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.
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
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 email@example.com