Dementia Care

Vol 5 No 3 June/July 2016

Australian Journal of Dementia Care

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Research Focus

The Research Focus section of the

Australian Journal of Dementia Care

aims to keep readers up to date with the fast expanding field of social, psychological and nursing research

in dementia care. By this we mean every aspect of person-to-person communication, nursing and care practice and organisation, and the influence of all aspects of the

environment. The aim is to provide a channel of two-way communication between researchers and practitioners, to ensure that research findings influence practice and that

practitioners’ concerns are fed into the research agenda. We would like to hear from you, specifically with:

notice of the publication (recent or imminent) of peer reviewed papers with practical relevance to dementia care;

research reports available for interested readers;

requests or offers for sharing information and experience in particular fields of interest.

This section aims to provide a channel of two-way communication between researchers and practitioners in the expanding field of social,

psychological and nursing research in dementia care, including all aspects of nursing and care practice, communication and the environment.

Translating knowledge about

environmental design into practice

Richard Fleming, Lyn Phillipson

and

Kirsty Bennett

report on the

results of an evaluation of the

Dementia Training Study Centres’

national environmental design

education and consultancy service

ccording to the Aged

Care Service List of June

2015 there are 2680

residential aged care homes in

Australia providing 192,370

beds at a cost to the govern-

ment of almost $10.6 billion. It

is estimated that 53% of aged

care residents have a diagnosis

of dementia (AIHW 2012).

There is a growing body of

evidence that the design of the

physical environment has a

significant effect on many

aspects of the experience of

people with dementia in

residential care and the way in

which they respond to their

circumstances (Fleming &

Purandare 2010; Joseph

et al

2015; Marquardt

et al

2014;

Fleming

et al

2014).

These facts tell us that it is

important to bring the

knowledge that we have about

the design of environments for

the care of people with

dementia to the attention of

those who are involved, or

likely to be involved, in

developing new facilities or

refurbishing old ones.

For the past six years the

Australian Government has

funded the Dementia Training

Study Centres (DTSC) to

deliver a national education

and consultancy service aimed

at providing residential aged

care facilities (RACF) with

evidence-based information on

the design of new and

refurbished environments for

people with dementia. The

service is delivered in three

ways:

1. Through Workshops in

every state and territory,

including regional areas.

These usually run for three

to five hours and give

participants the opportunity

to discuss their own projects.

They are focused on

introducing the participants

to 10 principles of designing

for people with dementia

(see p35).

2. By providing a seven-hour

on-site Consultation

comprising a Workshop,

followed by an audit of the

participant’s facility using

the Environmental Audit

Tool (EAT) (Fleming 2011)

and concluding with a

discussion of what might be

done in the short-, medium-

and long-term to overcome

the weaknesses identified in

the audit.

3. Via a smart phone app and a

teleconference – referred to

as the iPhone Plus service.

The user downloads the app

from the Apple Store,

registers as a user, receives a

copy of the literature review

and supportive material

provided during the

Workshops and

Consultations and carries

out an environmental audit

of their facility using the

EAT guided by the app. The

audit results and

photographs taken to

illustrate good and bad

features of the environment

are then uploaded and

processed by the DTSC.

A report identifying the

strengths and weaknesses of

the RACF environment is sent

back to the user who is then

invited to take part in a two-

hour telephone consultation to

begin developing short-,

medium- and long-term plans

to address the identified

weaknesses.

The extent of the on-site and

iPhone Plus services is

illustrated in the map on the

next page.

The effects of these

approaches have recently been

evaluated in relation to

Pathman’s Knowledge

Translation framework

(Pathman 1996). This

framework describes the

process of translating

knowledge into practice as

occurring in four stages:

• Awareness: raising the

Awareness of a potential

knowledge user of new or

relevant evidence.

• Agreement: bringing the

potential user to an

Agreement that new

knowledge is relevant and