title: Creating a therapeutic psychosocial environment in dementia care. A preliminary framework.
abstract: Research in dementia care during the past few years has focused on identifying and designing therapeutic physical environments while the psychosocial environment has remained a largely unexplored domain. More recently, discussions regarding the effect of the social environment on individuals with dementia have increased in the literature. Nevertheless, the authors suggest the term "social environment" does not adequately represent the critical psychological and emotional effect social interaction has on individuals with cognitive impairment. Through an examination of the literature, three conceptual frameworks, and clinical observations of several special care units (SCUs), the authors suggest that the psychosocial environment is the most important element of institutional dementia care. A preliminary conceptualization is offered which identifies the elements necessary to facilitate a supportive psychosocial environment in long-term care. The potential benefits of implementing such a model include preservation of personhood, simple recognition of remaining abilities and a decreased focus on disabilities, and reduction of pharmacologic therapy for disruptive behavior resulting in overall improvement in quality of life.
authors.affiliation: Nursing Education Program, Saskatchewan Institute of Applied Science and Technology, Kelsey Campus, Saskatoon, Saskatchewan, Canada.
authors.forename: Leona J
authors.initials: LJ
authors.lastname: Werezak
authors.forename: Debra G
authors.initials: DG
authors.lastname: Morgan
mesh_terms: D000368:Aged; D003704:Dementia / Q000523:psychology* / Q000628:therapy; D006272:Health Facility Environment / Q000592:standards*; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D008884:Milieu Therapy; D017146:Models, Organizational; D008960:Models, Psychological; D016134:Organizational Policy; D016730:Program Development; D011788:Quality of Life; D012931:Social Environment; D012944:Social Support