What is dementia?
A common misconception is that dementia is its own disease, however dementia is an umbrella term that encompasses a range of symptoms associated with the perpetual degeneration of brain function.
A decline in cognitive functions, such as memory, language comprehension and speech, can transform everyday life into a significant challenge for patients and their loved ones. Simple tasks, like finding your keys, can become very difficult. Personality changes and changes in behaviour are also common symptoms associated with dementia. Patients may find themselves frequently frustrated and lacking motivation.
There are many different subtypes of dementia, the most common types are: Alzheimer's disease, vascular dementia, lewy body dementia and frontotemporal lobe dementia.
It is estimated that by 2025 over 1 million people will be living with dementia.1 A huge majority of us will know somebody with a diagnosis and be inclined to help with their care as their ability to perform everyday tasks declines. Caring for somebody with dementia is incredibly challenging both physically and emotionally. It is time-consuming, stressful and costly whilst also increasing the risk of depression and social isolation.2 Caregiver interventions and proper preparation can be a useful tool to support the primary caregivers.
This guide is to inform you of ways to make a supportive environment at home for a dementia patient.
Understanding dementia
Types of dementia
- Alzheimer’s disease: The most common type of dementia. Caused by a buildup of amyloid and tau proteins in the brain which damage the brain cells resulting in symptoms3
- Vascular dementia: The second most common type of dementia. Caused by frequent disruptions to the blood supply of the brain as a result of transient ischemic attacks. Brain injury due to poor blood flow occurs culminating in the symptoms of dementia4
- Lewy body dementia: The third most common type of dementia. Abnormal deposits of the alpha-synuclein protein in the brain are called lewy bodies.5 The lewy bodies disrupt the normal cognitive pathways leading to symptoms associated with dementia
- Frontotemporal dementia: A rarer type of dementia accounting for less than 1 in 30 cases. Abnormal tau, TDP-43 and FET protein accumulation damages cells in the frontal and temporal lobe.6 The main effects are to personality, behaviour, emotions, speech and comprehension
Symptoms of dementia
Dementia affects people differently. However, there are some common early signs of dementia, these include:
- Memory loss
- Concentration difficulties
- Mood changes
- Confusion
- Struggling to carry out daily tasks
Alzheimer’s disease symptoms:
- Memory problems, for example facial recognition
- Repetitive questions
- Withdrawn and anxious
- Confusion in new environments
- Problems with numbers, for example working out change in the shops
Vascular dementia symptoms:
- Stroke-like symptoms, for example, weakness on one side
- Movement problems
- Mood changes
- Thinking problems, for example, inability to concentrate
Lewy body dementia symptoms:
- Visual hallucinations
- Rapid changes in attention
- Slower movements
- Frequent falls
- Problems sleeping
Frontotemporal dementia:
- Language problems
- Lack of social awareness
- Changes in personality
- Becoming obsessive
Designing a dementia-friendly home
The layout of the home can have a big impact on somebody with dementia. The symptoms of dementia, such as memory loss, confusion and frequent falls, can make living independently a huge risk.
Adapting the house for a dementia patient can significantly improve their safety and make life a little bit easier and more comfortable. Each of these changes may help maintain the normal routines and activities for as long as possible.
Lighting
Good natural lighting will make navigating around the house easier. Good lighting is particularly important on the stairs and by the toilet to help prevent falls.
Make sure light switches are easy to reach. Automatic light sensors may be useful as they switch on via detecting movement.
Darkness in the bedroom at night will help improve sleep quality.
Flooring
Rugs and mats can easily become trip hazards for dementia patients so it is best to remove them.
Shiny and reflective flooring may be confusing so it is best to opt for plain matt flooring.
Ensure the floor is not the same colour as the walls as this can also be confusing.
Contrasting colours
Dementia can affect a person's ability to interpret colours. Therefore, ensuring colour contrasts are present in the house can help.
- Contrast the colour of the walls and the floor
- Make sure furniture doesn’t blend into the floor or the walls
- Ensure the doors and bannisters stand out so are easily recognisable
- Contrast the toilet seat to the rest of the bathroom
- Crockery that contrasts the colour of food to make eating easier
Labels and signs
Printing off labels, signs and pictures can help patients remember where things are.
Useful signs include: putting a picture of a toilet on the bathroom door and picture of plates on the correct cupboard. See-through cupboards allow patients to see what's inside.
Keeping items, such as keys, wallet and TV remote, in the same place can be useful.
Declutter
A messy and disorganised home can cause unnecessary confusion and distraction. Therefore, a big clean up and give away may be very useful.
Outside
Going outside and getting some exercise can be beneficial for everyone. Make sure that the front door is easily recognisable and different to the other doors on the street.
If there is a garden ensure that no trip hazards are present, lighting is sufficient and there is a seating area.
Specific adaptations
Kitchen adaptations
- Label cupboards and drawers as a reminder of what’s inside
- Don’t mix up items such as pet food and normal food
- Ensure a smoke, gas and CO alarm is fitted
- Buy a cooker with an automatic shut-off device fitted
- Contrasting crockery helps with identifying food on your plate
Bathroom adaptations
- Label the bathroom door so it is easily recognisable
- Contrast the toilet seat to the rest of the bathroom
- Separate hot and cold taps
- Invest in flood prevention plugs
Living room adaptations
- Remove unnecessary furniture, clutter and trip hazards
- Display labelled photos to help trigger happy memories
- Turn off the TV when not in use as the background noise can cause confusion
Bedroom adaptations
- Install a night light to help when moving around at night
- Contrast the bed to the floor to aid in locating it
- Lay out clothes in the order you put them on to help with dressing
- Pressure sensors under the mattress can alert emergency services if the patient leaves and doesn’t return to bed at night
Stairs and hallway adaptations
- Remove trip hazards, such as rugs and mats
- Contrast the floor to the walls
- Mark the edge of each step on the stairs with a contrasting colour
- Ensure that the stair bannister stands out
- Leave signs on the front door to remember keys and to lock the door
Advice for a friend, family member or carer
When making changes around the house for a dementia patient it is helpful to remember the following tips:
- Include the patient as much as possible when redesigning the house. This helps maintain their independence and enables the adaptations to be suited to them
- Don’t make any drastic changes as a sudden change in familiarity can be particularly difficult and confusing
- Focus on one room at a time
- Don’t be afraid to seek advice from experts
Summary
To conclude, adaptations to the home environment offers a dementia patient a chance to stay living at home for longer. A dementia-friendly home improves the safety and comfort of somebody suffering from dementia, whilst also helping them maintain their normal activities and routines for longer.
Some key adaptations are:
- Better lighting
- Less clutter
- Contrasting colours
- Signs and labels
References
- What is dementia?. Dementia UK. https://www.dementiauk.org/information-and-support/about-dementia/what-is-dementia/ [Accessed 28th April 2024].
- Brodaty H, Donkin M. Family caregivers of people with dementia. Dialogues in Clinical Neuroscience. 2009;11(2): 217–228. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181916/
- Bloom GS. Amyloid-β and tau: the trigger and bullet in Alzheimer disease pathogenesis. JAMA neurology. 2014;71(4): 505–508. https://doi.org/10.1001/jamaneurol.2013.5847.
- Sanders AE, School C, Kalish VB. Vascular dementia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024. http://www.ncbi.nlm.nih.gov/books/NBK430817/ [Accessed 28th April 2024].
- What is lewy body dementia? Causes, symptoms, and treatments. National Institute on Aging. https://www.nia.nih.gov/health/lewy-body-dementia/what-lewy-body-dementia-causes-symptoms-and-treatments [Accessed 28th April 2024].
- What is frontotemporal dementia?. Alzheimer’s Research UK. https://www.alzheimersresearchuk.org/dementia-information/types-of-dementia/frontotemporal-dementia/ [Accessed 28th April 2024].