Ways to Improve the Environment for People With Dementia

Introduction

People living with dementia experience various difficulties due to the poor physical design of the environment where they live. Due to the changes that such people undergo upon the manifestation of the disease, the design and layout of the home have a big impact on such people. Besides, the items and products used at home, the living environment should be conducive and habitable and subsequently dementia-friendly. The environment on which this study is based is a 105-bed residential aged cafe facility that is located in a suburb of Brisbane Queensland Australia. Brisbane has a population of approximately 2.28 million people while the suburb has a population of 17,000 people. The cognitive and physical changes that occur in a patient suffering from dementia demand an enabling and friendly environment that has specific physical design features characteristic of the syndrome. Changes can be made on the environment where people living with dementia live to make it friendly.

Lighting

At the 105-bed residential aged cafe facility in a suburb of Brisbane Queensland Australia, the lighting is appropriate and bright and the small lights in the rooms create shades. At an old age, the eyes of a person with dementia become aged and the ability to see becomes reduced. An older person has a reduced contrast and can hardly see colors. Moreover, an individual with dementia finds it difficult to recognize whatever they see (O'Malley, Innes & Wiener, 2016). Imperatively, their vision becomes impaired. When the lighting is poor, people with dementia cannot see things clearly and this reduces their ability to do various things. Besides, poor lighting can lead to accidents, stress, and falls.

In retrospect, people living with dementia require good lighting and design to enable them to see and recognize items. The people living with dementia requires effective lighting to allow them to identify signs, rooms, spaces, and equipment.

Hence, the current lighting of the rooms appears appropriate. However, the shadows created by the mix of bright and the small lights in the rooms are not appropriate for people with dementia. The recommendation is, therefore, to install bulbs that will cause not shadows that can confuse people (O'Malley, Innes & Wiener, 2016).

Seating

The residential aged cafe facility has chairs consisting of a stripe pattern and lots of colors. The chairs are very deep and it is hard to get in and out. Deep seats make sitting down complicated and uncomfortable for people living with dementia. They, therefore, require seats that will allow proper and comfortable sitting. People living with dementia have problems with bold stripes since they cause confusion and disorientation making living in the room uncomfortable. Due to their blurred vision, people living to require seats whose colors are bright or bold but contrast with the walls and floors. Using such contrasting colors makes a person identify the seat easily without much struggle. A contrast of the colors allows the person to differentiate between different items.

People with dementia require seats that are comfortable so that they do not become strained. According to the dementia design checklist, the layout and the design of the furniture should enable and not restrain people.

The chairs are very deep and hard to get in and out. This design is not friendly to the dementia people hold be reconsidered to have a seat in which the patient can sit comfortably. Dementia Design Checklist requires that the layout and the design of the furniture be in a position to enable comfort and not restrain people (O'Malley, Innes & Wiener, 2016). However, the current situation of chairs at the delivery care facility makes people restrain. In this regard, the management should consider redesigning sits such that they are not very deep but shallow so that people can sit well and get out well without straining.

Besides, the cafe facility has chairs consist of a stripe pattern. These bold stripes are likely to cause confusion and disorientation of the people living within. The second recommendation is hence to avoid bold patterns. While the stripes patterns should not be bold, the colors on the seats should be bold or bright and contrasting with the walls and floors. Such contrasting colors make the seats to stand out and can hence be identified and used appropriately without the intervention of an assistant.

Signage

At the facility, the doors in the rooms bear the name of the resident for instance; the common toilet doors located in the corridors bear the basic signage, however, there is no signage at all in the rooms such as toilets and shower in every room. Besides, the facility has a plain white sliding floor and there is no signage in the toilet and shower room, although the walls, cabinets and toilets seats are white.

According to the Dementia Design Checklist, the facility where the dementia people stay should be furnished with landmarks that can assist people to find their way to certain areas (O'Malley, Innes & Wiener, 2016). Such landmarks should be attractive and interesting. Such landmarks imply signage or signs that can indicate the presence of a bedroom, toilet, sitting room, dining room, kitchen, among others. Visual signage in the bathrooms and toilets allows proper navigation and identification.

The recommendation to improve the signage for the residential care facility is the installation of the signage in all the rooms such as toilets and shower in every room. Moreover, the signage in the toilet and shower rooms should be painted in colors such as blue to contrast the white colors in the walls, cabinets, and toilets seats.

Navigation

The facility has no navigation signs at all, and the corridors have an H shape with the nursing station in the middle. The design of the facility has an effect on the cognitive ability of people living with dementia. As stated by Guure, Ibrahim, Adam & Said (2017), dementia causes problems such as difficulty in walking, poor judgment and the inability to recall recent events. A person with dementia cannot organize ideas and this is why the care facility should be easy to navigate so that there is no confusion along the way. To make the navigation easy for people living with dementia, the walking surfaces should be flat, adequately lit, and possess easy to identify entrance, to prevent falls, trips and loss of direction (Stankiewicz & Kalia, 2007).

According to Health Facilities Scotland (2007), landmarks support and guide navigation for a person with dementia. Such landmarks should be consistent, informative, and salient. Landmarks ought to bear the information on the navigator position and allow movement to a certain direction (Stankiewicz & Kalia, 2007). The mental representations and cognitive processes of an individual can aid in navigation. The neurons and their coding spatial information contribute significantly to navigation, hence, this ability is used to make environment dementia friendly.

The Dementia Design Checklist recommends the use of landmarks to necessitate navigation around the house, whether inside or outside the facility (O'Malley, Innes & Wiener, 2016). Moreover, it states that the areas should be attractive and interesting through painting use or use of the plant as the landmark. In this regard, the recommendation that suitable for the residential care facility is that the navigation signs be put in place so that ever entrance has a landmark showing the direction to take. The landmarks should be painted using a unique color such as green or blue to contrast the plain color on the floor. However, the H shape at the nursing station is suitable and appropriate for effective cognitive ability and should hence remain as it is.

Flooring

The floors consist of the occasional glare emanating from the lights, however, the overall floor has a good calm pattern with light wood. According to Cronin - Golomb (2011) people with dementia experiences problems related to motion perception. People with impaired cognition have problems with optic flow perception and the implication of the problem is that they make a poor judgment when moving from one place to another. Their navigation becomes impaired and movement becomes a problem. It is for this reason that the floor needs to be relatively flat without stairs. Moreover, people with dementia have impaired vision and will not see the stairs, hence will end up a step on them improperly and this can make them fall.

The guidelines for a dementia-friendly environment requires that the floor be plain and have no stairs. According to the Dementia design Checklist, the floor should be plainly covered and in contrast with the walls and furniture in the room (O'Malley, Innes & Wiener, 2016). Secondly, the occasional glare emanating from the lights should be removed. In addition, the patterned white light on the floor is dangerous since it can cause confusion. According to the Dementia Design Checklist, when used in areas where people with perceptual problems live, patterns cause problems (O'Malley, Innes & Wiener, 2016). The floor should hence me made up of only plain or mottled surfaces that do not cause any confusion.

Conclusion

The environment in which a dementia patient lives matter a lot since it has a great impact on their life. Aligning the environment with the cognitive and physical changes that a dementia patient undergoes is crucial for every associated facility. The coloring of the room should not be contrasting and have the lighting should be made without low glare, reflections, and shadows. It is, therefore, possible to improve the lives of the people living with dementia by developing environments that have suitable and friendly physical, social and psychological elements. Such environments, aid in improving the capabilities of the people living with syndrome rather than deteriorating their conditions. Modifications of the rooms and the general environment are essential in making the life of patients effective and better. Hence, having proper lighting, effective signage, good flooring, appropriate seating and navigation at the 105 residential care facility will be very important in improving the capabilities of the people living with dementia.

References

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Cronin - Golomb, A. (2011). Visuospatial Function in Alzheimer ' s Disease and Related Disorders. In A. Budson & N. Kowall, The Handbook of Alzheimer's Disease and Other Dementias (1st ed., pp. 457-482). Blackwell Publishing LtdBlackwell Publishing Ltd. Retrieved from http://www.bu.edu/neuropsychology/files/2015/02/Cronin-Golomb-AD-chapter-Budson-2011.pdf

Guure, C., Ibrahim, N., Adam, M., & Said, S. (2017). Impact of Physical Activity on Cognitive Decline, Dementia, and its Subtypes: Meta-Analysis of Prospective Studies. Biomed Research International, 2017, 1-13. doi: 10.1155/2017/9016924

Health Facilities Scotland. (2007). Dementia Design Checklist. Health Facilities Scotland, a Division of NHS National Services Scotland.

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Stankiewicz, B., & Kalia, A. (2007). Acquistion of structural versus object landmark knowledge. Journal Of Experimental Psychology: Human Perception and Performance, 33(2), 378-390. doi: 10.1037/0096-1523.33.2.378

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