, M. H. 1997. The design of shared social spaces in assisted living residences for older adults. Journal of Interior Design, 23, 2, 216.Google Scholar
Zimmerman, S., Mitchell, C. M., Chen, C. K., Morgan, L. A., Gruber-Baldini, A. L., Sloane, P. D., Eckert, J. K. and Munn, J. 2007. An observation of assisted living environments: space use and behavior. Journal of Gerontological Social Work, 49, 3, 185203.Google Scholar
Zimmerman, S., Scott, A. C., Park, N. S., Hall, S. A., Wetherby, M. M., Gruber-Baldini, A. L. and Morgan, L. A. 2003. Social engagement and its relationship to service provision in residential care and assisted living. Social Work Research, 27, 1, 618.Google Scholar
Zimmerman, S. and Sloane, P. D. 2007. Definition and classification of assisted living. The Gerontologist, 47, supplement 1, 33–9.Google Scholar