Differences in dementia services and settings across place types and regions.

People with dementia have complex and unique social, environmental, and communication needs arising from impaired cognition. One response to dissatisfaction with the medical model of care in nursing homes has been the creation of more homelike and social options for care in the community. These options include community-based residential facilities and a variety of more independent senior dwellings.

Environmental gerontology at the beginning of the new millennium: reflections on its historical, empirical, and theoretical development.

Over the past four decades the environmental context of aging has come to play an important role in gerontological theory, research, and practice. Environmental gerontology (EG)--focused on the description, explanation, and modification or optimization of the relation between elderly persons and their sociospatial surroundings--has emerged as a subfield in its own right. The aim of this article is to reflect on the historical, empirical, and theoretical development of recent EG, following Parmelee and Lawton's diagnosis from 1990 that there is a need to move the field beyond its current languishing state.

The Therapeutic Environment Screening Survey for Nursing Homes (TESS-NH): an observational instrument for assessing the physical environment of institutional settings for persons with dementia.

Objective: To develop an observational instrument that describes the ability of physical environments of institutional settings to address therapeutic goals for persons with dementia.

Methods: A National Institute on Aging workgroup identified and subsequently revised items that evaluated exit control, maintenance, cleanliness, safety, orientation/cueing, privacy, unit autonomy, outdoor access, lighting, noise, visual/tactile stimulation, space/seating, and familiarity/homelikeness. The final instrument contains 84 discrete items and one global rating.