Specialized Care Units (SCUs) in nursing home facilities offer care for individuals with late-stage dementia primarily when care in the home no longer supports physical and sociobehavioral needs. Prior research has primarily examined new facilities; however, due to market demand and financial constraints, many SCUs are retrofits of existing nursing homes. The purpose was to determine the capacity of the physical environment to enhance person-centered care (PCC) and identify potential design opportunities to help patients adapt to and cope with dementia progression to maintain quality of life (QoL). Grounded in empirical knowledge and best practices for SCU design, an instrumental case study of a retrofit SCU in the Rocky Mountain region of the United States examined relationships between the physical environment and the behavior of residents and staff. Qualitative and quantitative data were collected through a spatial inventory, staff e-survey, and behavioral observations in the unit's public spaces. Data indicate that even (less than ideal) retrofit SCU designs have the potential to support PCC goals significantly, and some physical conditions found to undermine PCC goals could be remedied by simple (low-cost) design interventions, suggesting staff may lack awareness of the capacity for the SCU physical environment to improve residents' QoL. By linking design features from empirical studies and best practices with observed behaviors in a retrofit SCU, the primary contribution of our exploratory study is a framework of roles design features play in adaptation–coping and maladjustment–stress for people managing progressive dementia conditions. This framework suggests directions for future research and evolving methods to better understand the impacts of environmental designs on users' QoL over the course of progressive illnesses, like dementia.

中文翻译：

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检查改造后的特护病房中物理环境与痴呆症患者行为之间的关系

疗养院设施中的专业护理单位 (SCU) 主要是在家里的护理不再支持身体和社会行为需求时为晚期痴呆症患者提供护理。先前的研究主要检查了新设施；然而，由于市场需求和资金限制，许多 SCU 是对现有疗养院的改造。目的是确定物理环境增强以人为本的护理 (PCC) 的能力，并确定潜在的设计机会，以帮助患者适应和应对痴呆症进展以维持生活质量 (QoL)。基于 SCU 设计的经验知识和最佳实践，美国落基山地区改造 SCU 的工具性案例研究检查了物理环境与居民和员工行为之间的关系。通过空间清单、员工电子调查和单位公共空间的行为观察收集定性和定量数据。数据表明，即使（不太理想的）改造 SCU 设计也有可能显着支持 PCC 目标，并且发现破坏 PCC 目标的一些物理条件可以通过简单的（低成本）设计干预来补救，这表明工作人员可能缺乏对 PCC 目标的认识。 SCU 物理环境改善居民生活质量的能力。通过将经验研究和最佳实践中的设计特征与改造 SCU 中观察到的行为联系起来，我们探索性研究的主要贡献是设计特征在适应 - 应对和适应不良 - 压力中扮演的角色框架，用于管理渐进性痴呆症的人。该框架为未来研究和发展方法提出了方向，以更好地了解环境设计在痴呆等渐进性疾病过程中对用户 QoL 的影响。