Dementia-friendly environments: Bedrooms
Help locating a bedroom door
Helping a person with dementia to get a good night's sleep is vitally important. For a person with dementia, just finding your bedroom when faced with a number of doors can be confusing. Painting the bedroom door in a contrasting colour to the surrounding wall is crucial for finding the door. Also, personalise the door by having a sign and perhaps incorporating pictures or photographs.
Helping a person with dementia to get a good night's sleep is vitally important.
Doors in care settings
In a care home, these adjustments can help to prevent residents walking into someone else's bedroom. In their confusion the person might start searching the drawers and cupboards because they think their own things have been replaced with lots of strange things. When the room's owner comes in they then think the person is prying, or worse, stealing. This can start a major incident, which could have been prevented.
Make the bed visible
A person with dementia may find it difficult to find or identify their bed. They should be able to see their bed easily from as many locations as possible and access it from both sides. Use contrasting bed linen and sheets to help define clearly the sleeping area. Bed covers are better in a colour that contrasts with the carpet. Ideally the bed should be visible from the toilet area so that when the person wakes up during the night they can see where they need to go and where to return to. This would help avoid people needing to ask where the toilet is and possibly not getting there in time.
The right bed
Raised rounded edges on a bed frame may not only help prevent people falling out of bed, but also provide psychological support for those who have shared a bed with a partner for many years. A hospital-style bed can be adjusted, raised and lowered when helping someone with dementia to get in and out of the bed more safely. It can also be placed at the exact height for the convenience of the person. Bed rails are a form of restraint and should only ever be used after a risk assessment and their use should be reviewed very frequently (in a care setting, probably at least at each change of shift).
Sometimes wardrobes can be adapted to part-open to be able to display only one day's clothing. Partially open-fronted drawers can indicate the contents. Chairs should be comfortable and made with rounded timber or padded upholstery in a strongly contrasting colour.
People with dementia can be anxious and frightened when they see their reflection in a mirror because they may not recognise the person who is looking back at them. If mirrors are the problem, cover or remove them.
Personalising the bedroom
Having personal items in a bedroom – photos, a hair brush, a favourite blanket or a bottle of perfume – can provide reassurance and remind the person with dementia what room they are in. An analogue clock, in the person’s field of view and set to the right time, can help someone make sense of the time of day.
Safety in the bedroom
A bedroom needs to be safe. For instance, can a person get in and out of bed easily? If the person lives in their own home is the bed too close to a fireplace or heater? Electric blankets and hot water bottles may become unsuitable quite quickly.
Night lights or lamps that light up when activated by a movement sensor may help a person get around safely. Commodes may be useful if a person cannot reach the bathroom, but if the person has dementia, they may forget what it is for or not recognise it. Certainly try to avoid waking the person up during the night to see if they have been incontinent of urine. A sensor mat in the bed can help, if required, and many modern body-worn continence products will contain urine and protect the skin for the whole night. If you enter the room, turn lights on and off, and feel about in the bed for damp patches, this will only disturb the person, with the risk that they end up needing medication to go back to sleep.
Care staff should feel free to wear a dressing gown on a night shift. If you are working in day clothes, the person is even more likely to be confused about the time of day and get up to join you, rather than settling down for a good night's sleep.
Access and download additional resources
Further reading Open
Brawley, E.C. (1997) Designing for Alzheimer’s disease: Strategies for creating better care environments. Chichester: John Wiley.
Dementia Services Development Centre (2007) Best practice in design for people with dementia, Stirling: Dementia Services Development Centre, Stirling University.
Dementia Services Development Centre (2008) Design for people with dementia: Audit tool, Stirling: Dementia Services Development Centre, Stirling University.
DSDC Virtual care home: The University of Stirling’s Dementia Services Development Centre has produced this ‘Virtual care home’, which allows users to navigate around the various areas within a care home (such as bedrooms, en-suite bathrooms, kitchens, lounges and so on), and read advice about things to consider and ways to improve the care environment for people with dementia.
Kerr, D., Wilkinson, H. and Cunningham, C. (2008) Supporting older people in care homes at night, York: Joseph Rowntree Foundation.
Pollock, R. (2003) Designing interiors for people with dementia, Stirling: Dementia Services Development Centre, Stirling University.
Useful links Open
Dementia-friendly health and social care environments
This 2015 resource from the Department of Health presents design guidance in relation to new buildings as well as the adaption or extension of existing facilities, and includes case studies drawn from projects funded by the Dementia Capital Programme.
Design Resource Centre
The University of Stirling’s Dementia Services Development Centre (DSDC) has always been a leader in the area of dementia and design. The DSDC website includes the Design Resource Centre. This section includes links to a substantial range of publications and resources in the area of dementia-friendly design including information on the importance of lighting, colour and contrast, getting outside, and orientation and signage. The site also includes the DSDC Virtual Care Home and the DSDC Virtual Hospital. Both these resources allow users to navigate around the various areas within a care home or hospital (such as bedroom, ward, ensuite, kitchens, lounges and so on), and read advice about things to consider and ways to improve the care environment for people with dementia.
Developing supportive design for people with dementia
This is the final report of The King’s Fund’s Enhancing the Healing Environment (EHE) Programme, which ran from 2009 until 2012. The well-illustrated report includes descriptions of the 26 EHE projects completed in NHS Trusts to improvement the environment of care for people with dementia, and also includes the EHE assessment tool and overarching design principles.
Home environment and dementia
This NHS Choices web page sets out good introductory information on how to improve the environment for a person living with dementia. It covers topics such as lighting, flooring, colours, noise and outside spaces.
Making your home dementia-friendly
This 2015 Alzheimer’s Society booklet is aimed at people living at home. It covers a wide range of topics such as lighting, flooring, furniture and furnishings, knowing where things are, and enjoying the outside.
Related pages from this section Open