Analysis of the Contents of the Memory Boxes - Coursework Example

Running Head: Deconstructed Research Report Name: Lecturer: Course: Date: Table of Contents Table of Contents 2 Introduction 3 Background and Theories 3 Method 6 Results and Discussion 7 Conclusion 9 References 10 Introduction A memory box refers to a wooden display case with a front glass panel. They are often installed in the hallways outside the entrance of individual rooms inside dementia care facilities. Each memory box holds personal memorabilia of individuals with dementia inside the rooms (Reynolds, 2013). They usually have three purposes: To establish the identity of individuals with dementia; To act as a reminder that directs individuals back to their rooms; To serve as a reminiscence tool. A memory box is essential for managing dementia, which is a condition that is characterized by symptoms of memory loss, behavioural and personality changes, disorientation and diminished judgment. The condition occurs mostly among the older adults and results to impairing one’s ability to remember or recognize things that were initially recognized (Moyle et al., 2008; Graff et al., 2008) Gulwadi’s (2013) study was aimed at examining the design features of memory boxes and their use in residential facilities designated for care of people with dementia. The researcher surveyed three facilities in Midwestern United States. Background and Theories U.S. Census Bureau estimates that the number of the elderly will reach 70 million by 2030 in the United States and around 80 million by 2050. The increase will be accompanied by a shift in the age structure. Gulwadi’s (2013) cited the statistics to show that the number of people with dementia will increase in the next 2 to 3 decades. Gulwadi’s (2013) talks in his study that since the elderly people are often frail and often in need of care, the growth of their number would affect designing and managing their care facilities in the future. Age-related physiological, psychological and physical changes have several impacts on the level of interaction between the elderly with dementia and their immediate environment. Several theories have been suggested, which Guldwadi (2013) used, to help explain the phenomena. In explaining the phenomena, Gulwadi (2013) uses ecological domicile hypothesis that was proposed by Lawton and Nahemow (1973). The hypothesis argues that when there is a match between individual’s personal capabilities and environmental demand, then successful daily functioning will occur. Technically, this depicts an individual in terms of a range of competences such as an individual’s cognitive functioning, motor and sensory skills and biological health. Some theorists however described these as functional capacities while the environment was depicted in terms of the demands placed on a person’s functional capacity (as Gulwadi (2013) cited Scheidt and Norris-Baker, 2003). From this perspective, it is perceivable that individuals with dementia who are in the same setting witness a mismatch sooner and with more extensive effects. In this case, an individual who has lower competences, such as a sick elderly, is more susceptible to the demands that the environment places on him. For instance, an elderly who has arthritic fingers will have difficulty in turning a door knob. According to such individuals, small negative changes in their environment significantly affect even the smallest positive changes that make things easy for them, such as replacing a doorknob with a lever. Person-centered approach is on the other hand effective in reducing environmental demands by introducing features that improve the conditions of residential environments of the elderly. The model design interventions proposed by this approach include eliminating environmental barriers and increasing relevant landmarks in organizations, reducing the number of occupancy rooms, allowing for expansive communal areas for easy movement and navigation and having special furnishing and lighting. Despite the potential benefits of this approach, Gulwadi (2013) attempts to demonstrate that it may be rendered ineffective in circumstances where there is inadequate staff at dementia care centres. In this way, it should be clearly perceived that the environment plays a key role in helping individuals at dementia care facilities to maintain their identity and to remember certain features. This is since dementia affects one’s cognitive judgment as well as affects one’s effective daily functioning. In regards to the importance of the environment, individuals with dementia face challenge in figuring out their location, recalling and maintaining their identity. In this case, having residential environment with supportive features can create a match between such vulnerabilities and environmental demands. This is consistent with ecological domicile hypothesis. Therefore, in such a situation, the role of residential environment comprises of being therapeutic and guarding individuals with dementia from institutional stigma. Gulwadi (2013) suggest three ways in which this can be ensured: First, environmental features can help dementia people to maintain identity. For instance, personalization can be promoted by allowing for adequate space in individual rooms so that individuals can arrange their own furniture in the ways that they like. Next, environmental features can help dementia people to orientate themselves with their surroundings. Indeed, it is explained that people with dementia can get to effectively find their way through possible landmarks or graphical information at dementia centres. The elderly have shown a tendency to be more successful in finding their way through features of the building, such as stairs, and the doorway (Nolan, Matthews & Harrison, 2001). Graphical information such as photographs is also effective in helping the elderly to orientate themselves to their environment. Third, some environmental features also help people with dementia to reconnect their memories. Technically, the memory consists of three components, namely long-term, short-term and sensory. The worsening of dementia comes along with disorganization of one’s memory. In such cases, the use of reminiscence therapy, such as prompting an individual to remember familiar memories through photographs, can help the individuals to reconnect their disorganized memories. In general, memory boxes are related to the three ways mentioned above. This is since they ensure meaningful personal items are displayed, they help in maintaining identity and lastly, they act as reminiscence tools, or tools for way-finding. Method In attempting to investigate the design and use of memory boxes in Midwestern United States, Gulwadi (2013) surveyed three demential facilities. These included skilled nursing facility, assisted living facility and special care unit. The researcher chose the facilities since they were part of a similar continuing care retirement community that had three differing kinds of memory boxes. The research was conducted by collecting data using photographic inventory of memory boxes placed at the three facilities. The research also used staff interviews and environmental walk-through. In all, 109 memory boxes were photographed for later analysis of contents and physical features. The environmental context of the facilities were understood and documented through walk-through. The researcher used one member of staff in each facility. The interviews helped understand the organizational structure of the facilities. Results and Discussion Analysis of the contents of the boxes revealed a range of items categorized as hobby-related, family-related, seasonal items, professional and non-professional affiliations. Family-related items consisted of past and current photographs and items issued by family members such as frames with “love” messaged. Those that suggested professional affiliation included photographs with colleagues, licenses and certificates. Next, non-professional items included those depicting ethnic heritage, club or religious items. Those that indicated hobby-related items included works of painting, embroidery and other craftworks (Fig 1). Figure 1: Items found in boxes (Gulwadi, 2013). Results of the survey indicated that the commonest items in the three facilities included family-related items followed by hobby items. In this case, it could be perceived that family-related items, in addition to professional and non-professional items helping in promoting and maintaining identities of people with dementia (Fig 2). Conversely, since hobby-related items are unique, they can help the elderly with dementia to orientate themselves with their surroundings to find their way to their rooms. It is however observed that all the items reviewed have the ability to help in helping the elderly with dementia to reconnect with their memories. Figure 2: Graphical presentation of items found in memory boxes (Gulwadi, 2013). Findings indicated that despite the small sizes of the memory boxes, they contribute meaning and significance to the experiences of the elderly in the dementia facilities. Conclusion The study has provided evidence that memory boxes are permeated with a range of significance and meanings for elderly people who use them at dementia centres in four main ways: as a tool for identity, reminiscence, tool, orientation and way-finding and as staff tool. Findings also suggest that although significant advances have taken place in the design of spaces of dementia or residential facilities of the elderly people, little regard has been paid to the design of the memory box. Overall, memory boxes and the contents inside them trigger reconnection of memory. In regards to way-finding, memory boxes function as reminder boxes for orientation within the facility. Regarding reminiscence, memory boxes help the elderly initiate conversations leading to healthy reminiscence. Additionally, they enable the staff at dementia facilities to train and familiarize with the residents and to support disoriented elderly residents. References Graff, M., Adang, E., vernooj-Dassen, M., Jonsson, L., Thijssen, M., Hoefnagelsm W. & Rikkert, M. (2008). Community occupational therapy for older patients with dementia and their care givers: cost effectiveness study. BMJ, 336:134 Gulwadi, G.B. (2013). Establishing Continuity of Self-Memory Boxes in Dementia Facilities for Older Adults: Their Use and Usefulness. Journal of Housing For the Elderly 27, 105-119 Moyle, W., Olorenshaw, R., Wallis, M. & Borbasi, S. (2008). Best practice for the management of older people with dementia in the acute care setting: a review of the literature. International Journal of Older People Nursing 3, 1-10 Nolan, B., Matthews, M. & Harrison, M.(2001). Using External memory Aids to Increase Room Finding by older Adults with Dementia. American Journal of Alzheimer's Disease and Other Dementias 16(4), 251-156 Reynolds, C. (2013). The Impacts of a Memory Box Activity on Relationships Between Residents of a Longterm care facility and the Staff. 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