Optimising care settings to reduce falls and behaviours. Think about your childhood home. Imagine you have lived your whole life in that home. You knew your home well and it gave you a sense of peace, of safety.

Now imagine that you are placed in a new environment, a new place to live. On top of that imagine that you might be suffering from a visual impairment, hearing loss, pain or confusion. It’s a scary thought, isn’t it?

Transitioning into residential care is a major life adjustment for any person, an adjustment that is only magnified to the resident with dementia.

Whilst their environment may be secure to prevent harm coming to them, there are strategies we can use to ensure that our residents not only live, but thrive, within their new home.

How to maximise environments for reducing falls and behaviours using the Dementia Enabling Environment Principles:

1. Reduce Risks… Subtly. Residents with dementia need to be kept safe and secure. However obvious bars and locks will only serve as agents of agitation or paranoia.
2. Mimic Homely Scale. The size and scale of buildings and areas should be kept within “the home”. Grand hallways and high ceilings may cause increased confusion. Staircases and railings pose falls hazards.
3. Good Visual Access. Having areas that flow logically into one another can help give the resident with dementia a sense of purpose to their wandering. Long winding corridors and confusing layouts will aggregate wandering and confusion behaviours.
4. Reduce White Noise and Unhelpful Cues. Excess visual and auditory background stimulation can agitate the resident with dementia. Assisting residents to focus on one purposeful task is more helpful than blasting them with a juke box, doll therapy, DVD and newspaper all at once.
5. Increase Helpful Cues! Carefully placed cues, for example, a resident’s favourite knitted blanket on the chair, their pair of reading glasses and a glass of port waiting at the dining table may help to orientate the agitated resident with dementia to dinner time because the cues reflect their own meaningful experience.
6. Flow Baby Flow. The resident who wanders should have the ability to do so in an environment free from clutter (especially clinical looking clutter), with plenty of choices for meaningful activities along the way, and the ability to go outdoors safely for fresh air and sunshine. Good contrasting colours, even footpaths and removal of trip hazards is important.
7. Familiarity. The resident should have the right to feel at home within their home, so it is important that it look like one. Homely fixtures and fittings with help orientate the resident to their perception of a home.
8. Facilitate social choices. The resident should be able to make choices as to whether to spend time with others or alone, so both such areas need to be available.
9. Bridge the Gap. Avoid social and identity isolation by encouraging regular interaction with the local community, including family members and friends. For inspiration from Holland see dementiavillage.com
10. Supporting Way of Life. Facilities need to empower residents living with dementia to live safe, purposeful and meaningful lives, whatever that looks like for each individual.

Agestrong Physio can provide allied health clinicians with experience in dementia care to assist with assessment, advice and ideas for reducing environmental risks within your facility.

Contact Agestrong Physio for more information.