Durham School of Architectural Engineering and Construction


First Advisor

Erica Ryherd

Date of this Version


Document Type



A DISSERTATION Presented to the Faculty of The Graduate College at the University of Nebraska In Partial Fulfillment of Requirements For the Degree of Doctor of Philosophy, Major: Architectural Engineering, Under the Supervision of Professor Erica E. Ryherd. Lincoln, Nebraska: August, 2023

Copyright © 2023 Brian Joseph Puckett


Nursing homes are complex, multi-faceted environments which provide necessary medical supervision and housing for older adults in need of long-term care. With cognitive and sensory impairments being common adversities faced throughout the aging process, research is needed to better understand characteristics of the built environment which may contribute to difficulties for nursing home residents. Noise, in particular, has been shown to be problematic for nursing home residents in a variety of ways including disrupting sleep, associating with behavioral and psychological symptoms of dementia, and leading to increased readmission to hospitals due to verbal communication misunderstandings. As the older adult population grows rapidly, there is a need for additional communities and resources tailored to meet the environmental qualities which promote a high quality of life in the nursing home. In the first phase of this work, different types of nursing home residences were analyzed on measures of their quality of care. The subsequent phase measured noise levels in 27 spaces across three nursing homes to obtain information about typical noise conditions over 72 hours at each facility. The final phase of this work investigated word recognition accuracy of medically related speech between older and younger adults in different types of background noise via online speech intelligibility testing. Results suggest that various characteristics of nursing homes can impact residents and that measured noise levels in nursing homes present concerns for resident health outcomes and verbal communication between older adults and caretakers. The studies provide novel groundwork to allow for future analyses to be conducted on the impacts of nursing home acoustics on older adults.

Advisor: Erica E. Ryherd