Falls


Physical and visual clutter can be overwhelming.


only be achieved if a systematic inclusive design approach is built into the project from inception through to completion. The day-to-day management and operation of an environment is also key to achieving successful outcomes for residents and staff alike.


Reduce sensory clutter Our brains are continually processing sensory information to understand and interpret our surroundings. For those living with CSI, managing this cognitive and sensory load can be more difficult – therefore, the less a person needs to process at one time, the easier and less taxing it will be. If we design familiar, intuitive, and uncluttered spaces, people will have more capacity to enjoy their surroundings and the people within it.


A primary goal should be to deliver


relevant information without overloading the senses. We can assist a person to read and interpret their surroundings without being overwhelmed with sensory input, aiming to reduce or eliminate auditory and/ or visual clutter which will confuse and distract, and ultimately may result in a fall. We can use design interventions including light, colour, contrast, texture, and acoustic design to compensate for lost abilities and support people to better understand and read their environment – thus, freeing up cognitive and sensory capacity to focus on the task in hand, in this instance, walking whilst maintaining gait and balance. All the senses should be considered and


supported to achieve optimum outcomes. The acoustic environment also needs to be considered. In many care spaces, a TV is a common feature, intended for the entertainment of residents in a shared space. In fact this TV - or other auditory


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distraction - could well be stopping residents from talking to each other, communicating their needs with staff, or from focusing on essential tasks. The acoustic tolerance threshold for


someone with CSI can be greatly reduced and a busy environment may be uncomfortable and disabling. Our goal in acoustic scenarios is to design environments that support social interaction and clear communication. Reducing or eliminating unnecessary noise will free up cognitive capacity and allow a person to focus on their journey with less distraction. Another example is floor finishes:


patterned finishes, changes in materials, threshold strips, polished surfaces, and floor mats all need to be interpreted and recognised – occupying cognitive capacity that could be deployed for other purposes, including walking. If a person misinterprets a mat as a change in level or perceives glare on a polished finish to be a liquid spill, they will hesitate, adjust their gait, and this can result in a fall. Enhanced visual clarity and


reduced visual clutter are fundamental requirements in supportive environments. We have all at some time experienced an environment in which we feel uncomfortable, overwhelmed, or even anxious or scared. We must recognise that, for us, the threshold of tolerance for poorly designed spaces may be higher than that of a person living with CSI. Some people can compensate and adapt while others are hypersensitive to their surroundings and the cognitive and sensory input required to navigate a space might overload their remaining abilities resulting in a fall. If we design for people who find it difficult to adapt to their environment and need additional support to stay actively


Pattern, reflection, shadow, and gloss finish add complexity to the visual environment, requiring cognitive capacity to interpret and decode, distracting from the task of walking.


engaged and mobile in their community, we design well for everyone.


Building legibility


Visual access and spatial proximity are also fundamental requirements for people living with CSI.


We must consider that a person living with CSI may not have the capacity to retain new information – for example, remembering the location of a communal toilet or their own bedroom. They struggle to build familiarity with a new setting, so every journey is a new challenge. Small scale units with simple layouts and direct visual access to key facilities are preferable to large units with institutional scale and feel. Design can support self-care and dignity if we enable residents to maintain independence. Designers can provide cues, prompts, and signage to support memory, orientation, and wayfinding, but the preferred solution would be to have optimised the spatial layout at the initial design stage of a project, so residents have direct access to facilities in the building which they use on a regular basis. Direct visual access is always preferrable to


www.thecarehomeenvironment.com February 2023


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