People living with dementia can experience a changed perception,
often resulting in visual misinterpretation and disorientation.
For example, a dark patterned carpet can be perceived as a hole in the floor and
white and cream colours of walls and floors can all blend into one.
These perceptions can cause individuals to feel anxious, confused, agitated and distressed.
Each Step, Blakeley, is a dementia friendly care home, designed to meet the needs of people living with dementia
and to ensure that emotional wellbeing is achieved for each of its residents.
Sue McLean is the director of quality and standards for community integrated care at Each Step.
Sue talks us through how Each Step have created their environment for people living with dementia
as there are various approaches that can be taken.
Simple changes to create a more dementia friendly environment can have a positive impact
on a person living with dementia’s emotional wellbeing and independence.
Each Step is a new concept for community integrated care.
We wanted to create an environment specifically for people with dementia.
The environment that we created at Each Step was looking at what is the best practice for people with dementia,
what creates a sense of calm, what reduces people’s agitation.
The environment can have a huge impact on people living with dementia.
It’s very much around the environment being very bright, being light and airy.
We focused very much on not having very bold, dark patterns.
People with dementia can often interpret very busy patterns as somebody looking at them,
something jumping out at them, which can obviously increase people’s agitation, people’s restlessness.
So what we wanted was colour, we wanted contrast because again
people with dementia can relate to contrasting colours.
Each of the corridors have a themed area so some of them are photographs of actors and film scenes.
As people are wandering around it gives a topic of conversation, we can point out the pictures
and if there’s a member of staff with that individual
conversation can start, they can discuss the old films that people have seen.
We have memory boxes for each individual and what that is, it’s just a box on the wall that
people can put in photographs or ornaments, anything that might allow them to remember
‘this is mine’ and ‘this is my bedroom’.
Along the corridors we have sideboards that have different coloured handles.
They are strategically placed on the corridors, as people are wandering around
they’re drawn to the contrasting colours, they can open the drawers, they can rummage in the drawers,
again it’s an activity that they can do but it also breaks up the journey along the corridor as well.
We chose block coloured curtains, fabrics and carpets because often if you have multiple colours,
this creates an illusion of either a hole or a shadow and that increases people’s confusion.
We chose signage for toilets and other areas that had both the picture and the words.
Sometimes individuals can relate more to the picture, other people can relate more to the word.
We chose mirrors and glass that wasn’t reflective because again that’s very important
to people with dementia, if they’re looking at something that’s reflecting back
again it’s creating an object or a shadow, and it’s important for people with dementia to be able to
see out into the garden, to have lots of natural light.
And we’ve also got some specialist lighting as well.
Very often in the evening a lot of people with dementia experience something called ‘sundowning’
as the sun goes down, people’s agitation increases.
In bedrooms, we had specialist lighting in the en suite facility that when people swing their legs out of bed at night,
a light comes on in the en suite facility.
And if people have the door closed, we’ve had the doors fitted so there’s about a half an inch gap right round the door
so the door frame lights up so that people can be guided,
that this is the bathroom, this is where you need to go.
So a lot of thought was given around the lighting when we designed the building.
Again when we designed the building we wanted lots of fresh air
and a garden that was again meaningful to the people that live here.
We didn’t have a lot of space within the site, so we haven’t got a huge garden.
But we planned the garden so that again wherever you walk you never come to a dead end,
and we have eight meaningful destinations in the garden.
So that might be one area, that focuses on plants that you can touch,
other areas are plants that have a lot of smell, we have a gardening club,
we have raised flower beds that people can stand and plant in.
Believe it or not, it took us a whole day just to pick out the plants for the garden,
around things that weren’t poisonous or that were suitable for people with dementia,
so again lots and lots of thought went into the garden area.
things you would have in your own home that people would relate to.
Because it’s a dementia care environment doesn’t mean that you can’t have ornaments,
you can’t have all the things you would have in your own home.
One of the meaningful activities that we encourage people to do is cook their own lunch,
whether that’s warming some soup up or making a sandwich,
we encourage them to do all the activities that they would normally do at home.
The environment at Each Step can be very easily applied to people’s own homes,
in simple terms such as just removing very busy patterns,
very dark colours, making people’s homes quite bright and airy.
And that might mean just some paint on the walls that’s a bit lighter than had previously been there.
It’s very important to assess an individual’s needs when creating that environment.
Everybody is very individual and everybody has very different needs so it’s about what’s,
understanding what’s important to that individual – do they like to have their familiar objects round them,
is there particular ornaments, are there particular pictures that are important to them,
what makes them agitated, what causes them to be over stimulated.
And if you have a true picture of what that is and what causes that then
clearly that’s something that has to be addressed straight away.
I can’t sit here and say to you for everybody you would do this, this and this because
it is all about that individual and what’s specific to them.