Clinical trial NCT04054583: Impact of Renovations in Long Term Care Living Spaces on Residents With Dementia, Their Families and Staff
Official title: The Impact of Renovations in Long Term Care Living Spaces on Residents With Dementia, Their Families and the Staff That Care for Them
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Dementia
Keywords: Long-term care
Renovations
Residents
Family
Staff
Lead sponsor: University of Manitoba
Sponsor class: OTHER
Collaborators: name: Riverview Health Centre Foundation
name: Mitacs
First posted: 2019-08-13
Enrollment: 75
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: OTHER
Time perspective: OTHER
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Residents living on a special care unit for residents with intermediate to advanced dementia or cognitive impairment, their family members, and staff who care for them

Brief summary: A long-term care facility in central Canada planned to renovate their existing dementia care units. The overarching objective of this study was to examine the effects of the renovations on residents, family, and staff.

Detailed description: A long-term care facility in central Canada renovated their existing dementia care units, which accommodates 60 residents with intermediate and advanced stages of dementia. The primary features of the renovation include physical upgrades and the addition of a large u-shaped activity pavilion. The overarching objective of this study was to examine the effects of these design transformations in the facility and grounds on residents, family, and staff. The overall project addressed the following questions:

* How does the long-term care unit renovation affect the health outcomes, quality of life, and lived experiences of residents?
* What are the effects of the long-term care unit renovation on care staff and family members?
* What aspects of the transformation were responsible for observed changes? And what aspects worked or did not?

A multi-component, mixed-methods (qualitative and quantitative) research plan was used in this project. Personal (resident, families, staff) and environmental variables (social interactions, implementation and use of technology and physical space) were assessed pre-renovation (spring/summer 2017) and post-renovation (summer 2019 and 2020). Due to the COVID-19 pandemic, plans for additional data collection in the summer of 2020 were not completed. With this mixed-methods research plan, the investigators gained valuable information about the renovation that is important for long term care facilities.

Eligibility criteria: Resident Inclusion Criteria:

* Currently living on special care unit for residents with intermediate to advanced dementia or cognitive impairment in a long-term care facility

Family Member Inclusion:

* Must have a family member/friend/neighbour currently living on the special care unit.
* For the QUALID, the family member must have visited the resident at least three out of the last seven days

Family Member Exclusion Criteria:

* Must be able to participate in-person.
* Must be able to communicate in English.
* Must be cognitively able to participate.

Staff Inclusion Criteria:

* Must currently work on the special care unit (either full or part-time or occasional)
* For the survey, staff must be able to read and understand English.

Primary outcomes:
measure: Satisfaction of Space on Resident Quality of Life and Family Interactions from Pre- to Post-renovation from Family Perspective Using Photovoice and Photo Elicitation
timeFrame: Perspectives taken a pre- and post-renovation (approximately 2 years later or whenever renovations are complete).
measure: Changes in Space Utilization
timeFrame: Data will be collected for six months prior to and six months after the renovations (approximately 2 years later or whenever renovations are complete)
measure: Changes in Building Occupant Satisfaction Survey of Staff
timeFrame: Perspectives taken pre- and post-renovation (approximately 2 years later or whenever renovations are complete).
Secondary outcomes:
measure: Neuropsychiatric Symptoms of Residents from Six Months Prior to Renovation to Six Months Post-Renovation
timeFrame: Measures will be collected six months prior to renovations and and six months after renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Physical Restraints of Residents from Six Months Prior to Renovation to Six Months Post-Renovation
timeFrame: Measures will be collected six months prior to renovations and and six months after renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Anti-psychotic Medications and Sedatives with Residents from Six Months Prior to Renovation to Six Months Post-Renovation
timeFrame: Measures will be collected six months prior to renovations and and six months after renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Patient Safety Indicators of Residents from Six Months Prior to Renovations to Six Months Post-renovation: Frequency of medication errors and residents falls
timeFrame: Measures will be collected six months prior to renovations and six months after renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Functional and Health Status of Residents: Changes in Sleep Records
timeFrame: Measures will be collected six months prior to renovations and six months after renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Functional and Health Status of Residents: Changes in Aggressive Behaviour Scale Scores
timeFrame: Measures will be collected six months prior to renovations and six months after renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Functional and Health Status of Residents: Changes in Cognitive Performance Scale Scores
timeFrame: Measures will be collected six months prior to renovations and six months after renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Functional and Health Status of Residents: Change in Pain Scale Scores
timeFrame: Measures will be collected six months prior to renovations and six months after renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Functional and Health Status of Residents: Changes in Falls Risks Assessment Scale Scores
timeFrame: Measures will be collected six months prior to renovations and six months after renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Functional and Health Status of Residents: Changes in the Index of Social Engagement Scale
timeFrame: Measures will be collected six months prior to renovations and six months after renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Functional and Health Status of Residents: Changes in Resident's Engagement Level using the Pool Activity Level (PAL) tool
timeFrame: Measures will be collected six months prior to renovations and six months after renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Functional and Health Status of Residents: Changes in Depression Rating Scale Scores
timeFrame: Measures will be collected six months prior to renovations and six months after renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Functional and Health Status of Residents: Changes in Activities of Daily Living Self-Performance Hierarchy Scale Scores
timeFrame: Measures will be collected six months prior to renovations and six months after renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Functional and Health Status of Residents: Changes in Activities of Daily Living Short Form Scale Scores
timeFrame: Measures will be collected six months prior to renovations and six months after renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Functional and Health Status of Residents: Changes in Activities of Daily Living Long Form Scale Scores
timeFrame: Measures will be collected six months prior to renovations and six months after renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Changes in Staffing from Pre- to Post-renovation: Worker's Compensation Board Claims
timeFrame: Data will be collected for six months prior to and six months after the renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Changes in Staffing from Pre- to Post-renovation: Absenteeism
timeFrame: Data will be collected for six months prior to and six months after the renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Changes in Staffing from Pre- to Post-renovation: Leave of Absence
timeFrame: Data will be collected for six months prior to and six months after the renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Changes in Staffing from Pre- to Post-renovation: Staff Retention
timeFrame: Data will be collected for six months prior to and six months after the renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Changes in Staffing from Pre- to Post-renovation: Staff Turnover
timeFrame: Data will be collected for six months prior to and six months after the renovations have been completed (approximately 2 years later or whenever renovations are complete).
measure: Changes in the Quality of Life in Late Stage Dementia (QUALID) Scores of Residents
timeFrame: Data will be taken pre- and post-renovation (approximately 2 years later or whenever renovations are complete). The QUALID takes approximately 10 minutes to complete whereas DCM occurs over 2 days.
measure: Changes in the Quality of Life of Residents: Dementia Care Mapping
timeFrame: Data will be taken pre- and post-renovation (approximately 2 years later or whenever renovations are complete). The QUALID takes approximately 10 minutes to complete whereas DCM occurs over 2 days.
measure: Use and Maintenance of Space from Pre- to Post-renovation
timeFrame: Perspectives taken pre- and post-renovation (approximately 2 years later or whenever renovations are complete).
measure: Changes in Indoor Environment Measures: Dry Bulb Temperature
timeFrame: Data will be collected for prior to and after the renovations (approximately 2 years later or whenever renovations are complete)
measure: Changes in Indoor Environment Measures: Air Speed
timeFrame: Data will be collected for prior to and after the renovations (approximately 2 years later or whenever renovations are complete)
measure: Changes in Indoor Environment Measures: Relative Humidity
timeFrame: Data will be collected for prior to and after the renovations (approximately 2 years later or whenever renovations are complete)
measure: Changes in Indoor Environment Measures: Light Level
timeFrame: Data will be collected for prior to and after the renovations (approximately 2 years later or whenever renovations are complete)
measure: Changes in Indoor Environment Measures: Noise Level
timeFrame: Data will be collected for prior to and after the renovations (approximately 2 years later or whenever renovations are complete)
measure: Changes in Indoor Environment Measures: Air Quality - Volatile Organic Compounds (VOC)
timeFrame: Data will be collected for prior to and after the renovations (approximately 2 years later or whenever renovations are complete)
measure: Changes in Indoor Environment Measures: Air Quality - Carbon Dioxide (CO2)
timeFrame: Data will be collected for prior to and after the renovations (approximately 2 years later or whenever renovations are complete)
measure: Changes in Indoor Environment Measures: Air Quality - Formaldehyde
timeFrame: Data will be collected for prior to and after the renovations (approximately 2 years later or whenever renovations are complete)
measure: Changes in Indoor Environment Measures: Air Quality - Airborne Particulates
timeFrame: Data will be collected for prior to and after the renovations (approximately 2 years later or whenever renovations are complete)
Other outcomes:
measure: Process Evaluation
timeFrame: Prior to, during and after the renovation (approximately 2 years later or whenever renovations are complete)
Locations:
city: Winnipeg
country: Canada
facility: University of Manitoba
state: Manitoba
Study officials:
affiliation: University of Manitoba
name: Michelle M Porter, PhD
role: PRINCIPAL_INVESTIGATOR
References: