Study. Architecture, Disability & Long-Term Care

Background: For people with a disability who are in long-term care, the impact of the built environment on their whole life is of particular importance, as they have limited capacity to actively seek out another environment themselves. The design of the environment is likely to influence their well-being, experience of stress, health, coping with their disability, level of independence, and even the extent of behavioral problems.

Purpose: The Netherlands Institute for Health Research and Development, a body of the Dutch government entrusts Kopvol, in collaboration with Leiden University, Department of Orthopedagogy, to review the knowledge available to date on this topic in order to formulate recommendations for policy, practice and research. The recommendations will form the basis of future design and building projects of care facilities for people who need care or companionship 24 hours a day due to an intellectual, physical and/or sensory disability and/or a mental illness.

Methods: Twelve scientific databases were searched for keyword combinations, supplemented by a field survey. After a systematic review of 3095 documents according to PRISMA, 276 documents were included and analyzed. The analysis followed a two-dimensional factor matrix.

Results: 42 literature reviews, 176 studies, 10 dissertations, 37 descriptive documents, and 11 books/chapters were found. Most documents pertain to people with a psychogeriatric disorder. There is little research on people with somatic, physical, sensory, or intellectual disabilities. Overall, 26 design components and 19 outcome clusters related to health, behavior, and quality of life were identified. The largest number of studies focused on housing designs. Design components are mostly studied in groups of people with psychogeriatric conditions.

Conclusions: Knowledge of evidence-based design is limited in long-term care.   Studies often suffer from severe quality deficiencies that can be mapped into four categories. In all of them, encouragement of prospective longitudinal studies is recommended. To date, there is insufficient scientific support for statements about the design and planning of long-term care homes that have a measurable impact on the quality of life et al. of residents. Only few results concern architectural interventions at all. Most of them refer to marginal changes in spatial design or comfort.

Roos, J.L., Vollmer, T.C., Dijkxhoorn, Y.M., Koppen, G., Van Schijndel-Speet, M. & Swaab, J.T. (2021). Unlimited Surrounding. A scoping review on supportive architecture and care-homes. Article in progress

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