3 Ways Good Design Can Help People Who Have Dementia

The design of the environment we live in has a profound impact on our mood and wellbeing, especially for people living with dementia. In this post, we’ll look at some ways that good design can make an impact, from the use of colors and lighting, to making it easy to perform daily tasks, helping you to plan a suitable environment for your loved one, or to identify a care home designed for the needs of people with dementia.

Good use of color

Color choices play an important part in ensuring people with dementia can navigate their surroundings, identify familiar places and affect their mood. Firstly, contrasting colors can be used on furniture, fittings and fixtures to help people navigate and interact with their surroundings. For example, using a light switch that contrasts in color to the wall it’s on can make it easier to identify, avoiding confusion. Similarly, utilizing handrails that contrast to the walls their mounted on makes them easier to find, encouraging people with dementia to explore their surroundings without fear of getting ‘stuck’. Ensuring furniture is a different color to the floor also makes it easier for people to negotiate the room without fear of tripping up, while also making it easier to identify where they are and find their way around.

Using different color doors is another good way to help people with dementia identify different rooms. For example, painting bathroom doors a different color to other doors can help people identify what’s inside them. Colored doors are also used in care homes for residents’ rooms, helping to make them more recognizable and making it less likely for residents with dementia to get lost and enter other people’s rooms accidentally.

Before painting any walls or changing fixtures and furniture, it’s important to remember that color can affect mood. Be aware of any preferences that your loved one may have, for example if they have eye conditions, yellow, orange and red can be easier to see. Others may prefer darker colors like black or dark blue against light backgrounds.

Using lighting correctly

If lighting is not used correctly, it can make it harder to identify objects, create shadows, and change perceptions of the passing of time, all of which can cause confusion and distress for people with dementia.

Natural light is the first important consideration. Not only does natural light provide higher levels of diffused light, which creates soft, unnoticeable shadows, it also helps to show the passing of time as the light source changes throughout the day, making it easier to stick to natural sleeping patterns.

Artificial lighting also plays a part as it can help compensate for poor eyesight, helping people find their way around their home. For example, additional artificial lighting can be used to make it clear that corridors and pathways around rooms are clear and unobstructed, avoiding confusing shadows. The position of lighting needs to be considered, for example to avoid bright light directly over beds, which can make it difficult for people to rest. The choice of lampshade is also important, as these can be used to create diffused light, reducing shadows and creating a uniform level of brightness around a room.

Make it easy to perform day to day tasks

Interior design also plays a part in making day to day tasks easier to perform for those with dementia. Lighting can again play a part here, for example by illuminating the insides of drawers and cupboards when they are open, making it easier to find things.

People with dementia can also struggle to remember where things are kept, for example in the kitchen. A solution is to use transparent cupboard doors allowing the contents to be seen, or use labels to mark what’s inside. Pictures or icons are a good idea, as it can be easier to remember the look of an item than its name.

Icons and signs are also a great way to direct people to certain rooms. For example, signs leading to the bathroom may include pictures or icons representing a shower, toilet and washbasin, to remind users what the bathroom contains. Meanwhile, the dining room door could feature an icon of a knife and fork to represent eating, providing a visual clue to what can be done in this room.

In conclusion

If you’re making changes to someone’s living space or finding a new home for them, it’s important to remember that everyone has different abilities and needs which can change over time. It’s important to take a person-centric approach as a result, ensuring your loved one continues to be able to make their own choices and uphold their dignity.

About the author

Seb Atkinson works for Hallmark Care Homes, a leading provider of dementia care.

Elder Care Issues: How to Reduce Caregiver Anxiety Symptoms

Caregiving is, by its very nature, the giving of yourself for someone else. Caregivers need to respond to the every need of the person they care for, and they often find themselves essentially giving up their own life for the life of someone else – all while dealing with the natural stresses and anxieties of caring for someone with special needs.
That kind of sacrifice comes with a price. Caregivers are often prone to serious stress and anxiety that can be debilitating, and may take away from your ability to deal with the needs of the person under your care. For those that are suffering from caregiver anxiety, consider these tools and tips for improving your own mental health.

Caregiver Anxiety Tips

  • Be “Selfish – Perhaps the most important thing to remember is that your mental health affects your ability to be a good caregiver. Caregivers with anxiety and stress won’t be 100% at all times. So if the stress is starting to get to you, it is in your best interests – and the best interests of the person you care for – to take a moment and find a way to relax. It’s not selfish to want yourself to be at your best, even if it takes away from your caregiving duties for a short time.
  • Join Support Groups – So much of caregiving involves taking care of those with dementia, or fading health, or Alzheimer’s, or some other disorder. Witnessing that breakdown can be emotionally difficult. Support groups give you an opportunity to surround yourself with others experiencing the same thing. It makes you feel like you’re not alone and supported. Developing that type of community can be powerful.
  • Exercise – One of the first things that caregivers neglect when they start caring for others is attention to their own physical health. Yet the mind and body are powerfully connected. If you’re consistently inactive you’ll end up with excess energy that will only fuel your anxiety further. If, on the other hand, you exercise regularly, you’ll burn away not only excess energy, but also cortisol (a hormone released when you’re stressed).
  • Go Out With Friends – As hard as caregiving is, chances are you have some free time (as little as it may be). It’s important you do not let yourself fall into the trap of using that time to simply mope about your stress. Force yourself to stay active. Go out and spend time with your friends, and allow yourself the opportunity to create social support for yourself, laugh, and create memories outside of your caregiving.
  • Therapy – Many people look at therapy the same way they do pharmaceutical medicines, and this is simply unfair. Therapy can be extremely effective at helping you cope with your stress and anxiety. Cognitive-behavioral therapy has received ample research into anxiety reduction tips and strategies, and seeing a therapist is 100% side effect free. If you can afford it, therapy can be an extremely helpful option to consider.

Developing Strategies to Cope With Anxiety

You can also find your own coping strategies as well, provided they are emotionally healthy. Skipping stones at a park or walking your dog may be a worthwhile way of coping, and if it helps you improve your mental health you should always find time to do it, even if it takes away from your caregiving duties for a short time.
The above methods of decreasing stress and anxiety are valuable, but they’re just suggestions. The most important thing you can do for your caregiver anxiety, however, is recognize that you own your mental health matters. No matter how much you need to care for someone else or how important that other person is, they – and you – need to always make sure that you’re taking at least a bit of time to ensure you are able to relax, otherwise neither of you will get the attention that you deserve from the caregiving relationship.

About the Author: Ryan Rivera is an anxiety specialist that has written countless tips for managing stress and anxiety. He has a website dedicated to anxiety disorders and treatments at www.calmclinic.com.

Ellen Dunnigan Provides Dementia Care and “Relief” With Sollievo (Podcast)

Ellen Dunnigan combines dementia care with a 360-degree home care philosophy to provide a unique option for families struggling with dementia or Alzheimer’s. The Sollievo model is one of many unique care models that are emerging as we grapple with how to care for our elders. What I found interesting about Ellen’s approach is her keen attention on serving the seniors AND providing stress relief to the family.
How Ellen Describes Sollievo

Sollievo is a care management network for families caring for an aging parent. We provide expert answers and relief to the daughters and sons who have taken on the exhausting caregiving of a parent who has been diagnosed with Alzheimer’s or a related dementia.

Typically we guide daughters who are trying to be both SuperMom and SuperDaughter, doing one job all day and then coming home in the evening to start the even tougher job.

They are stressed out, tired of being tired, and feeling guilty; consumed with trying to be the “answer” to everyone including their siblings in other states. They wish someone else could help them without getting in the way. And they need just-in-time resources to safely keep their mother or father at home longer.

Our process begins with a three-pronged assessment of the living environment, the well-being of the person diagnosed with dementia, and the burdens placed on family caregivers. We supply education and clarify expectations. We tailor strategies to make the days and nights better. Our 24/7 helpline is always answered live to address their immediate concerns. And most importantly we deliver the “just right” answers and network of services the first time, and every time.
About Ellen Dunnigan

As a strategist healthcare product development, and a Speech-Language Pathologist, Ellen Dunnigan has produced several healthcare product lines including Alzheimer’s care, Geri-psych programs, diabetes care, traumatic brain injury programs, and others. She has developed a balanced model of Alzheimer’s care for the long-term care segment which guides caregivers to exceptional results in patient care and meaningful resident days. Additionally, she has initiated a first-of-its-kind community model for the coordinated care of families caring for an aging parent diagnosed with dementia.

Ellen has a Masters degree in Speech-Language Pathology, certification in gerontology and case management. She is the author of several best practice clinical and operational methods in Alzheimer’s care and speaks internationally. She founded Alzheimer’s Care Group in 2002 and has grown it to a nationwide consulting firm specializing in healthcare strategy. Alzheimer’s Care Group has five associates and operates in care settings in 30 states. Their community resource network is called “Sollievo” and operates throughout Indiana, with plans to expand to neighboring states.
Contact Information

Sollievo office: 317-218-5111
24-hour Helpline: 317-753-7447



Validation Therapy and Dementia: Pros and Cons

Dementia is a decline in memory and/or intellectual functioning severe enough to interfere with social or occupational functioning. Dementia is not a disease itself, but group of symptoms. It is characterized as a progressive decline in cognitive function due to damage or disease (such as Alzheimer’s) in the brain. Areas particularly affected include: memory, attention, judgment, language and problem solving.

Dementia is condition in which a person loses the ability to think, remember, learn, make decisions and solve problems. Symptoms may also include personality changes and emotional problems. Personality does not change with age in the absence of mental disease.

There are many causes of dementia, including Alzheimer’s disease, brain cancer, and brain injury. Some Parkinson’s patients experience dementia at later stages of disease progression

Enter Validation Therapy

The idea behind validation therapy is to “validate” or accept the values, beliefs and “reality” of the person suffering from dementia. The key is to “agree” with them, but to also use conversation to get them to do something else without them realizing they are actually being redirected. So, if an 87 year old woman says that she needs a phone to call her grandmother, validation therapy says, “OK.” Here is an example for a caregiver working with someone with dementia in an adult day care:

Older adult: “I have to find my car keys.”
Caregiver: “Your car keys…” ( Don’t mention he doesn’t have a car and he hasn’t driven for years)
Older adult: “Yes, I need to go home – lot’s of work to do!”
Caregiver: “You are busy today?” (Don’t mention he is at adult day care and isn’t going home for hours)
Older adult: “Hell, yes! I’m busy every day.”
Caregiver: “You like being busy?” (Trying to find a topic of conversation that they might accept discussing)
Older adult: “Are your kidding? I didn’t say I LIKED it. I just have to work  like the rest of the world.” (He’s getting a little frustrated, but seems to have forgotten about the keys.)
Caregiver: “I know about work. I do some of that myself. In fact, I’m getting ready to fix some lunch for us. Care to join me?”
Older adult: “Lunch, huh? What are you having?”

Why Validation Therapy Works: The Pros

The number one reason why validation therapy works well is because it is not confrontational. Never is a person belittled, yelled at, or told “no.” Remember dementia is a group of symptoms, not a disease. It is easy to misdiagnose. For example, people suffering from UTIs (urinary tract infections) are said to demonstrate characteristics of dementia if the infection goes undetected.

Criticisms of Validation Therapy: The Cons

The biggest criticism of validation therapy is that it promotes lying. These lies weigh heavy on the consciouses of caregivers and family members. For example, validation therapy says that a family member should just accept their aging parent calling them someone else’s name, not correct them. When family stories are switched around, the family is suppose to just listen to the stories as they are told. While there seems to be significant emotional harm to caregivers and family members, very little harm is done to the person with dementia; but isn’t it the well-being of the person with dementia that is most important.

Photo credit: jam343

About the Author: Ryan Malone is the founder of Inside Elder Care and author of the By Families, For Families Guide to Assisted Living. He regularly speaks and advises families about how to improve their aging loved one’s quality of life. Ryan is also the president of SmartBug Media, a content marketing agency that helps companies increase leads, customers and influence. You can read more from Ryan on the SmartBug Media blog or follow him on Twitter.

New Social Security Benefits for Alzheimer’s

Early-onset Alzheimer’s disease is one of 38 degenerative conditions included in the Social Security Administration’s new Compassionate Allowances program.  This fast-tracking system is designed to aid younger patients and their families in moving quickly from diagnosis to benefits.  Expediting this process aids in reducing stress associated with waiting for the lengthy approval process, and trying to plan the next stages of life while in a state of limbo.  Many of these younger patients–most in their 30s and 40s–are still working and have more extensive financial responsibilities than the traditional Alzheimer’s patient.  More typical Alzheimer’s patients are in their mid-to-late 60s, retired, and also too young to be receiving Social Security retirement benefits in some cases.

Effective March 1, 2010, the Administration will be able to electronically target and make prompt decisions in the best interest of the disabled patients.  In the past, when a younger patient began experiencing the cognitive limitations, they were not traditionally tested for Alzheimer’s disease. Instead, they were thought to be suffering from job and life-related stress.  This issue added to the lengthy process of identifying the correct diagnosis and than being approved for disability benefits.  With this new program, it is estimated that tens of thousands of younger Alzheimer’s sufferers will now qualify in a matter of days rather than the traditional months or years it often took in the past.

According to the Administration, approximately 200,000 people under the age of 65 currently suffer from the symptoms of early-onset Alzheimer’s disease.  Due to the sheer volume of potential benefit applicants, the Administration will also benefit from this new program as it will reduce the time and effort of the appeals process that in the past would contribute to slowing down the system for every patient.

Photo: benprks

Top Brain Fitness Programs for Sustaining Mental Acuity

In aging seniors, healthy brain function is about more than just memory and coordination; everyday tasks, relationships, hobbies and quality of life are all affected.  It stands to reason that the more aware and capable you are of cognitive reasoning and performing independent living activities the higher your self confidence and emotional health.

The nation’s largest study on brain fitness was performed in 2002 by the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) and their results showed that a large percentage of participants over the age of 65 improved memory, reasoning and information-processing speed when they participated in training for five days per week.  In addition, the study showed a 47% lower risk of dementia in participants who worked crossword puzzles four days a week than those who only worked the puzzles once a week.  These results play into the notion of “Use it or Lose it” when it comes to cognitive aging.

Furthermore, an Australian study consisting of 30 peer-reviewed papers in controlled trials found that, as people experienced these lifestyle benefits they were also able to live longer and therefore reduce health care expenses.

Along with these studies, it is widely known that many seniors regularly engage in crossword puzzles, Sudoku and similar brain training games to slow dementia and aging.  Many software companies have tapped into this need by creating games and exercises that aid in sustaining mental acuity.  It has been reported that the brain fitness software market grew from $225 Million in 2007 to $265 Million in 2008.  Here are the top three systems that claim to reduce dementia rates in seniors.

Posit Science

Posit Science claims that their products will help the user “think faster, focus better, and remember more.”  Their software programs are designed for either a PC or a Mac. Each priced at $395.00

  1. Brain Fitness Program: Six programs that allow you to “Remember more & Feel Sharper” by practicing matching items, distinguishing objects, memory recall and story telling.
  2. InSight: Five programs designed for “Better Focus & Learn More” focusing on visual precision.
  3. DriveSharp: Two programs that deal with divided attention and increased processing times so that you will “Drive Carefully & React Faster”

Dakim BrainFitness

Dakim offers two brain training concepts for seniors.

  1. A complete self-contained console that only needs a high-speed internet connection but does not require a keyboard, mouse or software program installation.  It is marketed to both the individual senior and the senior living provider.  After the initial purchase of $2,299 for the touch-screen console, more than 150 games are available for a $19.95 per month subscription.
  2. 2. New brain fitness software to be released this April for $349.99, which includes a one-year subscription.


CogniFit is a web-based system that does not require you to install software or purchase a console.  Instead you access the programs through their website.  Both programs described below are priced based on the following subscription terms: $19.95 per month, $99.50 for 6 months, or $170 annually.

  1. CogniFit Personal Coach:  This program addresses overall cognitive skills and claims to improve memory and focus, and increase processing time.
  2. CogniFit Senior Driver: Similar to other driving programs, this system is designed to improve reaction time, handle multiple driving tasks and focus on potential road threat recognition.

About the Author: Ryan Malone is the founder and managing editor of Inside Elder Care and the author of the By Families, For Families Guide to Assisted Living.  He can be reach on Twitter at @RyanMalone.

Dr. Kevin O’Neil Helps Keep Your Brain in Shape

In this Leaders in Elder Care interview, I had the privilege to speak to Dr. Kevin O’Neil.  I first met Dr. O’Neil at Brookdale’s Brain Symposium a few months ago at UCLA, where I left quite impressed with the his approach to brain fitness and brain health.  Dr. O’Neil combines a deep understanding of both the science behind brain health and the practical advise that non-doctors require to do something about.  Congratulations, Dr. O’Neil, for being a Leader in Elder Care.

I hope you all enjoy the interview.

About Dr. Kevin O’Neil

Dr. Kevin O’Neil is the Medical Director for Brookdale Senior Living (BSL), the largest senior housing provided in the United States. Dr. O’Neil practiced and taught geriatric medicine for over 27 years (seven years in Massachusetts and 20 years in Sarasota, FL).  A graduate of Boston College and Georgetown University School of Medicine, he completed his internship in Internal Medicine at the Washington Hospital Center and his residency at the University of Massachusetts Medical Center.  He was formerly an assistant professor of medicine at the University of Massachusetts Medical Center and is currently a Clinical Professor in the Department of Aging at the University of South Florida.

He is certified by the American Board of Internal Medicine and holds a Certificate of Added Qualifications in Geriatric Medicine. He is a Fellow of the American College of Physicians and is a member of the American Geriatrics Society and the American Medical Directors Association.

Dr. O’Neil is co-editor and a contributing writer to Optimal Aging Manual, which Art Linkletter has called “the great master book for the boomers.”

Live Discussion: Dementia with Lewy Bodies

A dear friend of Inside Elder Care, Kim McRae, just shared a wonderful opportunity to learn more about the second leading type of demntia after Alzheimer’s.

Betwixt and Intermixed – Dementia With Lewy Bodies

Three members of the Lewy Body Dementia Association Scientific Advisory Council (SAC) are participating in an upcoming free webinar on dementia with Lewy bodies (DLB), the quintessential overlap disease between Alzheimer (AD) and Parkinson diseases (PD).

This live discussion, hosted by the Alzheimer Research Forum, will take place on Monday, 15 June 2009, from 12 noon to 1 p.m. EST and will feature short slide presentations by Drs. Ian McKeith, Brit Mollenhauer, James Galvin, James Leverenz, and Walter Schulz-Schaeffer, with audio provided via a telephone line. (Drs. McKeith, Galvin and Leverenz are members of LBDA’s Scientific Advisory Council.)

Questions for the panel can be submitted in advance and during the live event. An interactive chat session will follow the webinar.

Click here to learn more and register for the event.

Picture: Balazs Simon

Alzheimer’s Drug Shows Promise, Begins Phase III Trials

From Indystar.com:

A third set of clinical trials to seek a drug to delay the progression of mild to moderate Alzheimer’s disease is about to get underway, drugmaker Eli Lilly and Co. said today.

The Indianapolis company will begin enrolling patients this month in two separate but identical Phase III clinical trials of Solanezumab, an antibody that may hold the key to preventing the disease that affects 5.3 million people in the United States alone.

Lilly also is in the process of testing out a different type of Alzheimer’s treatment, also geared to help those with the disease, which is known to cause dementia.

“Current therapies available to treat Alzheimer’s disease may help with symptoms, but they haven’t been proven to change the disease progression,” said Eric Siemers M.D., medical director for Lilly’s Alzheimer’s disease research, in a news release. “Biomarker results from a Phase II solanezumab trial give us hope that Lilly is on a path toward a treatment that may slow the rate of progression of Alzheimer’s disease.”

Lilly expects to enroll a total of 2,000 patients age 55 and over from 16 countries, including the U.S., in the Phase III “Expedition” trials.

Patients or caregivers interested in learning how to enroll in the Expedition trials (or a companion trial for a different treatment, known as “Identity” trials) should visit www.clinicaltrials.gov or call (877) 285-4559.

Photo credit: Sam Catchesides