A Mixed-Methods Scoping Review of Innovative Long-term Care Facility Design and Associated Outcomes

Abstract

Background and Objectives: As people live to late older adulthood, their reliance on disability supports and services increases. While these supports and services can often be provided at home, many people spend a period of their lives in long-term care, and the quality of long-term care environments is of great significance to those who make this transition and to those who support it. The objective of this study was to survey the range of design innovations in long-term care and to consider outcomes for residents, family caregivers, employees, and healthcare organizations. Research Design and Methods: To achieve these goals, we conducted a systematic scoping review and analyzed results using a convergent segregated mixed-methods approach. We summarized 75 articles on the topic of long-term care home building design by classifying structural design features and associated outcomes. Results: We identified 3 innovative design types (small-scale homelike models, large-scale homelike models, and special small-scale approaches). A wide range of potential positive outcomes were identified for residents, families, and staff. These outcomes included outcomes of central significance for long-term care, including improved quality of life, improved family satisfaction, and improved staff engagement in work. Discussion and Implications: Based on these results, environmental design is a critical contributor to long-term care quality.