Designing with dementia in mind: Why a ‘one-size-fits-all’ approach doesn’t apply to safety flooring.
By Elizabeth Butch, UK Marketing Manager, Healthcare and Education, Tarkett UK.
IN the UK, safety flooring is often ‘a must’ for healthcare and aged care settings. However, in most cases, a tailored specification approach is required – especially when it comes to care units for those living with dementia. This is simply because each space has its own unique set of requirements, and there is no ‘one-size-fits-all’ solution.
What works for a hospital’s maternity ward, for example, may not suit a dedicated space for those with Alzheimer’s. Here Tarkett explores the key points to consider when specifying for specialist aged care projects.
Continued scientific advancement means we’re now living longer. A study in 2010 showed that people over the age of 80 accounted for 4% of the population among OECD member countries. And that share is expected to be 10% by 2050.
However, just because people’s lives are extended, it doesn’t mean they are necessarily healthier. A large ageing population poses challenges when it comes to the potential resulting health issues, such as dementia.
Today in the UK, an estimated 850k people are living with dementia – the second-largest cause of disability in those over 70. And with the condition linked to age this is only expected to increase. The knock-on effect of this is a greater need for specialised care solutions.
In support of this, Tarkett has conducted extensive research into the needs of older people in terms of their environment, particularly flooring, with a focus on dementia residents. Because a solution that’s suited to a generic hospital ward may not work for a dementia unit.
The contrasting colours, patterns and textures used to help brighten up a healthcare space can have an adverse effect on those living with dementia, such as high gloss floor finishes appearing wet and therefore dangerous to walk across.
One step beyond: Creating dedicated dementia and Alzheimer’s units
Although enabling the elderly to stay in their own homes is preferable, declining health often makes this impractical. Therefore, numerous countries have responded to the growth in dementia and Alzheimer’s disease by establishing specialist units.
This reflects the need to provide long-term care for people with the disease who can no longer live independently at home or in the care of relatives.
Creating an environment adapted to manage the symptoms
Alzheimer’s and dementia units must provide a space that’s adapted to the needs of the residents and care staff, as well as offering visitor comfort. These units must therefore be designed to take into account everyone’s requirements and specific usage.
The flooring plays an important role in the design, and the specification parameters for this should include: design, contrast, colours, acoustics and lighting – with rules defined according to the function of specific areas such as bedrooms, corridors, communal spaces and treatment areas. In addition to the flooring, the overarching interior design should respond to two key themes:
‘Just like home’
The interiors should help residents with dementia feel that they are in a reassuring and familiar environment that’s ‘just like home’. This makes it easier for them to continue routine activities, keeps them safe and reassures visiting families.
The idea of a familiar and comfortable environment is inseparable from the idea of more personalised spaces that enable residents to transpose their own memories into the Alzheimer’s or dementia unit.
Open spaces that flow
To counteract the sense of being enclosed, flexible multi-functional spaces that offer easy access and enhance movement are recommended.
It’s important to design light, large areas open to the outside and with numerous points of interest that will encourage exploration and ambulation. And not to isolate the building from the outside world.
Therefore, when supporting the design of a dementia unit, a new way of thinking is required from specifiers that goes beyond the general healthcare sector. Even closer attention must be paid to each and every element that makes up the interior solutions. And when it comes to the flooring, there are some key considerations to make.
Flooring: An added value tool in managing dementia and Alzheimer’s
Contrast, colour, design, light and acoustics are the essential parameters to consider in designing a dementia unit. It is important that the architectural design stage incorporates these criteria into the choice of flooring to both ensure technical added value and a sensory, psychological contribution. Here are some of the main factors to consider:
A balance of form and function
Attractive environments are 100% possible within the principles of good dementia design.
One of the fundamental principles is the correct use of contrast – both holistically but also within individual product selection. Knowing the rules and then correctly applying them to the vast array of colours and patterns on the market, means environments and their interiors can be exactly as you desire.
Choosing the correct flooring pattern is more essential than most realise. Knowing the rules and then learning how to apply them to interiors is necessary in achieving positive outcomes such as reduced anxiety, easier navigation and the reduction of slips, trips and falls. Unlike paint for example, flooring patterns are often made up of more than one colour meaning contrast is present.
Wood designs are popular in the UK because they create the desired domestic effect, however the wood grain pattern can be disturbing to those living with dementia if not carefully considered. Incorrect wood designs can often create the illusion of an unstable floor which someone living with dementia will try to avoid and really low contrast wood designs will appear institutional, with the wood grain disappearing altogether
While colour cannot be seen by around 40% of those living with dementia, caused by the aging eye, colour still appears to perform an important function in how people with Alzheimer’s and dementia perceive their environment. Studies show that certain colours can cause behavioural problems. On the other hand, some colours seem to encourage a sense of wellbeing and help to create a setting that patients find reassuring. Colour can also be crucial in ensuring that an environment remains familiar to a resident, even as their condition evolves.
In response, designers should avoid using:
- Acid and electric colours that can lead to agitation and confusion
- Sombre colours such as black and dark grey, that can create a fear of falling or the sensation that there is an obstacle to cross
- Very light colours and white in particular, which can seem blinding
- Grass green at ground floor level, which patients can mistake for outside space like the garden
- Bright red, which can create over-excitement
- Mauve, which doesn’t reflect light well and that can be perceived as a gloomy colour
- Turquoise blue that can be mistaken for water
Alzheimer’s disease and dementia are characterised by memory loss but flooring can actually help stimulate memories by re-creating home-like spaces through design.
For example, using materials such as wood, and traditional hexagonal tiles or square tiles may have a familiar reference for the patient, reminding them of home or evoking childhood memories, helping to make them feel more ‘at home’.
By contrast, certain patterns could disturb or confuse patients: large stripes, repetitive geometric patterns, contrasting colours, typographical motifs and imitations of natural materials, such as grass or pebbles.
Light Insomnia is one of the most frequent problems to affect Alzheimer’s residents. More characteristic, still, is the inversion of the wake/sleep pattern called the circadian rhythm.
The choice of a suitable flooring can play a part in helping to re-establish the wake/ sleep cycle. Improving the use of light, which studies show affect the secretion of melatonin and cortisol hormones, is important in regulating the body clock.
Noise can be a source of anxiety, particularly in the advanced stages of Alzheimer’s. By using absorbent partitions and acoustic flooring specially designed to reduce the clang of falling objects and the sound of footsteps, noise is kept down to a minimum and the comfort of residents and care staff is ensured.
As with any commercial flooring solution – especially for a healthcare project – non-slip is extremely important for dementia units. However, whereas traditional safety flooring is the usual go-to for healthcare settings, Tarkett believes for spaces designed specifically for the elderly a slightly different approach should be taken.
High friction solutions work to combat slips, but for individuals with limited movement capabilities, this can actually lead to a greater chance of tripping. Therefore, supporting the case for individual solutions to be selected depending on the specific project at hand.
Tarkett’s Trentino Silencio xf² Linoleum range has been designed specifically with aged care bedrooms in mind. Boasting acoustic qualities – an 18dB impact sound reduction – and xf²™ surface-treatment technology for excellent resistance and easy maintenance, its finish is ideal for specialist, high traffic environments.
The future’s bright
Over the last decade, Tarkett has built up an understanding of the needs and perceptions of the elderly and, in particular, those living with dementia. It continues to add to this knowledge, through regular research reports and whitepapers.
And its work with the different parties active in the care-home and specialist unit sector enables the company to develop floor- and wall-covering solutions with aesthetic design and technical benefits that enhance the quality of life for residents in care and the staff looking after them.
To directly support specifiers, architects and designers working in this sector, Tarkett has launched a virtual reality empathy platform (VR-EP) tool that has been endorsed by the leading experts in dementia design. Constantly being updated and refined, the platform is now higher resolution offering an enhanced user experience.
By using the world’s only evidence-based dementia filter, users can understand how colour, contrast, texture and material play a key role in overcoming resident anxiety and slips, trips and falls by making spaces easier to navigate.
For more information on specifying flooring solutions with dementia care in mind, and to try out the VR-EP platform, visit www.designingfordementia.tarkett.co.uk.