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Articulating Environmental Press in Environments for People With Dementia

Calkins, Margaret P. PhD

Feature Topic: Making the most of the day: Quality of life and Meaningful Activity

Alzheimer's is a progressive, degenerative disease that impairs the ability of the affected individuals to function independently. At the broadest level, there are 3 classes of interventions: pharmacologic, cognitive training, and environmental (physical and social) manipulation. The focus of this article is on this third class of interventions. For years, both long-term care facilities and families who provide care to people with dementia have worked to create physical and social environments that enhance or at least serve to maintain the ability of an individual with dementia to function as independently as possible. Unfortunately, the state of our knowledge about which strategies are most effective is hampered by the lack of a theoretical framework that specifically links physiologic changes that occur in the brains of individuals with dementia with aspects of the environment. This article, the first in a 2-part series, reports on the development of such a framework.

Internationally recognized leader in environments for the elderly, particularly people with dementia. She is a dynamic speaker and has written extensively. Dr Calkins is President of Innovative Designs for an Aging Society (IDEAS).

Address correspondence to: Margaret P. Calkins, MArch, PhD, President, IDEAS, Inc, 8055 Chardon Rd, Kirtland, OH 44094. E-mail:

This research was funded in part by the Helen Bader Foundation, Milwaukee, Wis.

©2004Lippincott Williams & Wilkins, Inc.