Hammink Jhw Coosje, van Buuren Lpg Leonie, Moor Ja Nienke, Derks Daja Daantje, Mohammadi M Masi
Research Group Architecture in Health, HAN University of Applied Sciences, The Netherlands.
Chair Smart Architectural Technologies, Department of Built Environment, Eindhoven University of Technology, The Netherlands.
Dementia (London). 2025 Apr;24(3):456-479. doi: 10.1177/14713012241301474. Epub 2024 Nov 19.
IntroductionThis study explores the lived experiences of older adults with dementia in Dutch nursing homes, focusing on daily activities and emotional responses. With a growing number of older adults with dementia, gaining a deeper understanding of their lived experience is imperative.MethodsUsing a mixed-method narrative approach involving observations, informal interviews, and physiological monitoring through wearable sensors, the study engaged eight participants in psychogeriatric wards across two Dutch nursing homes. Observations and interviews aimed to provide context to daily activities, while wearable sensors tracked emotional responses through heart rate (HR) and heart rate variability (HRV).ResultsKey activities included eating, drinking, communication, mobility, and inactivity. Positive experiences were consistently observed during eating and drinking and communication, respectively influenced by the nursing home's social and organizational structures and social and personal contexts. In contrast, mobility and inactivity exhibited diverse physiological responses, reflecting a range of stress, concentration, or relaxation.Conclusion & DiscussionThis study offers valuable insights into the lived experiences of older adults with dementia in nursing homes. It highlights the generally positive nature of eating and drinking, shaped by social and organizational factors. Communication's impact varies with individual context. The study also reveals a complex interplay of emotions during activities related to mobility and inactivity, as evidenced by diverse physiological responses. Regarding implications for dementia care, the study emphasizes the need to redefine 'inactivity' as 'under-stimulation,' assess appropriate (in)activity levels, and acknowledge the significance of the nursing home's physical and organizational context. This redefinition should distinguish between 'physical' and 'mental' inactivity, address concerns related to under-stimulation, and cater to individual preferences. Recognizing the residents' restricted environment and reliance on care professionals and volunteers underscores the urgency of tailored approaches. Addressing these implications can provide fresh perspectives for evolving dementia care, creating a more supportive environment that promotes well-being.
引言
本研究探讨了荷兰养老院中患有痴呆症的老年人的生活经历，重点关注日常活动和情绪反应。随着患有痴呆症的老年人数量不断增加，深入了解他们的生活经历势在必行。
方法
本研究采用混合方法叙事法，包括观察、非正式访谈以及通过可穿戴传感器进行生理监测，研究涉及荷兰两家养老院心理老年病房的八名参与者。观察和访谈旨在为日常活动提供背景信息，而可穿戴传感器通过心率（HR）和心率变异性（HRV）跟踪情绪反应。
结果
关键活动包括进食、饮水、沟通、活动和不活动。在进食和饮水过程中始终观察到积极体验，分别受到养老院的社会和组织结构以及社会和个人背景的影响。相比之下，活动和不活动表现出不同的生理反应，反映出一系列压力、专注或放松状态。
结论与讨论
本研究为养老院中患有痴呆症的老年人的生活经历提供了有价值的见解。它强调了进食和饮水受社会和组织因素影响通常具有积极性质。沟通的影响因个人背景而异。该研究还揭示了与活动和不活动相关的活动中情绪的复杂相互作用，不同的生理反应证明了这一点。关于对痴呆症护理的影响，该研究强调需要将“不活动”重新定义为“刺激不足”，评估适当的（不）活动水平，并认识到养老院的物理和组织环境的重要性。这种重新定义应区分“身体”和“精神”上的不活动，解决与刺激不足相关的问题，并迎合个人偏好。认识到居民受限的环境以及对护理专业人员和志愿者的依赖凸显了采用量身定制方法的紧迫性。解决这些影响因素可以为不断发展的痴呆症护理提供新的视角，创造一个更具支持性的促进福祉的环境。
