WAYFINDING&DEMENTIA:HowDesignCanImproveNaviga3onAmongOlderAdultsInAssisted-LivingFacili3es

KaitlynKleibusch;MHACandidateSchoolofPublic,Nonprofit,andHealthAdministra3on

GrandValleyStateUniversity

INTRODUCTION:Asweage,ourabilitytonavigatewithintheenvironmentbeginstodiminishwhichmayleadtoincreasedconfusion,anxiety,fearofmobility,anddifficultywayfindingamongolderadultslivingwithmildtosevereformsofdemen3a.Wayfindingistheabilitytoreachadesireddes3na3oninthenaturalorbuiltenvironment,andreturntoapointoforigin.Alongwithaging,theworkingmemorybeginstodeclineandasmalleramountofenvironmentalinforma3oniscollectedbyapor3onofthebraincalledthehippocampus,tocreatealessdetailedcogni3vemap.Asneurologicaldegenera3onoccurs,manyindividualsmayseekaddi3onalcareinassisted-livingfacili3es.Itisimportantthesefacili3esaccommodatewayfindingandspa3alorienta3onneeds.Inordertogainagreaterunderstandingofhowassisted-livingdesignimpactswayfinding,anoverviewofdemen3a-friendlyenvironmentaldesignandbestprac3ceswillbereviewed.

THEORETICALFRAMEWORKS:EnvironmentalDocilityHypothesis:CreatedbyLawtonandSimon,thismodel“indicatespeoplewhoaresubjectedtorestric3onsontheirhealthorcogni3veabilitycannotalwaysadapttheenvironmenttotheirspecificneedsandbecomemoredependentontheirenvironment1.”

Competence–EnvironmentalPressModel(Fig1):The“primarythesisthathumanbehaviorandfunc3onresultsfromthecompetenciesoftheindividual,the“press”ofenvironment,andtheinterac3onoradapta3onofthepersontotheenvironment3.”

REFERENCES:Figure1

DEMENTIAFRIENDLYDESIGN:Overtheyears,long-termcareandassisted-livingfacili3eshavemovedawayfromthemedicalmodel,andshiWedtowardthesocialmodel–whiles3llemployingaspectsofthemedicalmodel4.Thesocialmodelsupportsdemen3a-friendlyenvironments.

Themostcommonenvironmentalelementsusedtopromotewayfindingandspa3alorienta3onincludefloorplantypologyanddesign,andappropriateenvironmentalcuessuchas:signage,flooring,furnishings,ligh3ng,color,andcontrast5.

BUILDINGSTRUCTURE:FloorPlanTypology:GoodDesign§  Straightcorridorswithclear,visibleends,andwide

enoughtoaccommodatewalkingaids.§  Circula3onsystemsshouldhavefixedreference

points–likealivingroomornursingsta3on.§  Commonareasshouldrequireminimaltravel

distancetoop3mizefrequencyofuse6.BadDesign§  Repe33veelementssuchasdoorsoneachsideof

thecorridor6.§  L-shapeandT-shapewithoutreferencepoints.

INTERIORDESIGN&DÉCOR:LighPng:Corridorsandspacesshouldbewell-littoaidinnaviga3on.Therecommendedlightlevelsshouldfallbetween500to2000lux–whichisthemeasurementoftheintensityoflightinanarea5.Thereshouldbeaminimumof500luxincorridors.Naturallightismoredesirablethanar3ficiallight.Translucentblindsshouldbeusedtopreventvisuospa3aldisorienta3onassociatedwithlightreflec3onsorglare.Spotligh3ngshouldbeavoidedbecauseitproducesshadowsthatnega3velyimpactwayfinding9.

Flooring:Variousflooringmaterialscannega3velyorposi3velyimpactwayfinding.§  Flooringtransi3onsbetweentwodifferentmaterials

shouldbelaidtoblendtogethertoavoidcrea3ngsharpcontrastthatcanbeperceivedasastep.

§  Transi3onstripsofasimilarcolorshouldbeusedtoblendandconnectfloorpaferns9.

§  Warmtonesshouldbeusedforfloormaterialsbecausetheyareeasilyseenbyadultswithvisuospa3aldisorienta3onordecliningeyesight9.

§  Surfacesshouldbeflatandbeslip-resistant.§  Flooringshouldnotcontainboldpaferns,speckles,

orsparkles9.

Color&TonalContrast:Theabilitytodifferen3atebetweencolorsdecreasewithageanditisimportanttousecolorthatcompensatesforvisualimpairment.Astheeyelensage,thepercep3onofcolorchangesreducingtheeffec3venessofcolorcodinganditbecomeshardertodifferen3atebetweendarkshadesandlighttones9.Strongcolorcontrastsshouldbeusedoversubtleorboldcolors.Tocreatetheop3malcontrast,thelightreflec3vevalue(LRV)shouldbe30orgreater1.

CONCLUSION:Residentsrelyheavilyonvisualcuesintheenvironmenttohelpthemnavigate.Itisimportanttounderstandhowphysicalandcogni3veabili3esdeclinewithage,andaffecttheabilitytowayfind.Astheassisted-livingindustrycon3nuestosupportindividualswithdemen3a,itistheresponsibilityofthedirectcareteam,architects,anddesignerstocreatesalientenvironmentsandadoptdesigntechniquesthatallowindividualstonavigatesuccessfullyandindependently,whileimprovingqualityoflifeandoverallwell-being.

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Signage:Combiningpictogramsandgeneralleferingshouldbeusedtopromoteeffec3vewayfinding1.Contrastshouldbeu3lizedbetweenwords,pictures,andbackground.Theloweredgeofthesignshouldbemountednohigherthan4to5feetofftheground2.