Person-Centred Environment and Care for Residents with Dementia.

Interventions using Person-centred care delivery according to Kitwood's care principles (PCC) and making adjustments to spatial configuration employing Kitwood's Person-centred dementia environment design (PCD). (1) PCC - Experiential & adult learning approaches using Kitwood's PCC principles will be facilitated by 2 PCC trainers in a train-the-trainer course for 5 care staff (1*care manager, 1*RN, 2*EN/AINs, 1*Diversional Therapist) in each of the 10*PCC and 10*PCC+PCD units. This will take 32 hours over one week. PCC trained staff will, in turn be supported to train all care & therapy staff in PCC, we will provide them with individual learning resources, assist staff to develop PCC resident care plans that focus on improving resident's QOL. New staff will education. Further 10 hours of telephone support per site will be provided. (2) PCD - to be implemented at each of the 10*PCD and 10*PCD+PCC sites. Two CI's will supervise two Masters' students in administering the Environment Audit Tool (EAT) as developed & validated by the two CI's to evaluate the relationshipsbetween operations & space in terms of effectiveness and ideal resident care & determining required changes to meet pCD principles at the sites. Discussions will be held with managers and care staff at each site to determine their understanding of the dysfunction generated by poor physical environments and changes will be planned with managers to address the issues identified. Minor modifications to the environment in each of the 20 sites will be undertaken under the supervison of the 2 CI's, to reduce the worst of the physical environmental effects, including: arranging objects & increasing natural light so that there is no confusion caused by the person's inability to distinguish foreground objects from nearbackground context; reducing the residents ability to distinguish a door or exit by painting-out in the wall or covered with curtain; not stimulating fear & frustration by avoiding dead-end situations; stimulating appropriate behaviours in spaces taht are made to deliberately look like dining, living & bedrooms; and adapting the style & type of furniture, colours & settings to provide cues that jog memory of appropriate behaviour.