Impact of Spatial Design on Patients with Dementia in Special Care Units of Acute Care Hospitals

Julia Kirch (TU Dresden)

Due to demographic change, the number of acutely ill, geriatric patients with additional cognitive impairments is increasing. Since this patient group often shows adverse outcomes during their hospital stay, specialised wards ("special care units") have been implemented as part of dementia-friendly hospital concepts. Research has shown positive effects on patients’ self-care and mobility as well as a decrease in challenging behaviour. However, evidence-based research that links environmental characteristics with patients’ health outcomes is missing.

By using a linear mixed model, associations between spatial characteristics and treatment results based on patients’ routine data will be assessed. In this ongoing study, we collected data from 960 geriatric early rehabilitation patients treated in eight special care units in German acute care hospitals. Based on the changes in mobility (e.g., Demmi-Index, Tinetti-Test) and self-care (Barthel-Index) at two times of measurement, values for mobility and self-care are going to be calculated for each unit and will further be correlated to specific spatial characteristics. Data of space was collected by documenting the implementation of dementia-friendly design recommendations, spatial programmes and space syntax analysis.

Data shows that the special care units differ in their spatial programmes and building layouts. However, dementia-friendly design recommendations, especially with regard to easy-applicable interior design features, are often applied in all of them. Expected findings will show, whether (1) a high number of dementia-friendly design features, (2) high spatial visibility of building layout, and (3) unit size (between 10 and 16 beds) are associated with better health outcomes regarding mobility and self-care.

This research will determine environmental characteristics that positively influence patients’ health status. Based on the results, evidence-based planning recommendations for the built environment of special care units can be provided. As patients with dementia are also present in many other hospital departments, recommendations might further be considered in non-specialised wards.