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Residential care and senile dementia : the effect of the physical and social environment of homes for elderly people on residents suffering from senile dementia

Netten, Ann Penelope (1989) Residential care and senile dementia : the effect of the physical and social environment of homes for elderly people on residents suffering from senile dementia. Doctor of Philosophy (PhD) thesis, University of Kent. (doi:10.22024/UniKent/01.02.85957) (KAR id:85957)


Projected changes in the population structure are such that there is little doubt that the condition of senile dementia will present a major problem for the "carers", be they professional or "informal", in the coming decades. This problem has to be put in the context of a growing emphasis on caring for elderly mentally infirm people "in the community" rather than in hospitals. It is likely, therefore, that there will be an increased need for, and pressure on, residential care services. In the residential care of demented elderly people the major policy issues are: the use of specialist facilities, staffing, the role of the home as a community resource, building design, and, increasingly, performance review and monitoring. The study used a model based on the social ecology of aging to examine how these, and other environmental influences impact upon the demented elderly residents of the homes. The study was limited in scale and any conclusions drawn must be tentative, therefore. However, the results confirm some of the current trends in residential care policy and cast doubt upon others. On balance the evidence is in favour of the use of specialist facilities, although the wide variety of provision under this label needs to be recognised and the formation of "positive" regimes encouraged Recommendations to enhance the status of residential care staff are supported by the results of the study and there would appear to be a future in the development of in-service training which could build on the strengths and mitigate the weaknesses of backgrounds in nursing qualifications. The use of homes as resource centres for the communities in which they are based, needs careful consideration. While any policy which encourages visitors to keep up regular contact is likely to have a beneficial effect on residents, the provision of short-term respite care in long-term facilities is brought into question by the results of this study. The trend towards group-living units would appear to benefit the spatial orientation of residents. The study provides a starting point for effective monitoring of residential care by linking a number of indicators of "process", such as regime type, to outcomes for residents with senile dementia.

Item Type: Thesis (Doctor of Philosophy (PhD))
DOI/Identification number: 10.22024/UniKent/01.02.85957
Additional information: This thesis has been digitised by EThOS, the British Library digitisation service, for purposes of preservation and dissemination. It was uploaded to KAR on 09 February 2021 in order to hold its content and record within University of Kent systems. It is available Open Access using a Creative Commons Attribution, Non-commercial, No Derivatives ( licence so that the thesis and its author, can benefit from opportunities for increased readership and citation. This was done in line with University of Kent policies ( If you feel that your rights are compromised by open access to this thesis, or if you would like more information about its availability, please contact us at and we will seriously consider your claim under the terms of our Take-Down Policy (
Uncontrolled keywords: Health services; community care services
Subjects: H Social Sciences
Divisions: Divisions > Division of Human and Social Sciences > School of Psychology
SWORD Depositor: SWORD Copy
Depositing User: SWORD Copy
Date Deposited: 29 Oct 2019 16:22 UTC
Last Modified: 15 Feb 2022 11:38 UTC
Resource URI: (The current URI for this page, for reference purposes)

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