Easing The Wait

According to the World Health Organization, approximately 50 million people worldwide have dementia, with nearly 10 million new cases diagnosed each year. Though dementia mainly affects older adults, it can be diagnosed in much younger people, as well, because it’s caused by a variety of diseases and injuries that impact the brain. Here in the U.S., due to our growing population and the aging of the baby boomers, the number of people with Alzheimer’s disease and related dementias is expected to rise to nearly 14 million by 2060.

Dementia leads to a deterioration in memory, thinking, and behavior as well as creates challenges in the ability to perform everyday activities. Designing spaces that accommodate people with dementia has become increasingly important throughout the continuum of care.

That’s why The Center for Health Design is adding dementia-friendly design to one of our most popular online tools, the Interactive Design Diagrams. The tool is funded through the generous support of the Angelo Donghia Foundation and can be used to connect desired outcomes to design strategies and then link to research that underpins those strategies. Since the tool’s inception, the research team at The Center has created 10 different diagrams focused on inpatient rooms, outpatient/ambulatory care rooms, and home environments. This month, we added a dementia-friendly waiting room.

Waiting room configurations, clearances, and characteristics can influence the patient and family experience as well as organizational efficiency by either accommodating or compromising a patient’s needs. For older adults, especially those with dementia, waiting room design can unintentionally present acoustic, visual, perceptual, and physical barriers to accessing medical care. Patient confusion and difficulty in negotiating spaces increases reliance upon mobility aids and dependencies upon companions, which, in turn, poses challenges to waiting room occupancy and comfort. By translating person-centered strategies drawn from dementia-focused design interventions used in residential settings, waiting rooms can better support a broad range of patients.

For example, the overall layout of the space should avoid obstructions in pathways between seating areas and restrooms. Flooring with energy-absorbent properties (such as rubber, cork, or linoleum) will help reduce impact that causes injury while also providing enough firmness to reduce the risk of falling due to poor balance. Flooring should also avoid glare and excessive contrast and patterns, which can be perceived as or conceal actual changes in level, which pose a potential trip hazard. Walls might feature a wainscot trim that’s securely fastened to the wall while offering a frame of reference and a touchstone for balance. Color-coded elements, such as flooring and walls, together with lighting, landmarks, and views of the exterior, also will make wayfinding easier for patients. Noise reduction measures and positive audio distractions (music, nature sounds, etc.) can help minimize patient stress and anxiety.

I encourage you to check out the tool on The Center’s website to explore a variety of settings and the evidence-based design strategies and desired outcomes tied to them. Two additional diagrams will be added later this year, including one on safe emergency department design.

Debra Levin is president and CEO of The Center for Health Design. She can be reached at dlevin@healthdesign.org .Addie Abushousheh is a research associate at The Center. She can be reached at aabushousheh@healthdesign.org.

 

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