Safety and Security Design Measures for People with Dementia in Special Care Units

Dementia, a broad category of brain diseases that cause a long-term and often gradual decrease in the ability to think and remember, poses unique challenges in care giving and living arrangements. Special care units designed for individuals with dementia must address these challenges by incorporating specific safety and security measures. This article explores essential design considerations to create environments that are not only safe and secure but also supportive and enriching for people with dementia.

1. Environmental Design and Layout

Way finding and Orientation

• Clear Signage: Use large, easily readable signs with both words and images to help residents navigate the facility. Consistent use of color-coding for different areas can aid in way finding.
• Landmarks: Incorporate distinctive landmarks and features (e.g., artwork, unique furniture) in different parts of the unit to help residents recognize and remember locations.

Dementia Signage - https://eyecareoncall.co.uk/care-home/dementia-signage/

Simplified Layouts

• Circular or Straight Corridors: Avoid dead ends which can cause confusion and frustration. Circular or straight corridor designs encourage continuous movement without abrupt stops.
• Small, Homelike Settings: Create smaller, more manageable spaces that feel like home rather than an institutional environment. This can reduce anxiety and make it easier for residents to find their way around.

Layout of the specialized dementia care inpatient unit map. The red arrows represent the camera’s locations. - www.researchgate.com

2. Safety Measures

Fall Prevention

• Non-slip Flooring: Use materials that reduce the risk of slipping. Carpets should be secured to prevent tripping.
• Adequate Lighting: Ensure that all areas are well-lit, with even lighting to reduce shadows that can cause confusion. Nightlights in bedrooms and bathrooms can prevent falls during nighttime.

Non slip floor mat - John Preston Healthcare Group

Wandering Prevention

• Secured Exits: Install alarms and locks on doors that lead to unsafe areas. However, these should be discreet to avoid causing stress or feelings of confinement.
• Wandering Paths: Design safe, enclosed outdoor and indoor wandering paths where residents can walk freely without the risk of getting lost.

Wandering path- Robert Kreek Nov. 2020

3. Security Measures

Monitoring Systems

• Surveillance Cameras: Strategically place cameras in common areas to monitor for any incidents or emergencies while respecting residents' privacy.
• Wearable Tracking Devices: Offer non-intrusive tracking devices for residents prone to wandering, ensuring they can be quickly located if they leave safe areas.

Staff Training and Presence

• Regular Staff Checks: Ensure that staff conduct regular checks on residents, particularly those who are at higher risk of wandering or falling.
• Emergency Response Training: Train staff in handling emergencies, including missing residents, falls, and health crises, to ensure swift and effective responses.
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4. Cognitive and Emotional Support

Therapeutic Design

• Memory Boxes: Place personalized memory boxes outside residents' rooms containing familiar items and photos to help them identify their space and evoke positive memories.
• Calming Spaces: Create quiet, comfortable areas with soothing colors and furnishings where residents can retreat to reduce anxiety and agitation.

Engagement and Activities

• Safe Activity Areas: Designate spaces for activities that cater to residents' abilities and interests, such as art, music, gardening, and exercise. Ensure these areas are safe and supervised.
• Routine and Familiarity: Maintain consistent daily routines and familiar settings to help residents feel more secure and oriented.

5. Family and Community Integration

Visitor Access

• Controlled Entry Points: Designate specific entry points for visitors that are monitored and secure, ensuring that all visitors are accounted for without causing disruption.
• Family Involvement Areas: Create welcoming spaces where families can spend time with residents in a comfortable, home-like setting.

Community Interaction

• Social Areas: Incorporate communal areas where residents can engage with each other and with visitors, fostering a sense of community and reducing isolation.
• Outreach Programs: Facilitate programs that bring community members into the facility for activities and interactions, enhancing residents' social connections and engagement.

Conclusion

Designing special care units for people with dementia requires a careful balance of safety, security, and supportive environments. By incorporating thoughtful design elements and measures, these units can significantly enhance the quality of life for residents, ensuring they live in a space that is not only secure and safe but also enriching and supportive. Implementing these design principles can help caregivers provide the best possible care and create an environment where residents feel valued, understood, and at ease.

References

1. Marquardt, G., Bueter, K., & Motzek, T. (2014). Impact of the Design of the Built Environment on People with Dementia: An Evidence-Based Review. HERD: Health Environments Research & Design Journal, 7(2), 127-157. Link
2. van Hoof, J., Kort, H. S. M., van Waarde, H., & Blom, M. M. (2010). Environmental Interventions and the Design of Homes for Older Adults with Dementia: An Overview. American Journal of Alzheimer's Disease & Other Dementias, 25(3), 202-232. Link
3. Fleming, R., & Purandare, N. (2010). Long-Term Care for People with Dementia: Environmental Design Guidelines. International Psychogeriatrics, 22(7), 1084-1096. Link
4. Waller, S., Masterson, A., & Finn, H. (2017). Designing Interiors to Support People with Dementia. Journal of Dementia Care, 25(4), 20-22. Link
5. Zeisel, J. (2009). I’m Still Here: A New Philosophy of Alzheimer's Care. New York: Penguin Group.