Wayfinding for People with Dementia: A Review of the Role of Architectural Design

By Marquardt, Gesine | HERD : Health Environments Research & Design Journal, Winter 2011 | Go to article overview
Save to active project

Wayfinding for People with Dementia: A Review of the Role of Architectural Design


Marquardt, Gesine, HERD : Health Environments Research & Design Journal


Abstract

Objective: This paper provides an overview of the available literature on architectural wayfinding design for people with dementia in nursing homes. The results were to be summarized and substantiated through an interdisciplinary interpretation, taking into account changes in the orientation process of people with dementia.

Background: Spatial disorientation and declining wayfinding abilities are among the early symptoms of dementia, limiting a person's ability to perform activities of daily living (ADLs) independently and ultimately, perhaps leading to institutionalization. A prerequisite to maintaining residents' quality of life in a nursing home is their ability to orient themselves within their new environment.

Approach: The available literature on wayfinding design for people with dementia in nursing homes was reviewed. Two aspects of interventions for residents' wayfinding abilities were identified: the design of the floor plan typology and environmental cues.

Results: The design of the physical environment plays a major role in supporting the wayfinding abilities of people with dementia. The floor plan design of a nursing home in particular has a significant influence on residents' spatial orientation and wayfinding. Additional interventions such as signage, furnishing, lighting, and colors are additional supporting features but they cannot compensate for an adverse architectural design.

Conclusions: For the creation of a supportive, dementiafriendly environment, both aspects of architectural design must be considered. Design guidelines to support the wayfinding abilities of people with dementia were developed to synthesize both.

Key Words: Dementia, wayfinding, orientation, architecture, nursing home

Introduction

Finding one's way is an essential ability and a prerequisite for autonomy and independence, thereby promoting self-sufficiency and self-esteem. However, spatial disorientation and declining wayfinding abilities are among the frequently mentioned early symptoms of dementia. In 2002, the prevalence of dementia among individuals aged 71 and older was 13.9% and comprised 3.4 million individuals in the United States (Plassmann et al., 2007). The prevalence increases dramatically with age: approximately 5% to 8% of individuals over the age of 65, 15% to 20% of individuals over the age of 75, and 25% to 50% of individuals over the age of 85 years are affected (Kawas & Katzman, 1999).

By definition of the American Psychiatric Association (APA, 2007), the essential features of a dementia are multiple acquired cognitive deficits that usually include memory impairment and at least one of the following phenomena in the absence of a delirium that might explain the deficit: aphasia (inability to speak), apraxia (disorder of motor planning), agnosia (inability to recognize objects, shapes, persons, etc.), or a disturbance in executive functioning (the ability to think abstractly and to plan, initiate, sequence, monitor, and stop complex behavior). Dementia of the Alzheimer's type, commonly referred to as Alzheimer's disease, is the most common dementia, accounting for 50% to 75% of the total number of cases, the percentage increasing with age (APA, 2007).

The reason for spatial disorientation in dementia might be found in memory deficits (Monacelli, Cushman, Kavcic, & Duffy, 2003), visuospatial deficits (Liu, Gauthier, & Gauthier, 1991), and dementia-specific changes in orientation strategies and in the loss of planning abilities (Passini, Rainville, Marchand, & Joanette, 1998). Getting lost in unfamiliar locations is already mentioned at Stage 3 of the Global Deterioration Scale (GDS) (Reisberg, Ferris, de Leon, & Crook, 1982). The GDS is a seven-stage rating scale used to assess whether a person has cognitive impairments that are related to dementia. It ranges from no cognitive decline (Stage 1) to severe dementia (Stage 7).

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

Wayfinding for People with Dementia: A Review of the Role of Architectural Design
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?