Residential Environment Impact Scale (REIS)

Residential Environment Impact Scale (REIS)

Learning Team 4: Trinity, Alana, Margaret, Noor & Josephine

start

CONTENTS

Overview

case study EXAMPLES

ADMINISTRATION

INTERPRETATION

SCORING

for more information

CONSOLIDATION ACTIVITY

Overview of the REIS

OVERVIEW OF THE REIS

This 5 minute video will explore:

1. What the REIS is 2. The target population for the REIS 3. The purpose of using the REIS 4. How to administer, score and interpret the REIS 5. How to access the REIS

Learning sessions

WELCOME TO THE TRAINING MODULE!

This module will explore how to:

ADMINISTER the reis

SCORE the reis

INTERPRET the reis

ADMINISTRATION OF THE REIS

administering

• The first step in conducting the REIS is to gather background information about the facility, staff and residents prior to the visit.
• This may look like contacting staff to arrange and identify suitable times to visit, and identifying resident's availabilities.
• Typically, the most ideal time to carry out the REIS would be when residents are in the facility and natural daily activities can be observed.

Step 4

Interviewing staff

Step 3

Interviewing residents

Step 2

Step 1

Observation of activities

Walkthrough of the facility (with residents if possible)

ADMINISTRATION OF THE REIS

administering

• The walkthrough of the home allows you to observe the environment and note down observations in accordance with the items in the REIS form.
• The observation of activities should have at least 3 activities in both private and communal spaces to develop an overall view of the interaction between physical space, support provided by staff, relationships with other residents, and the activities available and performed within the facility.

ADMINISTRATION OF THE REIS

administering

The staff interview, like the resident interview, can be as formal or informal as appropriate. There is also an interview guide provided in the assessment manual. Interviewing a variety of staff who have different roles would provide you with a range of professional and personal perspectives of the environment and support provided.

The interview with residents is flexible and should provide you the opportunity to explore the residents' perspectives of the environmental features. You should also be able to explore in more depth some concerns raised in earlier parts of the data gathering process, either through your observations or resident-raised concerns. The REIS manual has an interview guide for less experienced therapists or for those who prefer a more structured interview approach.

The interviews with the residents and staff should allow for information to be crosschecked. However, it is also important to consider confidentiality of those interviewed so explicitly asking for consent for information sharing is important.

CASE STUDY EXAMPLE

CASE STUDY - walk through of bathroom

CASE STUDY EXAMPLE

CASE STUDY - resident interview

CASE STUDY EXAMPLE

CASE STUDY - summary points

• The Residential Environmental Impact Scale (REIS) serves as a valuable tool for assessing the social and physical domains of residents in residential care facilities. In this case study it comprehensively evaluates the physical environment, including factors like accessibility and safety, and residents concerns regarding the social aspects such as communal spaces and social interactions. This dual focus allows for a holistic understanding of the living conditions in resdiental aged care facilities

• The insights gained from REIS assessment in this case study enable the occupational therapists identifying of areas that require improvement to enhance comfort, accessibility, and overall quality of life for the resident in these facilities.

• The common concerns raised by the resident in this case study include:

- Risk of fall in bathroom - Concerns about shared environment - Clutter within shared spaces - Environmental impacts - Neglect in recieving aid from care coordinators and health professionals

SCORING THE REIS

SCORING

As per the manual instructions; “for each item, the therapist is required to assign a rating of 1, 2, 3, or 4 as an indication of how the environment supports people’s identity and competence” (Fisher et al, 2014). The REIS contains four domains including

• Everyday space
• Everyday objects
• Enabling relationships
• Structure of activities

Each of the four domains contain multiple items in which a score is given based on a rating scale.

SCORING THE REIS

scoring

All items within each domain are scored using a 4-point scale. Based on the REIS rating scale:

A summary of the scores for each of the domains and items can be placed into the table below.

A score of 4 indicates that the environment is highly supportive of a person’s sense of identity and competence through providing extensive opportunities and resources for engagement and participation in meaningful activities.

A score of 1 suggests that the environment strongly interferes with a person’s sense of identity and competence, whereby limited opportunities and resources are offered to an individual. This indicates that improvements and further actions are required.

SCORING THE REIS

scoring

The scores are allocated based on the information the therapist has gathered from multiple sources including: 1) observations of the environment 2) observation of residents engaging in everyday routines 3) resident interview and 4) staff interview. The same rating scale is used for all items across all four domains, however, an extensive outline and criterion is provided in the REIS manual for each item to guide the therapist’s scoring. For example, in the ‘Everyday Space’ domain, when considering the accessibility of space, this may include:

• the placement of doors/rails/ramps
• poor/adequate lighting
• hazards and safety issues eg. untidiness/clutter and

uneven paths

SCORING THE REIS - QUIZ

quiz time!

the environment supports people’s identity and competence

Q1

the environment supports people's participation in leisure activities

As per the REIS manual instructions, the scores are indicative of how....

the environment supports people's physical and emotional wellbeing

SCORING THE REIS - QUIZ

ANSWER

CORRECT!

As per the REIS manual instructions, the scores are indicative of how the environment supports people’s identity and competence!

SCORING THE REIS - QUIZ

quiz time!

Structure of activites & Enabling Relationships

q2

Everyday Spaces & Enabling Relationships

Refer to the case study video earlier where Ms M. did a walk through of the bathroom with her therapist. Which domains would be most relevant for scoring based on the observations and information collected in this video?

Everday Spaces & Everyday Objects

SCORING THE REIS - QUIZ

ANSWER

correct!

The domains that would be most relevant for scoring based on the observations and information collected from the video where Ms M. did a walk through of the bathroom with her therapist would be: Everday Spaces & Everyday Objects!

INTERPRETATION OF THE REIS

INTERPRETATION

Following the scoring of the REIS assessment tool:

Results within the final summary report are interpreted to guide intervention planning in terms of modifying the residential environment to improve the perosn-environment fit.

Areas of focus for further assessment or intervention in terms of environmental modification or staff training would be on items where a score of 1 or 2 were obtained.

The therapist would be able to identify the strengths and main challenges or limitations of the environment that influences an individual's sense of identity and competence.

INTERPRETATION OF THE REIS

INTERPRETATION

Example interpretation for scoring of 1

Environment strongly interferes with the sense of identity & competence of the residents

Factors that contributed to a score of 1 for Accessibility of Space:

• Layout of furniture & accessories like cables in living room obstructing passageway
• Poorly lit room
• Information gathered from residents and staff regarding negative impact on residents' ability to mobilise with their walking frame or walker, or for residents with reduced vision
• Obstructions contribute to an increased risk & fear of falls

Potential Recommendations:

• Review the layout of the furniture or room to increase safety when mobilising through falls risk reduction
• Review the lighting of the room to ensure it is well-lit

INTERPRETATION OF THE REIS

INTERPRETATION

Example interpretation for scoring of 4

The environment strongly supports the sense of identity & competence of the residents

Factors that contributed to a score of 4 for Physical Attributes of Objects:

• Physical objects such as adaptive equipment (e.g. adaptive cutlery used within the kitchen) have been made fit for purpose
• The physical attributes of objects such as the sizing and weight are appropriate and comfortable to use, and support their ability to complete tasks or activities of daily living

Interventions will not need to be put in place or considered as the person-environment fit is sufficient for these areas

INTERPRETATION OF THE REIS - QUIZ

quiz time!

q1

If interventions around environmental modifications were required for a particular item as identified through the REIS, what would be the likely scoring of the item? Choose the most appropriate answer.

INTERPRETATION OF THE REIS - QUIZ

ANSWER

Correct!

As the scoring of 2 reflects how the environment interferes with people's sense of identity and competence, interventions around environmental modifications may be necessary to increase the environmental supports towards this.

INTERPRETATION OF THE REIS - QUIZ

quiz time!

Sink too low, too cold due to no heater

Q2

Unable to understand how to operate shower taps, lighting too dim in bathroom

Refer to the case study video earlier where Ms M. did a walk through of the bathroom with her therapist. What were some factors within the environment that may have interfered with the sense of identity and competence for Ms M.?

Slippery surface in bathroom, getting up & down from toilet

INTERPRETATION OF THE REIS - QUIZ

Answer

Correct!

Ms M. reported that her main concerns were feeling unsafe in the bathroom due to the slippery surface, and sometimes feeling unsteady when getting up and down from the toilet. Hence, this has been identified to interfere with her sense of identity and competence as she reported negative experiences around this.

Learning sessions

wrong!

Why don't you try it again? Courage!

Consolidation activity -True or False 1

Consolidation activity-True or False 2

FOR MORE INFORMATION

REFERENCES

Fisher, G., Forsyth, K., Harrison, M., Angarola, R., Kayhan, E., Noga, P., . . . Irvine, L. (2014). Resident Environment Impact Scale (REIS), 4.0 User's Manual. Chicago: The MOHO Clearinghouse, Department of Occupational Therapy, College of Applied Sciences at University of Illinois at Chicago Harrison, M., Forsyth, K., Murray, A. L., Angarola, R., Henderson, S., Irvine Fitzpatrick, L., & Fisher, G. (2023). Establishing the measurement properties of the Residential Environment Impact Scale (Version 4.0). Scandinavian Journal of Occupational Therapy, 30(6), 898–907. https://doi.org/10.1080/11038128.2022.2143891 Toit, S. H. J., Fitch, S. J., Jessup, G. M., & Low, L. F. (2021). The residential environment impact scale: Benefits and barriers to implementation in the Australian residential aged care facility context. Australian Occupational Therapy Journal, 68(6), 477–489. https://doi.org/10.1111/1440-1630.12757 University of Illinois at Chicago Board of Trustees (n.d.). Residential Environment Impact Scale (REIS) Version 4.0, 2014. Retrieved August 27, 2023, from https://moho-irm.uic.edu/productDetails.aspx?iid=5

REIS training module completed

CONGRATULATIONS!

Reflect on what you have learned in this UNIT

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