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Browsing Theses and Dissertations by Author "Apple, Christine Elaine, author"

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    Patterns of behavior in Alzheimer units: examining the role of the physical environment interface
    (Colorado State University. Libraries, 2015) Apple, Christine Elaine, author; Leigh, Katharine, advisor; Malinin, Laura, advisor; Wood, Wendy, committee member
    The purpose of this study was to examine the relationship among the physical environment and behaviors within individuals with Alzheimer’s in a Special Care Unit (SCU). The SCU was located in a skilled nursing facility in Fort Collins, CO providing care for individuals with mid to late stage dementia, including individuals with Alzheimer’s. Of interest in this research study was the impact of this relationship to influence positive, and negative, behaviors contributing to positive quality of life, or positive behaviors supported by one’s physical surroundings creating a living environment directed at acknowledging the person’s life experiences, opportunities for choice and decision, and activities replicating prior home/work activities for residents with Alzheimer’s or dementia. This study sought to enhance the existing body of knowledge about environmental impacts on behavior in care for individuals with Alzheimer’s. Day, Carreon, and Stump (2000) suggested design of the physical environment should be therapeutic, promoting well-being and functionality for individuals with Alzheimer’s or dementia. The research design was an instrumental case study investigating issues surrounding a specific phenomenon (i.e., the relationship of environment and behavior in the SCU) and collected both qualitative and quantitative data. Data collection began with a physical inventory documenting the environment through photographs noting furniture locations, lighting, colors, contrast, materials and finishes, and wear within the space. Observational data were collected over a 10 week consecutive period, during non-randomized times to accommodate the facility (three times a week) for 30 minutes each. Finally, the e-Survey with qualitative and quantifiable data obtained from staff (ns = 6) perceptions of the physical environment and residents’ (nr = 9) behaviors. Findings suggested staff behavior reinforcing a medical model of care in contrast to contemporary approaches providing person-centered care; staff perceptions of communications differed from observed instances of communication; resident wandering and communication were the two most frequently occurring behaviors recorded during observations. Instances where the physical environment impacted resident behaviors considered: a flooring transition strip instigated frustration by a resident in a wheelchair unable to move over the height difference; areas with greater levels of lighting, whether natural or artificial, appeared to promote greater socialization; and furniture placement and corridor planning in the unit shaped the pathways for movement through the unit. Two specific behaviors, not identified in the empirical literature, were found in the study to potentially contribute to a positive quality of life for residents with Alzheimer’s: physical touch and cleaning. Observed body language and facial expressions, of residents, during these behaviors suggest possible connection supporting in individual’s positive quality of life. The study revealed positive quality of life and person-centered care to be interlaced and not separate entities due to their concentration on personalization of care and establishing a connection to the individual’s past experiences.