Is the use of murals in a care home a positive thing? “If you follow certain guidelines, they can have a number of positive benefits for residents, staff and visitors,” says Karen Clayton, dementia environment specialist, Find Memory Care
According to research carried out by the Dementia Services Development Centre (DSDC), a good dementia-friendly environment can help to reduce falls by 70 per cent, agitation by 60 per cent and incontinence by 50 per cent. The tools used to achieve such improvements include dementia-friendly signage, orientation aids, clocks, good quality flooring, and the use of colour contrast (in particular in toilet areas) and high levels of lighting. Case studies have also shown that when murals are used correctly they can bring about a number of positive changes.
Appropriately positioned murals offer residents choices about where to go and what to do and can encourage social interaction and engagement with their surroundings as well as providing appropriate levels of stimulation. There is a list of additional health and wellbeing benefits too, which includes increased levels of exercise and in turn, increased levels of nutrition and hydration. Unfortunately, there are also many examples of their use resulting in an increase in agitation and confusion, which has a negative impact on the quality of life and wellbeing and potentially increases the risk of falls. For example, a mural on a wall showing tables and chairs in a café could cause frustration if someone wanted to sit down, not to mention being painful if they tried to pull out a chair or sit down. If a mural includes a carpeted floor that goes up the wall, how would someone who is already disoriented and might have a sight impairment know where it is safe to walk? This could lead to unnecessary confusion and distress and yet again increase the risk of falls.
Similarly, if you walked down a corridor that apparently leads to a pub, how would you feel if there was nothing there, not even a bar serving drinks? How confusing and frustrating all these situations could be and how easily a person’s reactions could be misunderstood as behavioural changes due to the progression of their condition. There is still evidence that too often residents are given antipsychotic drugs to manage behaviours when actually it is the environment that has caused a reaction. It is safe to say that poor quality design and the inappropriate use of murals can have an adverse effect on a person living with dementia, so care is certainly needed to ensure the right products are chosen. Developing the concept So, why use murals in a care home? It’s not just about making a room or a corridor look pretty, although of course, this gives a great impression to visitors.
Murals should add something positive to the environment, have a purpose and bring measurable benefits. Care homes should be designed to be safe and secure environments for people living with dementia. However, they should also be enabling and promote independence, confidence and dignity.
A good environment will encourage exercise and social interaction and should offer a range of opportunities and choices that prior to care home life would have been taken for granted. Regardless of a person’s condition, it is their right to live a good quality of life, which includes wherever possible making their own choices and decisions. Therefore, care homeowners should consider how best to make this possible.
A mural should be used as a destination point – somewhere a person can go and enjoy an experience. They are a way of offering choice, keeping minds active, adding appropriate levels of stimulation and quite simply giving individual’s options and the opportunity to engage in ways previously unavailable. However, the mural itself is only one of the tools that should be used and it is just as important that the right furniture and accessories are also provided.
A prime example would be a coffee shop. The mural gives residents a strong clue about the purpose of the destination, but there must at least be tables and chairs set out with food and drink available. A post office without a post box would make no sense, but makes a great setting in which to write cards and letters and then of course to post them. Activity coordinators can use this area as the main focus for activities. People who are given choices can be more independent. They have a sense of purpose – something we all need – and experience a sense of achievement when arriving at their destination without support. The increased levels of exercise can bring a range of benefits too, including improved strength and stamina, increased appetite and better sleep patterns.