Housing Adaptations for Dementia

The statistics on dementia are startling: 1 in 1,000 people under the age of 65 will develop dementia and beyond the age of 65, the figures jump to 1 in 13 people, according research from the Alzheimer Society ofCanada.  The term dementia encompasses a range of conditions: Alzheimer’s disease; vascular dementia; Creutzfeldt-Jakob disease; cross-species prion infection from the meat of infected livestock; Huntington's disease; Lewy body dementia and cognitive impairment among others.  Vascular dementia is the second most common type of dementia after Alzheimer’s disease and is associated with blood vessel damage from stroke, high blood pressure, cholesterol and/or diabetes.

With an ageing population, many families will have a loved one who experiences dementia.  In the early stages, the symptoms are often mild enough to allow the person to continue with basic, daily tasks although they can experience mood swings, forgetfulness, and changes in thinking.  They typically have difficulty with abstract processing, which is used to prepare a grocery list or do banking; however, procedural memory, such as that used to drive a car or cook a meal, often remains intact for a longer time.  

With some adjustments, people in the early stages of dementia can enjoy their usual activities and some autonomy while remaining at home with loved ones.

Safety is the primary concern when adapting a home for a dementia sufferer, who can be at risk from common domestic features such as stairways, stove elements, bathtubs, etc.  In addition to safety, adaptations can compensation for perception difficulties.  The Canadian Mortgage and Housing Corporation commissioned a study on these housing issues and reports the findings in their paper  “Housing Options for People Living with Dementia” (1999; updated 2015).

 

The report offers these home adaptation suggestions:

 

  • Stairways should have handrails but not all designs are ideal.  Research shows that a handrail should be circular, with a diameter of 1.5 inches, so fingers can wrap around it in a power grip.
  • Avoid contrast changes where different flooring surfaces meet.  Those living with dementia can struggle with 3D perception and may misinterpret changes in contrast as steps or holes. 
  • Remove clutter particularly any items that can shatter or pose a trip hazard.
  • Avoid rearranging furniture.  A person with dementia may lose their balance and reach out for a familiar support only to find the item is gone.  Rearranging furniture can also create stress.  If you must make changes, make them small and incremental.
  • Reduce noise pollution to avoid possible agitation and confusion.  Locate bedrooms away from street noise.  Consider using acoustical ceiling and wall products, low pile carpeting and heavy curtains to help absorb sound.  Schedule intrusive noise, such as vacuuming, when the person living with dementia is out of the house or engaged in another room.
  • Ensure that kitchens and bathrooms are easy to understand (e.g., avoid modern fixtures that turn on automatically and consider traditional hot and cold fittings for taps).
  • Install glass doors on kitchen cupboards where commonly needed items are kept.  The glass will make it easy for the person to locate what they need without becoming flustered.
  • Install handrails near the toilet and in the bathtub/shower area.
  • Doormats that are a dark colour from the floor can look like a hole, so choose mats that are the same tone as the floor.
  • Any kind of linoleum or other flooring with large speckles and sparkles should be avoided as people with dementia may stoop and attempt to pick them up.
  • Install a lock on yard gates that requires a key to open when both exiting and entering to reduce the risk of wandering.

Lighting:

With age, it becomes more difficult to see in low light.  Additionally, for those with dementia, shadows on the walls and floor from a shifting curtain or car headlights through a window can be frightening. 

  • Double the usual levels of lighting in the home to help with visual impairments as well as possible shadows and misperceptions.
  • Do not use lace curtains since sunlight through lace curtains can cause shadows that can lead to possible unwanted behaviours.
  • Replace light bulbs immediately when they burn out.
  • Install light switches that contrast with walls making them easy to find.
  • Extend curtain rails beyond windows so windows are fully exposed when curtains are open.

The home environment can either support a person living with dementia or hasten their deterioration, according to a 2012 study by the National Institute of Health in theUnited Kingdom.  This research revealed that along with declining memory and reasoning skills, a person with dementia has the potential for high levels of stress and acute sensitivity to their social and physical surroundings. 

These small but important changes around the home can help to make life comfortable for loved ones facing a frightening diagnosis.  Make each day count by sharing pleasant conversation, interaction with pets and access to hobbies such as gardening, playing music and creating art.

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