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Adapting day care center settings for persons with Alzheimer's disease: Environmental design training for staff

Evelyn Cohen & Associates, Environmental Gerontology Design, Research & Planning, Santa Monica, California

Karen Lyman, PhD

Chaffey College; Gerontology Research Institute, University of Southern California, Claremont, California

Jon Pynoos, PhD

Policy and Services Research, Andrus Gerontology Center, University of Southern California, Los Angeles, California

Until recently there has been limited awareness of the interaction between the adult day care environment and the functioning of participants and staff. Emphasis is often put on the program rather than on the setting in which it takes place. Even when environmental knowledge exists, there is often a lack of input by staff and adaptations may be made to poor physical conditions that can contribute to staff stress as well as reduced participant functioning.

This paper describes the development of training materials for an educational workshop. Thirty Alzheimer day care staff were participants. The purpose was to increase information concerning the impact of the physical environment on Alzheimer care, and to train "trainers" in this area. In developing training materials, evaluations of adult day care settings were made which included observer ratings, interviews with staff, and 35mm. slides of 12 Alzheimer day care facilities. A variety of materials were developed including a slide show and a script that represented three major areas of environmental design:

* Environmental cues to promote recall and wayfinding;

* Safety and accessibility; and

* Surveillance and wandering.

Findings within the adult day care centers evaluated are described. Pre- and post-test results are reported, indicating that awareness of the Participants was heightened in identifying and modifying design features in adult day care settings.

Practical contributions to the literature include materials on the planning of facilities for dementia care and training tools for staff.

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