Design Considerations for Dementia

Amanda Massengale
Feb 26, 2019
7 min read

Dementia causes those effected to experience the world around them differently than most people. Not only does it affect their brain functioning but the way they interpret things through their five senses. The way a senior resident with dementia experiences a space is in the hands of the designer when it comes to everything from the lighting to the color pallet chosen.

All About Lighting

When choosing lighting for a dementia care community its important to consider key elements including consistency, color, watts, glares, and different sources of lighting. The biggest aspect of lighting is the amount of light throughout the space being consistent. Designers must be aware of light and dark spots throughout the space due to the possibility of dark spots bringing distress to the brain of the resident. In many cases, residents with dementia can interpret the dark spot as a hole in the ground, causing fear that the resident is going to fall. Also, the even lighting throughout the space will help residents move throughout the space smoother. It is important to make sure lighting units are evenly spaced and the area is provided with the correct amount of light needed to do daily activities. Color is an aspect that could actually help with the residents circadian rhythm. By implementing the changing of colors that reflect the changing of lighting outdoors, designers can help residents understand time of day. Warm reds and oranges in the morning to mimic the rising of the sun can help the body wake up, brighter natural light during the day to depict the sun at its fullest and encourage more activity, and repeating the warm reds and oranges at night to mimic the setting of the sun can calm the resident and encourage the resident to settle for the night. Wattage of lighting is very important in designing for any time of elder care because by the age of 75, residents require twice as much lighting as the standard and four times as much lighting as a young 20 year old. To accommodate, it is recommended to use more watts in a space to continue the consistent lighting throughout the space. Glares can also be caused by uneven, inconsistent spacing of lighting. Glares can cause disorientation and confusion in a space. By spacing lighting units properly and even incorporating light fixtures that hide the light source, you can greatly decrease the glares in the space (Progressive AE, 2016, September 28).

Lighting should also come from a variety of sources including natural lighting, nighttime lighting, and task lighting. Natural lighting should be included throughout the space to encourage outdoor activities. A secure access to an outdoor courtyard is highly recommended and all windows should have a good view that allows for the natural rhythms of the body to stay in high function and to encourage well-being. Nighttime lighting should be provided during the night to help the residents understand time of day and to help with their circadian rhythm. Lights should not be set to cool lighting outside of their rooms to illuminate the corridor. Instead they should have settings that allow the fixture to change to a yellow and red to allow them clear sight to maneuver but also signal to them the time of the day. Task lighting should also be provided in bedrooms and activity areas to allow for residents to have direct lighting over their daily activities such as crosswords, knitting, reading, or even shaving (Progressive AE, 2016, September 28).

Colors, Patterns, Materials, & Finishes Galore

Materials and finishes used throughout the design should also be highly considered when designing specifically for dementia care. When choosing colors, it is important to understand that residents with memory impairment cannot see the difference in colors on the blue-violet spectrum (Interior Perspectives Part 1: Selecting the Right Finishes, n.d.). There should be a drastic color difference between walls and flooring. This can help residents to get around easier and understand when the space they are in. Same goes for surface changes, it should be apparent to a resident where the edge of a table is in comparison to the floor. Rule of thumb is anytime there is a change in height, there should be an apparent change in color. Textures and Patterns should also be considered and should be true to what they are. All signals being sent to the brain regarding the different senses should match, for example, wood textures should look and feel like wood textures. When it comes to patterns, carpets should not have large changes in color, this can cause a misunderstanding in depth and bring fear to a resident that they are going to fall. Patterns on furniture should also be carefully considered. Hallucinations in residents could be triggered that make them believe the pattern is moving and sometimes even talking. To prevent this, keep patterns small and realistic when possible to avoid confusion (Progressive AE, 2016, November 21).

Furniture Selections

Furniture for a memory care community should be durable and easy to clean, easy to understand, should not hinder them from independent daily activity, and all furniture should be ergonomically designed for easy use. Furniture should be very durable and easy to clean in all situations, yet each piece should still have a residential feel to them to give the resident an at home feel. Lounge chairs should have firm, high arms to assist them when standing up and sitting down, a removable, firmer cushion so users do not sink into the chair making it harder for them to stand, and chairs should have an open base for easy cleaning. Crypton fabrics are recommended because they are water resistant and easy to clean. Furniture throughout the space should be easily recognized and its purpose should be easily understood. Abstract furniture is not ideal and patterns that can be misunderstood are not recommended since a resident may try to interact with the patterns on the fabric chosen. For comfort, tables could be adjustable to make it easier for a frontward approach and avoid the impact of the chair arms. Locking motion casters on chairs can also help residents move chairs around as they sit. In addition, all furniture should be ergonomically correct so residents can use them easily and safely. (Progressive AE, 2016,September 28). Movement is a huge aspect of memory care and keeping a resident active, so by providing stationary rockers, residents are able to rock their seat and backrest while keeping their feet and hands in place to not cause instability. These rockers can promote blood flow for those who have a hard time getting on by their feet (6 Tips for Designing Memory Care Spaces, 2018).

Artwork Innovations

Artwork in memory care should be realistic and unstimulating to not cause confusion to the resident. Like in patterns and fabrics, it is not recommended to have any abstract artwork throughout the space to avoid hallucinations and confusion. Instead, incorporating therapeutic artwork is an emerging trend. This may include tactile art, textured panels, audio art, decorative light panels on ceilings, hobby windows to express a resident’s old hobbies, large ultimatescrabble on the wall to encourage socialization, and resident shadow boxes. Each of these forms of artwork bring a sense of excitement to the space while also stimulating recollection, encouraging long-term memory stimulus, and bringing a sense of awareness and belonging to a space. A very important aspect of artwork is providing resident shadow boxes and hobbywindows outside of each resident’s room (About Memory Care, n.d.). These boxes help theresident understand the room they belong to, but also it stimulates the memory center to remind them of important places, activities, and people in their past. Shadow boxes and hobby windows also spark conversation with caregivers, by giving them the reminder of these times in their life they are accessing their memory center but also by sharing their experiences they are keeping their cognitive and logical thinking active (5 Reasons to Make a Memory Box for Alzheimer's, 2017).

Safety, Security, & Accessibility

Safety and Security are an imperative factor in memory care design. When creating a secure environment it is important to keep the space comfortable by providing safety measures that do not make them feel uneasy or anxious by making the space actually safe while also

perceived safe. Simple safety measures for the resident’s health could include locked cabinets forhazardous materials such as shampoos and lotions, as well as locked windows that still allow the resident to see the outdoors, and garden fences that do not resemble a fence or a cage but instead add interest to the space. Accessible entry and exits should be regulated due to the residents need to wander. In some cases, having direct exits to the outside from common areas can cause frustration due to others being able to come and go while they must stay put. In this, it is important to consider adjacencies to exit doors to limit the residents exposure in activity areas. Egress and accessibility should also be considered in designing to allow for all potential users of the space to interact and function within the community. All egress and accessible routes should follow ADA guidelines (Designing for memory care, senior-living facilities, n.d.).

Overall Design

The overall design of the community can either help or hinder residents during their time in the community. For the overall design to be effective designers must consider keeping the space as home-feeling as possible while keeping the quality of furniture and spaces up to a high standard. Residents should feel independent in their stay, so keeping a constant flow and an understanding of each space can make a huge difference in their mind. Wayfinding can be incorporated through different colored spaces and large tactile signage that allows the resident to understand where they are and what that space is used for (Designing for memory care, senior- living facilities, n.d.). Colored door panels can help residents identify the neighborhood they are in, and different colored activity rooms can help a resident understand the use of that specific room (Progressive AE, 2016, November 21).

References

5 Reasons to Make a Memory Box for Alzheimer's. (2017, November 17). Retrieved from https://www.alzheimers.net/2014-02-06/memory-boxes-for-patients/

6 Tips for Designing Memory Care Spaces. (2018, July 30). Retrieved from

https://www.directsupply.com/blog/6-tips-for-designing-memory-care-spaces/

About Memory Care. (n.d.). Retrieved from https://www.artlineltd.com/about-memory-care

Designing for memory care, senior-living facilities. (n.d.). Retrieved from

https://www.hfmmagazine.com/articles/2730-designing-for-memory-care

Interior Perspectives Part 1: Selecting the Right Finishes. (n.d.). Retrieved from

https://meyerseniorliving.com/interior-perspectives-part-1-selecting-the-right-finishes/

Progressive AE. (2016, September 28). Why Lighting Is So Important When Designing for

Dementia Patients. Retrieved from https://www.progressiveae.com/importance-of-Lighting/

Progressive AE. (2016, November 21). Designing Interiors That Work for Memory Care

Residents. Retrieved from https://www.progressiveae.com/interiors-for-memory-care/

Progressive AE. (2016, September 28). Choosing Furniture and Fixtures in Memory Care.

Retrieved from https://www.progressiveae.com/furniture-fixtures-memory-care/