Changes in interactive occupation and social engagement for people with Dementia: Comparing household to traditional nursing home environments in Ireland
AIM: To understand and evaluate the effect of a change from a Traditional Model Unit \ud (TMU) to a Household Model Unit (HMU) for people with dementia, using social \ud engagement and interactive occupation of residents, staff and relatives as outcome \ud measures, in order to make recommendations for future nursing home development.\ud Methods: A mixed methods approach was adopted. Residents, staff and relatives were \ud observed using a snapshot observational method for 11 days pre renovation and 14 days \ud post renovation. Pre renovation interviews with staff (n=25) and relatives (n=22) were \ud contrasted with 19 staff and 14 relatives post renovation interviews.\ud Results: Residents spent more time in the HMU communal living spaces (p≤.001). They \ud were more independently active (p≤.001), more socially engaged (p≤.001) and more \ud involved in interactive occupations (p≤.001). \ud There were significant increases in the time that staff spent in the room (p≤.001), being \ud socially engaged with residents (p≤.001), and performing their work tasks (p≤.001). \ud The data set for relatives was smaller and significance was only achieved in an aggregated \ud grouping engaged and interactive category (p≤.05). \ud Qualitative interview data was used to elaborate on this quantitative data. The interview \ud data was condensed into a multi-component typology of HMU features for future \ud comparison and research. \ud Conclusion: Adopting an HMU environment created behavioural changes in interactive \ud occupation and social engagement of residents, staff and relatives utilizing the main sitting \ud areas. The physical, operation and social environments which created these changes are \ud described in detail. Recommendations are made for nursing home environments and future \ud research.