Caregiving and dementia/Projects/Environmental design audit tool

Overview
When the staff of an aged care facility are guided through a systematic assessment of the strengths and weaknesses of the environment in which they provide care, their understanding of the opportunities to use the environment to improve the quality of life of people with dementia is increased. This project provide the tools needed to undertake this assessment.

The overall aim of this project was to provide the tools needed for the staff of a health or aged care facility to assess the strengths and weaknesses of their physical environment. The specific objectives were to provide health and aged care staff with
 * 1) an assessment tool that will systematically prompt the evaluation of key aspects of the design of the physical environment
 * 2) a handbook to guide the process
 * 3) an iPhone application that will support automated scoring and provide the option of sending the results to the NSW/ACT DTSC for discussion.

A report written for the UNSW DCRC[9] details the auditing of 10 facilities providing accommodation to people with dementia. The audits were carried out using the Environmental Audit Tool (EAT)[10-12]. The feedback provided from the use of this tool was greatly appreciated by the aged care providers and the architects. They unanimously agreed that the auditing process, and the discussions that followed, provided an excellent form of education on the principles of good design for people with dementia. The understanding of the principles of good design by facility managers has been linked to the provision of significantly better environments [9].

The tool used in the DCRC research required revision to incorporate recent research findings, particularly concerning aspects of the environment that support care when the resident becomes immobile and those that facilitate engagement with the local community. It also required the development of an automated, or simplified, scoring system so that the user can easily understand the results of the assessment. This project addressed these issues by the development of an alternative version of the tool, the provision of a handbook and the development of an iPhone application that automates the scoring and reporting of the results.

This package provides users with the opportunity to engage in a process of self education but it also provides information to be used in the educational sessions described in Project 5.3. These sessions will assist aged and health care staff who are actively involved in designing or refurbishing their facilities.

The decision to include the development of an iPhone app was been brought about by the recognition of the need for staff in regional and remote areas to have an easy means of carrying out an assessment of their environment and accessing information and education of direct relevance to their needs. The iPhone app provides them with the option of sending their results to the NSW/ACT DTSC for analysis. Once they have done this an appointment is made for them to discuss the results with a specialist who provides information and educational material to assist them to understand the role of the environment in general and the ways in which their environment in particular can be improved.

In brief, this project provided free availability of an assessment that guides users through a systematic, educational, process that identifies the strengths and weaknesses of the environment and provides the information required for them to identify features that are amenable to improvement. The development of this educational package has particular benefits for those working in regional and remote areas.

The response of the facility managers to the environmental audits carried out in the DCRC research leaves no doubt that the opportunity to have a systematic discussion on the strengths and weaknesses of their environments is highly valued. It is therefore anticipated that there will be a high level of demand for this educational tool.