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Better health for people living
with dementia

Home environment

Recent research investigating what makes an environment ‘dementia-friendly’ has resulted in the articulation of principles, the development of audit tools and advances in design and technology that can enable a person living with dementia to stay at home.

When applied, these principles, design features and technologies can increase safety and reduce stress for the person living with dementia. In practical terms, this translates to a home with:

  • a layout that is easy to navigate
  • lighting that is comfortable and consistent
  • a low noise level
  • a comfortable range of temperature
  • minimal clutter
  • furniture that is easy to get into and out of
  • communications systems – telephones, doorbells and more – that are able to be found, heard and used easily.

The preferences of the person living with dementia and others living in the home will inform the practical application of the new knowledge.

Assistive technology is broadly defined as devices or systems that enable independence, safety and wellbeing. For people living with dementia, this refers to devices and technology that assist with memory and cognition, way finding and safe walking, leisure and socialising, and monitoring health.

Technology is developing rapidly and becoming ‘smarter’ and more accessible for a person living with dementia and their carer as it targets an increasing range of everyday issues. However, it has to be carefully tailored to individual experience, preferences and needs.

Practice points

Occupational therapists:

  • assess the home environment and advise what minor adjustments can be made easily, such as labelling kitchen cupboards to enable items to be more easily located, and what major changes might be worth investing in
  • provide advice around assistive technologies that can help with safe use of home appliances, medication management, emergency help, sleep disturbance, locating misplaced items, orientation, safe walking and way finding
  • help the person living with dementia and any carers understand the cognitive components of daily tasks and activities, and how to adapt the tasks, taking into account the person’s cognitive strengths and losses
  • assess people’s ability to manage personal care and aim to increase independence with all activities of daily living.

Kevin's story

Kevin wasn’t nicknamed Mr Gadget for nothing. He could turn his hand to anything – he mastered computers, fixed washing machines, put up shelves. He also had a day job; he was a professional man running his own practice. So being diagnosed with Alzheimer’s disease at the age of 66 was a big shock for Kevin and his family.

Soon after this diagnosis, an occupational therapist came to the house to work out with Kevin and his wife how they could use his strengths to aid his memory. Mr Gadget had a labelling machine – so they used this to label all the cupboards and shelves to prompt him to put things away in the correct place, and to find them again. He labelled the microwave with step by step instructions on how to cook his oats for breakfast each morning, which meant he could continue to do this for himself.

Kevin likes routine and structure; so the occupational therapist worked with Kevin and his wife Diane to introduce a weekly timetable of arrangements and activities that Kevin enjoys; it also gives Diane the time and space to continue her interests and pursuits as a mother, friend and grandmother.

The weekly timetable includes a discussion group, a men’s lunch group, and going for walks, with friends and family members being included in regular weekly time slots. A big clock with the date as well as the time prompts Kevin to keep track of his timetable.

Comment from occupational therapist Natalie

Meeting Kevin soon after his diagnosis was great as I could identify the many strengths he had and target OT strategies to build on those strengths to aid him through his memory decline. It also meant that I could begin a relationship with Kevin and his wife that would continue as the disease progressed. From time to time, as changes occurred, I was consulted to provide strategies to support Diane; for example, laying his clothes out so he does not have to choose; offering him two choices that she knows he would like when choosing from a menu at a restaurant. Besides working one to one with family, the OT role extends to the community and encourages involvement in other programs at the appropriate time; for example a referral to a carer support group for Diane as the changes of behaviour in her husband became more stressful and difficult to understand; and referring Kevin to an exercise program where he receives support to prompt his memory about the exercises, and where he has great social connections.