Abstract:

The effect of environment on confused elderly patients in homes for the elderly in the United Kingdom was investigated. Six group homes and seven run on communal lines were studied. Group homes are those in which activities of daily living, eating, and sleeping are confined to a definable area for a particular subgroup of residents. Communal homes are characterized by a single dining area where all residents eat. Staff members rated 104 residents on their ability to find their way at key places in the home and assessed their overall functional ability. Results showed that simple decisions were important aids in communal homes, such as when a sitting area or other zone was encountered. Complex decisions were important aids in group homes; these occurred when bedrooms or doors to communal areas were positioned at junctions. In communal homes, residents were most able to find their way around homes that had been adapted from older premises. The more doors in a corridor, the more confusing it was for residents in a communal home. The more light there was, the more able an individual was to find his/her way. The level of light tended to be lower in the group-designed homes. The degree of mobility and reliance on staff were linked to overall level of orientation and level of physical disability. A test using individual route diagrams appeared to support the current trend toward group living in homes for the elderly. The most important aids to people finding their way around seemed to be the level of lighting and number of landmarks.