RESUMO
Dementia care currently presents a challenge to healthcare providers on many levels. The rapid increase in the number of people with dementia and the costs of care certainly contribute to these challenges. However, managing the behavioral and psychological symptoms of dementia (BPSDs) has become one of the most significant tasks in providing care and can lead to poor health and well-being outcomes, not only for the people living with dementia (PLWD) but also for those providing their care. Cost-effective, easily implemented, highly adaptable, empirically based alternatives are needed. Interventions such as Horticultural Therapy (HT), which is naturally informed by Montessori-Based Methods for Dementia and sensory reminiscence therapies, meets these qualifying factors. This article, based on a review of current best practices and clinical experience, hopes to provide recommendations for such an intervention along with special considerations for PLWD and adaptations for different acuity levels. With additional safe and effective, person-centered, non-pharmacological interventions available for the complex cognitive and neuropsychiatric manifestations of this disease, a better care milieu can be provided, improving the quality of life for both patients and caregivers. This article also identifies the need for continued research into the synergistic effects of person-centered behavioral and psychosocial interventions combined with environmental approaches to provide the optimal healing environment for those coping with dementia.
RESUMO
OBJECTIVE: Exposure to nature has been shown to influence various dimensions of human experience in the healthcare environment. This mixed method study explores the effects of the presence of biophilic, nature-based imagery on patient perceptions of their hospital room and aspects of their experience in rehabilitation. BACKGROUND: In settings where patients have high degrees of medical acuity and infection control is a major concern, exposure to the benefits of real nature may be precluded. This is also true in many older healthcare facilities which were not designed with salutatory nature exposure in mind. In these settings, the presence of nature imagery may provide benefits which positively impact patient experience. METHOD: Seventy-six physical rehabilitation patients on a medically complex/cardiopulmonary rehabilitation unit filled out questionnaires assessing their perceptions of their room and various indexes of patient satisfaction. Data were collected from 47 patients in enhanced room containing nature imagery and 29 patients in standard rooms which served as controls. RESULTS: Scores on the Environmental Assessment Scale (EAS) indicated a significant difference between experimental and control group in the rating of their rooms (p = .0071). Ratings of quality of room, quality of stay, quality of sleep, and overall care trended in the direction of the hypothesis but were not significant. Data from qualitative questionnaires supported the results of the EAS. CONCLUSION: We conclude that the presence of biophilic nature imagery in the hospital rooms had a significant effect on patients' room ratings and positively influenced indexes of patient satisfaction.
