Icon for Key Principle 7

PRINCIPLE 7: Supportive care environments for older people with confusion

NSW hospitals will provide a supportive care environment for the older person with confusion.

Supportive care environment

A good environment can help to reduce confusion and agitation, improve orientation and encourage social interaction (1). An older person’s confusion and behavioural disturbance may be worsened by an unfamiliar environment.

The design of general hospitals and emergency departments can often make people with dementia even more confused (2,3). Despite the increasing prevalence of dementia and delirium in hospitals, few wards are designed appropriately for people with cognitive impairment (4).

Strategies to orientate older people and minimise confusion include:

  • clear signage, in contrasting colours
  • minimising noise and hustle
  • positioning familiar items around the bed area to create a warm and friendly atmosphere
  • ensuring toilet doors are painted with an identifiable colour and illustrating ward signs with pictures (3,5).


  1. Fleming R. FI, & Bennett K. Adapting the ward for people with dementia. Sydney: 2003.
  2. NSW Dementia Policy Team. The NSW Dementia Services Framework 2010 – 2015. Sydney: 2010.
  3. Dementia Services Development Centre. Design features to assist patients with dementia in general hospitals and emergency departments Stirling: 2012.
  4. NSW Dementia Policy Team. The NSW Dementia Services Framework 2010–2015. Sydney: 2010.
  5. Australian Institute of Health and Welfare. Dementia Care in hospitals: costs and strategies. Canberra: AIHW, 2013.