Environmental Attributes of Person-Centered Care

Abstract

The purpose of this study was to document the existing environmental, organizational, and operational patterns of PEAK 2.0 participating homes at early stages of adoption and the patterns of sustained adopters to determine whether there were notable or distinguishing features that were different between these two groups. Using a case-study approach, a qualitative mixed-methods research design was employed. The patterns of staffing structures and patterns of spatial layout are used to understand the environmental affordances provided to residents and staff of these settings. The theory of environmental affordances has been applied here as a perceptual framework for understanding how person-centered care (PCC) behaviors can be enacted within a space. Environmental assessments revealed that advanced adopters had patterns of building use that were notably different from those of early adopters. Advanced adopters designated more staff to a single area; early adopters expected staff to cover multiple areas on each shift. Additionally, advanced adopters created more environmental affordances for residents and staff through the types of space allocations and features present. Results demonstrated that if considered holistically and strategically, impactful changes to institutionally shaped buildings can be made to accomplish and sustain PCC goals.

Keywords:

• Environmental assessment
• person-centered care
• affordances
• quality of life

Notes

1 The term “staff work area” (SWA) is as a generic term used by the PEAK program to define the zone where staff members are assigned. Individual homes may refer to these identifiable areas as “house,” “household,” or “neighborhood.” The purpose of using a generic term in the PEAK 2.0 program was to be inclusive of all the variations of approaches that a nursing home may apply to meeting this standard, and to avoid implying that a facility had to have invested in a major construction project to accomplish this expectation.