4.4 Dementia Friendly Homes or “like at home”
All the surveys determine the preferences of the person with dementia (same as the elderly) to remain at home, and if this is not possible, to live “like at home”.
According to a survey carried out by the Organization of Consumers and Users (OCU) to 1,380 people between 65 and 84 years old in the year .017 with the aim of knowing where the Spanish people prefer to spend their last years of life, 82 percent of Spaniards intend to stay at home as long as they can, 4 percent believe they will move shortly and 1 percent think they will move in a couple of years. Even among those who are highly dependent, the vast majority (74%) prefer to continue living in their current home. But among those who intend to move elsewhere, only 8 percent plan to move to a nursing home.
As we have mentioned, the environment where a person living with dementia lives is a fundamental determining factor of their quality of life, but not only with regard to the physical part, but also the emotional bond that develops with the space where they live, as well as with the neighbourhood, the neighbourhood, and the connection with the world in general (Yanguas, Sancho, Del Barrio, 2012)
According to the new study by Sanitas Mayores on physical barriers and Alzheimer’s (2018), in Spain eight out of 10 people with Alzheimer’s are cared for in private homes but only two out of 10 homes in which there are people with this disease are adapted.
This means that both caregivers and people suffering from Alzheimer’s face barriers in their own homes on a daily basis.
Making a home dementia friendly is extremely important to the person with dementia, making a difference to their everyday life.
A person with dementia will appreciate the fact that the home will be less confusing and not be restrictive.
Some of these ideas will need to be tried and tested, as everyone experiences dementia in their own way. Some things are quick and easy; others will take more time and money and may need external assistance.
- Furniture and furnishings
- Knowing where things are
- Eating and drinking
- Using the bathroom
- Keeping things in order
- Keeping safe
- Keeping active and engaged
- Getting outside
Good lighting helps a person see clearly and make sense of where they are. As someone gets older, they find that they need a lot more light than before to be able to see properly. They should have their eyes tested regularly.
Daylight coming through the windows will help a person stay aware of the time of day and the weather. Improved lighting can prevent dark areas and shadows on the floor, which can be confusing. Reflective glare from windows, computer screens and TVs can cause confusion. Dimmer switches will give more control over lighting. Keeping the bedroom dark will help better sleep.
- Check that curtains or blinds, furniture, TVs or plants are not blocking natural light coming through the windows.
- Get the windows cleaned regularly.
- Use brighter bulbs in light fittings, if it is safe to do so, or use extra lights.
- Make sure that the bedroom can be made dark at night.
- To make sure you can see the TV, adjust the settings, move other light sources such as lamps, or change the TV position to reduce glare.
It is very easy to trip over uneven floors or mats. Changes in the colour of the floor from room to room, rugs or dark floor mats can sometimes look like something you need to step over. Shiny floors can look wet or slippery and speckles in flooring may look like litter.
People will be able to walk more confidently and safely over plain matt flooring. The colour of the floor, particularly on stairs, should contrast with the walls. It may be best to avoid floor colours that might be confused with real things, such as blue looking like water or green looking like grass.
- Remove floor mats and rugs as they can cause trips and falls.
- Check that cables for lights and other appliances are not a trip hazard.
- Make sure that floor mats between rooms are a similar colour to the flooring, as well as any carpet edging or cover strips holding the carpet down.
- Where possible lay plain-coloured matt flooring throughout the home.
- Indicate the edges of stairs with brightly-coloured tape or paint.
Dementia may affect how well a person can tell the difference between colours. It may also affect how objects are seen in three dimensions. Using bright and contrasting colours for furniture and furnishings helps everybody see things more easily. Contrast the colours of furniture, including beds, tables, chairs and lamps with the walls and floor.
Stripes or strong patterns can be confusing and disorientating. Paintings or other artwork could be misinterpreted as dementia progresses and a person living with dementia may not recognise their reflection in a mirror.
- Check pictures and mirrors and cover or remove them if they are likely to cause confusion.
- Use plain, brightly coloured bed and table linen that contrasts with the walls and floor.
- Make sure the colour of the switches for lights and appliances contrasts with the wall.
- Replace furnishings that have stripes or strong patterns.
- Use furniture and plain coloured furnishings that contrast with the walls and floors so that they can be seen easily
- Choose items to help with orientation, such as a houseplant to show the way to the garden.
If there are have memory problems, the person may forget where things are kept. Visual cues such as putting pictures or labels on the outside of cupboards, wardrobes and drawers can help with this. They can also help make sense of the home generally.
Open shelves or transparent doors will make it easier for them to find things. Appliances should be easy to find and not hidden behind cupboard doors. It is also important that things used every day can be found easily.
- Always keep keys, glasses and mobile phone in the same place.
- Label cupboards and drawers with pictures or text telling what is inside.
- Make sure appliances are easy to find.
- Take the doors off cupboards and wardrobes if it is safe to do this.
- Fit cupboards with non-reflective, transparent and shatterproof fronts so contents can be seen inside.
- Leave the bathroom door open when not in use so the toilet can be easily seen.
Eating and drinking well is important for health. However, the person may find that they have a reduced appetite, losing their interest in preparing meals or do not eat at usual mealtimes.
The person may also find it difficult to see white food on a white plate or a white plate on a white table.
- Make sure the items used every day are easy to find.
- Use brightly coloured cloths, towels and kitchen rolls that contrast with surfaces and appliances.
- Ensure that appliances such as kettles can be seen and are easy to use.
- Use coloured crockery that contrasts with the food the person is going to eat, as well as the table or tablecloth.
- Use clear plastic containers to store food so that inside can be seen.
- If there is a need to replace equipment or appliances, like a kettle, try to make sure they are the same design or model as the old one, so the person can remember how to use them.
Not being able to find the toilet when needed can cause anxiety. The toilet seat and lid should be in a contrasting colour to the rest of the toilet so they are easier to see. Rails in a different colour to the walls, traditional-style or lever taps that are marked hot and cold, easy-to-use basin, bath and shower controls and a traditional toilet flush will also be more obvious.
Bathrooms can get crowded with items that are not used every day and this can be distracting.
- Put away any items that are causing clutter on surfaces.
- Use towels and toilet rolls in contrasting colours to the wall, to make them easier to see.
- Put a sign with a picture of a toilet and the word ‘toilet’ on the door at a height where it can be seen easily.
- Try leaving the bathroom light on during the night.
- Consider removing the toilet lid.
- Ensure that toilet, bath and shower switches and controls are of familiar design and easy to use.
- Use a flood prevention plug in the basin and the bath.
- Change any door locks so that they can be easily opened in an emergency.
- Remove the wastepaper bin if it might be mistaken for the toilet.
Clutter around the home may make a person feel confused and distracted. It may also make it difficult for them to find things.
Items left on the floor can lead to trips and falls. Noise and other distractions can make concentration difficult, so try to reduce these as much as possible. Turn off the TV or radio when they are not watching or listening to them.
- Remove excess clutter and unused items (such as old newspapers) but keep enough so that the space feels personal.
- Consider having a basket or tray for important paperwork.
- Make sure that cupboards and drawers are tidy so it is easy to find things.
- Remove any unnecessary cushions or throws.
- Try to reduce background noise.
- Put things back where they belong when the person has finished with them.
- Buy more cupboards if you need more space to store things.
- Put up extra open shelves if needed.
Feeling safe and confident in your own home is very important if a person is living on their own. There are different types of grab rails, alarms and sensors, including smoke detectors that can be installed to help them stay safe at home.
Professionals, for example occupational therapists, the fire and rescue service, or home improvement agencies can help them make their home safe. It is also important to keep a home at an appropriate temperature throughout the seasons to prevent the person getting too hot or too cold.
- Lock away any potentially hazardous or sharp items.
- Make sure the TV and radio are switched off if not in use.
- Check thermostat settings as the weather changes.
- Reduce the temperature of hot water to avoid scalds.
- Make sure ICE (in case of emergency) numbers are near the telephone.
- Consider using socket covers if sockets are not being used.
- Get gas or electric fires checked for safety.
- Check that door handles and locks are easy to see and use.
- Consider installing grab rails on stairs or along long walls.
Keeping active and engaged can really improve quality of life, so making sure that the person can still enjoy doing their favourite things and stay in contact with people is important.
Being able to see and get outside throughout the year can improve wellbeing. Gardening or enjoying nature can be very therapeutic. If the person’s front door is easy to recognise, this will help prevent them from feeling disorientated.
A clock and calendar will help them remember the time and date so they do not miss appointments or events.
- Make sure items like puzzles, photographs or books are easy to find.
- Make sure the person can see the outside through their windows.
- Place a chair (and table if needed) so that they can sit and watch what’s happening outside.
- Make sure that there is somewhere sheltered to sit outside.
- Make sure a large-faced clock and calendar can be seen.
- Check the telephone is easy to use.
- Put a photo of a friend or family member next to their telephone number, to help the person remember who to call.
- Put a whiteboard where it can be seen easily, so you can write reminders of things to do.
- Make sure there are some chairs with arms, as they are much easier to use.