Design for Their Eyes: Five Considerations for Keeping Residents with Dementia Safe and Engaged

Senior living designers discuss the critical role design plays in keeping senior living residents with dementia safe and engaged.

A senior living environment that is thoughtfully planned and well-designed enables residents with dementia to move around confidently and safely with a greater sense of independence. Design elements are interpreted by a dementia-affected brain differently and can be used to encourage healthy behaviors in residents with cognitive decline. RDG designers Kelley Hoffman, NCIDQ and Mitch Elliott, AIA explore five essential considerations in designing for this distinct population of elders.

Input from Staff
Best practices for dementia-friendly design follow specific guidelines, but should also marry those guidelines with each community’s individual needs. Caregiver feedback is crucial in understanding how a space might help or hinder someone’s ability to do their work; letting go of any preconceived notions or ego about how the area should be designed and instead tapping into the knowledge and experience of the caregivers can help guide the design and ultimately create an environment where workers are happier, healthier and empowered to provide the best care possible.

In a senior living space that serves residents with dementia, it’s essential to strike a balance between practicality, usability and safety. For example, high-gloss or heavily patterned floors, while forgiving when it comes to maintenance, may present visual or navigational issues for residents. Consideration for the transitions between flooring surfaces is also crucial to ensure residents don’t trip or become confused. As designers and manufacturers have learned more about dementia-related behavior, flooring philosophies have evolved to better serve residents and create spaces that support people with vision, gate or balance issues.

Newton Presbyterian Manor Renovation in Newton, Kansas. Photo by Emma Morem Photography.

Lighting design plays a crucial role in helping keep patients with dementia safe and secure. Advances in technology allow for design solutions that help maintain residents’ circadian rhythms to improve sleep patterns and reduce sundowning and can also be used as a tool to redirect residents from leaving or venturing into unsafe areas. Lighting is not only a vital element of living spaces for dementia patients but for their caregivers as well, who may be more heavily depended upon by residents who become uncomfortable, afraid or confused when lighting isn’t customized to their needs.

Simply put, simplicity is key to wayfinding in an environment designed for elders with dementia. Color, imagery and shapes can provide wayfinding cues, from making the style, shape or color of a resident’s room door or doorway slightly different from others, putting a memorable piece of artwork or a memory box near their room door and creating differentiators for each residence corridor. The scale of the space is essential as well – the distance between areas should be short and easy to navigate to encourage independence and ease of access.

Pacific Springs Village in Omaha, Nebraska. Photography by Alise O’Brien.

At its core, dementia is a devastatingly isolating disease, and so it’s critical to keep residents engaged outside of just meal and activity times. Inviting design elements in dining areas and common rooms that mimic a home-like setting can encourage interactivity and socialization. Smaller room sizes designed for sleep rather than activity, encourage residents to linger in common rooms and social spaces.

Updated: November 2022. Original Article Published: November 2017.

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