Defining and assessing the characteristics of the built environment that contribute to the well-being of people with dementia living in aged care facilities in Singapore

Background: Dementia enabling environments are a key factor in addressing the needs of people living with dementia in residential aged care facilities. Despite the evidence supporting the development of these environments, there are no salutogenic validated or reliable tools that can guide, measure, or evaluate dementia enabling environments in Singapore. The study uncovers the characteristics of the built environment that contribute to the well-being of Singaporeans living with dementia. With the findings, the study plans to translate the knowledge into action by developing an acceptable, reliable, and culturally sensitive tool for Singapore. Methods: The study employed a sequential qualitative-quantitative mixed method design. The study was structured into two phases. A scoping review was carried out in the first phase to understand the characteristics of nursing homes in East and Southeast Asia in relation to eight design principles (Chapter 2). An investigation was carried out into the cultural characteristics and the acceptance of eight principles of design in Singapore through focus group discussions (FGD, n=150). Qualitative data and descriptive statistics were collected and analysed (Chapter 3). The testing of the Singaporean Environmental Audit Tool (SEAT) made up the second phase and data via interviews on the barriers and facilitators and usability were obtained after participants (n=6) tested the tool in eight nursing homes in Singapore (Chapter 4). The quantitative data on the internal consistency and reliability of the tool was collected and analysed using SPSS version 25. All qualitative data were thematically analysed using NVivo 11.