A structural approach for the redesign of a small-scale care facility as a guideline for decision-makers

\u3cp\u3eLong-term care facilities in the Netherlands try to implement new design approaches to enrich their environments and to cope with the changes and innovations in the Dutch healthcare sector. An enriched environment supports both quality of life of people with frail health and the well-being of the healthcare professionals who take care of them. Despite the increased attention devoted to built environments in relation to health, a gap in knowledge remains how to implement new design approaches. The aim of this study is to present a structural approach for a decision-making process to help to create enriched small-scale care facilities for older people with a frail health condition. A case study was conducted to understand how the structural approach contributes to implementing design features of an enriched environment. The structural approach identifies the key factors (such as shared language, collective understanding and involvement of stakeholders) that should be considered when developing such facilities and describes the critical steps for decision-makers for such environment. This case study provides a rich source of information from actual experiences for a better understanding of steering mechanisms for decision-making by the management of small-scale care facilities.\u3c/p\u3

A systematic approach to assessing indoor air quality of long term care facilities

Not much is known about the favourable indoor air quality in long term care facilities (LTCFs), where older adults suffering from dementia live. Older adults, especially those who suffer from dementia, are more sensible to the indoor environment. However, no special requirements for the indoor air in long term care facilities exist. Due to the decrease in cognition function, it is hard to evaluate comfort and health in this group. Nevertheless, infectious diseases are a persistent problem. Based on literature an assessment methodology has been developed to analyse LTCFs to determine if differences in building characteristics and Heating, Ventilation and Air Conditioning (HVAC) systems influence the spread of airborne infectious diseases. The developed methodology is applied in seven long term care facilities in the Netherlands. After that,\u3cbr/\u3ethe methodology has been evaluated and its feasibility and applicability are discussed.\u3cbr/\u3eFrom this study, it can be concluded that this method has potential to evaluate, compare\u3cbr/\u3eLTCFs, and develop design guidelines for these buildings. However, some adjustments to\u3cbr/\u3ethe methodology are necessary to achieve this objective. Therefore, the relation between\u3cbr/\u3ethe indoor environment and infection risk is not yet analysed, but a consistent procedure\u3cbr/\u3eto analyse this link is provided

The importance of the physical environment to support individualised care

The physical environment is an important part of individualised care. Creating care environments tailored towards the individual person’s needs is essential for high-quality care and is increasingly recognised as being associated with improved health and well-being among older people. Today, care should be holistic and view the person behind the disease, taking that person’s perspective and treating the patient as a unique individual. Despite the emerging focus on individualised care approaches, the physical environment is still not considered as an integral part of care, and relatively little attention has been paid to environmental aspects. However, the physical environment has a great potential to facilitate or restrict care processes in a broad range of care settings, not least in residential care facilities for older people. The present chapter focuses on ways to support the individual in terms of the physical environment