title: Engaging life in two Irish nursing home units for people with dementia: quantitative comparisons before and after implementing household environments.
abstract: OBJECTIVE
  This study compares the Social Engagement and Interactive Occupation of residents with dementia in two Irish nursing homes, before and after conversion to a household model environment. The changes were an open plan design and a functioning unit kitchen, supported by a homemaker role and operational policies which reduced task-based work in favour of person-centred care offering choice.
  
  
  METHODS
  A snapshot observation method was used to obtain quantitative data of resident activity using the Assessment Tool for Occupation and Social Engagement (ATOSE). Residents were assessed for four hours, on seven different weekdays, over a six-week period both pre- and post-renovation. The exception to this was the assessment of the traditional model unit (TMU) for Nursing Home 1 which was reduced to four days due to the early start of the building work.
  
  
  RESULTS
  The results were consistent for both nursing homes and data were aggregated. Residents spent more time in the communal living spaces and were more likely to be active and engaged in the household model units (HMUs) compared to the TMUs. Using the independent t-test, these changes were found to be highly significant (p < 0.001).
  
  
  CONCLUSIONS
  Creating an HMU increased the Interactive Occupation and Social Engagement of residents in the communal areas of the two nursing homes. The physical environment change, in conjunction with supportive staff procedures and organizational initiatives, improved the well-being of residents with dementia. The outcomes must be viewed in context with financial implications.
authors.affiliation: SURFACE Inclusive Design Research Centre, School of the Built Environment, The University of Salford, Salford, UK. Mark.Morgan-Brown@hotmail.com
authors.forename: Mark
authors.initials: M
authors.lastname: Morgan-Brown
authors.forename: Rita
authors.initials: R
authors.lastname: Newton
authors.forename: Marcus
authors.initials: M
authors.lastname: Ormerod
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003704:Dementia; D004779:Environment Design; D005260:Female; D015577:Geriatric Assessment; D006707:Homes for the Aged / Q000458:organization & administration*; D006801:Humans; D007374:Interior Design and Furnishings; D007494:Ireland; D009735:Nursing Homes / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D012931:Social Environment; D011795:Surveys and Questionnaires