1. Creating a Safe and Friendly Place for a Person with Dementia

2. Look, Listen & Feel Looking at the Role the Environment Has on Abilities & Behavior

3. Supportive Environments Include 2 Factors –What you LIKE…

4. Supportive Environments Include 2 Factors –What you LIKE… –What’s GOOD for you!

5. Supportive Environments The 3 Positive P’s P hysical Environment P eople—the ways they act and respond P rogramming

6. Finding Balance Support or impair Too much or too little

7. The Supportive Sensory Environment What you Hear What you See What you Smell/Taste What you Feel

8. What you Hear

9. SupportsImpairs Quiet Purposeful music Familiar cues Positive human sounds Constant background noise Intrusive sounds Care noise Negative human noise

10. What we See

11. Can you See?

12. SupportsImpairs Bright light Non-Glare light Directed at work area Directed up-diffused Dim light Inconsistent light Glaring light Light in eyes

13. What can you SEE? Visual Cues Too much Too little

14. Visual Cues Where to be What to do Orienting to place Orienting to task

15. Too Much Dangerous items Clutter Too Busy Where’s the focus

16. Too Little Sterile or Cold Hidden cues Lack of contrast

17. What we Smell/Taste Affects… –Appetite –Social interactions –Quality of life

18. SupportImpair Food Calming scents Stimulating scents Waste odors Medicinal odors Cleaning odors Perfumes

19. What you FEEL Temperature Surfaces Spaces

20. Temperature Very individual Older/colder? Disease states Type of activity

21. Surfaces SupportImpair Safe and stable Right height Flexible Activity based Very mobile Dangerous to touch “Functional”

22. Spaces Familiar Friendly Functional Forgiving

23. Supportive Environment What you LIKE What you NEED Would you?

24. Can You See Why….

25. Environments Can Support Life! Use them Wisely

26. One Story… What NEEDED to change in the PHYSICAL ENVIRONMENT… 1st - the LIGHTS And the EXIT DOOR

27. How it was… the Activity Room

28. The Nurse’s Station - The FORTRESS

29. The ‘Kitchen’...

30. Why the Lights? Because the amount of light needed to see the same amount increases with age Because lack of light increases fall risk Because lack of light keeps people from using their hands Because lack of light limits oral intake Because lack of light is depressing

31. Add Lights... BETTER … but still a FORTRESS!

32. Creating People Space

33. Why the EXIT? It was either a DEAD END and people got stuck there … OR People wanted to leave with visitors People saw the door and tried to go out People followed others off the unit There was nothing else down that hall but a way out….

34. Instead … a Bookshelf

35. Then WHAT???? What else is NOT working???? What is not helping? What feels wrong?

36. What are the MAIN problems? Flooring - looks like holes Glare - from the windows Lack of definition - what’s this place for? Work surfaces - what can I do here? Furniture - Where can I visit? No conversational spaces - ‘line-up’ On the edges - not the focus of space...

37. Instead … a Fun ‘to be’ Place

38. Instead … a Meaningful Place

39. The fortress comes down...

40. Better … but a little cold looking

41. A Dining Space & Place

42. Activity Space without definition

43. Making dedicated space...

44. Look at it NOW!

45. What does it say?

46. Environment in USE!

47. The nurse’s station is in it’s place --- supporting care NOT being the center of it!

48. Not a fortress… a Place to be

49. Now for the GEMS… Diamonds Emeralds Ambers Rubies Pearls

50. teepas@posapproach.com Gems slide show