The Swedish BPSD registry and outdoor environment assessment : potential for development in dementia care

Abstract: Aging populations and a subsequent increasing number of people suffering from dementia are worldwide growing issues. Only in Sweden, 150000 people are diag-nosed with dementia and within 30 years that number are expected to be doubled. Somewhat 90% of the patients will experience Behavioral and Psychological Symp-toms in Dementia (BPSD), which creates suffering for both patients and relatives. The current project acknowledges these problems and proposes utilization of Evidence-Based Design (EBD), with focus on outdoor environment, to develop the dementia care. Studies indicate benefits of an EBD in healthcare settings and natural environ-ment has been suggested to have positive impact on people suffering from dementia. However, more research is required to convince authorities in concern. Thus, the AIM of this project is to explore a potential approach to epidemiological studies including exploration of the effects of outdoor stay and environment on BPSD, and further iden-tifying a method for environment assessment to increase general understanding of the potential of outdoor EBD. The project´s METHOD included an exploration of Swe-dish BPSD registry, a quality registry designed to improve the quality of care of pa-tients with dementia, and outdoor environment assessments based on the Quality Eval-uation Tool (QET). On paper, the BPSD registry include over 40 000 patients and somewhat 190 000 separate registrations, counting more than 90 variables including, inter alia, the care measure outdoor stay and BPSD frequency and severity. Thus, the registry seems to qualify in larger epidemiological studies. Trying to understand the registry in a context, Falkenberg´s care homes were selected as a sample, which in this case imply collecting related data from the BPSD registry and conduct environmental assessment at each care home. The RESULT indicates a great variance in BPSD pro-gression, both at individual level and among the different care homes. The BPSD da-taset linked to Falkenberg seems to be non-normal distributed, including numerous extreme values. Changes in statistical values like mean and median demonstrate con-flicting tendencies when comparing BPSD for groups with and without the variable outdoor stay. However, central, i.e. interquartile, values indicate an advantage for the group included in outdoor stay. Further, higher level of evidence based environmental qualities in the outdoor could correlate with higher percentage of BPSD improvement. However, it wasn’t possible to establish any CONCLUSIONS about the BPSD regis-try´s capability in epidemiological studies linked to outdoor environment. More re-search is required. Still, the outdoor environment assessment managed to distinguish the care home according to environmental qualities and the result is considered easy to grasp also for laypersons.