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2023 Advancing Research on Care and Outcome Measurements (ARCOM)

Continued Development of the Next Generation Environmental Assessment Tool

How can researchers effectively assess the range of care environments for individuals with dementia?

Margaret P Calkins. Ph.D.
IDEAS Institute
Cleveland Heights, OH - United States


Many studies show that individuals living with Alzheimer’s and other dementia benefit from a holistic care approach – one that considers an individual's physical, mental, and emotional needs. More traditional care models, where patients are passive recipients of medical services, are evolving into more “person-centered” approaches designed to empower patients. Person-centered care is now a key part of practice recommendations endorsed by the Alzheimer’s Association.

One important element of person-centered care is the care environment. Studies in long-term care facilities show improved outcomes for residents, families, and staff when person-centered values and practices are adopted into the environment. More research is needed to understand the specific environmental factors that might support person-centered care and lead to these improved outcomes.

Research Plan

Dr. Margaret Calkins has worked with colleagues to expand and validate an environment assessment tool known as the Environmental Audit Scoring Evaluation (EASE). The EASE includes 145 environmental factors found to associate with resident well-being or care processes at long-term care facilities.

Dr. Calkins plans to administer EASE in 200-250 different long-term care facilities that accommodate individuals with dementia across the U.S. and Canada at all care levels. Dr. Calkins will include traditional, institution-style facilities, facilities that take a household-style approach, and hybrid facilities. The study will include both memory care centers and places where residents of different cognitive abilities reside together. Dr. Calkins’ team will administer EASE in each setting. Their goal is to determine whether EASE can be used across the wide range of facilities that provide care for individuals with dementia. Dr. Calkins also plans to refine EASE if needed based on the findings to enhance its applicability, ease of use, and validity.


This study could establish EASE as a reliable tool for assessing the many different kinds of long-term care environments. A validated tool would provide more rigor for future environment-behavior research. This could lead to improvements in person-centered care for individuals living with Alzheimer’s or other dementia.

The ARCOM Grant Program was developed jointly with Leveraging an Interdisciplinary Consortium to Improve Care and Outcomes for Persons Living With Alzheimer’s and Dementia (LINC-AD).

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