DANTE - Development and testing of a person-centred assessment tool for dementia-sensitive environments in nursing homes

Background

As dementia progresses and care needs become more complex, many people move from their homes to residential long-term care facilities. Despite the development of innovative housing models, nursing homes remain a central component of the German long-term care system. However, relocation also involves leaving a familiar living environment, which makes dementia-sensitive design in residential long-term care facilities particularly relevant.

Dementia-sensitive design of the built environment can facilitate orientation, support social interaction, and promote autonomy and quality of life—even in advanced stages of dementia. It encompasses architectural and spatial concepts as well as carefully designed elements of interior design and represents a key component of person-centred dementia-specific care in nursing homes. International design principles and existing assessment instruments provide conceptual foundations for capturing and evaluating such design elements. However, a systematic assessment approach that is oriented toward the perspective of residents and captures the extent to which dementia-sensitive design elements are implemented in German nursing homes is still lacking. Although the German Environmental Audit Tool (G-EAT), developed at DZNE, provides an initial practice-oriented instrument, it is not designed to systematically assess the perspective of people with dementia.

To comprehensively assess dementia-sensitive design elements, evaluate their implementation, and determine their relevance for person-centred care, systematic instrument components must therefore be combined with methods that actively involve residents in the practical application of such an instrument. 

Objectives

The aim is to develop an assessment instrument to capture the dementia sensitivity of environmental elements in nursing homes. The definition of the living environment is consistently guided by the perspective of people with dementia living there and their everyday experiences. On this basis, a procedure will be developed that systematically takes into account perceptions, needs, and the use of space—even in advanced stages of dementia.

Methods

A systematic literature review is conducted to identify the most recent evidence, followed by the adaptation of key design principles to the German context and the development of appropriate qualitative methods to capture environment-related aspects from the perspective of people with dementia.

On this basis, a set of items is developed and evaluated by dementia experts with regard to relevance and clarity. In parallel, workshops are conducted with residents to define the living environment from their perspective and to identify relevant spaces and activities.

The instrument is subsequently piloted in residential long-term care facilities. Staff members from different professional groups apply it independently and involve residents in defining the living environment. The collected data are used to examine reliability, validity, and feasibility.

Expected outcomes

DANTE focusses on the development of an evidence-based and practice-oriented instrument for assessing dementia-sensitive environmental elements that systematically incorporates the perspective of residents. It will be provided in digital form together with accompanying informational materials on dementia-sensitive environmental design and is intended both for residential long-term care facilities to support change processes within internal quality management and for researchers to apply in studies.Nutzung in wissenschaftlichen Studien richten.

Discover the digital “German Environmental Audit Tool” and find additional guidance on dementia-sensitive design in the DZNE TanDem website.