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Dignity Plus: an evaluation of the impact of changes to physical environments on the health and well-being of people with dementia using those environments, including residents/patients, staff and visitors.

There are an estimated 800,000 people living with dementia in England. In Oxfordshire at least 63% of the residents living in our 102 care homes have been diagnosed with some form of dementia – more may yet lack an official diagnosis – but many homes and hospitals were not purpose built or ideally designed to meet their needs.

Oxfordshire County Council and NHS partners took a county-wide approach that aimed to improve the lives of people with dementia through a managed programme of environmental changes in care facilities across the county.

Care providers bid to create 'dementia friendly' environments, which met Department of Health criteria, and participate in an individual and whole programme evaluation of the project to contribute to the development of best practice, both locally and nationally.

The evaluation assessed the impact of the changes on residents, staff and visitors at the end of the building construction phase and followed-up after 12 months to assess the enduring effects.

A full report was written for Department of Health at the end of the build phase of the project with examples of environmental changes taking place in 15 care homes and 7 community hospital wards. These included, for example:

  • newly renovated communal areas;
  • landscaped garden areas and conservatories;
  • new flooring lighting and signage; 

Findings from interviews, field visits, questionnaires and health information identified social and practical benefits for residents, staff and visitors along with positive changes in practice – for example, by working more closely with family members – and there were few reported negative effects.

Organisations also saw benefit from closer working and sharing knowledge.

A 12-month evaluation of the longer term effects of the project is underway. Our aim is to develop evidence-based guidance that will shape the best practice for environmental design and care for people with dementia.

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