Author: Chinchu Joseph, Facility Manager, Vermeer House
17th June, 2018
People with dementia often face difficulty in making sense of the world around them. The environment around them is important because, that should be supporting their functions, accommodating behavioural changes, maximizing their abilities, promoting safety and encouraging maximum independence. As caregivers we can design environments for them that help maintain their sense of control and personal dignity. In order to promote all of the functional skills and abilities that remain, importance needs to be given to what the person can still do, rather than what they can no longer do, and then design their environment in such a way that supports their maximum independence.
We, at Epoch Elder Care consider this as one of the major aspects in caring for a person with dementia. We personalise the room before the arrival of a resident to make the transition easier and comfortable for them and minimise changes in environment. Most people are still not aware of how small things can do wonders and support the life of a person with dementia if we can put little time and effort to customise the space where the person spends most of his /her time.
So what are the major aspects to consider when designing and personalising a room for a person with dementia? Here is a description of things we give importance to.
- Minimize confusion and maximize orientation
Dementia often causes lack of orientation in time, place and person. Even early stages of dementia can create confusion in time and place. This increases particularly in unfamiliar surroundings. So steps need to be taken to minimize this confusion.
How can we do our best?
- Personalized environment: Transition from home to an assisted living home creates a lot of confusion and frustration in people suffering from Dementia. Personalizing their room makes this period more easy and less stressful . We ask relatives to get old photographs, mementos, paintings, other familiar items which is used by their loved ones at home or which they are more attached to like their chair, table, eating utensils, any other items like their alarm, pen etc. before the resident comes. When they see all these in their new environment, which make them more comfortable and so reduces confusion. Colouring walls same as their home will also help.
- Personalizing room entry helps the resident to understand and locate their rooms easily by building an association (not remembering through memory). This can be done by colouring the doors, hanging decorations, placing decorated name board in bright colour etc. We decorated the door of one of our resident who is in the stage 5 using bright colours, whenever he entered into that floor, this helped him locate his room very easily without any confusion.
- Keep the environment clutter free and avoid complicated signs and symbols. A person with dementia may not be able to comprehend complex signs or language and it makes them more confused leading to increased anxiety and agitation. Keep their favourite items close to their bedside table, so even if they wake up suddenly there would be a sense of familiarity.
- Using colours: Always use bright and contrasting colours as this sharpens the environment as well as has an effect on the mood and feelings of the residents. This also helps the residents to differentiate between different things and surfaces. For example, using coloured towels in the wash room helps the resident to differentiate between bathroom wall and the hanging towel.
- Fix their schedule: Always try to keep the activity timings and schedule fixed and in same place to reduce confusion. Changing the timings and area may make the resident more confused and disoriented to the time and place .
2. Safety and Security
This is one of the major aspects to consider while designing a room for a person with dementia .While ensuring safety and security, the settings should allow the person to get maximum independency also. Here are some points which will be helpful:
- Use adequate lightings: This not only helps for aiding vision so helps them to prevent any falls or injuries but also helps keep sleep cycles intact. Proper lighting in bedrooms and bathrooms are very important to promote independence and safety.
- Use of Furniture: Use all furniture like chairs and tables with blunt edges to prevent any accidental injuries. Keep the furniture in appropriate places to avoid any interference with daily activities of the patient. Avoid glass table tops since depth perception of a person with dementia is affected and it can lead to mishaps.
- Floors: Floors should not be slippery. Use of carpets (sturdy and taped) will help minimize falls and injuries. Avoid wires, or any loose objects lying around on the floor.
3. Promote independence in activities of daily living (ADLs)
Activities of daily living are routine activities people do every day without assistance. This includes eating, bathing, getting dressed, toileting, transferring and continence. People with dementia may not be able to do all these on their own and the assistance required increases over time, our aim should be making them as much independent as they can. This provides them a sense of satisfaction and a feeling of meaningful life. To ensure the maximum comfort in their daily activities we can do many things which we may seem minor or silly sometimes but can change the daily life of a dementia person significantly. Here are some tips.
- Place all the belongings of the patient in a constant place- changing of places creates confusion and makes daily routine more difficult.
- Bathrooms can be customised to enhance more comfort and safety. Eg: Fixing grab bars, Increasing the height of the toilet by keeping a commode chair over the toilet seat, keeping things like soap, towels , mugs etc in designated places so that the person can easily locate and recognise those things.
By incorporating these small but important modifications we can bring many changes in the life of a person with dementia. These may slow down the progression of the disease, but this will definitely help them minimize confusion and promote comfort, can help reduce difficult behaviours and agitation and live a purposeful life.