Dementia care

stimulate residents. Both physical and mental activity should be promoted and destination points – a reason to go somewhere and do something – can have a key role in this.

Destination points can be anything from a well stocked hat stand to a functioning café, hair salon or sensory garden. With some effort, the dining room and bathroom can also become valuable destination points that are associated with enjoyable experiences. Destination points should provide opportunities for engaging in activities while also creating reliable, attractive landmarks. Increased activity and a sense of purpose provide healthy, mental and physical stimulation through engagement with other people and with comforting surroundings. Carers benefit from the availability of activities that residents can engage in independently as well as those in which they can offer support and participation. A care home team should strive to create a sense of community with relevant focal points that are supportive of a community strategy.

Lighting quality

In the simplest of terms, but worthy of note, we can only see something if there is light bouncing off it. So, making things easier to visually interpret in a care setting is profoundly affected by the quality of lighting. There are no exceptions. LED lighting is the perfect illumination (ignoring natural light for a moment), especially if you’re prepared to invest in a circadian lighting system, but even if you’re not, standard flat panel LEDs will provide huge improvements over any other form of illumination as well as having a positive effect on the people who live and work in the home. Quality and levels of illumination can be easily and cheaply improved by replacing older lighting with new LED flat panel lamps. They distribute the light well with greater amounts of reflected light from wall surfaces (which will have been painted in appropriate colours, of course), helping to reduce troublesome shadows. The right lamps will reliably deliver the recommended amount of light without glare. LED lamps are cost-effective to buy and running and replacement costs are lower than any alternatives. Improved levels of illumination make surroundings more visible and easier to interpret. This impacts positively on levels of fear and anxiety, falls, depression, confidence, independence, appetite and activity. Light is essential to good health and profoundly affects mental and physical wellbeing. For the


A care home team should strive to create a sense of community with relevant focal points that are supportive of a community strategy

greatest health benefits from light, the sun is the best source of course, and people should be given every opportunity to safely enjoy natural daylight as often as possible. For additional, not too technical information on the effects of light on our health and wellbeing, Hammond Care’s new publication ‘Enlighten’ explains how we react to different types of light and the effect it has on us. It also provides some useful recommendations on ideal levels of light in various parts of the home depending on their function. Whether or not you think the lighting in your home is adequate, obtaining a cheap light meter and walking around your home with it, can be a useful exercise.

Toilets and bathrooms

Of all the things any individual would want to manage independently, using the toilet and bathroom are top of the list and there are two aspects to this – finding them and using them. An effective door sign means the facilities can be more easily located. Often, even in new buildings, the entrances to these vital facilities are set back and effectively hidden from view from any distance. To overcome this, a toilet or bathroom may need two signs to help locate it; one on the nearest visible wall surface or even a double sided projecting sign if it is sited down a corridor and a second sign on the door itself. Successfully located, the facilities within the toilet and bathroom should be high contrast and well lit to minimise hard and dangerous shadows. For example, toilet seats, grab bars and frames should all contrast clearly with the surroundings. Bathrooms need to be functional, but there are greater benefits if they have a therapeutic feel that promotes relaxation. Just think spa.

Creating toilets and bathrooms that are easy to locate and safe to use independently is important to promote dignity, confidence, self-esteem and much more. Losing any of these is detrimental in so many ways it would warrant an entire article in itself. Correctly presenting toilet and bathroom facilities is a small price to pay for ensuring residents maintain their dignity and self-esteem.


Most people severely underestimate the influence the environment has on physical and mental wellbeing. In a dementia care home the environment directly influences the habits and behaviour of the people who live there, work there and visit, all of which significantly reflects on the success of the home as a business.

These basic elements are commonly not addressed because of uncertainty about what to do and how to go about it. Some operators and managers with great aspirations fail to achieve them and are put off by misconceptions over cost and a lack of appreciation for the magnitude of the returns. Others acknowledge the importance of the environment but don’t really deliver.

The environment is gradually being recognised as the most effective, non- chemical means of improving the quality of dementia care, reducing costs and helping homes to remain or become viable, but which operators will be brave enough to take the necessary steps to fully embrace a resident-focused design strategy and lead the way for the rest of the sector?


Peter Rose

Peter Rose is the owner of The Care Home Designer and former owner of Find Signage. He has a background in engineering and has worked with care providers for 18 years, with a specific focus on dementia related design for 11 years. He has a track record of successful innovations that have become standard features in care facilities around the world. • November 2018

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