Charlotte Designs

I spent most of last week preparing a proposal for murals in a care facility dedicated to dementia patients. I have done this kind of work before, but decided to refresh myself on the latest thinking on the topic. There have been a number of studies showing that the physical environment plays an important part in the quality of life of dementia suffers. Many studies suggest that a well designed environment can even slow down the advancement of dementia and aid the wellbeing and independence of residents.

This shows an impression of one of the corridors in the home. It features a calming scene punctuated with different colours.

Murals are unique in their ability to add colour, fun and meaning to a space. Their size makes them an obvious choice for patients with cognitive challenges, who struggle to make out smaller details. Suitable designs for murals in care homes include calming scenes of tranquility, such as beach, garden and countryside scenes and images that trigger memories, such as scenes and icons from the residents’ youth.

The practical strengths of murals should also be noted. Unlike framed art, murals can be wiped clean with a cloth as with any painted wall, they are also not vulnerable to being knocked off the walls. Whilst wallpaper murals can provide an alternative, they are not as practical to keep clean as painted murals and are prone to damage.

Colour and the aging eye
As people age, there are a number of changes that occur which affect both vision and colour perception. Of course, many people, particularly men, are considered “colour blind” even at a young age. Most typically, these individuals have a hard time distinguishing between reds and greens. Changes in vision and colour perception typically begin to occur in the 20′s and continue to deteriorate through the end of life.  There is also a thickening and yellowing of the lens of the eye, which is similar to viewing the world through a pale yellow film (approximately the colour of ginger ale). This makes it harder to differentiate between colours in the green and blue shades (because green is a combination of blue and yellow). This yellowing also “absorbs” more of the blue light entering the eye (up to 75%), which means things in the environment look much more yellow to an older person than to a younger individual.

There has been some research on colour preference, both across the life span and for people over 65. Results are generally very consistent, at least for the top three preference choices, with blue, red and green being most preferred, in that order.

Those with cognitive impairment have reduced ability to make sense of the environment, and thus consideration of its impact is particularly important. People may remember their own home and familiar environments, but impaired ability to learn can prevent them from recognising locations in new environments, such as the route to their room. Similarly, they remember minute details from their youth, but not what they had for breakfast.

Using colour in the Care Home environment

1. Colour should be sued to emphasize what’s important. , such as doors, staircases etc. or views to interesting vistas or activity areas. Pay close attention to those elements that have the potential to provide useful information to the cognitively impaired individual, and give these more emphasis with brighter colours  and high contrast with the background.

Conversely, de-emphasize what’s not important. People with dementia struggle to make sense of their environments, and should not have their attention unnecessarily drawn to elements that do not require their focus. Therefore doors to areas such as medical supplies stores, staff rooms etc., should not be treated with colour cues, so that attention is not diverted.

2. Compensate for known visual deficits. Older people require three times the amount of light to see as well as younger people, but are more sensitive to glare. People with dementia have impaired contrast perception, which makes it harder to see the edges of objects, particularly when the foreground (object) and background are similar colour. This is particularly important when designing to support functional independence.

- Chair seats should contrast with the floor, so people can see where the edge of the chair is.

- Sink basins should contrast with the surrounding counter/vanity top.

- Toilets (or toilet seats) should contrast with both the floor and surrounding walls to make them more visible.

- Table settings should provide high contrast between the plates (usually white or pale coloured) and the table/tablecloth/placemat (dark colour).

3. Apply colour according to known principles. People with dementia may have some unique needs, but they are still people, and no research has yet suggested they respond differently emotionally/visually to colours than the general population.

- Rooms that are habitually too warm should be decorated in cooler colours (blues and violets) to be perceived as cooler. Conversely, decorating a cool room with warm colours will make it appear to be warmer than it actually is.

- If you want to space to be an “active” place, use warm colours, particularly red and orange, which is physiologically stimulating. Red is known to raise the blood pressure slightly and increases blood flow and therefore appetite. Orange encourages sociability being a mixture of red and yellow.

Reminiscence in decoration

This is an impression of what the reminicense corridor will look like.

The use of reminiscence in the care of people with cognitive impairment is well documented and there is increasing enthusiasm for decoration that includes these elements. Studies have been made of patients who used a reminiscence room for activity. The patients had a range of mental health needs sufficiently complex to warrant their admission to a specialist hospital unit.

Overall, their perceptions were positive and a positive link between a themed room and stimulating memories from the same period was established. Reminiscence decoration should be carefully considered with respect to era and the culture of the current and potential client group and having a dedicated room should not restrict the more widespread use of this valued therapy.

In conclusion, much can be done to improve the lives of dementia sufferers through well thought out interiors and use of colour. As we are an aging population, the number of individuals experiencing these kinds of issues will only increase, and knowing that there are simple, inexpensive ways of improving the lives of the elderly, can only be a good thing. Not least because one day, it could be us.

If you would like to find out more about designing for those with cognitive impairment, please contact me on sarah@charlottedesigns.co.uk

Sarah Hodgkins

I have just come back from two weeks traveling the beautiful Garden Route in South Africa. A popular tourist destination, but one that like many tourist hot spots, has seen a decline in trade over the past few years due to the global recession. Like many businesses, the restaurants, attractions and guest houses have had to think of inventive ways of attracting customers, making themselves stand out from what is a very crowded market place. One thing that we saw a lot of is murals, obvious when you think about it, if you are driving down a seafront, looking for a place to eat or drink, a building that has been beautifully painted is going to stand out in the African sun and entice you in, but all types of business can benefit from this thinking.

Kalk Bay Shop

Kalk Bay is a popular tourist spot on the east side of the Cape Peninsula. The High Street is full of shops, cafes and restaurants all plying their trade. Here we found a shop that stood out visually on the both to drivers and those on foot. Not only did is make their business stand out, but it also advertised another business. We also saw an ice-cream parlour with ice-creams painted onto the pillars and a cafe with a large coffee cup painted in it. Was it a coincidence that these places seems busier than some of the others?

Port Elizabeth Aquarium

Many of the attractions we went to incorporated murals either inside  or out, to educate, make the place more interesting or to attract passers by. My favourite however, has to be the Aquarium in Port Elizabeth on which the most amazing, yet simple mural has been painted. I am guessing it may have been sponsored by Coca Cola, but the simple colourway and design really work and make a building that could easily have been a concrete blob, interesting, fun and a talking point.

So what can we learn from this? Well, it never ceases to amaze me how much some people spend on advertising and yet leave acres of wall blank and doing nothing for them. If you want to attract people, look attractive. Show people what you do, be interesting and a talking point. The branding mural that I painted on the outside of Milton Keynes art gallery a couple of years ago is often used as a backdrop by photographers and video makers and has served to enhance their reputation. The space that you already own should be working for you. Whether it is attracting customers, educating customers or making the workplace a fun place to be. A well painted mural will last for years, much longer than a newspaper advertisement, which will be wrapping fish and chips by the end of the week. Ooops, back in holiday mode again….

…is a joy forever, as Keats quite rightly said.

Klimt, a thing of beauty

Its loveliness increases; it will never
Pass into nothingness; but still will keep
A bower quiet for us, and a sleep
Full of sweet dreams, and health, and quiet breathing.

And this has got me thinking. Making something beautiful is a joy for all concerned. The artisan will gain skills and enjoyment from creating something that brings joy to others and the onlooker will simply enjoy. But Keats’ poem also points out that our enjoyment outlives the physical act of experiencing that beauty. The memory is a powerful thing and our life will be forever enriched by what may only be a fleeting glance at something that connects with our hearts.

I met a lady a few years ago, who told me that she had been bought up in a city by her mother; who had painted a countryside mural with a rainbow, trees and animals in the bedroom that her and her brother shared. The lady went on to say that the only time her and her brother were not arguing was when they were making up stories about adventures they would have in the imaginary landscape. To her and her brother, this mural was a thing of beauty and it filled their lives with sweet dreams. She decided that when she grew up, she would live in the country, and I am happy to report that she does.

I watched her face as she was telling me this story, her smile was broad and her eyes sparkled. A little younger than me she may have been, but I am guessing that even after well over 35 years, this thing of beauty was fulfilling it’s promise.

As we all begin our new year, take some time to enjoy a thing of beauty, whether it be music, a painting or they way the sun glistens off a frozen pond. Fill your lives and homes with things that make you happy, not just the practical things that make life easier. The memories that you create now, will never pass in nothingness.