Environmental cues: Their influence within assisted living facilities

Jeanneane Wood-Nartker, Denise A. Guerin, Emily Beuschel

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


OBJECTIVE: This observational study examined the relationship between the number of environmental sensory cues within assisted living facilities (ALFs) and the number of falls by residents, using Lawton's environmental press theory as framework. BACKGROUND: A result of declining physical health is unintentional injury, for example, falling, which is one of the leading causes of death for older adults. Physical limitations increase largely due to age-related physical and sensory decline, which can increase the risk of people falling. Therefore, fall prevention becomes essential (Willis, 2000). METHODS: On-site interviews were scheduled with 140 ALF directors located in the lower peninsula of Michigan. The researchers collected physical environmental data using a sensory cue checklist on a subset of rooms, for example, Lounge/Living Room, Dining Room, Corridor, Public Restroom, and Foyers in ALFs, because of the prevalence of falls within these rooms. RESULTS: Findings showed that fall rates and environmental cues sometimes have a negative correlation. A positive correlation was found between the number of residents living in an ALF and the mean number of cues included in the overall environment. Finally, there were a greater number of environmental cues incorporated when design professionals were involved. CONCLUSIONS: The need to control for facility size and for some room types when relating environmental cues to falls became clear. In addition, design professionals should have a thorough understanding of the nature of the facility and the need to control some factors in facilities, especially when including environmental cues.

Original languageEnglish
Pages (from-to)120-143
Number of pages24
JournalHealth Environments Research and Design Journal
Issue number3
StatePublished - Apr 2014


  • Built environment
  • Elderly
  • Evidence-based design
  • Falls
  • Safety


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