nursing homes evidens based ane boa
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Architecture & Architecture & InteriorInterior Design for Dementia Design for Dementia
Sufferes Sufferes
Ane Boa www.aneboa.dkAne Boa www.aneboa.dk
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.
Ane Boa www.aneboa.dkAne Boa www.aneboa.dk
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?
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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
Ane Boa www.aneboa.dkAne Boa www.aneboa.dk
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
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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
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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
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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.
Ane Boa www.aneboa.dkAne Boa www.aneboa.dk
?
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)
Ane Boa www.aneboa.dkAne Boa www.aneboa.dk
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
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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
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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
Ane Boa www.aneboa.dkAne Boa www.aneboa.dk
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
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HomelinessHomeliness
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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
Ane Boa www.aneboa.dkAne Boa www.aneboa.dk
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