The relationship between patient behaviour and environmental quality for the dementing

The quality of long-term hospital care for demented patients has never been studied in relation to the behaviour of the residents, although this relationship has been studied for other patient groups and in other settings.

Five aspects of environmental quality were assessed using a rating scale package. Seven wards with a range of quality were selected and patient behaviour categorized and recorded using a direct observation method.

Comparative analyses revealed that institutional ward practices were associated with abnormal motor activity and inappropriate behaviour. In addition, social/recreational provision was associated with increased social behaviour and less time spent doing nothing, although high levels of provision were also associated with abnormal motor activity and inappropriate behaviour. Inappropriate behaviour also appeared to be related to a lack of provision of reality orientation cues and to better quality of ward condition. Space availability was not associated with any behavioural patterns.

Some aspects of the environment are associated with patterns of behaviour. There is a need for further research both in this setting and in non-hospital settings.