SUMMARY
PAR-19-071/NOT-AG-18-056 calls for “Identifying best models of care in LTSS settings (design,
organization, financing) to maintain quality of life for PWD and their caregivers.” Person-
Centered Care (PCC), which is emerging as a preferred model of care for long-term care,
promotes choice, purpose, meaning and deep relationships as a part of daily life. Alongside the
evolution of PCC has been the development of the household model of design, which seeks to
recreate the core elements of a home environment for residents to live in. A major limitation to
identifying the “best environmental model” is the lack of standardized definition of, or tool to
measure, the homelike character of a long-term care setting. This project will validate a newly
developed tool, the Environmental Audit Screening Evaluation (EASE) which is specifically
focused on the household model design, and was developed from several comprehensive
reviews of the research on designs for individuals living with dementia. No other existing tool
provides the specificity or evidence-based foundation for this approach to designing long-term
care settings. The two most commonly used US-based tools are either not household-focused
or don’t measure specific elements of the environment. Using a sample of 15 nursing homes
that are all moderate to deep adopters of person-centered care and which are stratified to reflect
three distinct design styles (traditional/institutional, partial household/neighborhood, and full
household model) the EASE will be validated against the Therapeutic Environment Screen
Scale, the Professional Environmental Assessment Protocol and the Environmental Audit Tool,
and reliability will be assessed. This is in preparation for a future study to use the EASE to
identify which specific aspects of household design are most highly correlated with a variety of
resident (clinical, psychological, well-being and quality of life), staff (satisfaction, turnover, etc.),
family (satisfaction) and organizational outcomes (payor mix, quality ratings, etc.).