Impact of temperature and indoor environmental quality in nursing homes on thermal comfort of occupants and agitation of residents with dementia

Driven by an unprecedented increase in life expectancy, for the first time in human history most people can expect to live into their 60s and beyond (WHO, 2015). This demographic shift is affecting all countries, including Australia, and it will have profound implications for our society in the future. As the population ages, the number of people who are likely to experience health problems and chronic diseases is also projected to increase. Although dementia is not a natural part of ageing, there is a strong relationship between age and dementia, therefore, the number of people with dementia is expected to rapidly increase over the coming decades. At present there is no cure for most forms of dementia, and symptoms of dementia are usually progressive in nature and are irreversible (AIHW, 2012a). Providing appropriate support for people with these conditions and their caregivers is vital. Nursing homes need to ensure that people experiencing a decline in their capabilities receive the appropriate level of care so that they can live comfortable and dignified lives. It is generally believed that residents of nursing homes spend the majority of their day indoors and that many of them depend on their environment to compensate for the physical and cognitive frailties associated with their conditions. Hence, it is necessary that nursing homes provide supportive living environments for residents which enhance their health and wellbeing. However, there has been a lack of clear evidence and understanding as to how older people and people with dementia perceive their indoor environment. While a comfortable environment is shown to contribute positively to their health and wellbeing, limited quantitative evidence is available on how thermal discomfort affects behavioural and psychological symptoms of people with dementia. The primary aim of this research was, therefore, to understand and quantify the impacts of Indoor Environmental Quality (IEQ) factors on perceptions and comfort of all building occupants and agitated behaviours of residents in nursing homes. All building occupants (staff members, volunteers, residents and visitors) were included in the study since a well-designed facility should provide comfortable thermal conditions to all building users. The research was carried out in six case study nursing homes, which ranged in age from 9 to 62 years since the date of construction, and were all located in the state of New South Wales, Australia.