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Paper代写:Design Attributes of Nursing Homes in the UK

2018-02-09 | 来源:51due教员组 | 类别:Paper代写范文

下面为大家整理一篇优秀的paper代写范文- Design Attributes of Nursing Homes in the UK,供大家参考学习,这篇论文讨论了英国养老院的设计。养老院现有的设计趋向于客户的长期居住的需要,因为养老院不仅是一间房子,更像是他们的家,所以我们必须要考虑到更多。在这样的条件下,养老院首先得为老年居民提供照顾和医疗服务。除此之外,居家环境可以为老年人提供舒适的体验,户外景观也可以增加养老院的魅力。在建筑设计方面,我们也要应该积极研究当地老年人的需求,按需要设计。

Nursing Home,英国养老院,英国论文代写,paper代写,论文代写

Abstract

I am interested in the purpose behind the design of senior nursing homes, how people think of it, and what can be done in the future. Recently, there has been news about old people being abused and mistreated at some nursing facilities, and this is unacceptable. After all, we are all going to age, and I would like to be in a nursing home where old people have been taken good care. Health is the priority, but life is more than about birth and death. It is important that the quality of life at the senior nursing home will be guaranteed. This research project explores nursing home designs in the UK, see how people think of them, and suggest improvements in terms of high quality of life. 

Introduction

The world is ageing at an accelerated rate, and still hasn’t come to terms with it. By 2050, more than 21% of the world population would be 60 years or older (DESA UN, 2000). Therefore, it is a serious issue that not only affects the old, but also every man, woman and child. The well-being of aged population requires proper health care, housing, living arrangements and other services that normal families can’t provide. As a result, having qualified senior nursing home near one’s community has become a vital problem for almost each and every family.

 What makes a well-designed nursing home? A good nursing home would be the ultimate choice for those in need. Previous research and related documents show that there are several aspects regarding the essential design of a high-quality nursing home that satisfies us. The existing challenges for nursing homes are to design both a sensitive and responsive residence that tend to clients’ long term needs due to the fact that the nursing home is not just a facility to them, but more like their home (Carr, 2011).   However, limited resources have discussed about the valuing of specific design attributes of nursing homes. Therefore, this paper would like to research about the design attributed cared by most people living in the nursing home or know about the nursing homes.

The method that is used in this paper is mainly primary research and secondary research. In this paper, primary research contains surveys that are distributed to those staying at nursing homes and random passengers in the UK. Secondary research includes information and previous writings in books, website, or journals.

Secondary Research

Nursing home and its importance

Nursing homes provide caring and rehabilitative services to its elder residents under the condition of long terms. According to Carr (2011), the nursing home does not provide specialized clinical treatments to the elder people, as they usually obtain these services from outside at clinics and healthcare facilities. What is more, nursing homes are usually classified as Medicare/Medicaid nursing units that provide intermediate nursing care in the US. A nursing home often operates towards patient-care rather than medical, which should be bear in mind of a designer.

The study of Dwyer, Nordenfelt and Ternestedt (2008) on three residents at a nursing home indicates that nursing homes are not just simple facilities for the old, but also a representation of the care culture. By having an experience at the nursing home that provides care and service, the elders find their lives to be significant and meaningful.  Such meaningful experiences are therefore enhanced if the nursing home allows their bodies to be well-functioned, and other residents can provide confirmation and support.

Design factors

There is evidence that design factors take up significant roles in affecting the residents’ well-being. Scholars like Duffy et al. (1986) point out that this happens especially when the setting is ‘less adapted to individual needs’. The nursing home is an obvious example of such kind. It is impossible for a nursing home to cover all individual needs of the many elders living inside, and therefore it put them in double jeopardy as the elders suffer from more vulnerability than normal people. Duffy et al. (1986) state that their study show a clear pattern of the different preferences between designers and residents when it comes to the design planning of several places, such as the lounge, furniture, dining, and more. Residents are likely to choose privacy-enhancing designs, while designers and nursing home administrators are likely to choose social-enhancing designs (Duffy et al., 1986). Such difference calls for further interactions between the two groups and more understanding of the real needs of residents for them to live more comfortably.

Design attributes

According to Carr (2011), the necessary attributes of a nursing home are listed as follows. If a nursing home can fulfill the following, it would be considered to be a Class A nursing home in worldwide standards. The following attributes can be included in the questionnaire for further evaluation:

Environment

A homelike environment can provide comfortable experience for elders, and the outdoor views can add to the charm of the nursing home. According to the Department of Health (2005), those in need of help, such as dementia patients, also prefer home with outdoor views, for it gives them opportunities to stretch and increase outdoor activities. Besides providing the residents a sense of ownership, it also helps to alleviate stress and aggression, increase exposure to natural light, and improve sleep problems (Department of Health, 2005).

The elders need proportional size and scale in their rooms to fully embrace the convenience of the nursing home. The rooms should have the right size that not only adapt to the elders’ need but also be economically suitable for the facility owner.

Lighting is very important for those in caring need, such as patients and elders. The elders usually suffer from ageing of the eyes and decline in sensitivity to colors, objects and signals in their visual field. Therefore it is vital to install natural and energy-efficient lighting in indoor and outdoor settings of the residence.

Efficiency

Research shows that privacy matters a lot to the elders as they need to feel safe and comfortable in a non-home environment (Barnes, 2002).  Barnes (2002) states that a successful design that considers the privacy needs of clients will enable them to between interact socially with others and blend in the community.

Sanitation

Sanitation is one of the most important issues to clients at the facility. It is necessary for their well-being and life. A clean environment helps to increase the clients’ feeling about their health and well-being at the nursing home, and unclean floors might cause slippery issues. Schweitzer et. al (2004) states that fresh air and ventilation gives the elders health benefits and much energy, and that indoor air pollution being one of the top environmental risks that hinders public health.

Safety

Department of Health (2015) listed safety as the no. 1 principle in the design principles for people with dementia. Since the elders are in similar conditions to those who with dementia both require a safe, secure environment for their living conditions. Elder people also suffer from one to more conditions listed below, such as sensory impairment, cognitive impairment, or physical impairments (Department of Health, 2015).

The non-reflective and non-slip floors can avoid falls for elder people and keep them safe from breaking their legs, waist, and other medical conditions. Secure spaces in nursing homes can make sure that the facility and clients are protected from sudden injuries, unknown accidents, and liabilities. Accessing to hazardous spaces might cause dangerous situations for elders, so therefore the best way to avoid such circumstances is to control access and only allow professionals to enter.

Due to the high possibility of being lost on the way, the design of exits should minimize the exposure of residents to unknown circumstances such as leaving the nursing home. The Department of Health (2005) also stated similar principles which include that ‘dementia-friendly health and social care environments should be designed, considering the full range of senses, to minimise exposure to stimuli that are not helpful, such as busy and crowded environments, patterned walls and flooring, unnecessary clutter, noise from televisions, alarms and so forth’.

Accessibility

Many elders might have more or less disability problems when it comes to their age. Therefore by adopting the local disability code in architecture design, the facility can suit the best interest of these elders.

Some residents might be in need of wheelchairs, and they might find it difficult to access to certain facilities and spaces. Therefore, all spaces should be designed to be easily usable by those in wheelchairs to prevent accidents and uncomfortableness.

Grab bars are convenient for the elders because they can assist those with difficulty to walk or climb to find balance and support. In certain locations, grab bars can save the elders much energy, time, and efforts. Therefore, by installing grab bars in appropriate locations, the elders will find it more comfortable living at the nursing home.

Every year, many elders trip over hazards or obstacles and are therefore injured. To prevent such tragedies, the nursing home should inspect its spaces and facilities to get rid of hazardous obstacles and similar items.

If the facilities are located on different floors, the elders would have to climb up and down or wait for elevators. This would be very uncomfortable for those with physical conditions and aging joints. Therefore, all facilities should be located on one floor, if possible.

Aesthetics

Appropriate use of artwork can create a bright, smoothing environment for the elders to enjoy their retired life. These artworks can be paintings, printed posters, mosaics, statues, and more.

Living in a resident home sometimes makes the elders homesick, especially when they feel that they are just a client at a facility. Therefore, creating a homelike environment is essential for their mental and physical health. The intimacy created by objects and facilities, as well as the serving attitudes of staffs, would allow residents to forget their problems and embrace their elder life.

A nursing home is a caring facility for the elders, not a hospital. If the exterior of the facility looks like a hospital, residents might experience stress and self-doubt. By creating a relaxing, appropriate exterior of the nursing home, residents can feel that they are welcomed in the place instead of being held in a hospital, worrying about their conditions.

The exterior should be compatible with its surroundings, such as forests, hills, open spaces and more. The natural view should be combined with the design so that the overall appearance of the facility looks natural and aesthetic.

Sustainability

Parker et.al (2004) states that the design of care buildings in the UK should follow a unified set of criteria that is under the administration of the National Care Standards Commission. The regulations used to vary across the country, but recently the standards have been set by the Department of Health (Parker et. al, 2004). According to Parker et.al (2004), the standards focus mainly on the residents’ needs and requirements such as room size, facilities, furniture, environment, etc. Scholars suggest that psychological needs of the residents also require consideration when it comes to design of the building, as such needs are only dealt as care issues instead of building features (Parker et. al, 2004). Therefore, by including the physical and psychological needs of residents in the design criteria, the nursing homes can better meet with requirements of sustainability and better treat its clients.

Floor plans

According to Benbow (2011), the small house models and neighborhood models are now more and more popular across North America. He notes, ‘small-House Models and Neighbourhood/Household Models for Nursing Home care are emergingacross Canada and the United States and are proving to be operationally feasible, particularly if linked or grouped together. More research is needed to compare capital and operating costs of these models with more traditional Nursing Homes.(Benhow, 2011)’ Benbow (2011) provides several floor plans to demonstrate their grouping of core services and amenities, location of bathing rooms, short corridors and privacy zones. Therefore it would be meaningful to include the floor plans of the particular nursing home that paid visit to evaluate its efficiency of design.

Nelson (2006) states that the ‘hierarchy of space’ is a crucial concept that needs to be considered in the arrangement of nursing homes. In order to promote interaction between people residing at the nursing home, sociopetal spaces must be included in the design. Shared spaces, including the public zone, semi-public zone and semi-private zone, should be noted with the physical environment to older people as they are usually vulnerable to sudden changes of the environment (Nelson, 2006).

Problem Definition

Meeting the requirements of its residents is the No.1 priority for any nursing home. It has been mentioned in above secondary research and introduction about why design matters to nursing homes, and what major attributes does design feature covers.

However, the importance of design features rate varies for different residents under different scenarios, not to mention the fact that nursing homes don’t have unified criteria for designs that can cover all physical and psychological needs of various clients. Therefore, the primary research below aims to find out about the design features that matter most to residents and non-residents at nursing homes. It also tends to discover people’s attitudes towards nursing homes and other key attributes. 

Research Questions:

What makes a well-designed nursing home in the UK?

What are the most popular features of nursing homes in the UK when it comes to design?

Are people familiar with nursing home design in the UK?

What are the current attitudes towards nursing home design in the UK?

Are there any areas of improvement on current nursing home design?

Hypothesis:

Designs of a successful nursing home must include some of the following attributes that residents value most: environment, efficiency, sanitation, safety, accessibility, and aesthetics.

This hypothesis is based on the research, texts and literatures mentioned above that the design of the nursing home can effectively help the elders to live well both mentally and physically. This paper would like to see if there is such direct relationship between the design of the nursing home and the level of content of residents/possible residents.

Primary Research

Methods

The major methodology to gain first-hand data in this paper is random survey. The survey is designed to be distributed to passengers and those residing in the nursing home. Two types of questionnaires are designed for participants and I distributed them accordingly. All participants remain anonymous and they have all signed consent forms.

Data Collection

Data collection is realized through survey questionnaires. For the study, I distributed 130 questionnaires and received 95 responses. Since there was limited access to nursing homes, 35 people in the nursing home participated in the Type A of questionnaire (see appendix) and 60 random passengers participated in Type B of questionnaire. Among all the respondents, 45 are male and 50 are female. The age distribution is as follows: 35 respondents are aged above 60, 13 of them are below 30, 22 of them aged between 30-45, and 25 aged between 45 and 60.

Data Analysis

For Type A questionnaire:

35 participants responded to this questionnaire. Among the 35, up to 18 are aged above 70, with the other 17 aged in between 60 to 70. They are from a variety of nursing homes in the UK.

Type A questionnaire is composed of 2 sections, each 7 set of questions. 15 participants are clients at nursing homes, 10 of them are clients’ relatives, and 10 are staffs working at the nursing homes.  Therefore, 25 participants responded to Section 1 in the survey, and 10 responded to section 2.

Among the 25 participants that responded to section 1, all finished the 7 questions listed in the surveys. For question 1, a majority of 15 people chose friend/relative as their primary source of knowing about the nursing home, and other sources include TV, newspaper, online ads, and local tours. The average time they have spent at the facility is 8 years.  Among the amenities at the nursing home design, the most chosen amenities are TV cable, 24-hour nursing services, and individual and group social activities. Moving on to the evaluation section, up to 10 people rated the option ‘neatness and cleanliness of the facility’ as a 5. The other options that received 4 points ratings are ‘convenience of the nursing home’s location’, ‘the staff’s willingness to help you’, and ‘the ease of accessing medical care in the nursing home’. There are also several options that only received 3 point ratings or below, namely ‘hour of nursing services’, ‘time you spend in group social activities’, and ‘safety and convenience design’. The average rating of overall design of the nursing homes participants are at is 6.5 out of 10. Some common subjective responses on the possible improvements about the nursing home design include ‘more natural light’, ‘more outdoor facilities’, and ‘staff stability’.

Among the 10 participants that responded as staffs at nursing homes, all finished the 7 questions in section 2. The average time these staffs start working at the particular facility is 2.5 years. The most common option the participants choose about the amenities the nursing home provide to clients are TV cable, air-conditioning, laundry services, full-time nurse practitioner, musical groups, and individual and group social activities. However, as of the special deign that could provide to its clients, only 4 participants can name up to 3 items. The competitive advantage that the participants point out is usually ‘nice services’, ‘social activities’, or ‘good food’. 5 participants point out that they find facilities like the wheelchair access, handrails or signal boards to be uneasy for clients to use. Moving on to the evaluation section, 5 people rated the option ‘neatness and cleanliness of the facility’ as a 5. The other options that received 4 points ratings are ‘Prompt answering of calls’, ‘time clients spend in group social activities’, and ‘the staff’s willingness to help’. There are also several options that only received 3 point ratings or below, namely ‘the means of payment’, and ‘safety and convenience design’. Some common subjective responses on the possible improvements about the nursing home design include ‘more outdoor greens, ‘more accessible wellness facilities’, and ‘better welfare for staffs’.

For Type B questionnaire:

60 participants responded to this questionnaire. Among the 60, 25 are aged in between 45 to 60 (or middle aged), 22 are aged in between 30 to 45, and 13 are below 30 (or young).

Type B questionnaire is composed of 8 set of questions. Of the 60 participants, only 32 responded to know someone who has lived/is currently living in a nursing home. The other 28 responded that they don’t. Among the 32 participants, the people they know who have been staying at the nursing home for an average time of 7.6 years. As of question 3, almost all amenities are chosen by all 60 participants except for ‘registered consulting dietician’. As of the factor that participants consider to be most important when deciding if a nursing home is worth going, more than 22 people, or 37% of all respondents, chose option d ‘Easy access to nature and outdoors provided by ceiling and corridors’, following by 18 participants (30%) choosing ‘Privacy, dignity and independence given by self-care facilities and quiet rooms’, 13 participants (21%) choosing ‘safe environment with non-slip matt flooring, safety handrails, and reduced clutter’, and 7 participants (12%) choosing ‘optimum lighting and contrast with natural patterns and changing light intensity’. When it comes to the question about whether they would consider staying at nursing home in the future, participants have various responses. Over 30% of the participants state that ‘maybe. I haven’t thought about it yet’, while another 50% participants state that they won’t consider going. The reasons are mainly as follows: ‘it seems the end of life’, ‘I value my independence’, or ‘I feel like nursing home is for people whose families don’t care about them’. Only 20% participants answered ‘yes’ to this question.

Participants are then asked to rate the service of UK’s average nursing homes based on their knowledge or impressions. 10 people (16.6%) rated the option ‘the ease of accessing medical care in the nursing home’ as a 5. The other options that received 4 points ratings are ‘Prompt answering of calls’, ‘hour of nursing services’, and ‘the staff’s willingness to help’. There are also several options that only received 3 point ratings or below, namely ‘the neatness and cleanliness of the facility’, and ‘safety and convenience design’. Participants have suggested mostly about improvements on the nursing home’s clean environment, activity rooms, the quality of care, safety, and accessibility for those in wheelchairs. In design aspects, participants contributed most on topics like ‘natural lighting’, ‘homelike feel’, ‘green environment’, ‘safety facilities’, and ‘spacious and comfortable’.

Key Findings

According to the data analysis, we can see that there are several issues that matters most to people when it comes to nursing home designs.

Firstly, all participants agree to the options listed in the survey about a qualified nursing home. For those who participated in type A questionnaire, since they are those who are more familiar with nursing homes, their inputs are considered to be more inspiring to future nursing home designs. For those who participated in type B questionnaire, their responses are also helpful because they know about UK’s nursing homes more or less from their relatives, friends, or other sources. All participants agree that nursing homes should have services like TV cables, 24 hour nursing services, in-house air-conditioning, laundry services, outdoor landscaped courtyard, full-time nurse practitioners on site, individual and group social activities, musical groups, beauty/barber shop services.

Secondly, it seems that the most essential features of a qualified nursing home are the cleanliness or neatness of the facility. Not only did those who participated in type A questionnaires responded so, those who participated in type B also emphasized that cleanliness of facility and odor free environment matters a lot to potential clients at nursing homes. Those who participated in type B also rated only 3 points for UK’s average nursing homes’ neatness and cleanliness based on their impressions. It shows that there is a lot of room for improvements in future nursing home design when it comes to this issue.

Thirdly, current clients and staffs at nursing homes have contributed some key factors of improvement about the design, as they ask for more natural light, more outdoor activities, and more greens in their sights. The potential clients or younger respondents have also contributed to these factors, as they reflected in design aspects that could be improved consisting factors like natural light, green environment, and outdoor events. With the majority of respondents in type B questionnaire thinking that the most important factor of choosing a nursing home is ‘easy access to nature and outdoors provided by ceiling and corridors’, it shows how much these factors matter to them.

Fourthly, it is worth noticing that there is quite a similarity between those who have resided at nursing homes, and those who haven’t. For those living or working at nursing homes, the unsatisfied factors are usually ‘safety and convenience design’. For those who haven’t personally gone to any nursing homes, they think that the average UK nursing home still have to work hard on ‘the neatness and cleanliness of the facility’, and ‘safety and convenience design’. Apart from the difference of the understanding of cleanliness at nursing homes, we can see that both groups pay a lot of attention on the fact that current nursing homes could do better in terms of safety and convenience design.

Analysis of Key Findings

The key findings of the primary research which has been carried out in a form of random survey has given raw data about what makes a well-designed nursing home in the UK. Participants mainly value about the environment (natural lighting, outdoor greens), sanitation (cleanliness of the nursing home, odor-free), and accessibility (outdoor events, social occasions). What is more, most participants consider that safety and convenience design to be a weakness of UK’s nursing homes, and they hope that it can be improved.

The hypothesis of this paper that ‘designs of a successful nursing home must include some of the following attributes that residents value most: environment, efficiency, sanitation, safety, accessibility, and aesthetics’ is therefore supported by the survey and its findings.

Limitations

Although this study will provide significant insight into design attributes of the nursing home, there are limitations. First, the questionnaire uses hypothesis in most of its settings, which tends to ignore the possibilities of the real world. Due to the limit of access to nursing homes, not all respondents are elder people. I also think that the sample size is not big enough. It would be more credible to verify my assumption if more than 1000 people participated in this survey, but that is nearly impossible. What is more, the participants have various age and economic conditions, and it might affect their response to the questions.

Overall, the above findings will be helpful for designing nursing homes. To fully utilize the positive effects of the attributes, the nursing home should consider aspects of environment, efficiency, sanitation, safety, accessibility, and aesthetics.

Conclusion   

Nursing homes are becoming more and more vital nowadays, especially in an aging society that we are all in. Most of the participants show reluctance of going to nursing home because they feel that it seems ‘scary’ or ‘frustrating’ to do so. According to the findings, participants mostly value the following attributes when it comes to choosing a nursing home: the environment (natural lighting, outdoor greens), sanitation (cleanliness of the nursing home, odor-free), and accessibility (outdoor events, social occasions).

Therefore, nursing homes should actively research about the local elders’ needs when it comes to designs of the building. Such needs should cover both physical and psychological aspects of the potential residents and listen to their advices in the surveys. Designs of a successful nursing home must include several of the following attributes that residents value most: environment, efficiency, sanitation, safety, accessibility, and aesthetics. Of course, a resident building that has met many of the design attributes is more appealing to potential residents and current residents.

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