Living with dementia can be difficult and challenging for both the individual and for family and friends. However, with many people now opting for live-in care over care homes, it is important to understand how a home can be adapted to make it a dementia-friendly environment.
In the early stages, you may not need to make any changes to the home environment, however, it is best to understand how dementia can progress and the changes that will need to be put into place to ensure a safe environment. It is also not advisable to make major changes to the home overnight as this can be confusing. There are simple things you can do to help someone with dementia continue living at home.
Before these changes can be implemented it’s vital to understand what dementia is and the long-lasting effects it can have on a person. Many people think that dementia is just simply memory loss; this is untrue. There are many different symptoms that can have a huge impact on a person’s day to day life.
What is dementia?
Dementia is an overall term to describe a group of symptoms that are associated with both memory loss and other thinking skills that are severe enough to impact a person’s everyday life. The most common type of dementia is Alzheimer’s but others include vascular dementia (stroke-related dementia), dementia from Parkinson’s disease and dementia with Lewy-bodies, to name but a few. Each is different in its own way, however, they all have similar symptoms and effects.
Changes in moods
If you know someone living with dementia it may become apparent that they begin to suffer drastic mood changes. This can include paranoia, enhanced fear and confusion. You may also notice that a loved one becomes uninterested in conversation or appears distant.
These changes may be difficult to understand and can be upsetting for loved ones but it is important to remember that their behaviour is caused by damage to the brain.
The drastic changes in behaviour usually occur when the person is feeling confused or distressed, so it is important to take a step back and think about what may be causing these moods. It could be anything from:
Mental & Physical Health
Sense of Frustration
It may be harder for people with dementia to communicate what they need, so it is important to be patient, listen and try to understand what the problem may be.
Loss of reasoning & judgement
Poor judgment can be one of the earliest signs of dementia and this can sometimes precede memory loss. What defines poor judgment? It is the inability to make appropriate and rational decisions. This can affect many different aspects of someone’s life including;
People with dementia may be unable to assess the danger of certain situations. For example, they may walk out onto a busy road during rush hour because they have lost the ability to determine the traffic levels.
The concept of money may be lost on people living with dementia and you might notice them start to repeatedly give money away or spending spontaneously. For example, continuing to give money to salespeople even though there is barely enough for food.
Losing the ability to dress appropriately is another way someone can lose their sense of judgment. For example, it may be snowing outside yet someone with dementia could put on a pair of shorts and sandals.
Driving requires us to use multiple parts of our brain. As someone’s condition with dementia deteriorates they may have to stop driving as it can become increasingly dangerous. For example, they may start to struggle to judge the distance of a car that is in front of them; leading to an accident
If you begin to notice a loved one making increasingly more dangerous or spontaneous decisions, it’s important to seek help right away and book an appointment with your GP.
Loss of physical ability
As dementia progresses through the stages you’ll notice someone’s physical ability has become more and more impaired. In the early stages, a person’s physical ability will be more or less intact.
However, as dementia progresses into the middle stages, the brain forgets how to make the muscles work. This can mean difficulty in walking and can be challenging for someone to feed themselves. The physical ability to hold urine and bowel movements will also begin to decline.
In the late stages of dementia, walking and range of motion become severely limited. It is at this point someone living with dementia will need a full-time carer.
How to Create a Dementia-Friendly Environment
People with dementia need to be able to clearly see their environment so that they can make better sense of their situation. Good lighting can mean the difference between a person becoming confused & scared and someone remaining comfortable & relaxed.
There are things you can do to improve lighting, reducing the risk of falls and accidents and helping to make your home dementia-friendly;
- Reduce glare, shadows and reflections
- Have as much natural light as possible
- Keep curtains open in the day
- Get rid of any unnecessary nets and blinds
- If there are hedges/trees overshadowing windows, cut back to allow in sunlight
- Switches for lights must be easily accessible and easy to use, especially on stairs and in the toilet
- Automatic light sensors are a good addition
- Value natural daylight as much as possible
Dementia is more common in the elderly, therefore it is important to get regular eye tests to help pick up on any concerns. As we get older our vision becomes more impaired, contrast is reduced and some colours become harder to see. People living with dementia need to see as clearly as they possibly can so that they can make sense of their surroundings.
It is important to look at someone’s flooring who is living with dementia and decide whether or not it would be useful to change. The last thing you want is for someone to have a nasty trip or fall because they have become confused.
- Avoid rugs and mats. People with dementia may confuse them for objects they need to step over, leading to trips and falls
- Instead, use flooring in a colour that contrasts with the walls. This will help the person gain a better perspective of the size of the room and where things are
- Use a matt finish floor. Shiny floors may look to be wet and could confuse someone and make them wary about walking across the floor
- Avoid colours that can be mistaken for other things. E.g. the colour green could be mistaken for grass and blue for water
- Avoid patterned flooring as a person can get confused over what is an object they need to step over and what is the floor
Choosing dementia-friendly furniture will also be something you have to consider. A person living with dementia needs to be able to see the furniture clearly, so avoiding stripes and strong patterns is a necessity. Instead, choose something that;
- Is a bright and contrasting colour
- Has curved, not sharp edges for safety
- Is easy to wipe down for hygiene purposes
- Has viewing panels so a person can identify what is stored inside
- Strong, stable and comfortable seating
In the earlier stages of dementia, obtaining new furniture may not be a priority, but as one’s movement and mobility starts to decline you will need to think about how to best make the person’s life as comfortable as possible. The first few items you should consider are an armchair and a new bed. These are the two bits of furniture that can optimise a person’s comfort. There are lots of dementia-friendly options to choose from including recliner chairs, riser recliner chairs, chairs with manual seat risers and community profiling beds.
This is one of the first and foremost rooms you should consider changing if a loved one is living with dementia. A kitchen is a place where most accidents could occur due to sharp objects, hot appliances and clutter.
- Put pictures or signs on cupboards and drawers so you know what is inside them
- Use plates, cups and tablecloths that contrast with food
- Keep food in clear containers to enable you to see what is inside
- Keep your kitchen organised and uncluttered
- Invest in a cooker guard as this reduces all risk of fire and the misuse of a hob or cooker
- For a dementia-friendly kitchen, make sure smoke detectors and carbon monoxide alarms are working
- Invest in a tray trolly to avoid any unnecessary trips and falls with hot/wet food items
- Mark the hot and cold taps clearly to avoid scalds and burns
- Keep cleaning products locked in a separate cupboard to avoid confusion
- Purchase dementia-friendly gadgets such as chopping boards to avoid accidents
Safety is the most important factor when designing a dementia-friendly kitchen and these pointers will help you in the right direction.
As an individual’s dementia deteriorates someone’s condition worsens, their bowel and bladder strength will also deteriorate. It is important you help an individual stay as independent as possible, for as long as possible and making sure your bathroom is dementia-friendly is one way to do this. You will need to take precautions so that the bathroom is safe and easy to use and avoiding falls at all times.
- Put a picture/sign on the door labelling the toilet or bathroom
- Consider removing the toilet lid if it makes it easier to identify
- Avoid modern designs such as push-button flushes
- Use towels and toilet rolls in contrasting colours to the walls
- Get rid of any items that are not used
- Due to an increased danger of scalding, thermostatic taps and showers are a good investment
- Add rails and fixtures around the bathrooms in case of a fall
- Make sure there are no towel radiators as this could be confused for a rail to grab onto if a person should fall
- Install a level-access shower with a non-slip flooring to reduce the risk of slips and falls
- Include a shower seat
- Try to avoid shower curtains in case somebody pulls this down as they fall. If it is a necessity, make sure you purchase a breathable fabric
- A dementia-friendly shower will shut down after 30 minutes of continuous run time
A bathroom is the most likely place where a person may encounter a slip or fall, but these precautions will help ensure maximum safety and independence. A wet room is highly advised as this is the safest form of a bathroom for someone living with dementia.
Organisation plays a key part in creating a dementia-friendly home environment. The more organised things are, the less likely a person will become confused and disorientated.
- Remove any clutter (including unnecessary cushions and throws)
- Think about having a basket or a tray for paperwork
- Keep background noise to a minimum, i.e. TV or radio noise
- Ensure cupboards and shelves are kept tidy
- If necessary consider getting extra cupboards and shelves
Technology can play a massive role when creating a dementia-friendly environment. It can help keep someone safe, help with memory problems, help with socialising and assist with safer walking.
Using what is known as ‘assistive technology’ can help a person stay independent for longer and if you are a carer of someone with dementia, can help support you as well. Assisted technology is a bit of equipment that can help accommodate your everyday life. This can include smart home systems, mobility scooters or even handy apps for smartphones and tablets which help with reminders.
However, due to the severity of dementia, it is important that a person only uses technology if they are comfortable to do so. You don’t want somebody with dementia becoming confused at a device they are not familiar with as this can cause panic. If you yourself or you know someone who is in the early stages of dementia, it’s best to introduce technology as early as possible as it means you can get used to it and ultimately be able to use it for longer.
There is a lot of technology available to help a person living with dementia, below are a few useful contacts as to where you can find technology such as large screen digital calendars stating the date, time and even season, to contacts that can ensure your home is safe:
Age UK 0800 169 65 65 www.ageuk.org.uk/about-us/local-partners
Local council www.gov.uk/find-your-local-council
Fire and rescue service 01827 302300 www.cfoa.org.uk/frs
If you have any concerns about Alzheimer’s disease or any other form of dementia, visit alzheimers.org.uk or call the Alzheimer’s Society National Dementia Helpline on 0300 222 1122.