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PERSPECTIVES AND EXPERIENCES IN ADVANCE CARE PLANNING AMONG PERSONS WITH DEMENTIA: AN INTEGRATIVE REVIEW

Objective: With the progress of cognitive impairment, patients with dementia show compromised adaptability to environment. Moreover, physical environment is an important inducement of agitated behaviors among older adults with dementia. The present study aims to investi-gate the existing problems in the arrangement of physical environment among community-dwelling patients with dementia. Methods Totally 394 community-dwelling patients with dementia were recruited from Beijing, Tianjin and Hangzhou in China. A self-designed checklist of physical environment for older adults with dementia was used to assess the arrangement of physical environment rated by caregivers. The checklist consisted of four dimensions including safety, familiarity, orientation identity and sensory stimulation. The content validity index was 0.907 rated by 35 experts and the test-retest reliability was 0.895. Results The most frequent safety risks existed in the exit without electronic device (74.1%) and concealment of doors (89.3%); in the bathroom without calling device (82.0%) and exposure to risk wash supplies (61.7%); in the kitchen without smoke detector (68.8%), easy access to the kitchen (70.6%) and exposure to risk dishes and supplies (65.2%); in the bedroom without adjusted height bed (60.2%). Moreover, most families failed to provide orientation identity (80.5%) and sensory stimulation (69.8%). Conclusion Most families show safety risks in the arrangement of physical environment in the exit, bathroom, kitchen and bedroom, and they failed to provide proper orientation identity and sensory stimulation for older adults with dementia. It is suggested to provide assess-ment and targeted guidance in the arrangement of physical environment for caregivers of dementia patients.