The seven senses

The aroma of freshly brewed coffee, the warmth of sunshine diffused through a sheer curtain, sumptuously soft sheets – a space that appeals to all our five senses makes us feel safe and happy. But two additional senses are important to bear in mind when it comes to people with dementia.

Gun Aremyr has been working in the field of dementia since the late 1980s, and in her role as occupational therapist, relative consultant and lecturer has encountered numerous people and care homes along the way. It was very clear at an early stage how a well-planned physical environment can make life easier in several different areas for people with cognitive impairment.

While the most important lesson by far has been that everyone is an individual, with their own unique life stories, there are also a few general aspects to take into account, such as the seven senses. 

“Our five outer senses make us aware of where we are in the world, our two inner senses, muscle and joint senses, and our sense of balance, make us aware of this in our body,” she explains. “For example, I saw that when a person with dementia perceives a dark rug as a hole, but their joint and muscle sense then tells them that it’s not when they walk across it, this creates a lot of unnecessary anxiety and stress. 

A healthy mind is constantly interpreting and remembering, but when you’re unable to remember, you can’t hold on to knowledge and are equally surprised and scared every time the link between your senses doesn't match. When you’re healthy, your mind recalls information for you, but once your memory is impaired, your senses have to do the recalling for you. Gun gives one more example: imagine you put your hand in your bag to fish out your mobile phone and instead grab hold of a soft, mouldy fruit... we’ve all done something similar and know how it feels.

“It scares you, right? Your body releases cortisol and adrenaline, and you experience a significant surge in stress. If I, as a person with dementia, can no longer trust my surroundings, I will experience this level of discomfort all day long,” Gun explains.

Reflection cards

Based on their long experience of working in dementia care, Gun Aremyr and her colleague Bertha Ragnarsdóttir have produced a box of reflection cards. The idea is to give staff in home care or care homes a tool to reflect on ethically  difficult situations where, despite their good intentions, communication with relatives has broken down.

Creating security for both relatives and staff is equally important. And sometimes requires some thought and reflection. In this case, these cards with scenarios of common situations may help towards greater understanding.

Read more about the reflection cards at gunaremyr.se.

The right furniture and material choices make a difference

Dementia often affects a person’s sense of balance. That’s why it’s important to be able to rely on the furniture in the room for support. Sturdy furniture that makes it easy to sit down and stand up contributes towards the feeling of independence. The interior design should also offer reassurance by being authentic, i.e. the materials should be what they appear to be, that a wooden surface really feels like wood and is not in fact a hard plastic surface. 

“In a space where I don't need to be on my guard, I feel calmer and safer, and can more easily experience joy, which is what we want to achieve with all interior design really, but it’s absolutely crucial for the quality of life of people with dementia.” Well-thought-out interior design adapted to the activity and the individual makes both staff and residents happier and healthier. “We currently talk about dementia-friendly communities, but the things that support people with dementia are good for all of us.”

5x tips

on care environments for people with dementia

1. Create contrasts for better navigation 

Floors, walls, doors and interior design in contrasting colours make it easier to navigate a room and create a sense of independence for the resident. Clarity also reduces anxiety and frustration.

2. Soften the soundscapes

Make sure that furniture doesn’t make any scraping noises, and preferably add sound absorbers to the room. Soft music and nature sounds can be soothing and stimulating if residents can choose when they want to listen.

3. Keep changes to vision in mind

The right lighting prevents accidents, facilitates navigation and effects the day-night rhythm. Also remember that the way a person perceives colour changes with age.

4. A safe environment with the right furniture

Sofas and easy chairs that make it easy to sit down and stand up increase independence. And authentic natural materials eliminate surprises, and enhance the feeling of harmony and security.

5. Create a homely feel

When care homes have a homely feel, the residents are harmonious and safe. Remember that children and grandchildren should also feel welcome!