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Preventing falls in dementia

Posted on Fri 18th Jan, 2019 in: Dementia DesignDementia Friendly EnvironmentsDementia Friendly Products

Fall prevention dementia


Trips and falls are a big problem for older people and can have significant consequences. Fall prevention is something that all care environments try hard to implement but the risk of a fall increases greatly in those living with dementia.


This risk is predominantly due to the decline in visuoperceptual abilities. People with dementia are often not able to perceive things accurately any longer. They can’t work out perspective properly and find it much more difficult to make out outlines, meaning that objects blend together. This makes it hard to judge distance and to define the edges of things which can result in not being able to negotiate stairs or walking into door frames. We recently heard of a case where a man threw himself over a bannister, believing he was stepping over a gate (fortunately he wasn’t injured).


Preventative measures such as removing rugs, ensuring walkways are clear and installing rails are obvious things that any care environment should be doing but there are also a number of ways that good design can also significantly reduce the risk of falls for people with dementia.


The following interior design measures can be implemented in dementia environments to reduce the risk of falls:


  • Colour Contrast
    One of the worst things you can do in a dementia environment is apply no variation in colour. While it may give your care home a high end designer feel, it becomes very difficult for someone with dementia to navigate their way around. This is particularly true if furniture is the same colour or tone as the flooring or doors are the same colour as walls because they can’t see the edges properly. By contrasting colours in order to clearly define shapes, it makes it so much easier to see them. There is some science to this: there should be a Light Reflective Value (LRV) difference of at least 30 between two adjacent colours to maximise the ability to differentiate shape.

    As well as furniture/floor and door/wall as mentioned, this can be applied in a number of ways: to stairs and steps; to hand rails; to toilet seats and sinks (though avoid red in bathrooms as this will be associated with blood); to directional signage. Some care homes even serve meals on coloured plates to contrast with the food and find that it helps encourage people to eat more.

  • Better Wayfinding
    By providing strong wayfinding aids you create better opportunities for people to stay in areas that are safe. Not understanding where you are or being able to find where you want to go can cause distress and heightened emotions can in turn cause erratic behaviour such as not looking where they’re walking properly or trying to move too fast. By helping people navigate their spaces through signage and cues, you cut this risk.

    Dementia signage, applying all the theories of contrast, image/text combinations and position, is an obvious aid to wayfinding but so is demarcating areas through pictures or wall murals (with dementia friendly pictures obviously) or even wall mounted memory boxes.

  • Linear Layouts
    Space can be an issue in care homes and it can be necessary to need to get a lot of furniture in to accommodate residents and visitors but it is important that there be clear routes in and out of rooms and a direct path through. The more people have to navigate their way around furniture, not to mention walking aids that could be kept close to chairs, the more you increase the chance of trips. You should be able to clearly see your route through the room, which should obviously be uncluttered, and this could also be marked out by using different colours for pathways in flooring (though avoid patterned carpets completely as these will look too ‘busy’ to someone with dementia and make it much harder to walk on).


Good design needs to be a commitment for any care environment, both for the functional purposes outlined here and as an aid to well-being.


If you would like to speak to us about dementia wayfinding please give us a call on 01274 728831 or e-mail health@new-vision.co.uk


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