Environments that facilitate wayfinding in nursing homes - Dementia-friendly architecture

Spatial disorientation is among the first manifestations of dementia and a prime reason for institutionalization. However, the autonomy of residents and their quality of live are strongly linked with their ability to reach certain places within the nursing home. Also affected is the efficiency of the institutions and the quality of care provided. The physical environment has a great potential for supporting resident's residual wayfinding abilities. Until now little systematic research has been carried out to identify supportive architectural characteristics. For this exploratory study, extensive data on resident's spatial capabilities were collected in 30 German nursing homes. The architectural structure of the buildings was also analyzed. Within the nursing homes five identical, ADL-related wayfinding tasks were identified. Skilled nurses rated the resident's ability to perform those tasks on a three-point scale. The impact of the different architectural characteristics on the resulting scores was tested for statistical significance. Results show that people with advancing dementia are increasingly dependent on a compensating environment. Significant influencing factors are the number of residents per living area, the layout of the circulation system and the characteristics of the living/dining room. Smaller units facilitate wayfinding but larger entities may also provide good results, if they feature a straight circulation system without any changes in direction. Repetitive elements, such as several living/dining rooms, interfere with a resident's wayfinding abilities. These and further results were transformed into architectural policies and guidelines which can be used in the planning and remodelling of nursing homes.