Dementia Gateway: The environment

Bedrooms

Key messages

The bedroom should be a private, cosy and safe place which promotes a good night's sleep.
People with dementia may need help with finding and recognising their bedroom.
Design and technology can help improve arrangements for sleeping for people with dementia.

'Helping a person with dementia to get a good night's sleep is vitally important.'

There is much that can be done to make bedrooms as pleasant and user friendly as possible.

Explore the links below now to read a range of practical suggestions:

1. Help locating a bedroom doorOpen

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.
2. Doors in care settingsOpen

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.
3. Make the bed visibleOpen

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.
4. The right bedOpen

Raised rounded edges on a bed frame may not only help prevent people falling out of bed, but 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).
5. Other furnitureOpen

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.
6. MirrorsOpen

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.
7. Personalising the bedroomOpen

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.
8. Safety in the bedroomOpen

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.
9. Night-time careOpen

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.

Over to you!

Click here to do a quick activity that will deepen your understanding of this topic. The activity can be done alone or with colleagues and you can also download a copy. Trainer's notes have also been provided.