The Therapeutic Environment Screening Survey for nursing homes (TESS-NH): An observational instrument for assessing the physical environment of institutional settings for persons with dementia

A National Institute on Aging work group developed a measure to evaluate the capacity of a dementia care environment to provide for safety, security, physical health, orientation, privacy, control, autonomy, stimulation, enhancement of socialization, and personalization/ familiarity. The final instrument, the Therapeutic Environment Screening Survey (TESS-NH), contains 84 discrete items and one global rating. Inter-rater kappa statistics for 74% of items were above .60. In validation studies, light meter ratings correlated significantly with TESS-NH lighting items (r = .29-38, p=.01-.04). A scale of 18 TESS-NH items, The Special Care Unit Environment Quality Scale (SCUEQS), appears to be a valid, reliable overall measure of environmental quality.