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News archive - January 2014

A little goes a long way

A little goes a long way

Designing environments for people with dementia does not have to be expensive. In fact the cost of providing a holistic setting that promotes independence and relieves anxiety can be cheaper than you think.

This is the message being put across in an updated version of the guidance book, Designing interiors for people with dementia.

The new and expanded edition has been written by Liz Fuggle of BPA Architecture and is aimed at everyone concerned with the care of people with dementia. It is intended to assist commissioners, providers, operators, managers and staff of care homes as well as NHS facilities, including hospitals. It has also been written to help people with dementia living at home, as well as their carers, relatives and friends; and for architects planning the design of new facilities.

The icing on the cake

Speaking to hdm this week, Fuggle said: “There has been research around for several years on the importance of the environment for people with dementia, but more recently prominent people, including the Prime Minister, have put dementia at the forefront of conversation and that makes a big difference.

“In terms of the impact the environment has, it is quite clear from all the research that it makes a very big difference for people who have memory problems, confusion or anxiety.

“Having dementia makes it much harder to make sense of your environment.”

The book focuses mainly on interior design, showing how even the smallest intervention can have a profound effect on someone suffering from dementia.

Heavily illustrated, it initially covers the general principles of design, for example decluttering spaces, improving wayfinding, personalising individual areas, and improving lighting. The book then goes on to look at building elements such as glazing, floor finishes, handrails, lifts and acoustics; as well as appropriate furniture, and fixtures and fittings. There is also advice on deploying the solutions and change management.

Fuggle said: “A lot of people like to think that interiors are the icing on the cake and just something nice to have, but actually good interior design is critical in helping people to understand their surroundings and be more independent.”

Crucially these all-important interventions are often cheaper than many traditional alternatives.

“Flooring is a big issue within dementia care environments as tonally contrasting colours on floors and threshold strips will lead to an increase in falls,” said Fuggle.

“This means that when choosing colours, designers have to think holistically about the whole floor and how different surfaces meet, ensuring there is no tonal difference.

“What upsets and amazes me sometimes is that often a lot of money is spent on care environments, but many commissioners want to see a more high-tech solution when what will make a real difference is actually something less complex. In terms of dementia care environments, the small things often make the most difference. In some ways that is brilliant as it is so easy, but sometimes people don’t seem to want to hear about the simple things.”

Colour and contrast

As well as the importance of colour contrast to aid wayfinding and prevent trips, slips and falls, it can also have a positive impact in terms of highlighting specific areas. For example, storage cupboards along corridors or in communal spaces should be painted in the same colour as the walls so they do not stand out, while doorways and entrances to private and shared spaces should be painted in a contrasting colour so they can be easily identified.

Furniture is another important consideration. Specifically, ensuring appropriate furniture is used in the various different settings. For example, dining rooms should have dressers, dining chairs and tables with tablecloths and place settings to help the person recognise the kind of activity that is taking place in that room.

“Commissioners really need to think about things like appropriate chairs. Everyone is a different shape and the correct size and shape of chair is important if you are sitting for long periods of time. If sitting is uncomfortable a person will be restless, perhaps in pain and staff might not be able to pick up on other important visual clues.

“Creating a suitable environment is known to reduce anxiety and stress, instances of distressing behaviour, reliance on pharmacy, and falls, and it enables people lead more independent and fulfilling lives.”

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