Designing a “therapeutic home” can help preserve loss of self for people who are living with dementia in the community, a conference has heard.
Researcher Christine While, a former community nurse from La Trobe University, says making a home dementia-friendly involves more than just changing its physical design.
She says many older people have a strong emotional bond with their home. This bond is closely connected to their identity and selfhood, which can be eroded by a dementia diagnosis.
A therapeutic home can support this emotional bond through a range of modifications and strategies, such as establishing “favourite places”, integrating memories and supporting activities that were previously done around the home, such as household tasks and hobbies.
Strategies and modifications
While surveyed 11 people with dementia who were receiving home-based community services in Victoria, and 18 family members, between 2014-2017 to investigate changes people made to their homes following a dementia diagnosis.
She presented the findings at the AAG conference in Melbourne on Thursday, saying the meaning of “home” for of both people with dementia and family carers changed with a diagnosis.
For example, a home may no longer be fit for purpose, maintenance becomes more demanding and more than half of the family carers felt trapped in the home by their responsibilities.
The presence of aids and adaptations signalled disability, further threatening sense of self.
“The purpose of the home changed from supporting family life to supporting life with dementia,” she said.
The “keeper of memories”
But once the changes to home life had been acknowledged, participants undertook a process where they re-evaluated the situation and set about making changes, While found.
“There was a theme that I called the therapeutic home,” While said, where participants identified aspects within the home environment which could support the goal of remaining at home as long as possible.
One of the main aspects of as therapeutic home was around maintaining familiarity and independence.
“Emotional bonds in the home were strengthened to support the person with dementia’s sense of self as the dementia progressed,” she said.
Key elements included creation of “favourite places” linked to a hobby such as knitting and using notice boards to make it easier to achieve day-to-day tasks, thus re-establishing a person’s role within the house.
Family supporters described themselves as “the keepers of memories,” ensuring the person with dementia was surrounded objects that connected them to their personal history.
While found efforts to control the home space produced largely positive outcomes for most of the people she surveyed.
“(This) was achieved by identifying threats to the meaning of home caused by dementia and looking at ways of negating those threats,” she said.
Creating a therapeutic home
- Renovations and adaptations to increase independence
- Declutter and simplify to make the house easier and safer to live in
- Simplify the garden by removing hanging baskets and high maintenance plants
- Maintain familiarity and comfort through “favourite spaces” linked to a hobby
- Re-establish and strengthen roles and activities around the home
- Ensure a connection with personal history through presence of meaningful objects
- Devise systems to make day-to-day tasks easier to achieve, such as a noticeboard