Well-being Begins At Home
The physical environment plays an instrumental role in enhancing the well-being of the seniors and persons living with dementia. As such, a well- planned therapeutic design of the physical environment is important as it can reduce dysfunctional symptoms and behaviours.
Quality Of Life
For seniors and persons living with dementia to live well with their families, the physical environment must be facilitative of a good quality of life; enabling the individual to thrive and interact positively in one’s own home and remain at home for as long as possible. This, compared with early institutionalisation, is still the preferred option by most elderly, persons with dementia and their families.
Internal Environment – Apartment
The apartment house should preferably be designed with a balcony or a floor-to ceiling window to provide an unobstructed view to the outside/ external environment.
The space in a fully furnished apartment house should encourage interaction amongst the occupants and be able to accommodate a person requiring mobility aids to move around within the apartment.
The houseapartment’s unit number should be colour contrasted, and have a big enough letter height and font. The houseapartment should have an open-concept floor plan with no obvious corridors if possible, and relatively unobstructed visible access to the outdoors. The person living with dementia needs to have a clear and direct view of the en-suite bathroom-toilet from the bedroom/ bed. Doors (if any) within the houseapartment should have colour or tonal contrast to the wall. Adding signage on the door may be helpful if needed.
Accessibility and Safety
The flooring and pathways should be mostly flat, plain, non-reflective, wide, non-slip and paved in clear colour and textural contrast to the walls, doors, etc. There should be adequate storage space and no cluttering. Built-in cabinets and wardrobes should be adequately contrasted with the walls and have ‘see-through’ panels or open shelving units to provide visual access to items inside the cabinets for the person with dementia.
For an senior-inclusive houseapartment, an emergency pull cord alarm should be installed at the bathroom-toilet and bedroom; next to the shower and bed areas.
Lighting and Nature
The houseapartment should facilitate a sense of connection to the external environment. Windows should be fairly large with low sills. This would facilitate some views of nature, as well as for natural light to penetrate the entire houseapartment, allowing the occupants to sense the cycle of day and night. The glass used for windows should be anti-glare and non-reflective. There must be adequate lighting to light up the apartment at night. The entrance to the houseapartment should be well-lit and using as much natural light as possible. There should be no pools of bright light or deep shadows within the apartment.
Features such as plain, clear colour and tonal contrasts between door handles and doors, walls and floors, handrails and wall, doors and walls, sanitation ware and floors and walls, toilet seats, flush handles/ buttons and toilets, taps and basins, furniture and walls/ floors must be apparent in the houseapartment.
If the houseapartment is located at a busy traffic junction or near an expressway major traffic interaction area where traffic noise is anticipated; noise reduction is necessary. Unplasticised Polyvinyl Chloride (uPVC) windows and doors can be considered for the houseapartment if not constrained by cost. When used in conjunction with double glazed windows, uPVC can help to reduce noise by up to 40 decibels or almost 80%.
External Environment – Residential Estate
The apartment block/ building should promote circulation areas, is part of the public realm and has a natural environment (gardens and playgrounds at various levels). A multi-purpose space accommodating a range of activities is most ideal. It should be integrated and self- contained with all the required amenities as well as being conveniently located and within walking proximity to the transportation hub such as the MRT station and bus interchange.
Ideally, lifts should be directly visible to the person with dementia when they first exit from their apartments. Large, realistic graphics/ signages in clear, colour contrast to the background on essential destinations; and contrasting colours, e.g. between different doors or corridors at the apartment block/ building are recommended. Signages need to be located either above eye level, slightly below eye level and/ or on the floor with fonts that are in San Serifs and appropriately sized
Entrances to the residential block/ building need to be made obvious. The apartment block is “conveniently located” close to services, facilities, community activities and open space. There should be obvious landmarks, distinctive structures with special features (e.g. wall murals, street furniture, postboxes, telephone boxes, trees, statues) present at junctions, open spaces or places of activity to aid wayfinding. Linkways/ paths leading to and away from the residential blocks are recommended to have clear signages to aid the person with dementia.
Accessibility and Safety
A ramp should be easy for a person or his/ her caregiver to push the wheelchair up or down with minimal effort. There should be available wide, flat, smooth, plain, non-slip footways, separate from cycling lanes.
There should be sufficient handrails at the residential area. These need to be matte and in clear colour contrast to walls/ surrounding fixtures. Public seats and seats must be elderly-friendl – height appropriate with arm and backrests; dementia-friendly seats with colour contrast. The push button for disabled access doors, e.g. doors of lifts or automatic doors, need to be immediately/ visually obvious. The buttons should be non-reflective and contrasted against the surface/ background.
Lighting and Nature
Corridors if unavoidable should be minimum in numbers. They should be wide, short and single banked, without dead ends or blind bends, with views along them to functional destinations and views of the outside allowing natural light to pass through. The number of lighting must be adequate to light up the lift lobby at night. Avoid pools of bright light or deep shadows where natural light is obstructed.
The residential estate should have a quiet environment with calm surroundings, populated by permeable green buffer zones, common fruit trees, plants, flowers and a constant view of nature to create a stimulating yet tranquil environment for the person with dementia.
Barriers Or Challenges, If Any
Avoid patterned flooring with different colour tones as this may be confusing for the person with dementia who “sees these as black holes”. Food court and amenities should be directly accessible from the lifts serving the residential blocks.
Here are more resources about dementia
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