There are 850,000 people living with dementia in the UK, with numbers set to rise to over 1 million by 2025. One of the first symptoms of Alzheimer鈥檚 Disease is losing your ability to navigate and find your way around new places but 80 percent of people with dementia eventually move from their homes into unfamiliar assisted living or care home environments.聽
Professor Jan Wiener from the Psychology Department at 蜜桃AV has been studying the neuroscience behind navigation for almost 20 years. He is now using his knowledge to produce guidelines to help care home managers design layouts that stop residents from getting lost and disorientated.
鈥淯nfortunately the regions of the brain involved in navigation and spatial learning are some of the earliest affected by Alzheimer鈥檚 Disease and ageing,鈥� says Wiener.
鈥淭his means that people living with dementia are moving into care homes or sheltered housing at a time in their life when they have real problems learning new environments.鈥�
鈥淚n particular your ability to localise yourself with respect to the start place of your travel is one of the first to be affected by Alzheimer鈥檚, and if you can鈥檛 rely on this particular navigation mechanism then you need to use environmental cues. This is a problem if all of the corridors look the same.鈥�
As part of a two and a half year ESRC project called 鈥楧ementia Friendly Architecture鈥�, Wiener has devised a new set of guidelines to be used in care homes, inspired by his neuropsychological research and that of others. Although dementia-friendly guidelines already exist, they often do not address orientation and wayfinding, and those that do are not informed by neuropsychological evidence.
For example, many guidelines recommend placing recognisable objects at decision points along a route, such as at crossroads.聽 However, research by Wiener鈥檚 lab suggests that it is more the transitions between places that should be highlighted, as elderly people prefer to use different strategies to remember routes.
鈥淚f you learn a route you can use what is known as an associative cues strategy - where you associate a landmark with the direction you are coming in, for example by remembering 鈥業 turn left at the church and right at the gas station鈥�, says Wiener.
鈥淎lternatively you could use what is known as the beacon strategy, where all you have to remember is that you have to move towards the church when you see it. This requires you to memorise a sequence of landmarks rather than associating each landmark with a particular direction.鈥�
鈥淥ur research seems to suggest that that whilst younger people prefer the associative strategy, older participants struggle with this and instead find it much easier to use the second beacon strategy.鈥�
As a result, the guidelines produced by Wiener recommend placing distinctive landmarks within corridors as well as at the ends, in order to make corridors easily distinguishable from one another. His research shows that these landmarks should be bright, distinctive 鈥榮alient鈥� objects, that only appear once so as not to confuse residents.
鈥淚n order for a landmark to be useful for navigation it must stand out,鈥� says Wiener. 鈥淥ur research has shown that landmark recognition and navigational performance in people with memory problems can be improved by using more vividly coloured, high contrast objects. For example, brightly coloured photographs.鈥�
Other research by the team has shown that people often use verbal codes to memorise landmarks, such as remembering a picture of a flower as 鈥榯he sunflower painting鈥�.聽This means that paintings in corridors should be easy to describe and not abstract. Care home designers should also avoid placing different pictures of similar objects on the walls - for example, two pictures of sunflowers as both may be remembered verbally as 鈥渢he sunflower painting鈥�.
The guidelines, which will be officially launched later this year, have already been adopted by several care homes up and down the country. Wiener has also piloted a care home manager training scheme, which he has so far delivered to 40 managers of Dorset care homes to help them implement the guidelines.
He is also working with graphic designers from the Arts University Bournemouth to create designs that can be downloaded and printed by care home staff to make corridors more distinguishable.
