Designing a built environment for elders requires strict adherence to ADA standards, but designing a Memory Care unit for elders with Dementia requires that and much more. Instead of only denoting proper clearances, you now have to select the proper furnishings, fixtures, and equipment such as upholstery, wallcoverings, and flooring. Achieving a visually stunning space is one thing, but one that functions as a home for special needs is completely different. A life-enriching home for residents and a workplace for caregivers. Assisted living facilities are no longer bland keeping spaces, they are now environments for person-centered care. The ideal Memory Care residence would give access to and provide natural daylight, a calming atmosphere, memory boxes, communal spaces and great security to ensure the safety of its residents.
Patterns and colors have to be chosen that not only add a soothing effect to the space, but the patterns shouldn’t be too abstract. Meaning, that they should depict actual objects in a natural or literal demeanor. The goal of the color scheme should be to desensitize the residents to ensure that they remain calm at all times, or at least as much possible, while helping them feel at peace and at home. Some patterns may be problematic, say for instance a floral pattern might trigger residents to either pick the flowers out of them. Or a pattern that resembles the shape of an eye might look like an actual eye to someone with dementia and send them into panic or paranoia and trigger an extreme outburst. The same standards have to be applied when picking bold patterns with high amounts of contrast. “A heavily patterned tablecloth may even prevent a resident from concentrating on eating (Harris & Leibrock, 2011)”. Dramatic shifts in value or contrast in a flooring pattern may seem like an actual hole or change in elevation and also send a resident into panic because they would see it as a hole to fall through, or an obstacle that could possibly trip them that needs to be avoided. However, sharp changes in contrast are appropriate and should be applied when changes in surfaces occur, from floor to wall, or from space to space. Colors can also be applied to aide in “wayfinding” and can help aide the residents when they wander. Wandering is a common habit for elders suffering with dementia, therefore the color scheme can definitely help them find their way to their desired or forgotten destination. Designing for elders with Dementia also includes the use of memory boxes. A memory box is a tool used to help preserve the minds and memories of the residents and to illicit good memories and emotions that remind the residents of home. It is usually filled with the resident’s favorite objects from home that hold some sort of meaning, or portraits of the resident in their younger years, or either photos of their favorite loved ones, such as friends, family members, maybe even artwork if the resident were an artist. Another goal of the memory box is to create a beacon for the resident to help identify their room or space, which also helps with the wandering habit and wayfinding. Depending on the memory care unit, memory boxes are usually built into the walls almost like a niche with shelves and down lights, or either an iPad mounted to the wall with a picture slideshow on display. In terms of accessibility, all ADA standards have to be applied. Including the use of handrails, but there’s much debate as to which type of handrail is best. When leaning rails are used in designs, the residents have a tendency to leave trash on them as well as other things that may clutter the community, and handrails have been known to actually break the wrists and hands of residents when they try to prevent themselves from falling, when grabbing for the rail the hand and wrist usually get stuck between them and the walls resulting in breaks and sprains. Security is the most important aspect of a memory care unit. As stated before, one of the habits of a person suffering with Dementia is the tendency to wander. Residents often lose track or forget exactly where it is that they’re trying to go. Not only that, but sometimes they might actually believe that they’re at home and that they know their way around the neighborhood, instead of at an assisted living facility. It is important that the proper procedures are put in place, such as doors that remain locked at all times throughout the day, that can only be opened by authorized staff, accompanied by an alarm that notifies staff when a resident is trying to escape and leave the premises. Most times, residents are allowed outdoors but into an inner courtyard that is surrounded by more buildings or a fence that’s actually covered with foliage to hide the fact that they’re actually being held in a gated enclosure. Overall, “Architectural innovations such as smaller, more homelike environments and care practices such as consistent assignment, family style dining, and organization of routines around resident preferences are believed to improve both quality of life and quality of care (Bowers & Downs, 2014)”. Research confirms greater resident and family quality of life in such environments (Bowers & Downs, 2014)”. In terms of lighting, research has shown that lighting that closely mimics natural daylight “between the ranges of 2500 to 10,000 lux has increased night-time sleep, improved their circadian rhythm quality, daytime wakefulness, and decreased agitation and disruptive behavior (Bowers & Downs, 2014)”. Recent research indicates that exposure to higher lighting levels has beneficial effects on sleep and behavior. Noise should be kept at a minimum, startling noises such as “sudden vacuum cleaners, doors slamming, telephones ringing and doorbells buzzing” in particular have led to residents falling, instead research recommends that ambient noise be kept to a minimum (Harris & Leibrock, 2011). However, periodic use of nostalgic tunes may serve as an important memory cue. References Downs, M., & Bowers, B. (2014). Excellence In Dementia Care : Research Into Practice (Vol. 2nd ed). Maidenhead: McGraw-Hill Education. Retrieved from http://lynx.lib.usm.edu Leibrock, C. A., & Harris, D. (2011). Design details for health : Making the most of design's healing potential. Retrieved from https://ebookcentral-proquest-com.lynx.lib.usm.edu
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