The impact of therapeutic design on social engagement among residents with dementia during programmed activities in dementia care units.

Growing evidence suggests that therapeutic physical and social environments in dementia care units can enhance residents’ quality of life. A therapeutic milieu can be created within smaller units that have a homelike ambience, increased wayfinding, and regulation of sensory stimulation. Organizational philosophies can also reflect a holistic model of care that values personhood, fosters relationship building, and provides meaningful activity programming. While the body of literature on therapeutic design in dementia care has been expanding steadily since the early 1980's, little is known about the design of activity spaces, particularly what environmental features are conducive to successful activity programming and positive resident outcomes. This study explored the nature of residents’ engagement during group activities in two dementia special care environments purposively selected for their contrasting physical environments. Findings shed light upon the complex interactions between physical, organizational, and social environmental factors that shape residents' experiences during group activities.