Painting suggestions for Alzheimer's patients...

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Asked By: 
Elaine

I work in a Nursing Home and I've been asked to design the Alzeheimer's Unit. I have two rooms joined, one side is used for dining and activities and the other side is used for sitting, television and some activities. I know that with Alzeiheimers, Pastels are the chosen colors. The rooms are small, 15X18. Do I design and paint both rooms the same to make the area look larger? There is a small area between the rooms approx. 8X10. What happens when you paint one wall a darker color? Do you have any ideas for design and colors? I'd like to make the room appear outdoors without too much clutter, looking airy and open? Any ideas would be appreciated.

Thanks,

Answer: 

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This was definitely a thought-provoking question, one that took a bit of research on our part. There are two issues here &#8211; one of course being the need to design a comforting, safe environment for the Alzheimer's residents, the other being a basic design esthetic.
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In nursing homes, patient rooms are being made more home - like and common areas are being "deinstitutionalized" wherever possible. There are really no hard and fast rules on how to use color, but some general guidelines can be helpful.
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Color can do much to comfort, stimulate and reassure a nursing home resident. Its important to create a home-like surrounding, even though the materials used must enhance function and have the "industrial-strength" quality required to weather the use of medical and assistive equipment and the routine application of strong cleaning agents.
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Let's start with some basics about Alzheimer's and design necessities you may already know:
<ul>
<li>The role of design in this case is to support efforts essential to helping cognitively impaired residents retain maximum independence and dignity</li>
<li>High contrast should be used to effectively enhance residents' function. (eg. countertops should stand out strongly from floors, floors should stand out strongly from the walls. If the floor is a light color, make sure the wall color different enough). Often an edge band of contrasting color on a tabletop or other raised surface can help the resident identify it appropriately.</li>
<li>Color can also help with way finding - for an Alzheimer's patient, a room may be recognized more easily by color than by function. Therefore, use paint color to create differentiation between rooms. This enhances a person's ability to move independently throughout the building and understand the different room functions.</li>
<li>Visial cues are important, as is size and visibility. The key words are "large," "visible," and "identifiable." As patients lose cognitive or intellectual skills they become increasingly dependent on sensory cues, so pictures work better than words. But - enlarge the images! Think of visual landmarks, i.e., large items or cues, such as a grandfather clock or a large display case can provide necessary cues about location. For example, think about placing a large colorful aquarium just before one reaches the dining room.</li>
<li>Lighting within the room is as important, if not more so, than color. You need to make sure there is adequate lighting. Lighting not only affects the color itself, but for those with Alzheimer's poor lighting can contribute to problems with balance, mobility, and dementia - dimly lit areas may produce confusing shadows or difficulty with interpreting everyday objects. You want to make sure all areas of a room are adequately lit and there are no dark or shadowed areas You can reduce glare by using soft light or frosted bulbs, partially closing blinds or curtains, and maintaining adequate globes or shades on light fixtures. (Jane note: Lighting also greatly affects color, so be sure to get your lighting installed first before determining your final colors).</li>
<li>Texture and touch of fabrics, wall coverings, and other objects are also very important to those with Alzheimer's. Pillows of soft-textured fabrics, such as corduroy or velvet, are pleasant to touch and hold. You can even consider using fake fur. There are also many washable fabrics that can provide useful decorative accents, but also provide warmth.</li>
<li>Patterns (eg; flower or striped wallpaper) and bold contemporary colors should be avoided because they create confusion.</li>
</ul>
To answer your specific questions:
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<li>re: Do I design and paint both rooms the same to make the area look larger? When it comes to your smaller room spaces, this in fact can be a good thing. According to one recent report on Alzeheimer design trends, it's a good idea to provide smaller activities spaces to accommodate 6 to 8 residents. They say that "large activity rooms tend to be noisy and confusing when there are simultaneous activities going on. Smaller spaces for watching a video, singing, working puzzles or having tea can also provide warm, intimate places for families to visit loved ones." Based on this information, in addition to basic design asthetics, it may be better to create defined spaces to provide visual cues and help residents identify each areas use. This means that while painting all spaces 1 color may have more "flow" and openess to you &amp;I, from an Alzheimer's perspective this may create more confusion. Try using colors that compliment each other, but are distinct enough that they can be identified as separate spaces.
Ideally, you want to make the environment so the occupant is able to easily read their surroundings, know where they are, and make appropriate decisions and reach their destination.</li>
<li>re: There is a small area between the rooms approx. 8X10. What happens when you paint one wall a darker color? Specifically as it relates to darker colors, the general design rule is that dark colors absorb light and thus make objects seem heavier and make areas appear smaller or recess. However, making 1 wall dark can also create a good focal point for a large room. But keep in mind this could create confusion for patients. Is there a need to highlight that wall? If not, keep the walls for that space the same. Here are some other general color tips:</li>
<ol>
<li>Warm colors tend to attract attention, create excitement, promote cheerfulness and stimulate action</li>
<li>Cool colors (blues, greens, greys) tend to relax and refresh people, promote a peaceful, quiet atmosphere and encourage concentration.</li>
<li>Light colors tend to make objects lighter in weight, make areas seem more spacious, and tend to give people a psychological lift. Light colors also reflect light effectively, so are ideal for study &amp;work areas.</li>
<li>Bold colors attract the eye. The purer the color, the more rapid the attraction. They can also create excitement.</li>
<li>Whites reflect more light than any other color and can unite separate spaces.</li>
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<li>Re: Do you have any ideas for design and colors?</li>
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You had mentioned pastel colors, but be careful with their use. Pastel colors, especially toward the cool end of the spectrum (blues, greens or purples) are harder to see. They can appear gray or murky. This can cause frustration when color alone is used as a way finding cue. Research has shown that the use of full spectrum color theory can positively influence ones psychological, physical and social well being. This would certainly be true for victims of cognitive dysfunction like Alzheimer's. There must be a presence of green, yellow, orange, red, violet indigo and blue meet the criteria for full spectrum color.
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We see using contrast, so when our vision is affected and our cognitive state is altered, creating contrast can decrease frustration and reduce the number of falls. A person with Alzheimer's disease may not be able to distinguish between an off-white wall and a beige door or handrail. So examples would be to create contrast between: walls and floors, furniture and wall and floor, stair treads and counter tops.
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One great trick when choosing your color scheme is:
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Try looking at all proposed color schemes and combinations, including wall coverings, fabrics, flooring and paint selections, through yellow acetate. This will approximate what many elderly residents see as a result of physical changes to the aging eye, and you may be very surprised at how many colors turn brown or gray when viewed through a yellow filter. Color contrast is noticeably diminished. Since contrast is a strong cue for individuals who are reading or attempting to make sense of their environments, we need to use every device available to make good choices.
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A scheme of neutral tones and pastel colors with a few visual accents is appropriate in a hospital where a patient is likely to spend only a few days or a week or two. But in a long-term care facility where a patient spends large quantities of time in one room over a long period, such a design is likely to become boring as well as difficult to function in for low-vision elderly. In nursing homes, it is said that patient rooms should provide a balance of color and a mix of contrasting tones. The idea is to keep the space looking fresh and interesting, day-in and day-out, with clearly defined visual cues.
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Designers have also learned to avoid contemporary colors and bold patterns, but rather use solid colors, which are less confusing to an impaired person than a patterned wall. Large, bold prints (for example, florals in wallpaper or drapes) may cause confusing illusions.
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Instead, try to choose those which will create the greatest level of visual enjoyment for elderly patients, and research has shown that for most people, those colors and patterns come from the period when they were in their 40s and 50s, when they were both financially and physically comfortable.
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When choosing paint finishes, be sure to go with non-reflective kinds - therefore do not use a high gloss finish. Use an eggshell finish for walls and semi-gloss for trim. (Important note: Wall coverings placed in an institutional occupancy must be rated as a Class A or 1 rating with a type 2 or 3 weight rating for durability. Specify antimicrobial backing and remember there is a pattern and color issue for those with cognitive dysfunction. Be sure to specify corner guards in hallways with in a color as close as possible to the wall color to avoid distraction by residents. The use of a combination of simple crown molding, wall paper border and painted walls can create a value engineered residential ambiance.)
<li>re: I'd like to make the room appear outdoors without too much clutter, looking airy and open?
Clutter is definitely good to avoid, and again the use of large, identifiable visual cues is important. In doing this with color, I think your main focus should be on choosing colors and a design that reduces stress and tension. Using cool colors (such as blues, greens) can provide a comfortable, non-distracting environment. On the other hand, the dining &amp;activity area is more social, so you can use social colors (reds and yellows) that are more stimulating. Cafeterias, lounges and lobbies are better served by warmer, bolder colors; these encourage interaction and conversation. Also, you can reduce the "visual clutter" by getting rid of visually distracting elements, such as columns, beams, and pipes. These can be camouflaged by painting them the same color as an adjacent wall or ceiling.</li>
</ol>
<strong>Here are my last suggestions:</strong>
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<strong>1: Dining and activities</strong>Think social colors that can help promote conversation, interaction and energy. Warm colors include reds, yellows, or a variance of these colors.
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<strong>2: Sitting, television and some activities.</strong>Think relaxing, calming and soothing colors and tones with high-comfort, soft fabrics. Work to achieve a calming effect through color. Instead of relying on bright primary colors such as stark white, yellow, orange or red, use more soothing pastel shades such as peach, pink, beige, ivory, and light blues, greens or lavenders.
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<strong>3: For the "transition room"</strong>, could this be combined with one of the other areas? Or could this room have a purpose all itself (ie: general seating area, reading area, card or painting room, etc?)
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For a suggestion, one color combination you may want to consider is a soft shade of yellow or orange for the dining area (warm, social), light blue for the TV area &amp;transition room (calming, cool), with accents of each color in each of those room (pillows, vases, paintings) to create a sense of harmony between the spaces. These colors work well together, are fresh, but have separate and distinct attributes and can be easily identifiable. Hopefully, they both also contrast the floor color and other objects in the room.
Best of luck with your re-design, and definitely show us pictures once it's complete!

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