Recently we read this comment from Bryon Chappell who is the regional area manager for Impey, a shower manufacturer that specialises in equipment for people with disabilities and care needs. He spoke about fitting out care homes for people living with dementia and said:
“Due to the progressive nature of dementia, it is imperative to plan for future needs as well as present circumstances, as adaptations done in the later stages of dementia can be counterproductive causing apprehension, confusion or distress.”
This really got us thinking about the way care homes approach dementia and how taking a long term view could have a really positive impact on how care homes look after the needs of people with the disease.
Many care homes have a dementia unit and a non-dementia unit. The dementia unit will be equipped for the needs of service users with dementia but the non-dementia one usually won’t, because they don’t need it. Or do they? If Mr Chappell is right and introducing adaptations in later stages of dementia can be distressing then perhaps we should be implementing dementia friendly features at a much earlier stage, perhaps even in areas that are classed as non-dementia?
One of the reasons that care home operators don’t introduce dementia friendly products and features in non-dementia, or even early stage dementia, areas is because they don’t want service users who are not experiencing the symptoms of dementia to feel patronised in any way. Items like the very child-like dementia signage or actions like just removing all mirrors would not be appropriate in a non or early dementia environment, however the industry has now moved on.
When we first diversified into dementia friendly products we deliberately set out to create items that were flexible and suitable for a range of stages of dementia while still meeting dementia friendly criteria (as set out by the Stirling Dementia Design School) and enabling users to retain a sense of dignity. We looked at the signage that seemed more fitting to an infant school than a care home or hospital and knew that something more fit for purpose was possible and so we developed a range of dementia signage that was adult appropriate and aesthetically pleasing but communicated to someone with the impairments that come with dementia. When looking at how people with dementia can be frightened or confused by their reflection, we knew the solution wasn’t to simply take all mirrors away but to offer a choice: a mirror or a picture, hence we created a reversible mirror.
Many dementia friendly environments use nostalgia as a way of providing familiarity for people with dementia but, if done well, this can be just as applicable in a non-dementia environment where most service users will be of a similar generation and appreciate the opportunity to reminisce. Retro TVs, memory boxes containing a familiar or decorative item and Kodak slide displays can be enjoyed by anyone who remembers those periods.
By blurring the lines between dementia and non-dementia spaces, offering solutions for those worst affected while still maintaining an appropriate, dignified environment for the least affected, care homes can ‘future proof’ their environments meaning less disruption for those who develop dementia because they don’t have to familiarise themselves with new adaptations and even enabling people to delay longer, the move to a dementia unit.
In short, a dementia friendly environment can meet the needs of all users whereas one without dementia appropriate adaptations won’t. A care home that implements dementia friendly principles in all that they do will create flexibility and inclusivity, so it makes sense to be working towards making their non-dementia units, dementia friendly anyway.