Estimates of Crowding in Long-Term Care: Comparing Two Approaches
- 1 January 2011
- journal article
- research article
- Published by SAGE Publications in Herd: Health Environments Research & Design Journal
- Vol. 4 (2), 61-74
- https://doi.org/10.1177/193758671100400206
Abstract
Objective: Because studies of crowding in long-term care settings are lacking, the authors sought to: (1) generate initial estimates of crowding in nursing homes and assisted living facilities; and (2) evaluate two operational approaches to its measurement. Background: Reactions to density and proximity are complex. Greater density intensifies people's reaction to a situation in the direction (positive or negative) that they would react if the situation were to occur under less dense conditions. People with dementia are especially reactive to the environment. Methods: Using a cross-sectional correlational design in nursing homes and assisted living facilities involving 185 participants, multiple observations ( N = 6,455) of crowding and other environmental variables were made. Crowding, location, and sound were measured three times per observation; ambiance was measured once. Data analyses consisted of descriptive statistics, t-tests, and one-way analysis of variance. Results: Crowding estimates were higher for nursing homes and in dining and activity rooms. Crowding also varied across settings and locations by time of day. Overall, the interaction of location and time affected crowding significantly ( N = 5,559, df [47, 511], F = 105.69, p < .0001); effects were greater within location-by-hour than between location-by-hour, but the effect explained slightly less variance in Long-Term Care Crowding Index (LTC-CI) estimates (47.41%) than location alone. Crowding had small, direct, and highly significant correlations with sound and with the engaging subscale for ambiance; a similar, though inverse, correlation was seen with the soothing subscale for ambiance. Conclusions: Crowding fluctuates consistent with routine activities such as meals in long-term care settings. Furthermore, a relationship between crowding and other physical characteristics of the environment was found. The LTC-CI is likely to be more sensitive than simple people counts when seeking to evaluate the effects of crowding on the behavior of elders—particularly those with dementia—in long-term care settings. aging in place.Keywords
This publication has 6 references indexed in Scilit:
- Resident‐to‐Resident Aggression in Long‐Term Care Facilities: Insights from Focus Groups of Nursing Home Residents and StaffJournal of the American Geriatrics Society, 2008
- Childhood Socioeconomic Status and Serotonin Transporter Gene Polymorphism Enhance Cardiovascular Reactivity to Mental StressPsychosomatic Medicine, 2008
- Initial psychometrics of the ambiance scale: A tool to study person-environment interaction in dementiaAging & Mental Health, 2007
- Environmental correlates to behavioral health outcomes in Alzheimer's special care units.The Gerontologist, 2003
- The Therapeutic Environment Screening Survey for Nursing Homes (TESS-NH): An Observational Instrument for Assessing the Physical Environment of Institutional Settings for Persons With DementiaThe Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 2002
- The Therapeutic Design of Environments for People With DementiaThe Gerontologist, 2000