Dementia care


difference to a person’s confidence. Using similar carpet/flooring throughout a building also makes a considerable difference as a person may perceive a colour change as a step or a hole, increasing anxiety levels and creating frustrating if it is seen as a barrier that restricts their movement around the building. When we talk about the symptoms


of dementia, those most commonly referred to are memory loss, particularly short term recall, a reduced ability to communicate and increased difficulty in carrying out daily tasks. However, other symptoms can include losing the ability to distinguish between colours, spatial awareness problems, confusion and disorientation. The design and finish of a building will


have a very strong influence on how a person with dementia reacts to their environment and the people within it. Getting it wrong will result in increased levels of agitation and aggression, which put unnecessary stress not only on the person feeling vulnerable but also on other residents and care staff. It may also lead to the use of antipsychotic medication if care staff believe a person’s behaviour cannot be managed by any other means. Various incidents of abuse have hit


the headlines over recent years and although always inexcusable, perhaps that harsh word or delay in attending to a person’s needs could have been prevented if the environment promoted independence and confidence for residents, giving carers more time to spend with those in most urgent need. Working in care is certainly


pressurised and the right environment can most definitely support staff too. A prime example of how enhancing the environment can have positive outcomes for both residents and staff would be ensuring residents can locate and use a toilet independently. The resident thereby maintains their dignity and independence, making them less reliant on care staff for support.


Long term solutions Simple enhancements to any environment should include the introduction of good colour or tonal contrasts. Care is needed with colour contrast as very different colours can have the same or similar light reflectance value (LRV; a way of gauging the quality of light that will result from any particular paint, which does not deal with the intensity of colour (brightness/dullness), only lightness or darkness), meaning


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someone with dementia or sight impairment may not be able to tell the difference. Hand rails in visibly contrasting


colours are essential in all corridors to support independence. Using good quality dementia friendly signage, which includes colour strategies, appropriate imagery, shapes and clear wording on non-reflective materials that are correctly positioned, gives residents the ability to locate different areas of a building unaided.


Personalising spaces, particularly the


bedroom, can give a person a sense of comfort, security and belonging as well as providing somewhere they can choose to spend time alone (as is their right) rather than in busy communal areas. Keeping residents informed of the


date and time often reduces levels of anxiety, although I would never recommend including the year as this can be confusing and cause unnecessary distress, as can the excessive use of mirrors. Care is also needed when introducing patterns; small images can look like insects for example and narrow stripes can appear to be bars, both of which may cause agitation and fear. Many homes that are not purpose


built have narrow corridors and restricted pathways for movement around the building. However, many environments can be improved. For example, Ashlands Care Home in Methley near Leeds has made some remarkable improvements to its environment, which have helped to overcome some difficulties and enhanced the overall experience of residents (see case study). The introduction of reminiscence


jigsaws, interactive memory games and various art activities give residents more choice of how to spend their time


The design and finish of a building will have a very strong influence on how a person with dementia reacts to their environment and the people within it


www.thecarehomeenvi ronment .com • January 2017


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