Another challenge for architects facility

Another challenge for architects, facility managers, and interior designer is integrating a design specification that relates to the sense of home into a design of nursing homes, which is often based on dementia-friendly design models. Zeisel (2005), among other scholars, stated that several dementia care units exhibit a holistic understanding of integrating the separate elements of design guidelines to achieve an increased quality of life for the residents. Even willing designers did not seem to understand the full extent of the guidelines for designing a setting that provides residents with cues to help understand where they ap4 live. Guidelines that correlated the environmental design to behavioral outcomes (Zeisel et al., 1994, 2003; Fleming et al., 2003; van Hoof et al., 2010) alone are thus not yet a guarantee that all goals are achieved. Despite existing evidence, constituting a sense of home in nursing homes was proven difficult in daily practice. The care environment does not often match with the therapeutic goals that person-centered care approaches aim to realize, which is perceived as an important barrier (Cohen and Weisman, 1991; Verbeek, 2016). Thus, the present study aims to examine the architectural factors that contribute to a sense of home and how these can be implemented in design guidelines for practice. This study elaborates the theoretical themes related to the built environment in relation to the sense of home, and suggests these themes to practice health care organizations, architects, and decorators by formulating a preliminary overview or checklist for architects. Findings are presented as a case study or operationalization, i.e., as a design for an apartment that was retrofitted in a Dutch nursing home in Q1–Q3 of 2016.
Methodology In Part I, a secondary data analysis was conducted using existing data sets. These data sets were obtained from an international systematic literature review (Rijnaard et al., 2016) and integrated with the original findings from a user-centered perspective, i.e., real-life experiences of residents, family caregivers, and professional staff as collected in the photo-production study by van Hoof et al. (2016a) in the Netherlands. The first data set (Rijnaard et al., 2016) was derived from a systematic review of mixed studies. Five scientific databases (including MEDLINE, Scopus, and CINAHL) were searched using a combination of two groups of keywords: one focusing on the “meaning of home” or “sense of home” and the second on “care home” or “nursing home”. The full-search strategy is found in the study of Rijnaard et al. (2016). The inclusion criteria were as follows: (1) original and peer-reviewed research; (2) qualitative, quantitative, or mixed methods research; (3) research about participants who reside in a nursing home or a similar type of housing facility; and (4) research aimed at investigating factors that influence the sense of home, meaning of home, and at-homeness or homelikeness. Seventeen out of 2618 articles were included. The majority of these studies only contained qualitative research data. In the study by Rijnaard et al. (2016), the sense of home of nursing home residents is influenced by 15 factors, which are divided into three themes. The third theme is the built environment, which include the private space and the (quasi-)public space, personal belongings, technology, the look and feel, and the outdoors and location. For this design study, the findings in the third category (built environment) were reconsidered for the operationalization phase. The second data set was derived from van Hoof et al. (2016a), who studied the factors influencing the sense of home of old people residing in nursing homes, focusing on people with chronic somatic illnesses and mild dementia from the perspective of residents, relatives, and care professionals. A total of 78 participants (n=34 residents, n=18 relatives, and n=26 care professionals) from 4 nursing homes in the Netherlands were engaged in a qualitative study, in which photography was used as a supportive tool for subsequent individual interviews (with residents both with and without dementia) and focus groups (with relatives and staff). The data were analyzed based on open-ended coding, axial coding, and selective coding (van Hoof et al., 2016a).