‘Hearing, sound and the acoustic environment in dementia care’ Maria McManus Director (DSDC NI) maria.mcmanus@stir.ac.uk & Clifford McClenaghan, Associte Architect

How acoustically aware are you?

Hearing & Well-being Social Emotional Psychological Occupational Educational

Our ears Listening – focused attention Hearing – capacity to listen Balance – mobility and walking

Hearing Loss Conductive- esp. Down’s Syndrome Sensori-neural - hearing nerve Presbycusis- gradual, assoc. with hair cells Tinnitus Vestibular problems > 71% older adults aged over 70 have some hearing loss (RNID, 2008)

Hearing & Dementia Care Aid functioning by Simplifying and clarifying the environment. Reduce discomfort & ‘clutter’ Supporting the person to Communicate Belong Interact

Reduce Behavioural Symptoms Noisy & over-stimulating environment Anger Aggression Frustration

Hearing & Communication Hearing assessment Hearing aids Light levels Positioning of furniture Reduce excess noise Consider coping ability

Acoustic Basics Why are the acoustic properties of care buildings so important to the well-being of the residents? To answer that question we need to understand the nature of sound and its effect upon the receiver of that sound.

What is sound? Sound is the sensation produced by a certain range of rapid fluctuations of air pressure affecting the ear mechanism.

What is noise? “Unwanted sound”, can be defined as noise and as such it can increase heart rate, blood pressure, respiration rate and even blood cholesterol levels.

Two Types Airborne - sources such as external, speech, music and loudspeakers Impact - sources such as footsteps and the moving of furniture

The Acoustic Environment - Design Challenge Keeping noise sources as far as possible from quiet areas Structural precautions to reduce noise penetration Internal acoustics of individual rooms

Keeping noise sources away Traffic Aircraft Rail Building Operations Manufacturing

Traffic – 80/90 dB

Aircraft- 110 / 140 dB

Rail - 95dB

Building Operations crane 96dB – varies

Sources TV, radio, stereos Doors Alarms Mobile phones Chatter Meal times Activities & visitors Cutlery & crockery Bins Keys Trolleys Hoovers & buffers

Examples Door entry systems Common Kitchen Facilities Public address systems Delivery points Lifts Staircases Circulation areas Common Kitchen Facilities Communal rooms Occupants Fire Alarm Systems Services and Plant

2. Structural Precautions The Concepts of Absorption & Transmission Absorption – some sound absorbed by surfaces Transmission – how noise carries - vibrations in the air or the construction

Reverberation Time The time in seconds it takes for sound to die away by 60dB after a sound source has been stopped. (Sabine Formula) An optimum reverberation time depends on use of the space. Speech is best understood within a "dead" environment (0.8 -1.1) Music enhanced within a "live" environment (1.2 -1.4)

Reverberation time is affected by the size of the space the amount of reflective or absorptive surfaces within the space A space with highly absorptive surfaces will absorb the sound and stop reflection back into the space - yields a space with a short reverberation time

Designing for the Correct Reverberation Time (RT) Reverberation time can also be adjusted Absorptive materials can be added to or removed Consider reverberation time in the design stage. Making revisions to a space can be more costly.

Insulation The heavier the construction the higher its insulation value Reduce noise levels by using materials with a high sound insulation value

3. Internal Acoustics of Rooms Guidance 3. Internal Acoustics of Rooms

Individual areas Delivery / entry points Entrance/ circulation Stairwells Lifts Kitchens Fire alarms Ventilation Heating

Consider Floor finishes Wall finishes Ceilings Windows Soft furnishings Curtains

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Bedrooms Sleep Rest Privacy/ defensible space For activities, radio, TV, reading, Absorbent finishes Soft furnishings Carpets/ lino

Paving, planting, screening 

Key Points Think behaviour Night time, Sources - TV, radio, alarms, phones!! Staff chatter Meals and trolleys Respect quiet spaces

Summary: Key Points Insulation Absorption Transmission Reverberation Time Behaviour & Gadgets