JDC Spring-2001 v3 - A Pattern Language for Designing Interiors for Alzheimer's Patients

PATTERN 5 - Visual Cues

A painting, hanging quilt or 3-dimensional objects of interest hung in hallways and common areas assist in cueing. Simple graphical signs showing pictures of objects to be stored in the respective cabinets or a picture of the toilet on a bathroom door can also be used. Objects that act as memorabilia before the onset of the disease maybe selected by family members and placed in a lighted display case outside their room. Cues need to be varied distinctive and bold.

JUSTIFICATION

While disorientation and unfamiliar surroundings make the residents agitated and frustrated, an environment providing good cues assists in way finding, reducing wandering and enables residents to live with self-respect. Although people with dementia often cannot remember recent events, they retain their long- term memory until the later stages of the disease (Gwyther, 1986). Interestingly, the emotional components of memory may remain even after other components are lost ( Coons, 1985 ). Thus, familiar objects may provide important opportunities to exercise and celebrate the remaining capabilities of the individual. It has been reported that personal identification beside the door of their room enables the patients to find their rooms more easily ( Zandi and Woods, 1988 ). Objects encourage reminiscence by acting as a catalyst for long-term memory (Rapelje, 1981). Bio-boards also help residents identify their room as the residents readily identify pictures of themselves in their younger years. A picture of cutlery on kitchen cabinets and also on wardrobes encourages participation in domestic chores and guides the resident in putting away objects on their own, leading to functional independence and demanding lesser staff time ( Schiff, 1990 & Brawley, 1992 ). The inability to find the bathroom may lead to the problem of incontinence (Gwyther). But, appropriate environmental cues have helped 50% of the people with dementia to regain urinary control ( U.S Congress, Office of Technology Assessment, 1987 ). Providing graphical cues on bathroom doors not only helps in easy identification but also contributes to the problem of incontinence by acting as a reminder to use the restroom ( Hiatt, 1985 ). Signs at eye level increases visibility and convenience for the cognitively impaired patients who at a later stage do not have a wide range of head movements.