Bathrooms - Dementia-friendly environments - SCIE (2022)

The bathroom

The bathroom can present a number of challenges for a person with dementia, given they are likely to have problems with their memory or working out what things are. A number of design features can help. For example, contrasting colours will assist a person with dementia to use bathroom facilities. Toilet seats, handrails and towels should all be easy to identify. This means that they should be easy to see and look like the item they are supposed to be. Even something as simple as providing a bar of soap (which should be a different colour from the sink it sits on) can prompt a person to wash their hands when they might forget otherwise.

There are general design suggestions that are worth implementing to make bathrooms and toilets safer.

General improvements

While it’s vital to consider an individual's needs, there are general design suggestions that are worth implementing to make bathrooms and toilets safer.

Always provide handrails, bath seats and non-slip bath mats. Make sure that these are in contrasting colours so that people can see them, even if their eyesight is poor. Make sure that the thermostat for hot water is not set too high, in order to help prevent scalding. The person with dementia may forget to check that water is at a safe temperature.

(Video) The dementia environment at home

Use a special bath plug that allows the water to drain away if the bath gets too full. Although flood detectors are available, by the time there is a flood, this situation is already dangerous, with a risk of slipping.

Promoting a pleasant experience

Bathrooms should be furnished and decorated to promote a pleasant experience. Avoid a sterile hospital-like appearance that is pale and where it is hard to see things. People with dementia must be able to see what they need to use, because they may not remember easily (see the Lighting feature in this section). Use open shelving to display toothpaste, brushes, shampoo and so on.

A person could find mirrors disturbing in this and other settings as they may not recognise the person in the mirror as themselves. Cover or remove mirrors if necessary (see the Bedrooms feature in this section).

Baths

Bathing should be a comfortable experience and design can help facilitate this. The water must not be too hot or too deep. A person may prefer to use bubble bath or to have soap in clear water.

Taps should be of traditional appearance (separate hot and cold taps), simple to operate, with clear indications of hot and cold water. This allows the person with dementia to control the situation themselves.

Assistive technology can help avoid the bath being too hot (see the Assistive technology feature in this section), although you have to be careful not to create a noisy alarm that is hard to understand. People can trip over bath mats and some may be anxious about approaching the bath if they are not sure what it is they are about to step on. Non-slip mats, preferably blending with the bath colour, will reduce the risk of slipping in a wet area. However, if you can replace the whole floor with a non-slip surface, you may reduce the need for mats.

(Video) The dementia environment in a care home

Showers

Showers should be level to access and have controls that are easy to use. If the shower door and panels are made of glass, any reflections could cause distress or confusion to a person with dementia. You could overcome this by placing a towel or towels over the shower door. If you have a shower curtain, make it a contrasting colour with everything else in the bathroom. Avoid a jazzy pattern as this could be confusing and distracting.

Wash basins

Soap holders and toothbrush holders could be of contrasting colours to the wash basin. If not, use different-coloured soaps or face flannels to provide the contrast. Some care settings don’t allow the use of sink plugs, in order to prevent flooding. This is unnecessary because you can now buy an inexpensive sink plug which will automatically empty the sink if it gets too full.

Toilets

Toilets must be easy to find. Hang door signs at the right height for an older person and make them visible from as many viewpoints as possible. Seats should be of a contrasting colour to the pan. Some people think that colouring the toilet water can also aid recognition, which might help if the person is peering into the pan before using it. Of course, bright light in the toilet would help people see what is what, but make sure your lighting does not create glare (see the Lighting feature in this section).

Cisterns should be traditional in appearance: push-button designs are relatively new in the UK and an older person with dementia may search around for a lever flush. You can put simple 'push to flush' signs on concealed cisterns. Toilet roll holders, or toilet paper, should be a different colour from the walls and easy to reach. Some toilet paper dispensers are easier to use than others, so pick a simple one.

En-suite bathrooms

These should have low-level lighting overnight to improve visibility without disturbing sleep or a mechanism such as a movement sensor which automatically switches the light on when the person gets out of bed (see the Assistive technology feature in this section). The toilet should be visible from the bedhead position. The reason for this is that you want the person to be able to move between the bed and the toilet as they wish during the night without having to ask for help or being distracted, for as long as they are able to do this. It is more dignified to be able to look after your own needs and this can be made as safe as possible with the right design.

Downloads

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  • Activity: Toilets and bathrooms
  • What the research says: The environment
(Video) Creating Dementia-Friendly Spaces | Mary O'Malley | TEDxCoventry
  • Further reading Open

    Brawley, E.C. (1997) Designing for Alzheimer’s disease: Strategies for creating better care environments, Chichester: John Wiley.

    Dementia Services Development Centre (2007) Best practice in design for people with dementia, Stirling: Dementia Services Development Centre, Stirling University.

    Dementia Services Development Centre (2008) Design for people with dementia: Audit tool, Stirling: Dementia Services Development Centre, Stirling University.

    (Video) The dementia environment in care homes

    DSDC Virtual care home: The University of Stirling’s Dementia Services Development Centre has produced this ‘Virtual care home’, which allows users to navigate around the various areas within a care home (such as bedrooms, en-suite bathrooms, kitchens, lounges and so on), and read advice about things to consider and ways to improve the care environment for people with dementia.

    Pollock, R. (2003) Designing interiors for people with dementia, Stirling: Dementia Services Development Centre, Stirling University.

  • Useful links Open

    Dementia-friendly health and social care environments
    This 2015 resource from the Department of Health presents design guidance in relation to new buildings as well as the adaption or extension of existing facilities, and includes case studies drawn from projects funded by the Dementia Capital Programme.

    Design Resource Centre
    The University of Stirling’s Dementia Services Development Centre (DSDC) has always been a leader in the area of dementia and design. The DSDC website includes the Design Resource Centre. This section includes links to a substantial range of publications and resources in the area of dementia-friendly design including information on the importance of lighting, colour and contrast, getting outside, and orientation and signage. The site also includes theDSDC Virtual Care Home and the DSDC Virtual Hospital. Both these resources allow users to navigate around the various areas within a care home or hospital (such as bedroom, ward, ensuite, kitchens, lounges and so on), and read advice about things to consider and ways to improve the care environment for people with dementia.

    Developing supportive design for people with dementia
    This is the final report of The King’s Fund’s Enhancing the Healing Environment (EHE) Programme, which ran from 2009 until 2012. The well-illustrated report includes descriptions of the 26 EHE projects completed in NHS Trusts to improvement the environment of care for people with dementia, and also includes the EHE assessment tool and overarching design principles.

    (Video) Wendy Mitchell – How I made my home dementia-friendly

    Home environment and dementia
    This NHS Choices web page sets out good introductory information on how to improve the environment for a person living with dementia. It covers topics such as lighting, flooring, colours, noise and outside spaces.

    Making your home dementia-friendly
    This 2015 Alzheimer’s Society booklet is aimed at people living at home. It covers a wide range of topics such as lighting, flooring, furniture and furnishings, knowing where things are, and enjoying the outside.

  • Related pages from this section Open

    • Dementia-friendly environments
      • Environment at home (video)
      • Environment in a care home (video)
      • Kitchen and dining areas
      • Bedrooms
      • Toilets and bathrooms
      • Gardens
      • Lighting
      • Assistive technology
      • Creating a relaxing environment
      • Noise levels

FAQs

What type of environment is best for dementia patients? ›

People with dementia generally will be less likely to become agitated and distressed if they can have regular access to fresh air and exercise and a quiet space away from others as needed. The garden can be a safe and secure environment if designed properly.

How do you get a dementia patient out of the bathroom? ›

Set up the bathroom to make it as easy as possible for the person to get on to and off of the toilet, e.g. having a raised toilet seat and grab bars. Notice when the person gives a sign about needing to use the toilet, e.g. agitation, fidgeting, tugging on clothing, wandering, touching the genital area.

How should be the surrounding area of a patient with dementia? ›

For a person with dementia, it can help minimise their confusion and help them to concentrate and rest. To create a soothing, calm environment, look at the household routine, the noise levels, the lighting, the effects of mirrors, the state of the bedroom, and even the colours and patterns used through the house.

What Colours are dementia-friendly? ›

Green is the easiest color on the eyes and can improve vision. Green is the last color dementia patients lose the ability to see; so green is a good color for caregivers to wear.

What is dementia-friendly design? ›

Dementia-friendly design principles are based on the use of adapted patterns, contrast and colour to make an environment easier to perceive for the elderly and particularly those with dementia.

Why dementia friendly design is important? ›

A dementia-friendly environment helps people with dementia reach their full potential and does not cause needless disability. Design for people with dementia should be in line with people's social and cultural activities, their needs and capabilities, and organisational policies and procedures.

How do you decorate a room for someone with dementia? ›

Seniors struggling with dementia best navigate areas decorated with surfaces featuring contrasting colors. Choose furniture and fixtures consisting of distinct colors. Solid colors are ideal for couches and chairs. Position the couches in front of a window rather than in front of the television.

Why do dementia patients put themselves on the floor? ›

Orthostatic or postural hypotension is common in dementia patients and when your blood pressure drops, you sometimes don't feel safe standing or even sitting. Your body wants to get down flat and low, so, the floor.

Why do dementia patients not like to shower? ›

Bathing can be a challenge because people living with Alzheimer's may be uncomfortable receiving assistance with such an intimate activity. They may also have depth perception problems that make it scary to step into water. They may not perceive a need to bathe or may find it a cold, uncomfortable experience.

How often should dementia patients shower? ›

For most people, a full bath or shower two or three times a week is enough. Between full baths, a sponge bath to clean the face, hands, feet, underarms, and genitals is all you need to do every day.

How long can an 80 year old live with dementia? ›

Life expectancy is less if the person is diagnosed in their 80s or 90s. A few people with Alzheimer's live for longer, sometimes for 15 or even 20 years. Vascular dementia – around five years.

How do you keep a dementia patient out of the kitchen? ›

Turn off appliances by unplugging them, turning off circuit breakers, or removing fuses. Install smoke detectors (but not near the stove). Use an electric teakettle that has an automatic shutoff.

How does open spaces affect someone with dementia? ›

Research says ...

Carefully planned outdoor environments are valuable for people with dementia because they support independence and mobility, maximising abilities and wellbeing. Views of and access to enclosed outdoor areas can give people options for privacy and sociability.

Can dementia patients see white? ›

Anyone over the age of 60 should have an eye test every year. It's also thought that a person with dementia can be less sensitive to differences in colours – including colour contrast such as black or white. They may struggle to tell the difference between blue and black.

What is the most common cause of dementia? ›

Dementia is a general term for loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life. Alzheimer's is the most common cause of dementia.

What to say to a dementia patient when they say they want to go home? ›

Reassure the person verbally, and possibly with arm touches or hand-holding if this feels appropriate. Let the person know that they are safe. It may help to provide reassurance that the person is still cared about. They may be living somewhere different from where they lived before, and need to know they're cared for.

What are the five major needs of people with dementia? ›

Person-centered care for people with dementia emphasizes the importance of caring for all aspects of a person's well-being--social, mental, emotional, and spiritual needs in addition to diagnoses and physical and medical needs.

Why are red plates used in dementia units? ›

Red increases brain wave activity, seems to decrease the size of a room, and increases the perceived temperature of the room. If you want to get the attention of an individual with Alzheimer's or dementia, use red.

Why is it important to provide a structured environment for dementia patients? ›

The importance of routine and familiarity to persons with dementia is profound! Daily structure can help decrease these undesired behaviors such as aggression, restlessness and agitation. As a result, the caregiver will experience less stress and be able to give better care.

Why are dementia friendly environments important? ›

A dementia-friendly environment helps people with dementia reach their full potential and does not cause needless disability. The result is quality of life for people with dementia, their families and staff. There are five major needs of people with dementia, and they shape person-centred care.

How does change in environment affect someone with dementia? ›

The environment of the person with dementia can cause sleeping problems in a number of ways including: The bedroom may be too hot or too cold. Poor lighting may cause the person to become disoriented. The person may not be able to find the bathroom.

What are the five basic needs of a residential environment? ›

Residential environments☆

We assume that the human environmental needs can be divided into five levels, i.e. physical, security, leisure, social interaction, and aesthetic. These needs interact in contemporary society.

Videos

1. Webinar | Health Happy Places - Dementia Friendly Environments
(AHSN NENC (North East & North Cumbria))
2. Dementia Friendly Gurudwaras - Bradford - Dementia Friendly Communities - Alzheimer's Society
(Alzheimer's Society)
3. Living with dementia
(Social Care Institute for Excellence (SCIE))
4. Dementia and housing
(Social Care Institute for Excellence (SCIE))
5. How does a person with dementia see the world?
(Social Care Wales TV / Gofal Cymdeithasol Cymru)
6. Happy Holidays! Creating Dementia-Friendly Environments and Traditions
(UAB Alumni)

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