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Just the Facts and More: Environment
Alzheimer's patients often can't remember where they are and sometimes see their surroundings as threatening because they are unfamiliar. The reason may not be in the environment, but in the feelings of disorientation that are part of Alzheimer's disease. While most people can easily distinguish among many different noises, colors, or patterns in a room, the person with Alzheimer's is more likely to feel confused or overwhelmed. This kind of overstimulation can make the person feel hostile or worried. For these reasons, you need to create a calm, quiet, familiar, enjoyable, comfortable, and organized home environment.
If the person feels safe and secure, you might be able to better manage problems of wandering, anger, or agitated behavior. Keep in mind that something as simple as rearranging the living room furniture or stepping into a neighbor's kitchen might be unsettling to the person with Alzheimer's. A familiar, well-organized living area helps both you and the patient. In looking at your living environment, you should consider some of the following tips.
One of the best places to turn for additional help is the Alzheimer's Association. The Alzheimer's Association has more than 83 Chapters and 1,600 support groups nationwide, where family members of people with Alzheimer's disease or a related disorder share their experiences, provide each other with emotional support, hear practical suggestions and learn to rebuild their lives.
The primary resource for this fact sheet was Barbara Sand, RN, MSN, Faculty, College of Nursing, University of Nebraska, Lincoln, Nebraska.
Posted August 3rd, 2007
If the person feels safe and secure, you might be able to better manage problems of wandering, anger, or agitated behavior. Keep in mind that something as simple as rearranging the living room furniture or stepping into a neighbor's kitchen might be unsettling to the person with Alzheimer's. A familiar, well-organized living area helps both you and the patient. In looking at your living environment, you should consider some of the following tips.
| Action Steps |
Focus on consistency.
- Strive for consistency. Keep furniture in the same place.
- Help the person maintain a connection to the past with such familiar objects as old framed photographs, a favorite chair, cabinet or lamp, a piece of clothing such as a hat, or a wall hanging.
Use color and contrasts.
- Work to achieve a calming effect through color. Instead of relying on bright primary colors such as stark white, yellow, orange, or red, use more soothing pastel shades such as peach, pink, beige, ivory, and light blues, greens and lavenders. In addition, use flat paint rather than semi-gloss or high gloss to prevent glare.
- Use contrast. A person with Alzheimer's disease might not be able to distinguish between an off-white wall and a beige door or handrail. For this reason, you may want to have light walls and dark doors and handrails.
Pay attention to flooring.
- Keep floor surfaces uncomplicated. The person might perceive checkerboard linoleum squares as holes and certain patterns as cracks to be avoided.
- Use flooring that cuts down on glare. A shiny floor might prevent the person from seeing obstacles in his path. Some of the newer textured vinyls cut down on glare and are also less slippery.
- Consider using carpeting to help absorb noise, or to prevent slipping. Because of problems with incontinence, some caregivers eliminate carpeting on the floor and run it part way up the wall.
Limit distractions.
- Limit distractions and control noise. Provide soft, enjoyable background music and include some of the individual's favorite songs. In addition, control excessive switching of television channels and ringing of telephones.
- Avoid lighting that casts shadows and might disturb the patient. Whenever possible, use natural light and focus it directly on the area where it is needed.
Consider special furniture.
- Find nonabsorbent material to cover furniture or buy a comfortable recliner. If you purchase a special chair, make sure it has stable arms that extend past the seat so the patient can get up easily.
Orient the person.
- Experiment with labels, pictures, and numbers that help orient the person and understand where he is.
- Take responsibility for safety. Keep pathways clear and be especially aware of the dangers of cluttered furniture and throw rugs. In addition, use locks on doors and cupboards, and hidden switches or controls for the stove, thermostat and hot water heater.
Wall coverings make a difference.
- Use wall hangings made of various textured materials. Many people with Alzheimer's enjoy feeling textured materials such as yarn or wool and find these decorations less disorienting than those made of mirrors or glass.
- Avoid small, distracting wallpaper prints. In one nursing home, residents mistook the vines in a wallpaper pattern for snakes and began to beat on the wall. The individual might also try to pick flowers off the wallpaper.
Be aware of plants.
- Use house plants for decoration, especially if they have been an important part of the person's life, but first make sure that the plants are nontoxic.
- Consider the backyard or patio as part of the environment. Give the person an opportunity to garden, walk, or work outdoors in a safe, supervised area.
Pets in the house.
- Use pets as part of the environment. Many people with Alzheimer's disease find great pleasure in watching fish or a bird. Just make sure that you supervise the activity and keep the aquarium or cage locked. Also keep in mind that the person might not be able to assist in caring for the pets.
| Resources |
One of the best places to turn for additional help is the Alzheimer's Association. The Alzheimer's Association has more than 83 Chapters and 1,600 support groups nationwide, where family members of people with Alzheimer's disease or a related disorder share their experiences, provide each other with emotional support, hear practical suggestions and learn to rebuild their lives.
The primary resource for this fact sheet was Barbara Sand, RN, MSN, Faculty, College of Nursing, University of Nebraska, Lincoln, Nebraska.
Other Resources include:
- David L. Carroll. When Your Loved One Has Alzheimer's Disease: A Caregiver's Guide. New York: Harper and Row, 1989.
- Howard Gruetzner. Alzheimer's: A Caregiver's Guide and Sourcebook. New York: John Wiley and Sons, Inc., 1988.
- Lisa P. Gwyther. Care of Alzheimer's Patients: A Manual for Nursing Home Staff. Washington, DC: American Health Care Association, and Alzheimer's Disease and Related Disorders Association. 1985.
- Nancy L. Mace and Peter V. Rabins, MD. The 36-Hour Day. Baltimore: The Johns Hopkins University Press. 1991.
Compiled by the Lincoln/Greater Nebraska Chapter of the Alzheimer's Association, 1999.
- Alzheimer's Association of the Great Plains, 402-420-2540 or 1-800-487-2585 (Helpline)
- Midlands Chapter, 402-572-3010 or 1-800-309-2112 (Helpline)
