Care & Nursing Home Design Guide for Patients Living with Dementia and Sight Loss
Contents 1. Lighting 2. Interior Design - Colour Contrasting 3. Furnishings, Fixtures and Fittings 4. Dining Area 5. Bedrooms 6. Bathrooms 7. Entrances and Exits 8. Outdoor spaces
Introduction Care home design can significantly impact on the quality of life for residents. It is important to create a space that is safe and provides unrestricted movement, free from any physical or visual barriers. Whether you are adapting an existing residence, undertaking a care home refurbishment or new build development, creating homes that cater for all the people that live in them is challenging. Key to care home improvements, is ensuring your designs create an environment that positively impacts the quality of care. Central to this, is ensuring the layouts, furnishing, fixtures and fittings, work well for those with visual and cognitive impairments. This guide is intended to be used as a means to help those undertaking a care home refurbishment or new build development. The recommendations and suggestions can be used to help modify or adapt existing premises to meet the needs of peoples with dementia or sight loss.
0117 967 5923 harrisevolution.com enquiries@harrisevolution.com
Lighting Good lighting can not only improve health and wellbeing, but it can also help compensate for poor eyesight. When creating a shared living space, it’s important to consider different people’s lighting requirements. Think about whether a person will have particular needs for lighting at night, or how the space is used during the day. Maximise Natural Lighting – Very important
idesign & The Lighting People
The level of daylight in a room can transform the look and feel of a space. Even if your care home doesn’t have many windows, if you are clever with your design, you can enhance what you already have. Reconfiguring furniture (where possible), redecorating the room to use brighter colours and adding metallics can help maximise the amount of natural light in the room.
Artificial lighting – Low Energy There is a wide range of artificial lighting options available on the market, but some are not suitable for care homes. This is why it can be beneficial to consult with an expert such as The Lighting People at the design stages of your project.
idesign & The Lighting People
For instance, whilst it is encouraged that you use energy efficient lightbulbs, you will need to be selective over which ones you install. Low energy bulbs that take time to reach full brightness or provide insufficient lighting are not suitable for residents with cognitive or visual impairments. It is also important to have uniformity of lighting levels between rooms because some people with visual impairment find it difficult to adapt to changing light conditions and dementia patients may misinterpret shadows.
idesign & The Lighting People
All of the above should be factored in to ensure the light product selected is appropriate.
5
Positioning and Controls Positioning and controls can directly impact lighting levels and glare, so it is important to get this right. Lighting placed directly over the bed can be uncomfortable for people when resting, so make sure to add lamp shades or dimming controls if necessary. Add lights in the shower areas that support independent personal care and consider using under cabinet lighting where appropriate to help with tasks. Dining areas in particular need good lighting to allow residents with visual impairments to comfortably enjoy their meal.
idesign & The Lighting People
If you are undertaking M&E upgrades, it can also be beneficial to add in extra electrical points within the rooms. This will allow residents to add extra lighting where necessary.
Interior Design Colour Contrasting Many older people find it difficult to distinguish between blues, green and purples and may experience colours as washed out. So, when designing your interiors, you need to be careful about which colours you use. You also need to be mindful about how colour is used within your care home. You will want to avoid contrasting the same colours to distinguish hazards or feature as this can cause confusion. It is also worth considering how colour will affect mood and if dark patterns or shapes will be mistaken as shadows or holes by dementia patients. For example, dementia patients may mistake a dark mat as a hole and try stepping over it.
Colour and Contrast • Contrasting colours on walls and floors • Furniture and furnishings in bright or bold colours that contrast with the walls and floors, including beds, tables and chairs • Contrasting colours for doors and banisters to make them stand out • A toilet seat in a contrasting colour to the rest of the bathroom • Crockery in contrasting colours to the tablecloth or table help to define the edges of plates and dishes • Avoid bold patterns and stripes as they can be confusing and disorientating
6
7
Furnishing, Fixtures and Fittings Well-designed fixtures and fittings can help facilitate independent living. Features such as assisted living technology, handrails, signage and tactical markers can make it easier for residents to navigate around the care home. Residents with poor mobility will use furniture or fittings to balance themselves as they go through a room. Furniture should be stable enough to give support and layouts should have direct lines of access. Be careful with furnishings that can be hazardous, such as rugs or mats. And make sure heavy items such as wardrobes are securely fixed in place so there is no risk of them fall over should someone lean on them.
Dining Area As dementia progresses, a person can begin to have difficulty concentrating on a meal and become sensitive to excessive sensory stimulation. Dining areas that contain too many people, have high levels of noise or too many visual distractions (such as people walking past), can be stressful for residents. Make sure service areas are located outside of the dining areas and break up spaces using dividers if necessary. Control noise levels using sound absorbent materials and be mindful about the layout of the dining area and the location of toilets facilities; this will help limit the amount of distractions for residents and improve comfort conditions.
If possible, this room should link to an external terrace to allow dining outside in good weather. Allow space for residents using wheelchairs and walking aids.
9
Bedrooms We undertake hundreds of bedroom refurbishments each year and know there is incalculable value to providing a space that is not only comfortable and safe but can be identified as a person’s own. Whilst the bedrooms will have a similar aesthetic to the rest of the care home, it is possible to provide a level personalisation. Individual door décor, door furniture, personalised signage and memory boxes can all add to the sense of ‘home’. Personalisation can help reduce anxiety with dementia patients and provide cues to their own identity. It can also be used to separate the residents personal space from the communal environment outside their bedroom.
Bathrooms Bathroom lighting should be independent from any extractor fan as some residents may decide to leave the light on at night for background night lighting and to help them find the bathroom. Whilst mirrors are essential to help residents carry out personal care, it should also be possible to cover them up if necessary. This Is particularly important for dementia patients who may get confused or upset if they can no longer recognise their own reflection. Contrasting toilet seats and grab rails can make it easier for someone with a visual impairment locate the toilet. And avoid mixer taps where possible, as dementia patients can find them difficult to understand. Be careful about using sliding doors to bathrooms. Whilst some may find this helpful and reduces the risk of accidents, others may find them unfamiliar and confusing. Bathrooms can be very hazardous places, and when considering designs, it is important to balance the reduction of potential risks and protecting privacy. As a specialist contractor in care home refurbishments, we have an extensive network of designers that area familiar the with principles of good bathroom design and can create spaces that promote independence in a safe environment.
10
11
Entrances and Exits Residents with dementia and / or sight loss can find it difficult to navigate around a care home. Good entrances and exists can make it easier to move between rooms and to enter or leave the building freely. All corridors and doorways should be wide enough to accommodate people with different levels of mobility and entrances and exists should provide easy access to outdoor spaces. Not only are ramps and handrails important to assisting mobility but so is the route leading up to a door. Ensure door threshold are flush to the floor and free from any obstruction to prevent tripping. And wherever possible, provide large landings at stairs as this can be helpful for people with sight loss. Use additional interior and exterior lighting at the entrance and exits to make it easier for resident to locate. And also consider using contrasting colours that can be seen or recognised from a distance.
Outdoor Space There should be easy access to outdoor spaces, with seating in close proximity of the doors for residents with poor mobility. The outdoor space should have well-defined paths that are wide, firm and non-slip to help people find their way around without the risk of an accident; free flowing looped designs can be better for residents with cognitive of visual impairments. Make sure your outsdoor space is easy to navigate, has good lighting and provides adequate shelter. It’s important for residents to be able to recognised the door to get back inside, so consider using colours that are easy to see from a distance.
Sensory Gardens Numerous studies show that well-designed gardens in care homes help residents maintain and even improve their physical and mental health. As a result, more and more care homes are including sensory gardens within their refurbishment strategies. However, there can be many complications and pitfalls to enhancing your outdoor space. If you want to make the most of out of your investment, you will need to consider the technical aspects of your garden that are not merely related to touch and smell.
12
13
Accessibility The easier a sensory garden is to get to, the more likely it is to be used. Even small obstacles can deter residents from making the effort to go outside, so it is important that the designs are functional. Make sure the paths are wide, firm and non-slip. Be mindful about the materials and features used in your sensory garden – are they suitable? For example, glass panel doors are no good for residents with cognitive issues. Provide a choice of routes that are easy to navigate and make sure there is nothing obstructing the paths. Your outdoor space needs to feel safe and easy for residents to recognise the door to get back inside.
Seating and Shelter Some residents will only be able to go outside if there is seating within close range so make sure you provide resting points near the doors. You will need to include space next to your seating areas for wheelchairs and mobility scooters and be sure to avoid low seats that can be difficult to get up from. The areas just outside the doors are most likely to be used the most, so focus on providing attractive garden areas in these zones. You will also need to weatherproof your outdoor space. It is not just the rain and cold that you need to think about but also the hot summer days. Shade is the first thing people look for on hot days, so you need to choose the best option to shelter residents from the sun as well as passing rain showers.
Bring Outdoors Indoors Windows into your sensory garden might be the only way some residents can enjoy your outdoor space. This is particularly relevant during the winters months when the weather is poor. So, make sure to locate plants near the building that will enhance the view and include scented flowers that can be enjoyed by the residents indoors. Also consider including features close to the windows that can attract wildlife such as bird boxes or feeders.
Storage If your sensory garden will provide creative activities, make sure to include storage space for all your equipment. If residents will be gardening, be sure to include an outdoor tap and have raised planters that are easy to access for those less abled. Include shelves for tools and a water butt (if possible) to make it easy for residents to get involved.
14
Let’s chat Everyone has different needs and capabilities, and these can change over time. We understand that tailoring to these requirements can be challenging, especially when caring for residents with cognitive or visual impairments. If you are in the process of undertaking a care home refurbishment or new build development, speak to us today on 0117 967 5923 or email enquiries@harrisevolution.com. Alternatively, visit our website and check out some of our most recent projects. We work with a network of specialists within the industry and can take your project from concept through to completion. From assisted living technology, to lighting specialists, to Architects and interior designers, we can offer turnkey solutions that meet your project needs.
0117 967 5923 harrisevolution.com enquiries@harrisevolution.com
Lets chat Whatever the size of the project, our 10 years’ experience of working on commercial projects, small and large has taught us exactly how to deliver on time and on budget.
0117 967 5923 enquiries@harrisevolution.com harrisevolution.com