Enriching the Environment for Residents with Dementia

Good Shepherd Aged Services Maryville Hostel situated in Victoria, East of Melbourne in Boronia. Maryville Hostel is part of the wider Good Shepherd Aged Services, which has been recognised nationally for innovative programs aimed at ensuring residents have a high quality of life and continue to enjoy interests of their choice. Some of these programs include pet therapy, seniors' celebration of life sports day, creative writing, intergenerational friendship program, laughter and humour program, pastoral care program, dementia focused activities, fundraising activities for charities, and accessing the external community program. One such project arose from an improvement request lead by a staff member, whom after visiting the Alzheimer's Australia website saw the value of enriching the environment for residents with dementia.

A small staff working party was established to review the environment in the Lourdes unit (dementia specific unit), the aim being to create an environment for the residents that was comfortable, safe and familiar allowing greater mobility throughout the unit.
The working party worked through the ten Dementia Enabling Principles listed below:

1. Unobtrusively reduce risks
2. Provide a human scale
3. Allow people to see and be seen
4. Reduce unhelpful stimulation
5. Optimise helpful stimulation
6. Support movement and engagement
7. Create a familiar space
8. Provide opportunities to be alone or with others
9. Provide links to the community
10. Respond to a vision for a way of life

(Fleming R, Bowles J 1987) (Fleming R, Forbes I, Bennett K 2003)

The full details of the ten Dementia Enabling Environment principles can be obtained by clicking on the following website link:

www.enablingenvironments.com.au/Principles.aspx

A review of the Lourdes unit environment was conducted by the working party to identify improvements that would further enhance the resident environment. Familiar furnishings were sourced and a further review was conducted to identify the optimum placement of furnishings within common areas. The placement and type of wall furnishings was considered with relation to the enhancement of the environment. A hydration trolley was also provided that is readily available and accessible to residents.

In line with principle six, which advocates the benefits of access to outdoor areas, the garden was upgraded with artificial turf laid to provide an even surface between the path and turf, further reducing any trip hazards. A wall mounted water feature has also been installed to enhance the ambience of the outside environment.

Staff were provided with feedback regarding the changes within the Lourdes unit and the reasoning behind the changes, ensuring furnishings were not inadvertently moved back to their original positions. Discussions were held at the relative and friends meetings allowing them to be involved in the improvements and very positive feedback has been received during the process.

An internal audit was conducted in February 2013, with a subsequent audit conducted in May. Feedback from both relatives and staff regarding the changes continues to be extremely positive throughout. The atmosphere in the Lourdes unit is now more homelike with residents more engaged, settled and comfortable.

There has been a significant reduction in aggressive episodes occurring within the unit and there was a milestone achieved last quarter, with zero aggressive episodes occurring. This is indicative of the more relaxed and comforting environment provided for residents. The facility and working party are justifiably proud of the unit and the improvements to the quality of life for the residents achieved at the Lourdes unit and intend to continue to monitor the outcomes of this project.




References

1. Fleming R, Bowles J. Units for the confused and disturbed elderly: Development, Design, Programming and Evaluation. Australian Journal on Ageing. 1987 November; 6(4):25-8.
2. Fleming R, Forbes I, Bennett K. Adapting the ward for people with dementia. Sydney: NSW Department of Health; 2003.