practical living
IncIdence of dementIa by age/gender
AGE
MALES
FEMALES
85–90
19%
23%
90–94
37%
48%
95–99
37%
48%
your tolerance as an operator for that risk.
It is also useful to unobtrusively observe
residents with cognition challenges, as this
can highlight concerns that otherwise may
be overlooked.
Completing this two-step process will
enable the development of a strategic
risk-management plan with prioritised,
achievable actions, time lines and budgets.
Without this, the outcome may be a
shotgun approach that misses the target.
prepAre To modify
With a plan in place, simple changes to
the village can make a world of difference
to a person with dementia and do not
necessarily need to be cost prohibitive.
The Dementia Training Study Centre
at the University of Wollongong provides
guiding principles to help reduce the
frustration, anxiety, depression and
sometimes anger and aggression that can
arise for residents in environments that are
confusing and unsupportive.
Here are some examples of how
these principles may be applied. Firstly,
ensuites may need modifications. They
are frequently unsuitable for people with
diminishing cognition and are an area
of risk. Some suggested changes for
operators to discuss with residents and
their families include: installing lowwattage LED lights over toilets to provide
an immediate sight cue, particularly if the
toilet is visible from the bed; replacing
white toilet seats with a contrast colour;
installing vanities with contrast colours
between the bench top and the basin.
Secondly, kitchens in independent living
units also can be modified with some
reasonably simple adjustments. Operators
can replace solid-form kitchen cupboards
with glazed inserts, so residents can
easily see what is inside the cupboard.
Open shelving can be edged with a
contrast colour to differentiate it from the
supporting frame. It’s also a good idea to
ensure there is colour or tonal contrast
between the floor, cupboards, bench top
and back splash.
Externally, garden paths that lead
residents away from certain areas, as
well as camouflaged and integrating
gates and fencing, have a high degree of
acceptance from all residents – they don’t
feel institutional – and can easily be done.
Enabling wayfinding for residents so they
feel more confident and secure as they
navigate the village doesn’t require large
capital expenditure. Consider garden layouts
and theming: review locations of large dense
shrubs that may obscure vision, and prune as
necessary. Provide garden seating locations
at 20-metre intervals. Introduce colour
or fragrance theming to gardens; provide
auditory cues, such as garden chimes or
water features. These simple measures will
help residents navigate and will enhance
emotional and physical safety.
At some older villages each independent
living unit’s exterior looks similar, which is
confus ing for residents trying to find their
way home. Painting the front face of each
unit a strong and easily recognisable colour
can assist, as can personalising features such
as letter boxes, front doors and pot plants.
Again, simple measures with great benefits.
sAfeTy on siTe
Securing the perimeter of the village,
most particularly the front entrance,
can be challenging. This is perhaps the
biggest concern for operators of existing
villages where residents have begun
to wander. Newer village operators are
increasingly designing their villages with
a single point of secure entry and exit
and secure courtyards for those who
may wander.
Technology provides many solutions
with varying price ranges for both
existing and new villages. Geo-fencing,
closed-circuit TV, wrist monitors and
movement sensors for unit interiors are
all available. Residents who are engaged
within the village – for example, with raised
gardens, potting sheds or men’s sheds –
and feel safe and comforted are less likely
to wander.
There is no one answer to the vexed and
challenging reality that confronts many
operators. However, a systematic analysis
of the issues specific to your village is a
good place to start. n
erica Lambert and kerrie storey are
specialist aged care and supported living
advisers with paynter dixon Queensland.
agedcareinsite.com.au 25