Take care with flooring

With environment heavily influencing health and wellbeing, Ashley Hooper from Joseph Hamilton Seaton discusses how the specification of care home flooring can aid wayfinding, provide visual stimulation, and boost social connectedness

Conjure up in your mind the image of a care home. While specific features will vary, there are some commonalities about the way the interiors of these spaces look and feel. Long corridors, with equally spaced out doors, wide open plan communal spaces; care homes tend to be pragmatic rather than aesthetic in design. 

Architects often focus on making these spaces safer for vulnerable residents – by making design choices such as the use of non-slip flooring, accessible entrances and exits, and clean, hygienic furnishings that keep people safe. However, the use of aesthetics to improve the day-to-day wellbeing and health of care home residents often goes overlooked.

The use of design

The selection of certain colours, patterns and shapes can help, or hinder, the wayfinding abilities and comfort levels of those living with dementia. Roughly 70% of all care home residents in the UK have dementia, or some form of severe memory loss, according to the Alzheimer’s Society. Designing spaces that consider their specific needs, then, is crucial.

For people living with dementia, wayfinding problems can cause a great deal of stress, anxiety, and isolation. Wayfinding, i.e. the ability to navigate from one place to another, is integral to the independence and autonomy of a person, and the loss of this functional ability is one of the earliest signs of diseases such as Alzheimer’s. Without this crucial ability, even the most regularly frequented places can appear foreign, leading to feelings of panic and disorientation. 

This is why the use of design elements such as signage and colour are vital to enable people living in care homes to navigate comfortably, safely and independently. The long corridors and general lack of distinctiveness that are commonplace in care home environments pose a challenge when designing for recognition and visual stimulation – making it harder for residents to find their way around. But there are several design interventions that can make a huge impact.

Design considerations

Firstly, the care home environment should be distinctive, and contain visual cues to help residents create an enduring memory of the space. Even when little can be done about the structural layout of the building, interior design choices can boost wayfinding ability. Research has shown that people with Alzheimer’s disease who have difficulty orienting can still learn their way around if the environment is supportive
for wayfinding.

The colour and layout of flooring can be both functional – i.e. aiding navigation while being soothing. While colour associations aren’t ‘absolute fact’ and instead are dependent on a variety of cultural, personal and subjective factors, different colours generally induce different emotions and feelings. Blues are seen as calming and restful, while reds stimulate adrenaline. Neutral colours, such as beige, should be considered carefully when specifying floor coverings; dull colours that lack distinctiveness mean people with poor eyesight may find that the floors appear to blend together, and into the walls. Black flooring, similarly, can cause confusion – as it is much harder to perceive depth.

As well as this, the use of patterns can also prove a challenge in dementia care homes. While some may think patterns will bring life and vibrancy to a care home, they can often cause misperceptions in surface and depth. Therefore, bold patterns shouldn’t be used in a care home setting, unless for a functional purpose – such as to direct people. Instead, opting for strong block colours can provide that essential visual stimulation without leading to confusion.

Wayfinding design can be enhanced by using coloured carpet tiles to signify walkways and guidelines. While also having the practical benefits of design flexibility and ease of repair, using carpet tiles to create homogeneously coloured walkways enables residents to follow the path from the hallway to communal areas. Different coloured carpet tiles could also be used to signify the end of the path – i.e. where only staff should be accessing, or private rooms. 

Another design consideration is the importance of contrasting colours. NHS guidelines suggest that contrasting colours should be chosen for the walls and floors; similarly, furnishings should stand out against the walls and floors, to allow residents to see more clearly between levels and objects. Furthermore, choosing products that are accredited by industry bodies such as the DSDC (Dementia Services Development Centre) ensures flooring solutions do not cause confusion to dementia patients. Flooring solutions can attain Class 1a if they are plain rather than patterned, and contrast well with the walls, skirtings, doors, and furnishings. This factor is based on the Light Reflectance Values (LRV) – how much light a colour reflects or absorbs – of a product, with the DSDC recommending a minimum contrast of 30 LRV between flooring and other surfaces.

It might also be beneficial to incorporate nostalgic decor into the design of care homes. Feelings of nostalgia are intensely powerful; proven to trigger brain activity relating to memory in people and is strongly associated with optimism and resilience. In people living with dementia, there is significant evidence that nostalgia improves self-esteem and social connectedness. Where possible, choosing flooring colours, layouts and styles that echo the designs of 40 or 50 years in the past and which can tap into the positive effects nostalgia can have on people with dementia.

From the earliest stages of the design and specification process, design choices within care homes should be made with ease of navigation in mind. But it is also important to remember that many of these facilities become people’s homes – so, while clinical and practical safety will always be a priority, architects should strive to create spaces that are attractive and enjoyable for people to be in.

Ashley Hooper is commercial marketing manager at Joseph Hamilton Seaton