Facilitators and barriers to communication : an observational study of the long-term care environment
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The impact of the physical environment on communication for residents of long-term care (LTC) facilities has not been examined in depth. No study currently exists which explores environmental influences on communication within the long-term care setting. Investigation of such facilities is important because of the a large impact environmental features have on the quality of life of residents due to the often restricted nature of daily routines and reduced level of cognitive and/or physical function of residents. A definition of environment is needed in order to create a methodology for assessment and treatment of residents in LTC facilities. This study investigates what factors contribute to a positive communication environment in long-term care facilities and how the physical environment should be assessed. Observational data was obtained for three LTC residents with different types of physical and communicative impairments to determine what environmental factors inhibit or support communication. Barriers and facilitators to communication are identified, and recommendations for assessment of the long-term care environment are made. Contributions from the fields of aphasiology, environmental gerontology, and environmental psychology are described in order to contribute to the understanding of what contributes to a positive communication environment. Study results included support for: participant observation as a component of resident assessment, assessment of multiple environments, the importance considering individual needs during assessment, and assessment of resident perception of environment. Furthermore, this study presents a checklist to be used to guide observational assessments.