The Multi Sensory Environment (MSE) in dementia care: the role of design

这项建议建立在金斯顿大学设计环境研究小组之前进行的研究基础上，该小组在调查痴呆症患者的环境需求方面取得了成功的记录，并基于Co-I进行的先前研究，探讨了后者的参与策略和MSE对功能表现的影响。这个新项目将对MSE的概念和设计以及它们目前和未来在照顾痴呆症患者的家庭中所扮演的角色进行重点调查。这项研究的及时相关性取决于对老龄化人口的快速增长、越来越多的痴呆症患者以及在痴呆症治疗中过度使用抗精神病药物的更广泛考虑。迫切需要成本效益高的干预措施来支持痴呆症护理。因此，照顾者、治疗师和设计者热衷于在这种情况下调查MSE。观察到MSE在痴呆症护理中的好处是改善功能和缓解心理和行为症状，例如挑战行为、抑郁、增加适当的沟通、提高员工士气(Collier等人，2010)。MSE结合了以初级感官为目标的感觉设备，现在被广泛使用和指定，但有证据表明，由于设计不充分/糟糕和安排随意，它们往往无法成功(Dalke等人，2010年)。相反，缺乏关于未来为痴呆症患者开发MSE的设计创新的研究。该项目将通过一项涉及大伦敦地区15家拥有某种类型MSE设施的养老院的研究，调查上述批评在多大程度上可以得到证实。将对设施进行检查，并观察/约谈工作人员(使用专门设计的问卷)。其目的是评估与MSE的联合功能相关的服务和使用，MSE既是有意义的休闲活动的资源，也是痴呆症使用者的治疗干预。这项研究旨在确定改进的MSE整体设计是否可以增加所提供的体验的价值，最大限度地为这些特定的用户和他们的照顾者带来好处。更重要的是，由于几乎没有记录在案的老年痴呆患者MSE设计指南，拟议研究的总体目的是建立新的知识，以开发连贯的、以用户为中心的设计解决方案。这项拟议的研究有可能为MSE模板的设计思想和建议的发展提供信息，该模板是为痴呆症患者及其身体和情感需求量身定做的。为了改善MSE体验，设计开发不会局限于在房间中放置额外技术的解决方案。它将涉及到将空间作为一个整体来设计，以实现具有美学灵感的、具有刺激性的环境，这些环境足够灵活，能够适应用户的特定个人需求。采用包容的设计方法，这种空间应该产生一种幸福感和参与感，不仅为痴呆症患者，也为工作人员和亲属分享服务用户的经验。研究结果和结果将被写在一本设计资料手册中，并通过向安老院的职业治疗师、活动协调员、经理和设计师提供实践和策略规划方面的信息，特别是在改善现有的MSE设施或建立新的设施时，为他们提供帮助。另一项主要成果将是在项目结束时举办与展览有关的活动，届时研究成果将向更广泛的该领域专业人员、决策者和公众展示。在后续研究项目的过程中，社会和经济影响将增加，该项目将与重点小组一起进行试验，并随后提供概念验证和执行战略。

The proposal builds on previous research carried out by Kingston University's Designed Environment Research Group with its successful track record for investigating the environmental needs of people with dementia, and prior research undertaken by the Co-I exploring engagement strategies for the latter and the effect of MSEs on functional performance. This new project will conduct a focused investigation into the concept and design of MSEs and their current and future demanding role within homes caring for residents with dementia. The timely relevance of this research rests on a broader consideration of the rapid growth of an ageing population, the rising number of people affected by dementia, and the over-prescribed use of antipsychotic medication in dementia treatment. Cost-effective interventions supporting dementia care are urgently needed. Carers, therapists and designers are therefore keen to investigate the MSE in this context.The observed benefits of MSEs within dementia care are improved function and alleviated psychological and behavioural symptoms e.g. challenging behaviour, depression, increased appropriate communication, improved staff morale (Collier et al 2010). MSEs, incorporating sensory equipment which targets the primary senses, are now widely used and specified but evidence suggests that they often fail to succeed because of inadequate/poor design and haphazard arrangements (Dalke et al 2010). Conversely, there has been a lack of research into design innovations regarding the future development of MSEs for those living with dementia. The project will investigate to what extent the above criticisms can be substantiated via a study involving 15 care homes in Greater London with some type of MSE facility. The facilities will be examined and staff observed/interviewed (using a specifically designed questionnaire). The intention is to evaluate service and usage in relation to MSEs' joint function as both a resource for meaningful leisure activity and a therapeutic intervention for users with dementia. This study aims to establish whether the improved overall design of MSEs could add value to the experience on offer maximising the benefit for these particular users and their carers. More importantly, because little documented design guidance for MSEs for older people with dementia exists, the overall purpose of the proposed research is to establish new knowledge from which coherent, user-centred design solutions can be developed. The proposed study has the potential to inform the development of design ideas and recommendations for a MSE template tailored towards people with dementia, their physical and emotional needs. In order to improve the MSE experience the design development would not be confined to solutions that place additional technology in a room. It would involve designing the space as a whole to achieve aesthetically inspiring, stimulating environments which are sufficiently flexible and adaptable to the specific individual needs of users. Embracing an inclusive design approach, such spaces should generate a sense of wellbeing and engagement not only for people with dementia but also for staff and relatives sharing the experience of the service users. The research findings and results will be written up in a Design Sourcebook, and assist occupational therapists, activity co-ordinators, managers and designers of care homes by informing their practice and strategic planning, particularly when making improvements to existing MSE facilities or setting up new ones. Another main output will be an exhibition-related event at the end of the project where the research results will be presented to a wider audience of professionals in the field, policy makers and the general public. Societal and economic impacts would increase during the course of a follow-on research project linked to performing trials with focus groups and subsequently providing proof-of-concept and implementation strategies.