This presents the aged care sector with a range of challenges. How will our residential aged care facilities manage the increased demand for dementia places? If people stay at home, how can we support them? And how can we expand and prepare our care workforce to meet the need?
Amid all these challenges, it’s good to know that there’s a clear pathway forward to address at least one question: how can we make our aged care homes more enabling for people living with dementia?
New guidelines
The new National Aged Care Design Principles and Guidelines have been released to help us in the sector make better environments for people living with dementia.
The way a residence is designed can have a big impact on their behaviour and the dementia symptoms they experience.
At The Dementia Centre, we know that well-designed environments can help people living with dementia
- move around more independently
- understand how to engage with their spaces
- promote higher quality of life for them and their carers.
The guidelines are underpinned by four principles. We’ll be looking closely at each of these in turn, beginning here with the first one.
This first principle is about supporting the individual in their immediate environment with spaces that can be navigated independently and without stress, promoting better health, wellbeing and sense of identity.
There are 11 guidelines that aim to achieve this goal – we’ve summarised the issues and solutions for each of them to give you an overview.
Many people experience sensory overload and physical challenges when presented with busy, cluttered and/or noisy environments, and this can increase as health and care needs change. Remove unnecessary signage and obstacles, use plain not patterned flooring and wall treatments, and avoid the use of mirrors.
Noise is a known predictor of confusion, agitation and distress for people living with dementia. Reduce the noise level of phones, call systems, alarms and televisions, and choose materials that will improve acoustics.
Most aged care homes conform to codes written for younger eyes, resulting in poor lighting for older people. Double the normal levels of ambient light are recommended, with higher task lighting to support specific activities and light fittings selected to minimise glare, and make sure curtains are open during the day.
People with poor vision rely on tonal contrast and good lighting to see and use items. Tonal contrast is essential between surfaces such as walls, floors and ceilings, and also between special fixtures like toilet seats.
Mobility and cognitive difficulties can make it hard to get around, impacting on staff time and the resident’s sense of independence. So, keep circulation simple and easy to navigate without signage, avoiding dead ends. Make sure bedrooms have a direct line of sight to the main cluster of living rooms and, ideally, to a centrally located kitchen.
People living with dementia are eight times more likely to fall than the general population. Softer flooring reduces fall risk and severity, and should also be even, minimise risk of tripping, and avoid level changes.
Poor design of chairs (too low, high or deep), or infrequent or incorrect placement can make it difficult for people to easily move around between settings and activities. Seating should have arms and be varied, easy to see, comfortable, robust, and domestic in style. Additional seating should e provided where space allows.
Toilets that are not easy to find and use cause people unnecessary disability, shame, lower self-esteem, and greater dependence on others. Easy to see toilets increased their usage eightfold. Physical accessibility, tonal contrast, and familiarity of the fittings promotes use of toilets and helps staff support residents appropriately. Space for more than one person to assist comfortably is ideal.
Poor air quality impacts respiratory health, and in turn leads to fatigue, confusion, and stress. Open windows and outside doors to create cross ventilation. Spot-check quality of the air in the building every six months.
As we age it can become harder to regulate our body temperature and change clothing to suit an environment, resulting in a narrower range of comfortable ambient temperature. Monitoring temperature levels and greater local control for residents and staff are critical to comfort.
Not having access to plants or animals is a real loss to many people, and there is evidence that interaction with animals and caring for plants supports mental health and wellbeing. So, where possible integrate planting programs and pets into aged care homes, and promote the involvement of residents in the maintenance and care of both. Design windows and balconies to help residents connect with nature and the local community from within their home.
Some of these problems may seem like small things, but if they’re not right they can make an environment feel uncomfortable and less peaceful. This can lead to confusion and stress for residents.
But the reverse is true, too! Taken together, these improvements lead to much better spaces for people living with dementia. And better spaces lead to better lives.