Flooring is unlikely to attract the attention of visitors in care homes yet for residents, it can make a world of difference to their standard of living and how they feel in a space. Oliver explores inclusive principles for designing floors for people living with dementia.
Care home design has improved greatly in recent years, leaving behind uninspiring fabrics and clinical sheet vinyl flooring for a more contemporary and welcoming aesthetic. Specification is now geared towards creating a hospitality look and feel, providing residents with a high-quality standard of living that enables them to enjoy life and live in the moment.
Above all, residential care homes and assisted living facilities should maintain, but ideally improve, the quality of life for all residents. While this hospitality-style trend steps confidently away from the notions of institutional, sterile environments and outdated décor, the design must be inclusive and meet the needs of all residents, especially those with dementia. It’s estimated 944,000 people are living with dementia in the UK.
When specifying and designing for people with dementia, it’s important to understand the issues they face and ongoing changes, including sensory, mobility or cognitive difficulties. This can affect their function, behaviour, and independence which can make it difficult for them to navigate and understand the built environment. They may struggle with wayfinding or suffer memory failure, making them forget where they are/were going, and may experience issues with spatial and depth perception.
There are design principles that, when followed carefully, can have a positive impact on residents while also ensuring spaces conform to rules and regulations. For instance, The BS 8300 standard provides a ‘code of practice’ for design to make buildings more inclusive, while the British Standards Institution (BSI) developed PAS 6463 to assist in designing for people with neurodiverse conditions. The guidance can help organisations meet legal and social obligations, including under the Equality Act and the Autism Act, and dementia-friendly charters, such as the one recently introduced by Greater London and Article 9 in the UN Convention on the Rights of Persons with Disabilities.
The Dementia Services Development Centre (DSDC) says flooring is an essential part of a dementia-inclusive environment and is one of the most important elements to get right. Understanding the different types of dementia, the age-related impairments and the symptoms enables specifiers and installers to make better flooring choices, which will help the people who use the floors in these spaces. Luxury vinyl tiles are ideal for creating dementia- and neurodiverse-friendly environments, when adhering to the best practice guidelines:
Tone
Tone is the relative lightness or darkness of a colour. Removing the hue from colours leaves a tone which is essential to determine the degree of contrast between objects or elements in a space. There should be tonal continuity on level flooring. In other words, the floor should be viewed as one continuous surface, as a tonal contrast could be interpreted as a ‘step’ by someone living with dementia, causing them to hesitate or potentially tumble trying to go up the step. As such, contrasting tones should be used where levels change to help people see one object against another, such as a step or stairs with contrasting nosing on the stair edge of the tread, or between critical surfaces, such as flooring with floors, furniture or even a toilet seat. Tone can be measured using Light Reflectance Values (LRV).
Light Reflectance Values
Another key design factor is LRV – ‘a measure of the percentage of visible and useable light that’s reflected from a surface when illuminated by a light source’. While a designer’s first considerations will include colour, pattern and texture, they’ll need to check LRV to comply with Part M of the building regulations (access to and use of buildings), which details the requirements for disabled people in buildings. Like the BSI’s BS 8300 standard, aspects of Part M are also relevant to neurodiverse building users. Under Part M, a minimum of 30 points of LRV is accepted as providing visual separation by contrast, so the more choice a designer has in terms of product, the better. LVT has so many colours and finishes that this isn’t a problem, it also requires fewer light fittings in a space than a carpeted floor, which has a lack of reflectance.
Colour and pattern
It’s recommended to avoid flecked, striped or patterned effects for flooring. For instance, directional patterns can be visually overstimulating or confusing for people with dementia who may struggle with wayfinding, while knot details in wood planks can be misinterpreted as faces or holes. Patterns should be kept simple, subtle and discreet. Instead, use colours or high contrast to help draw attention to key elements of a space.
Colour can also be used to provoke cognitive and emotional reactions from residents; however, overstimulation can have a negative effect on their behaviour and wellbeing. For example, blue can be calming and is seen as the colour of authority and yellow encourages positive thinking and makes people feel energised. On the other hand, red is a stimulator that can increase heart rate, brain wave activity and respiration, but it can also make people feel agitated if in view for too long.
Trip hazards
When dealing with floor junctions, there are several options available to join adjacent surfaces together smoothly. Installers need to ensure any subfloor is level, or that tapered trims or joining strips are used between surfaces to eliminate the risk of people tripping. Transitional ‘threshold’ strips between any two floors should match the tones of both surfaces, while any barrier matting should blend in tonally. Ideally, there should be no more than three degrees of difference in LRV between flooring and transition strips.
There are many aspects to flooring in dementia-friendly care environments – from the choice of material to the design. At Amtico, we recommend working with our Commercial Project Specialists to discuss flooring requirements and keep up-to-date with the latest information via CPD seminars. They’ll be able to advise on best practices, such as using natural-looking timbers without knots or details that could be seen as holes and cracks, as well as tonal contrast where floor levels change or solutions for acoustic comfort.
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Oliver Roberts is healthcare specialist at Amtico
