title: Reconciling concepts of space and person-centred care of the older person with cognitive impairment in the acute care setting.
abstract: Although a large body of literature exists propounding the importance of space in aged care and care of the older person with dementia, there is, however, only limited exploration of the 'acute care space' as a particular type of space with archetypal constraints that maybe unfavourable to older people with cognitive impairment and nurses wanting to provide care that is person-centred. In this article, we explore concepts of space and examine the implications of these for the delivery of care to older people who are cognitively impaired. Our exploration is grounded in theorisations of space offered by key geographers and phenomenologists, but also draws on how space has been constructed within the nursing literature that refers specifically to acute care. We argue that space, once created, can be created and that nursing has a significant role to play in the process of its recreation in the pursuit of care that is person-centred. We conclude by introducing an alternative logic of space aimed at promoting the creation of more salutogenic spaces that invokes a sense of sanctuary, safeness, and inclusion, all of which are essential if the care provided to the older person with cognitive impairment is apposite to their needs. The concept of 'person-centred space' helps to crystallize the relationship between space and person-centred care and implies more intentional manipulation of space that is more conducive to caring and healing. Significantly, it marks a return to Nightingale's wisdom, that is, to put the person in the best possible conditions for nature to act upon them.
authors.affiliation: School of Nursing and Midwifery, College of Science, Health and Engineering, La Trobe University, Melbourne, Vic., Australia.
authors.forename: Carole
authors.initials: C
authors.lastname: Rushton
authors.affiliation: Austin Health/Northern Health Clinical Schools of Nursing, College of Science, Health and Engineering, La Trobe University, Heidelberg, Vic., Australia.|Department of Nursing, Umea University, Umea, Sweden.
authors.forename: David
authors.initials: D
authors.lastname: Edvardsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000150:complications*; D006760:Hospitalization; D006801:Humans; D009732:Nursing Care / Q000523:psychology; D018802:Patient-Centered Care / Q000941:ethics / Q000379:methods*; D010550:Personal Space
keywords:  cognitive impairment; acute care; older person; person-centered care; space