The effects of the indoor environment of residential care homes on dementia suffers in Hong Kong: A critical incident technique approach

• Loud announcement in RCHs triggers an emotional disorder in dementia residents.
• Poor internal lighting (too bright or too dim) leads to hallucinations/insomnia.
• Thermal comfort and IAQ are less significant in discomforting dementia residents.
• Epoxy floor finishes in RCHs creates hallucinations for some dementia sufferers.
• Sound-absorptive wall/ceiling panel which allows for regular cleaning is suggested.

Dementia is an irreversible and incurable syndrome that leads to progressive impairment of cognitive functions and behavioural and psychological symptoms such as agitation, depression and psychosis. Appropriate environmental conditions can help delay its onset and progression, and indoor environmental (IE) factors have a major impact. However, there is no firm understanding of the full range of relevant IE factors and their impact levels.This paper describes a preliminary study to investigate the effects of IE on Hong Kong residential care homes (RCH) dementia residents. This involved six purposively selected focus groups, each comprising the main stakeholders of the dementia residents' caregivers, RCH staff and/or registered nurses, and architects. Using the Critical Incident Technique, the main context and experiences of behavioural problems of dementia residents caused by IE were explored and the key causal RCH IE quality factors identified, together with the associated responses and stress levels involved.The findings indicate that the acoustic environment, lighting and thermal environment are the most important influencing factors. Many of the remedies provided by the focus groups are quite simple to carry out and are summarised in the form of recommendations to current RCHs providers and users.The knowledge acquired in this initial study will help enrich the knowledge of IE design for dementia-specific residential facilities. It also provides some preliminary insights for healthcare policymakers and practitioners in the building design/facilities management and dementia-care sectors into the IE factors contributing to a more comfortable, healthy and sustainable RCH living environment in Hong Kong.