Home is where you feel at home and are treated well
People living with dementia often fare best in surroundings that are familiar to them. The home environment can provide a sense of security and with that, can help to maintain a feeling of confidence and when being mindful of aspects written in this column you may decrease the risk of falls, confusion and improve food intake by creating a place of calmness. In fact, Florence Nightingale wrote much about the importance of environment for healing and caring. It is important also, to get outdoors and socialise as much as possible too, for yourself and your loved one where possible. Don’t forget to involve any family and friends and let them read these columns too.
When at home, there may be a few things to consider that may help. Bearing in mind that often people living with dementia may have difficulty with their eyesight, whether it is failing sight or the dementia may affect how a person sees and perceives things. Make sure your home is light, making full use of natural light, try and avoid shadows, patterned carpets and wallpaper that may be seen as objects or holes. Where you have a difference between flooring, your loved one may see it as a step, so be aware that they may feel the need to step up over a line between carpets. Try and clear clutter and make distinctions between walls and floors. I have some experience of this personally, when at the opticians one day my glasses were taken from me (I am extremely short sighted!) and I was asked to sit in the chair. I nearly fell on the floor! Because the chairs and the floor were the same colour, I couldn’t distinguish between what was floor and what was the chair. This can often be the case for the person who has dementia who may see things differently. Sometimes where there are patterned carpets the person may think there is a hole in the floor and may be fearful of stepping into it. Remove rugs as they can be dangerous in the sense that they can often cause falls and shiny floors may be viewed as wet and slippery. Remember that what they are seeing is very real to them and is very different from what you may be seeing. The person with dementia may have difficulty recognising their own face in the mirror and become troubled by this, if this happens, fit a blind over the mirror, so that you can continue to use it for yourself and cover it up at other times.
Your loved one may also have difficulty distinguishing between light switches and the walls and toilet seats and the floors, it is a good idea to try and create a contrast of colours. For instance, if the light switch is white, the wall needs to have a colour and if the toilet seat is a certain colour, avoid floor mats that blend with that colour. The same principle goes for food on their plates, if the food is the same colour as the plate it may be difficult to see the food. Try and keep plates pattern free also
Try and create a calm environment through the use of natural light, open the curtains and if you have a nice view make the most of that. Relaxing music and plants can be helpful, the colour green is associated with calmness and healing. Be aware that if there is background noise from a TV, computer or radio, you may be competing with it when trying to have a conversation. When speaking with your loved one, turn off all extraneous noise to give them full opportunity to hear what you are saying (they may not always be able to understand the words that you are speaking and I will cover this in another column soon) and to be able to gather their thoughts and speech too. Remember sometimes you need to stop doing and just be with your loved one maybe listening to music, looking though photographs or favourite films and remember to rest when they rest.
If there comes a time when your loved one may move to a residential home, these important aspects around environment should also be considered.
By Jane Mullins
Jane Mullins (RGN, Bn, PGcASR) is a dementia nurse consultant. She has worked on the Memory Teams of Bath and Cardiff, managed a Nursing Home and cared for older people in many hospital settings. Her PhD; A Suitcase Full of Memories explores holiday reminiscence activities for people with dementia and their partners.
She is the creator of DUETcare, Dignity, Understanding and Empathy Training, specialising in training in Dementia and Care of the Older Person. She is involved in a number of creative projects including playfulness and the use of music and playlists for people living with dementia and their partners and families.
This column is here to help you understand what is happening and how the dementia may affect your loved one and offers tips and suggestions to help you. This column is not intended to replace your GP or Specialist Doctor, it is to give a guide to explain what may be happening to your loved one living with dementia and how you may be able to help through adopting interesting and helpful approaches.
Dementia affects people individually and different stages will come with different issues, therefore, the advice here is general and I would always recommend speaking with your doctor.