Title : Enhancing well-being and self-directed engagement through therapeutic environmental design for ageing individuals with Intellectual Disability (ID) – A pilot study
Abstract:
Introduction: As individuals with Intellectual Disabilities (ID) age, they often face declines in physical, cognitive, and sensory abilities, undermining independence and quality of life. Therapeutic environmental design offers a promising approach to mitigate these challenges by creating supportive, engaging spaces. This study provides preliminary insights into how such design enhancements can promote self-directed engagement and well-being among ageing ID populations within a single residential home.
Design Description: This project implements a person-centered therapeutic environmental design to create an engaging living space for residents with moderate ID. Drawing on Montessori and reminiscence therapy principles, it fosters self-directed engagement, multisensory stimulation, and nostalgic familiarity. Two corridors—"Montessori Street" and "Reminiscence Street" address physical, cognitive, and psychological needs while enhancing emotional well-being. Features include autonomy-promoting tools (e.g., accessible activity stations), multisensory elements (e.g., tactile panels, calming sounds, colour-coded pathways), motor skill-focused activities (e.g., interactive panels), and nostalgia cues (e.g., historical photos, rotary phones), tailored to encourage exploration and emotional well-being in ageing ID individuals.
Methods: This mixed-methods post-intervention evaluation was conducted in a residential home for ageing individuals with intellectual disabilities. A purposive sample of 62 residents and 31 staff participated. Qualitative data were collected through observations and semi-structured interviews to explore emotional well-being and behavioural changes. Quantitative data were collected using a survey to assess the perceived impact of the therapeutic environmental design across four domains: participation, freedom of choice, satisfaction and preference. Thematic analysis and descriptive statistics evaluated the design’s effects.
Results & Discussion: Quantitative findings from 62 residents demonstrated moderate-to-high perceived benefits across all domains including self-initiated exploration, ability to select preferred activities, liking for the design, and overall satisfaction. Staff responses (n=31) indicated higher ratings, particularly for exploration and satisfaction.
Qualitative feedback highlighted that users particularly appreciated the nostalgic elements (e.g., historical photos, rotary phones), which evoked memories of their past experiences, and found the designed activities, such as fruit-themed sorting tasks, to be enjoyable and engaging. Staff reported increased smiles, happiness and eagerness to share life stories. The rise in engagement underscored the design’s positive influence on well-being. Though user satisfaction varies, reflecting individual needs and preferences, this model shows promise for residential care, with potential refinements to reduce staff reliance and broaden applicability.
Conclusion: The therapeutic environmental design enhances autonomy and well-being in ageing ID populations, offering a promising care model, with longitudinal evaluation is needed to confirm sustained benefits.
