It is important that people living with dementia have the best quality of life possible, remaining as independent as possible in their home environment.
Simple changes to create a more dementia friendly environment can have a positive impact on a person living with dementia’s emotional wellbeing and independence.
Steve Amos, from the Avalon Group, has headed up a project called Smarter Homes in the North East of England.
The project involves undertaking assessments and making changes to the home environment to make it more calming and practical for people living with dementia.
For people with dementia and actually people who have visual problems, we know that by the age of 60 – 65, we all need up to 60 per cent more light to see clearly.
When people get dementia, senses can be heightened, and one of those senses is seeing, is sight.
And what we can understand from all the research that’s been undertaken is that by promoting and introducing contrasting colours, real visual targets for people, it helps to reduce levels of anxiety, agitation, and in some cases it’s been proven to reduce severe changes in behaviour.
Steve carried out an assessment with Ian Mackie, who was recently diagnosed with Alzheimer’s.
Steve suggested a number of changes that he could implement immediately for Ian and his wife Mary, along with other suggested changes that they could make in the future.
These include changes such as introducing more contrasting bright colours to create a more 3D environment and having one block colour carpet throughout the house to prevent Ian from perceiving the floor as having holes.
And just having a through carpeting -
Just the floor through - yes.
The same colour in every room.
Yeah.
Ian and wife Mary have a very positive approach to life, and welcome any changes that will help to maintain their independence.
We found the visit from Steve very helpful and we found it very easy because they just came in like a couple of folk we’ve maybe known for a year or two and made themselves at ease in our house.
Which made it far more easy to be open and express how we were feeling about this.
Because it is quite a massive change in your life when you get a diagnosis of Alzheimer’s because it’s not like getting a rash that’s going to clear up in a few week’s time or a few day’s time, or tablets that’s going to make it all go away, it’s something that we’re going to have to accommodate and live with for the rest of time.
So anything that we can do and help we can get from people like Avalon and Steve, we’re very open to taking what help we can get.
We’re quite keen to make the few changes, to remain independent in a sense. And just maintain the level that we’re at now, if it helps just being that little bit independent, then that in turn helps me.
In terms of obstacles, I really don’t meet many obstacles in my practical life, even within the house.
But I am at a stage where I contemplate this arising and it could be quietly happening even as I speak.
Mary and Ian are starting with some of the small changes that Steve suggested such as using signage to help Ian differentiate between the different rooms in the house.
New coloured grab rails will be introduced to help them stand out against the white backdrop of the walls. Little raised coloured bumper stickers are applied to the tap to provide Ian and Mary with a visual target when using the hot and cold water.
A night and day clock will help Ian to know if it is morning or night when he wakes up and feels disorientated.
Steve has recommended that introducing bright vibrant crockery will help Ian to see clearly what he is eating and will help make his food look more appetising.
Steve has introduced covers for the light switches to help the white switch stand out against the cream wall.
We will revisit Ian and Mary in a couple of weeks to find out how they have got on with the changes.
Steve has come to Manchester to see James Manning, who was diagnosed with Alzheimer’s in February 2012.
He’s carrying out an assessment of James’ house, which he occupies alone.
Steve: 00:04:49:13 Just come around today to talk to you about some of the things that we can do with your environment that will help in terms of dementia, ok?
We know from a lot of research that’s been carried out that if we look at things like colour contrasting, give people visual targets, it helps them around their own homes.
But what will be good is to have a look around some of your other rooms.
James shows Steve around his home while Steve assesses what changes he thinks should be introduced to keep James living independently.
He takes into account James’ background and personality to make recommendations for changes that James will benefit from.
He makes suggestions for future changes that James can implement. Once Steve has carried out the assessment he sits down with James to confirm the changes that James has agreed to.
I think they will be a real benefit. James:
Yeah, yeah. James:
I look forward to the changes that are going to be made and hopefully they will make a difference to me and other people as well.
It is the day of the changes for James’ home environment.
Manchester’s Care and Repair team are going to be making the changes. They provide a free handyman service for people over the age of 60, with clients only needing to cover the cost of materials.
Steve has proposed changing the curtains and duvet cover in James room to a bright block colour as the current ones are very patterned and could affect the way in which James perceives them.
James chooses some maroon curtains and a matching bed cover. The team are changing the front room walls to a brighter shade to open up the room and create a clear contrast with a vibrant feature wall.
These changes will generate more natural light, which is very important for people living with dementia. James’ wooden toilet seat is replaced as it doesn’t contrast against the wooden floor in the bathroom.
The new bright red toilet seat will provide James with a more visual target.
James’ towel rail was dark brown and was hard to spot against the wooden panelling, so we’ve swapped it for a vibrant red rail.
The light throughout James’ house is a little dull due to the energy saving bulbs. Steve has suggested that we change the bulbs for energy efficient bulbs with a higher lumen to provide more light.
It is important to get as much natural light in a kitchen as possible so James’ blind has been replaced with a vibrant block colour so that he is drawn to it and is prompted to open it.
Steve suggested that James would benefit from a bright coloured handrail on the staircase, so the Care and Repair team have installed one for James and are painting it red to help create that visual 3D effect.
When Steve carried out his assessment it became apparent that James loves to be outside and keeping busy.
His yard area wasn’t getting utilised and there wasn’t anything outside to him there. Steve suggested a bench, some flowers and a bird table for the yard area.
In James’ bedroom, Steve has put in two touch lamps either side of the bed. If James needs to get up when it is dark, he doesn’t have to look around for the light switch, he can just touch the base and the light will come on.
Although James has already invested in a descriptive clock, he was keen to also try out the night and day clock.
We are keen to see how James gets on with the changes that we have made to the environment, so we will be back to visit him in a couple of weeks.
We have come back to find out how useful Mary and Ian are finding their changes.
The colour of the grab rails in the loo, dead simple, but it’s there.
And first time I used them, three times a night, ok, but usual drills at night time, came along, sat down saying huh, these new coloured things, but immediately even in the dark they stood out as red.
And I said hey brilliant. I was quietly chuffed actually and being a male just a bit slow to accept new things, but hey yeah they made a difference.
Our clock has been mounted just absolutely where I am on my left hand side, not high up the wall, just right at eye level and I can just put the light on, minimum shine and I can see this little sign that says ‘midnight’ and ‘two in the morning’.
Yes, brilliant, it’s brilliant, yes. Just as with the red grab rails, the red light switches, brilliant. Distinct, eyes go to them, no problem.
The changes we’ve had done so far are really quite simple things and quite basic, but I do feel that they’re helpful in as much as it keeps recognition going without having to think about it.
I would suggest to anybody that’s having sort of mixed feelings about making little changes, not to hesitate.
Change is not always a good thing for older people but if little changes have to be made, if you make the small changes they might keep things going so as bigger changes don’t become too necessary too soon.
We are back in Manchester with James to see if the changes have had a positive impact on James.
James found it helpful to write down his thoughts on the changes that had been made and read them out.
I was impressed with the quality of the painting which was very good and made a difference to the whole room.
Yes I was impressed with the quality of yard which was well presented. The yard needs to be in good condition and needs to be open more and used, which I think is better than the rest of the other things.
The handrail is red and stands out against the walls. I find it useful.
I was happy with the duvet and curtains, which made a huge difference to the rooms and also the touch lamp, which I am using a lot.
Yes, I was very impressed with the toilet seat.
There are a number of changes really that can happen.
And what we’re looking for is as I said earlier in terms of the well-being assessment, we want to see if possible that people’s well-being has improved over a six month period of time.
And if it does that’s significant for the person with dementia and their carer because it means that their perspective on the world that they live in, with dementia, is changed and improved somewhat.