Environmental Cues, Colour & Design

Members article

By Jane Verity © Dementia Care International

Visual Cues

It is a great idea to camouflage doors that you don’t want people with dementia to use simply by painting the door in the same colour as the walls, using the same type of paint. Murals can also be effective placed over the actual door and extends out over the walls. Jane saw a beautiful example of this in a facility that had an old style painting featuring two people on bench in garden that covered two doors. This was so effective that it even fooled a visiting GP who had to be shown the way out. There was another facility in the US where the exit door was made to look like an entry door. This prompted people with dementia to ring the doorbell, which notified staff that they were leaving.

The mural room supervised by Hilary Lee in WA 

You can help people with dementia to find their own rooms by using colour and tonal contrast, which is shading of colours seen in different lights. You can check if a colour has sufficient contrast by conducting this simple test. Paint a sample card with your selected colour and put the sample up on the wall. Take a photograph of the wall and then put this through a photocopier. If the sample stands out on the black and white page, then there is good contrast.

Sufficient light, be it fluorescent, incandescent, or daylight, is vital for older people to distinguish different things. Older people need up to three times more light to see clearly. Blue light bulbs simulate light that is as close to daylight as possible, making them ideal for reading lamps. A spotlight on a person’s bedroom door will help them find their room and you can use colour contrast and signage. Remember to include their name in large type and a photograph.

Always use the Spark of Life Formula:

  • Font: Times New Roman or another serif font – easier to understand and up to 40% easier to remember
  • Size: 26 for normal information
  • Size 60 for name badges
  • Bold all writing
    Use upper and lower case (never only upper case)
  • Use black print on a white or yellow background

When you use photographs, be aware that people with dementia might not recognise a recent photograph of themselves. A great technique is to ask how old the person feels and then finding a photograph of them at that age. You can enlist the families help to source a clear, black and white photograph for this purpose. As people with dementia tend to look down to the door handle, place the sign lower at or just above door handle height.

Kinaesthetic Cues

People with moderate to severe dementia love cute, colourful, and vibrant things with personality. A great example of this is a velvet flower with a smiley face. Shadow boxes can also be effective to provide cues to the person’s identity or past life history. (See photograph) Note that this box would be better on the actual door, as would the signage of the person’s name. Remember that appropriate lighting is important so the person with dementia can identify what is in the shadow box. Collages are also a lovely and inexpensive idea and making them is an excellent activity for relatives and people with dementia to do together.

You can also use auditory signals to help a person with dementia to find their room by installing a light beam alarm similar to what plays in some shops when you enter. You could have a special tune for that person to indicate they have approached their room.

An easy solution for people with dementia who find it hard to sleep in during the mornings or to obtain rest in the afternoon is to ensure their curtains are lined with blackout material to ensure sufficient darkening of the room. This not only ensures the person receives sufficient rest but also results in a reduction of fall related incidents.

The parts of the brain that store memory are stimulated by anything unusual, colourful, and humorous or something that holds strong sensory experiences. You can help the person with dementia to find the right corridor they need by placing something colourful and fun in the entrance to work as a memory trigger.

You can also help people with dementia to be aware of which meal of the day they are eating by making a set of placemats featuring a corresponding symbol representing that particular meal. (For more information read our article, Which Meal is This?

Set up nooks and crannies with special interest areas such as a baby change station. Make sure it is very nicely done and aesthetically pleasing and include a baby doll etc. Men might enjoy golf paraphernalia, aeroplanes, or caps from different sports. Facilities overseas have also been successful in setting up old school rooms and offices. These areas create cues to people with dementia about different areas of the facility as well as giving the opportunity to engage in meaningful activity.

Reminiscing Cues

Looking into the person with dementia’s past can provide clues and triggers to solve difficult behaviour in the present. For example; one facility solved the problem of a gentleman who insisted on urinating on pot plants etc. by building an older style ‘thunderbox’ around the toilet to encourage him to use it. It was a great success, as the toilet now resembled something he was accustomed to using.  Read more about this interesting solution in the article, Creative Thinking Solves Toilet Challenge.

Signs and Symbols

Using creativity and the Spark of Life Formula for signage enables people with dementia to have the best possible opportunity to understand what is being communicated. A great example of using signage to minimise wandering was the facility that had a gentlemen who kept escaping through the laundry door. This gentleman had impeccable manners so they solved this problem by putting a sign saying ‘Ladies’ on door. It now looked like the entrance to the female toilets and this simple action stopped him going through.