Marquardt G, Schmieg P
Fakultät Architektur, Lehrstuhl für Sozial- und Gesundheitsbauten, Technische Universität Dresden, Dresden, Germany.
Z Gerontol Geriatr. 2009 Oct;42(5):402-7. doi: 10.1007/s00391-008-0029-x. Epub 2009 Jul 29.
Spatial disorientation is among the first manifestations of dementia and a prime reason for institutionalization. However, the autonomy of residents and their quality of live are strongly linked with their ability to reach certain places within the nursing home. Also affected is the efficiency of the institutions and the quality of care provided.The physical environment has a great potential for supporting resident's residual wayfinding abilities. Until now little systematic research has been carried out to identify supportive architectural characteristics.For this exploratory study, extensive data on resident's spatial capabilities were collected in 30 German nursing homes. The architectural structure of the buildings was also analyzed. Within the nursing homes five identical, ADL-related wayfinding tasks were identified. Skilled nurses rated the resident's ability to perform those tasks on a three-point scale. The impact of the different architectural characteristics on the resulting scores was tested for statistical significance.Results show that people with advancing dementia are increasingly dependent on a compensating environment. Significant influencing factors are the number of residents per living area, the layout of the circulation system and the characteristics of the living/dining room. Smaller units facilitate wayfinding but larger entities may also provide good results, if they feature a straight circulation system without any changes in direction. Repetitive elements, such as several living/dining rooms, interfere with a resident's wayfinding abilities. These and further results were transformed into architectural policies and guidelines which can be used in the planning and remodelling of nursing homes.
空间定向障碍是痴呆症的首批表现之一，也是将患者送入养老院的主要原因。然而，居民的自主性及其生活质量与他们在养老院中到达特定地点的能力密切相关。机构的效率和所提供护理的质量也会受到影响。物理环境在支持居民残留的寻路能力方面具有巨大潜力。到目前为止，尚未开展多少系统性研究来确定支持性的建筑特征。
在这项探索性研究中，在30家德国养老院收集了关于居民空间能力的大量数据。还对建筑物的建筑结构进行了分析。在养老院中确定了五项与日常生活活动（ADL）相关的相同寻路任务。熟练的护士以三分制对居民执行这些任务的能力进行评分。测试了不同建筑特征对所得分数的影响是否具有统计学意义。
结果表明，痴呆症病情加重的人越来越依赖补偿性环境。重要的影响因素包括每个居住区域的居民数量、循环系统的布局以及起居/餐厅的特征。较小的单元便于寻路，但如果大型单元具有无方向变化的直线循环系统，也可能会有良好效果。重复元素，如多个起居/餐厅，会干扰居民的寻路能力。这些及其他结果被转化为可用于养老院规划和改造的建筑政策和指南。
