NeuroRehabilitation - Volume 25, issue 3

Authors: Zasler, Nathan

Article Type: Editorial

DOI: 10.3233/NRE-2009-0511

Citation: NeuroRehabilitation, vol. 25, no. 3, pp. 143-143, 2009

Authors: Calkins, Margaret P.

Article Type: Research Article

Abstract: Research on the impact of the built environment in long-term care settings continues to grow. This article focuses on work conducted and published since 2000, when an earlier review on research on dementia and design was published. The vast majority of research that addressed neurological conditions in residents in long-term care settings (assisted living and nursing homes) relates to Alzheimer's disease and related dementias.

Keywords: Design, architecture, dementia, sleep, disability, evidence based, neurodisability, neurobehavioral, accessibility

DOI: 10.3233/NRE-2009-0512

Citation: NeuroRehabilitation, vol. 25, no. 3, pp. 145-154, 2009

Authors: Joines, Sharon

Article Type: Research Article

Abstract: Objectives: To inform clinicians, caregivers and researchers involved with assessing and treating individuals with neurological disabilities of the benefits of universal design in enhancing quality of life. The improvement of quality of life has the potential to benefit the individuals with neurological disabilities and those whose lives overlap and intersect with those individuals. Methods: Literature and design reviews are used as a foundation for a model for incorporating and leveraging universal design to the benefit of the patient’s social sphere, which includes caregivers, family members and medical staff. By matching patients varied abilities with universal design solutions, the …model of universal design benefitting the patients’ social sphere will be demonstrated. Recommendations: Recommendations are made for clinicians and researchers that they may use in their practices and investigations in three areas: 1) educating patients to the benefits of universal design, 2) helping inform patients how to leverage universally designed products and approaches in their lives and living spaces and 3) understanding how to incorporate universal design principles into research and clinical spaces as demonstration pieces for patients. Show more

Keywords: Universal Design, neurological disabilities, inclusive design, design for all, stroke, spinal cord injury

DOI: 10.3233/NRE-2009-0513

Citation: NeuroRehabilitation, vol. 25, no. 3, pp. 155-167, 2009

Authors: Regnier, Victor | Denton, Alexis

Article Type: Research Article

Abstract: Residential styled environments for physically challenged people with neuro disabilities are rapidly replacing the standard institutional skilled nursing home. Ten trends are described that utilize residential design approaches to the physical environment while relying on home-care style methods for service delivery. Combined these two forces create powerful differentiators which make group residential settings more friendly and humane. Northern European, as well as, US best practices and prototypes are described that combine housing with services in a range of contexts. The success of northern Europeans in promulgating models of aging-in-place that keep those at risk more independent in the community or …within family settings are remarkable. Topics like the impact of small group living clusters, interior design treatments, access to landscape gardens, life skill management methods, movement systems for circulation and exercise, shared space priorities, unit design trends and innovative care giving techniques are introduced. The focus of the article is on specific practices gleaned from cultures and exemplars that appear to increase autonomy, independence and privacy for those who are threatened because of their disabilities with the loss of these lifestyle attributes. Promising concepts of service organization and community outreach are combined with detailed recommendations that address the need for lift technology and safety features in bathrooms and kitchens. Show more

Keywords: Architectural design, residential group living, older mentally and physically frail people, home care, northern european service housing

DOI: 10.3233/NRE-2009-0514

Citation: NeuroRehabilitation, vol. 25, no. 3, pp. 169-188, 2009

Authors: Brawley, Elizabeth C.

Article Type: Research Article

Abstract: Good lighting is perhaps the most important and least understood element in designing healthcare environments. Both physically and mentally challenged individuals become more vulnerable and dependent on their environment to compensate for sensory impairments, including dimming eyesight, which interferes to some degree with daily activities as well as social and leisure activities – the things that provide emotional and social well-being. Too few building designs today result in lighting that meets the needs of these individuals, regardless of age. Typical lighting in most care environments is inadequate to meet lighting needs affecting both vision and the photobiological (non-visual) needs …of synchronization of circadian rhythm, which impacts sleep and depression. Well-designed lighting is one of the most important design elements that will support an individual's ability to perform normal daily activities and decrease the level of disability associated with these impairments. Daylight contains the spectrum to which the circadian clock is most sensitive and provides higher light levels during the day. Easily accessible outdoor gardens encourage individuals outside, providing the necessary regular exposure to direct bright light that sunlight provides. The combination good interior lighting and regular daylight exposure contributes to regaining and maintaining an active and fulfilling lifestyle – greatly improving quality of life. Show more

Keywords: Lighting, adaptive healthcare environments, rehabilitation, light for vision, light for health, light quality, daylighting, glare, sunlight, sleep

DOI: 10.3233/NRE-2009-0515

Citation: NeuroRehabilitation, vol. 25, no. 3, pp. 189-199, 2009

Authors: York, Sherril L.

Article Type: Research Article

Abstract: The outdoor environment can provide many positive and therapeutic benefits for persons with complex neurological conditions. In order to benefit from outdoor exposure and experiences, individuals need to be able to access that environment. This article provides a discussion of physical and programmatic access to outdoor living elements in homes and residential facilities for persons with neuro-disabilities. Design considerations for outdoor elements such as common gathering areas, walking paths and paths to/between elements, gardens (viewing and working), and resting areas are presented using legal standards or universal design principles as guides.

Keywords: Outdoor accessibility, neurorehabilitation, outdoor living, community barriers

DOI: 10.3233/NRE-2009-0516

Citation: NeuroRehabilitation, vol. 25, no. 3, pp. 201-208, 2009

Authors: Gentry, Tony

Article Type: Research Article

Abstract: Smart home technology can include environmental adaptations that allow remote control of home appliances, electronic communication, safety monitoring and automated task cueing, any of which may prove useful for people with neurological disability. This article outlines currently available smart home technologies, examines the burgeoning research in this area, discusses clinical and consumer resources and reviews ethical, funding and professional training considerations for smart home applications. I conclude that more outcomes-based research and collaboration among stakeholders is essential in order to establish guidance for designing, selecting and implementing individualized smart home solutions for those with neurological disability.

Keywords: Smart home, EADL, cognitive orthotic, learning home, attentive home, connected home

DOI: 10.3233/NRE-2009-0517

Citation: NeuroRehabilitation, vol. 25, no. 3, pp. 209-217, 2009

Authors: Kiser, Laura | Zasler, Nathan

Article Type: Research Article

Abstract: This article provides readers with a review of the major considerations for designing living environments for persons with neurodisability due to acquired brain injury (ABI). Components that need to be considered in order to assure that the environment is designed with a functional perspective in mind are explored. The issues to be considered herein include the influences of cognition and visual and visuoperceptual, motor, behavioral, and sensory impairment on residential design considerations. Resources for individuals involved in residential design for this special population are also provided to facilitate design decisions and implementation.

DOI: 10.3233/NRE-2009-0518

Citation: NeuroRehabilitation, vol. 25, no. 3, pp. 219-227, 2009