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How the right flooring can help patients living with dementia

Posted by Sandy Mc Lardy on 2018/03/13 9:24 AM
Sandy Mc Lardy

Flooring is an integral part of an interior space and can influence how patients with dementia both feel and function. Polyflor has dedicated time, effort and funds to research dementia friendly-flooring and has collaborated with global dementia organisations to determine important flooring design principles for patients living with dementia

Imagine waking up one day and discovering that your whole world is confusing, frightening and difficult to navigate. Your world feels, looks and sounds so different from what you have always known. You feel confused, afraid, angry and unsure of who you (or anyone around you) is. Watch this emotional and enlightening video to find out how dementia feels from the inside out.

This distressing disease is on the rise globally and could be more prevalent due to people living longer. As of 2013, there were an estimated 44.4 million people with dementia worldwide. This number is forecast to increase to an estimated 75.6 million in 2030, and 135.5 million in 2050. 62% of people with dementia live in developing countries, but by 2050 this is forecast to rise to 71%. According to South Africa’s 2011 census, there are approximately 2.2 million people in South Africa with some form of dementia.

Did you know that dementia can cause visual, depth and perception challenges in addition to memory loss? These visual changes together with age-related eye-sight deterioration can make discrimination of surfaces and environments frightening and confusing for patients living with dementia. Suddenly shiny surfaces can look wet, dark surfaces can look like holes, patterns can cause frightening optical illusions and spaces can appear flat or in 2D.


The healthcare sector is aware that dementia-friendly interior design can have a real impact on the health and well-being of patients.  

It is therefore incumbent upon us, as contributors to the healthcare industry, to consider, develop and design products and facilities that help aid performance of activities-of-daily-living and alleviate the distress, discomfort and confusion that people living with dementia experience daily.

As a flooring specialist, Polyflor understands the role that flooring can play in helping patients living with dementia. 

Develop one continuous flooring surface

Tonal contrast of flooring is important and is more than just the colour (hue) of the product. Ideally, the floor needs to be both seen and experienced as one continuous surface. Choosing flooring products in adjacent areas with similar tones and light reflectance values (LRV) is therefore important.

A large tonal contrast between two adjacent floor surfaces could be perceived as a step and confuse those living with dementia. Threshold strips between two floor surfaces should match the tones of both surfaces so that it doesn’t appear to be a hole or a step. Similarly, barrier matting should blend tonally with adjacent flooring.  Make sure you understand the LRV of the flooring products and specify according to this design principle.

Provide clear transition between different floor finishes

Sudden changes in flooring material type, i.e. low to high friction or soft to hard, may confuse people with dementia and may present a fall hazard. The transition between different flooring should be as smooth as possible, and pronounced changes in surface finish should be avoided. Where flooring with a raised emboss is used, ensure that its use is limited to areas where additional safety flooring is required, such as wet rooms and barefoot areas.

Careful use of tonal contrast

A large tonal contrast is required between staff only and resident areas to provide visual barriers. Similarly, the flooring can be used to highlight main features of a room by having a good tonal contrast with walls and skirting, fixed and loose furniture and sanitary ware. Tonal contrast allows patients to distinguish the floor from the other features. As a rule of thumb, the light reflectance value (LRV) should have a 30 points difference between surfaces to ensure good tonal contrast (BS 8300 S 9.1.1). Additionally, being consistent in the use of materials, finishes and colours to differentiate room and space function is an important consideration. Consistency in change is easier for patients with dementia to understand.

Accentuate colours to give depth

Using strong hues/colours will give more depth to a room than paler shades, and this can help in the perception of the size and shape of rooms and can help patients with dementia to perceive their space and find their way more easily. People with dementia can find that rooms appear two dimensional if the colours are subdued, particularly if their vision is compromised. Avoid very dark colours as these may be perceived by the person with dementia as holes to fall into, or the dark colours may trigger emotions of imprisonment.

Promote the use of a matt floor finish

A matt floor finish will reduce problems of glare and will avoid pools of reflected light from the overhead light fittings. Glossy surfaces may be perceived by a person with dementia as slippery or wet, leading to confusion and anxiety.

Avoid sensory overload and false steps

Using flooring products without too many differing colours and patterns in the design or textures on the floor is important. Similarly, avoid inlaid logos and bands, as well as strong and contrasting grout lines in the flooring finish. Flooring which contributes to sensory overload can confuse the eye and cause a person with dementia to perceive a false step, an obstacle, hole, or to see the pattern as something it is not (for example, blue swirls as a pattern in a floor may be interpreted as water). This can deter people with dementia from walking across the floor safely without getting distracted, causing disorientation and putting them off balance.

Reduce sparkle

Using flooring products without any sparkle or shimmer effect in their design is important as these may be perceived by a person with dementia as being a wet floor surface, which can affect their gait and provide a slip risk.

Blend flecks with the tone of the main floor surface

When speckles or secondary flecks are used in the floor material, avoid those with a high tonal contrast between the secondary flecks and the main floor tone. People with dementia may interpret the flecks as pieces on the floor surface and try to pick them up or step around them. Solid colour or flooring with subtle tonal secondary flecks is preferable.

Avoid unpleasant smells and odours

Consideration should be given to the fact that smells might build up through the spillage of foods/liquids and incontinence onto floor surfaces. People with dementia may have a strong emotional reaction to particular smells and odours which can lead to confusion and stress. Choosing the right flooring product along with an appropriate cleaning regime is important. Products with built-in maintenance enhancements to facilitate easier cleaning are preferable.

Reduce impact sound

The acoustics of environments used by people with dementia should strike a careful balance between ensuring that the environment is not over stimulating with unwanted noise while not being too sound absorbent which can make the space monotonous. Choosing flooring products with acoustic absorption properties can help soften hard and noisy environments and reduce impact sound levels between rooms.

See a summary of the 10 basic principles to be mindful of when specifying for those living with dementia.

Download our full dementia care flooring brochure here.  

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