How to redecorate homes for people with dementia

Image: BoKlok/IKEA
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A well-designed home can make us happier and healthier, a principle that is even more relevant for older people living with mental health disorders. In a project meant to serve Sweden’s aging population, the IKEA and Skanska-backed company BoKlok has unveiled renderings of SilvaBo homes designed for residents 55 or older who have dementia.

Named for Queen Silvia of Sweden, who conceived of the project with IKEA’s late founder Ingvar Kamprad in 2015, the apartment units feature elements such as extra wide doors, easy-grip handles on doors and walls, non-slip bathroom floor tiles, and a soothing color scheme. SilviaBo units will be priced along BoKlok’s “left-to-live” model, which calibrates the mortgage based on what an individual can afford to pay monthly and still have enough money left in the bank for other expenses.

The first six SilviaBo units are being developed in the suburbs of Stockholm, and a BoKlok spokesperson tells Quartz that it is in the initial stages of securing land in other parts of Sweden for future units. The relatively slow construction timeline allows for consultation with mental health researchers and health professionals to ensure the units are suited for people with progressive neurological disorders.

Among those experts is Helle Wijk, deputy chair of the University of Gothenburg’s Centre for Person-Centered Care, where she specializes in the physical design of healthcare environments. “I am most impressed with the way evidence-based design was integrated in the residential facilities,” she said of the SilviaBo design plans (pdf). “The outcome is a modern, pleasant, attractive home that support the residents’ dignity, autonomy and well-being,” she said.

Redecorating for independent living

Research shows that well-designed environments can improve on the dispiritingly sterile living quarters in nursing homes which are often pattered after the design of medical settings. “We try to deinstitutionalize that approach because people want to live as normally as possible,” Frank van Dillen, co-founder of Dementia Village Advisors, told the Guardian. Van Dillen is one of the architects who designed Hogeweyk, a dementia community near Amsterdam. “You want to go to a restaurant, do your own grocery shopping, sit in a bar, walk outside and meet people,” he said.

Numerous studies affirm how a well-designed home can be therapeutic for someone with dementia, even serving as “prosthetic for various changes in cognition,” as a 2018 article in The Gerontologist suggests.  A poorly conceived space can be debilitating, even traumatizing, and can prevent patients from becoming self-sufficient.

For now, the SilviaBo initiative will be focused in Sweden, but there are design pointers that can be useful anywhere for the estimated 50 million people with disease today. We consulted the US Alzheimer’s Association for a few general guidelines:

Empathy is the golden rule in designing for people with dementia, explained Ruth Drew, director of information and support service at the Alzheimer’s Association. “Overall it’s important to really look at a home through the eyes of a person with Alzheimer’s or another dementia disease,” she said.

The instinct for many caregivers is introduce nostalgic elements from the patient’s history, to possibly trigger good memories. This “reminiscence therapy” animates Town Square, an Alzheimer’s care facility franchise in California decorated to evoke the 1950s. Operated by the nonprofit George G. Glenner Alzheimer’s Family Centers Inc. and Senior Helpers, the “imitation villages” feature a sequence of retro-themed American vignettes (pdf) such as a diner with a jukebox playing 1950s tunes, an old-fashioned barbershop, and a garage where patients can tinker with cars from their youth.

Drew similarly recalled one woman who meticulously recreated her childhood living home for her mother who was moving into an assisted-living facility. She carefully positioned the furniture, drapery, picture frames, and even tracked down the same wallpaper print. In the end, she had to readjust the room because her mother saw the tiny patterns as live bugs creeping on her wall. “Color and patterns are very important,” Drew said. “There have been times when someone will have a small, dark area rug and notice that the person with Alzheimer’s is walking around it because it looks like a hole in the floor to them.”

The UK Social Care Institute for Excellence cautions about the limits to the nostalgia-based approach.”Talking about the past can also bring up happy memories and good feelings, and this can be wonderful in itself, but particularly if a person is finding life difficult. It is also the case that reminiscence can sometimes provoke painful memories.”

The most important tip in designing for people dementia is remembering to change things up based on their perceptions. “These are progressive diseases,” Drew said. “Something that might work for a time may not work forever and something that works for one person may not work so well for someone else.”