NURSING HOMES Evidens Based Ane Boa

NURSINGNURSINGHOMESHOMES

Evidens B

ased

Ane Boa www.aneboa.dkAne Boa www.aneboa.dk

Architecture & Architecture & InteriorInterior Design for Dementia Design for Dementia

Sufferes Sufferes


Dem

entia is an organic disorder

The first symptoms of dementia is reduced The first symptoms of dementia is reduced sense of space, poor memory, confusion sense of space, poor memory, confusion and decreased ability to function in and decreased ability to function in everyday life.everyday life.

When submitting to a nursing home, the When submitting to a nursing home, the symptoms are so severe, that constant care symptoms are so severe, that constant care is needed. is needed. The brain can no longer interpret sight and The brain can no longer interpret sight and sense impressions as normal, and almost sense impressions as normal, and almost all body functions are affected.all body functions are affected.

Dementia is a fatal disease and eventually Dementia is a fatal disease and eventually the nursing home acts as a hospice.the nursing home acts as a hospice.


How many How many In Denmark up to 90% of all nursing home In Denmark up to 90% of all nursing home residents residents sufferssuffers from a form of dementia from a form of dementia (depending on survey)(depending on survey)

MMany are not diagnosed with dementia, but with any are not diagnosed with dementia, but with stroke, Parkinson's, multiple sclerosis and others. stroke, Parkinson's, multiple sclerosis and others. All diseases that may cause dementiaAll diseases that may cause dementia

Is dementia the criterion for nursing home Is dementia the criterion for nursing home accommodation?accommodation?

How many demented must there be, before we How many demented must there be, before we make nursing homes evidens based dementia make nursing homes evidens based dementia friendly?friendly?

What if they instead suffered from blindness or cancer?


Among others Among others

Dementia changes the Dementia changes the ability to:ability to:

Perceive space and depth Perceive space and depth

Percieve patternsPercieve patterns

Recognize designRecognize design

Concentrate and learn Concentrate and learn

Find their way – Up to instant memory Find their way – Up to instant memory loselose

Read wordsRead words

Stop negative emotionsStop negative emotions


arch

itectu

ral co

nsidera

tions n

eed

ed

Space & depthSpace & depthWe must explain space and We must explain space and depth by using colors and depth by using colors and light. light.

All surfaces within a space All surfaces within a space must be emphasized by must be emphasized by difference in color and light difference in color and light reflectance value.reflectance value.

Light up all Light up all areas whereareas where something new is something new is happening: happening: A door, a toilet, the A door, a toilet, the direction of the hallway… direction of the hallway…

There must be no There must be no reflections of light, it reflections of light, it overstimulates the brainoverstimulates the brain


Only build one floor Only build one floor buildingsbuildingsGlass will be Glass will be perceived as perceived as nothing, dark nothing, dark colors as distancecolors as distance

Light reflectance value


Explain space by 30% LRV contrast between door, Explain space by 30% LRV contrast between door, floor, wall, ceiling, furnitures eg.floor, wall, ceiling, furnitures eg.

Note: Materials and colors can have the same Note: Materials and colors can have the same LRV, we have to consider both.LRV, we have to consider both.

Unneeded spatial information can be toned down Unneeded spatial information can be toned down using the same LRVusing the same LRV

PatternsPatternsNever use decorative patternsNever use decorative patterns

• Small patterns can be percieved as bugs Small patterns can be percieved as bugs or dirtor dirt

• large pattern will be taken literally and large pattern will be taken literally and spatiallyspatially

• Patterns overstimulate the brainPatterns overstimulate the brain

Beware of furnishing fabrics, curtains, tablecloths, murals and flooring

Only use patterns for reminiscence on surfaces Only use patterns for reminiscence on surfaces that have no other functionthat have no other function


DesignDesign Examples: Examples:

Windows that looks Windows that looks like doors, toilets, like doors, toilets, faucets, light switches, faucets, light switches, (missing) handles, etc.(missing) handles, etc.

Design must be Design must be archetypical. - People who archetypical. - People who only remember 70 years only remember 70 years

old design, should be able old design, should be able to understand how things to understand how things work and what they are work and what they are

for.for.

OBS Wrong design causes unnecessary anxiety and confusion and increase

the need for help.


?

Show and hideShow and hide


Way findingWay findingImagine being lost in your own homeImagine being lost in your own home

Building layout must be Building layout must be straight forward and straight forward and with excellent with excellent overview to the overview to the shared shared dining / living dining / living room, and toilet.room, and toilet.

The The number of residents number of residents is crucial to how long is crucial to how long the hallway will be the hallway will be (No more then 9, but (No more then 9, but rather less)rather less)


Dementia-Friendly Architecture: Environments That Facilitate Wayfinding in Nursing Homes. Gesine Marquardt, PhD, and Peter Schmieg, PhD. 2009

We We must act like, act like, learning new is not learning new is not possible at all.possible at all.

OverviewOverviewDemented need overview:Demented need overview:

Only one room in the appartment with all Only one room in the appartment with all over view to the toilet and the entrance over view to the toilet and the entrance door (must look like an entrance door)door (must look like an entrance door)

Mirrors are banned, so are any reflective Mirrors are banned, so are any reflective materialsmaterials

No repeated furnitures - They must No repeated furnitures - They must stand stand out from each other by at least color or out from each other by at least color or 30LRV30LRV


SignsSignsAvoid signs – Be Avoid signs – Be

straight forward straight forward insteadinstead

Use pictograms instead Use pictograms instead of writingof writing

Remember it is a homeRemember it is a home


Plan signagePlan signage

Dementia and Dementia and emotionsemotionsIt is important to know, that It is important to know, that

emotions lasts longer than emotions lasts longer than memory – Hours longermemory – Hours longer

Demented have normal feelings – Demented have normal feelings – It is the triggering cause that It is the triggering cause that is abnormal is abnormal

If it is hard to find the way or to If it is hard to find the way or to use the bathroom for instanse, use the bathroom for instanse, it will cause axiety and restless it will cause axiety and restless wandering, and the need for wandering, and the need for personal care is increased personal care is increased drasticallydrastically


Care and architecture must support positive emotions

Normal daily Normal daily rhythmrhythm

Dementia affects the circadian rhythmDementia affects the circadian rhythm

Make sure there is sufficient daylight in Make sure there is sufficient daylight in every roomevery room

Provide safe open air areas (Provide safe open air areas (Without Without possibility of being lost).possibility of being lost). Sensory Sensory garden is preferable.garden is preferable.

Working lights for night shifts should be Working lights for night shifts should be incorporated independently in the décorincorporated independently in the décor


HomelinessHomeliness


How many furnitures will How many furnitures will actualy fit into the room?actualy fit into the room?Is there room for a three-Is there room for a three-seater?seater?How many people has a How many people has a kitchen in the entrance hall?kitchen in the entrance hall?

NOTE windows, sliding doors, radiators NOTE windows, sliding doors, radiators and installations blocks interior and installations blocks interior decoration possibilitiesdecoration possibilities

Recent research Recent research indicate the indicate the

potential to treat potential to treat dementia using dementia using architecture and architecture and interior design interior design combined with combined with

pedagogical pedagogical methods methods Ane Boa www.aneboa.dkAne Boa www.aneboa.dk

SummarySummaryStraight forward building layout with complete overviewStraight forward building layout with complete overview

Only one room that exudes the same useOnly one room that exudes the same use

Archetypal decor and designArchetypal decor and design

Emphasis need to knowEmphasis need to know

Dim unnecessary (or unwanted)Dim unnecessary (or unwanted)

Color and LRV = Depth and visabilityColor and LRV = Depth and visability

What you think is beautiful is subordinate – We are building “medication” for severely ill people.

Please go to Please go to www.aneboa.dk for more information for more information


http://www.aneboa.dk/

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