Housing and adaptations
Housing and adaptations
Focus on
Cognitive impairment design
Adapted from an online blog for the Housing LIN , Jane Jones talks to OTnews about how she has developed a cognitive impairment shower specification , with colleague Louise Hamilton .
J
ane Jones is a Senior Occupational Therapist of 28 years , working for Stoke on Trent City Council . Along with her colleague Louise Hamilton , an OT Assistant , they have worked for the last three years on a project to design level access shower schemes for clients with a cognitive impairment – both for council-owned properties and privately-owned homes .
Jane explains : ‘‘ We have worked with many clients with dementia over the years and then my father was diagnosed with dementia approximately six years ago . Historically , clients with a dementia diagnosis have not necessarily been considered a priority , unless there is an immediate risk .
‘ So , adaptations are installed too late into their diagnosis , whereby the person ’ s condition has advanced to an extent that they struggle to use the new adaptation as this is so unfamiliar .’
Through research and working with a local dementia specialist charity , Jane and Louise concluded that if a level access shower adaptation was in place earlier in a person ’ s diagnosis there is less burden on carers , as the person is more independent and less supervision is required .
Jane adds : ‘ Appropriate housing , including adaptations , can support older people to stay healthy and live independently for longer . This might reduce the need for social care .’
What they did first
To develop the specific cognitive impairment specification , Jane and Louise carried out research and worked with the local dementia charity to identify aspects of a new level access shower bathroom adaptation that would allow someone to be more independent .
‘ Research identified how a person with a dementia sees the world around them , which colours they can identify more easily and looking at light reflective values of anything we intended to trial ,’ Jane says .
‘ The local dementia charity provided training to the whole team , then Louise and myself provided further training on what aspects of a person ’ s dementia journey we need to identify at the initial assessment stage .’
Developing the specification
They broke down a standard level access shower specification into sections , then researched each area to see if there are alternative fitments that could be installed to aid anyone with a cognitive impairment . ‘ We specified a shower tray that is as large a possible , covered with non-slip flooring that is lighter than the walls and is as plain as possible ,’ Jane goes on . ‘ If a person with dementia sees flecks or shining pieces within the non-slip flooring , they can think that they have dropped something and are more likely to bend and fall .
‘ The flooring needs to be lighter than the walls , as a person with dementia sees a dark flooring as if they are falling down a hole . A colour contrast drainage was also specified , as a white drainage can be seen as a bar of soap dropped on the floor and can again lead to falls while bending .’
She adds : ‘ We specified darker matt wall tiles , so there is a contrast with the floor and no reflection , as a person with dementia can become frightened when they see their own reflection thinking someone else is in the room .
‘ The shower unit specified is a matt surface , again for the same reason , with options of a button or lever control dependent on what the person is used to using .’
The two worked with a company that was already looking to develop a shower of this type and this is now readily available on the market .
‘ We researched equipment that is available in different colours , such as grab rails , shower chairs and toilet seats and frames , so that a colour contrast with the floor or walls could be created ,’ Jane explains .
‘ We specified that wherever possible the sink , basin and new shower area remain in the same positions within the bathroom for familiarity ; same taps , in the same position , same type of toilet flush as is existing if required to be changed again for familiarity .
‘ Directional lighting was specified if required , so that instead of one light fitting in the ceiling there would be a light fitted above the sink , toilet and shower , to direct the person to the function they wanted to complete . Directional automatic lighting was specified above the person ’ s bedroom door and bathroom door , so as to stop confusion at night-time .
‘ Consideration was also given to heating , as many people with dementia tend to have a shuffling
16 OTnews June 2023