Search Results (8)

Background/Objectives: People with advanced dementia experience difficulties in navigating, while wayfinding is essential for a level of autonomy. A properly designed building has the strength to facilitate this target group in wayfinding. While understanding their wayfinding needs and experiences, and the spatial characteristics (both facilitating and confusing) during the wayfinding process is crucial, this knowledge is still limited. This study mapped challenges that people with advanced dementia encounter on a route to an irregular destination in their familiar nursing home environment, specifically addressing confusing spatial characteristics. Methods: An observational study design with a mixed-method approach was applied. First, a navigation task was conducted to identify places of confusion on the way to the destination (n = 15 participants in four nursing homes). Affective states were captured by observations combined with biometric measurements. Second, both manual and space syntax floorplan analysis techniques were used to identify the spatial characteristics of potentially stressful spaces in nursing homes. Results: Nine participants reached the destination. The most observed wayfinding behaviors were looking at various things and stops on the route, and they were often accompanied by verbal navigational cues. Furthermore, most participants experienced some signs of stress or concentration. In total, eighteen confusing places in the nursing homes were identified. Conclusions: Regarding spatial characteristics supporting or hindering wayfinding skills for people with advanced dementia in nursing homes, this study confirmed some of the findings in the existing research (e.g., minimizing shifting directions for supporting wayfinding), contradicted the existing research (e.g., confusion arose at places with high visibility values), and added new findings (e.g., significantly widening corridors may be confusing). This study revealed that high-visibility areas and squares on the route confuse people with advanced dementia while wayfinding. Full article

Dementia’s escalating incidence, coupled with its economic burden, highlights the need for architectural designs and forms that benefit people living with dementia. This research explores strategies and design principles that focus on establishing supportive spaces for the prolonged autonomy, well-being, and safety of dementia patients. Contemporary research emphasizes the implementation of effective navigational techniques, via visual cues, familiar landmarks, and simplified layouts. For greater navigational signage, the intentional use of contrasting colors, textures, and lighting are recommended to demarcate functional areas within a structure. Incorporating familiar objects in personalized areas enhances treatment outcomes, e.g., reminiscence therapy leverages familiar objects, environmental cues, scents, sounds, and tactile features to trigger and retain memory. Integrating safety precautions such as slip-resistant flooring, handrails, and accessible bathrooms helps mitigate falls for the cognitively impaired. From a therapeutic perspective, this study draws attention towards incorporating gardens and outdoor spaces, which offers sensory stimulation, encourages physical activity, and fosters social engagement. Additionally, the integration of scents, sounds, and tactile features enriches the sensory experience for individuals with dementia. Through comprehensive consideration of design elements, this research highlights how intentionally crafted, dementia-friendly environments can convert spaces into empowering therapeutic settings tailored to address the unique need of this vulnerable group. This architectural approach acts as a valuable complement to the medical and therapeutic interventions in the treatment and care of people living with dementia and their families. Full article

With an aging population and the rapid increase in the rate of dementia, the care of patients is a significant problem for caregivers and family members at home. Patients’ spatial and environmental cognitive impairments require caregivers to pay attention to their walking routes, walking safety, and avoiding dangerous areas. With this in mind, this study developed the Dementia Care Management and Mentoring Guarantee System (DECMGSS) to examine the accuracy and efficiency of patient wayfinding, and to reduce the stress on institutional caregivers through a wayfinding task and a caregiver stress scale (CSS). The results showed that the mean time spent with the DECMGSS on 10 subjects with mild to moderate dementia was significantly less than that without the device (t = −2.930, p = 0.017), and the number of errors was also less but not significantly different. In addition, the DECMGSS did significantly reduce the caregiver stress load. Twenty institutional caregivers were divided into experimental and control groups. There was no significant difference in the stress load scores of the control group before and after the test. However, a significant mean difference was found between the pre-test and post-test scores of the experimental group (t = 3.315, p < 0.009). DECMGSS’s intervention significantly reduced the caregiver’s personal anxiety and stress in caregiving and the patient’s time dependence on the caregiver. Although this product is primarily used for patients in the Care Center, it can also be used in other home care settings. Full article

Age-related spatial navigation decline is more pronounced in patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) dementia. We used a realistic-looking virtual navigation test suite to analyze different aspects of visuospatial processing in typical and atypical aging. A total of 219 older adults were recruited from the Czech Brain Aging Study cohort. Cognitively normal older adults (CN; n = 78), patients with amnestic MCI (n = 75), and those with mild AD dementia (n = 66) underwent three navigational tasks, cognitive assessment, and brain MRI. Route learning and wayfinding/perspective-taking tasks distinguished the groups as performance and learning declined and specific visuospatial strategies were less utilized with increasing cognitive impairment. Increased perspective shift and utilization of non-specific strategies were associated with worse task performance across the groups. Primacy and recency effects were observed across the groups in the route learning and the wayfinding/perspective-taking task, respectively. In addition, a primacy effect was present in the wayfinding/perspective-taking task in the CN older adults. More effective spatial navigation was associated with better memory and executive functions. The results demonstrate that a realistic and ecologically valid spatial navigation test suite can reveal different aspects of visuospatial processing in typical and atypical aging. Full article

Based on a targeted literature review, this vision paper emphasizes the importance of dementia-sensitive built space. The article specifically focuses on supporting spatial orientation and wayfinding for people living with dementia. First, we discuss types of wayfinding challenges, underlying processes, and consequences of spatial disorientation in the context of dementia of the Alzheimer’s type. Second, we focus on current efforts aimed at planning and evaluating dementia-sensitive built space, i.e., environmental design principles, interventions, evaluation tools, strategies, and planning processes. Third, we use our findings as a starting point for developing an interdisciplinary research vision aimed at encouraging further debates and research about: (1) the perspective of a person with dementia, specifically in the context of wayfinding and spatial orientation, and (2) how this perspective supplements planning and design processes of dementia-sensitive built space. We conclude that more closely considering the perspective of people with dementia supports the development of demographically sustainable future cities and care institutions. Full article

The care of dementia patients presents a large challenge for caregivers and family members. Whether it is at home or in institutional care, patients have problems with spatial and environmental cognition. It often leads to abnormal behaviors such as a route recognition problem, wandering, or even getting lost. These behaviors require caregivers to keep an eye on the movement of the cognitively impaired elderly and the safety of these movement processes, to avoid them approaching dangerous areas or leaving the care environment. This paper used qualitative research methods (i.e., participatory interviews, case studies, and contextual observation methods) in the demand exploration phase and quantitative research methods in the product’s technological verification phase. In this study, we implemented a three-stage service design process—demand exploration, demand definition, and design execution—to analyze the care status and route recognition obstacles of elders with dementia, to identify hidden needs as a turning point for new product innovations in care management and guidance security. This study summarizes six service needs for care management and guides the surveillance and safety of elders with dementia: (1) offering indoor user-centered guidance, (2) providing the instant location information of elders with dementia to caregivers, (3) landmarks setting, (4) assistance notification, (5) environmental route planning, (6) use of a wearable device as a guide for indoor route guidance. Based on the potential deficiencies and demands of observation, the care management and guidance security system (CMGSS) was designed. The experimental results show that the use of ultra-wide band positioning technology used in the indoor guiding system can accurately guide the behavior of patients to the right position, provide accurate information for caregivers, and record their daily behavior. The error range of this technology was not only within 42.42 cm in indoor static positioning but also within 55 cm in dynamic positioning, even where wall thickness was 18 cm. Although the device was designed for institutional care, it can also be applied to the management and care of general home-based patients. Full article

There is a significant increase in the number of people with dementia, and the demand for residential support facilities is expected to increase. Providing an appropriate living environment for residents with dementia, which can cater for their specific needs is crucial. Residential aged care design can impact the quality of life and wellbeing of the residents. In this investigation, three recently constructed dementia support facilities in Victoria, Australia are selected for evaluation. Through fieldwork observation, design evaluation and space syntax analysis, the aim of this investigation is to consider the design of these three facilities in the context of current evidence on how the built environment can best accommodate residents with dementia. Full article

The ability to successfully navigate in healthcare facilities is an important goal for patients, visitors, and staff. Despite the fundamental nature of such behavior, it is not infrequent for planners to consider wayfinding only after the fact, once the building or building complex is complete. This review argues that more recognition is needed for the pivotal role of wayfinding in healthcare facilities. First, to provide context, the review presents a brief overview of the relationship between environmental psychology and healthcare facility design. Then, the core of the article covers advances in wayfinding research with an emphasis on healthcare environments, including the roles of plan configuration and manifest cues, technology, and user characteristics. Plan configuration and manifest cues, which appeared early on in wayfinding research, continue to play a role in wayfinding success and should inform design decisions. Such considerations are joined by emerging technologies (e.g., mobile applications, virtual reality, and computational models of wayfinding) as a way to both enhance our theoretical knowledge of wayfinding and advance its applications for users. Among the users discussed here are those with cognitive and/or visual challenges (e.g., Down syndrome, age-related decrements such as dementia, and limitations of vision). In addition, research on the role of cross-cultural comprehension and the effort to develop a system of universal healthcare symbols is included. The article concludes with a summary of the status of these advances and directions for future research. Full article