People with Dementia are particularly affected by Acoustic Environments. Overexposure to non regulated noise can cause confusion, illusions, frustration, and agitation. In this blog, we’re going to explore the world of noise and how it affects those with dementia. We’re also going to show you how not designing for Acoustics can contribute to increased levels of agitation and aggression among residents who have dementia.
What is Dementia?
Dementia is not a single disease. It is a term used to describe a syndrome associated with more than 100 different diseases that are characterized by the impairment of brain functions, including language, memory, perception, personality and cognitive skills. Vascular Dementia which occurs after a stroke is the second most common type of dementia. 10 common signs are:
- Ability to focus and pay attention
- Reasoning and Judgment
- Visual perception
Did you know that Dementia affects young people as well? Dementia is not just a disease of old age. Younger-onset (also known as early-onset) Alzheimer’s affects people younger than age 65. Up to 5 percent of more than 5 million Americans with Alzheimer’s have younger-onset. Source: ALZ.ORG
The Impact of Noise
The ability to have a normal conversation typically isn’t a problem. However, high-frequency pitches become less audible along with sensitivity to lower frequency sound around the age of 40. This means a lesser chance of comprehension due to background noise. Most older people learn to compensate by reading lips and increased attention to what they can hear. This can pose a problem with someone suffering from dementia.
The physical and mental effect
Did you know that being surrounded by an unidentified noise makes a person suffering from dementia feel like their living in cacophony all the time? Unidentifiable noise makes a person with dementia feel even more disconnected from their environment. See the Experience for yourself: https://www.secondwind.org/virtual-dementia-tourreg.html
Hearing, out of all of the senses is the one that has the greatest impact on people with dementia when it comes to their quality of life. With hearing being linked to balance, the risk of falls is even greater due to increase disorientation as a result of those diagnosed with dementia trying to orientate themselves in an overstimulated environment. Having high noise levels can lead to anxiety due to stress. Including but not limited to:
- Increased heart rate
- High Blood Pressure
It has been demonstrated that noise can also impair immune function. See the conclusion of Immune Alterations Induced by Chronic Noise from
Adopting EAT ( Environmental Audit Tool) and the 10 Design Principals
A tool selected to compare with TESS-NH was the most recent version of the Environmental Audit Tool (EAT) developed in an NSW Department of Health project on adapting wards in small, regional hospitals for long-term use by people with dementia. The EAT comprises 72 items that have been selected to exemplify a set of design principles first used in the development of the units for the confused and disturbed elderly (CADE) built by the NSW Department of Health in the late 1980’s and early 1990’s. Source: https://www.worldhealthdesign.com/Dementia-Care-Determining-an-environmental-audit- tool.aspx According to the EAT tool, the 10 Principals state that the environment should:
- Be Safe
- Be Small
- Be simple with good visual access
- Have unnecessary stimulation reduced
- Have helpful stimuli highlighted
- Provide for planned wandering
- Be familiar
- Provide opportunities for a range of social interactions from private to communal
- Encourage links with the community
- Be domestic in nature, providing opportunities for engagement in the ordinary tasks of daily living.
Controlling Airborne and Structure Borne Noise
Things like persistent intermittent noise (tap dripping) can trigger unpleasant memories, increase agitation and cause annoyance. There are sources that can potentially generate unwanted noise that should be considered during the planning and design stage. For example:
External: Road Traffic, Rail Traffic, Leaf Blowers, Unamplified Entertainment, Dogs Barking and Service Areas
Mechanical: Air Conditioners, Pumps, Air Compressors, Hydraulic Pipework, and Lifts.
Safety Systems: Medical Emergency Alarms. Wander -Guard Systems, Trolley Wheels, Dish Washing Machines, Photocopiers and Vacuum Cleaners.
Controlling Reverberation is important to ensure speech intelligibility is achieved, increase privacy and reduce agitation and confusion.
Recommended Reverberation Times for Different Spaces
Sleeping Areas : 0.5
Common Areas: < 1.0
Staff work areas: 0.6 to 0.8
Corridors and lobbies: 0.6 to 0.8
Recommended Design Sound Level ( DBA)
Sleeping Areas: 35
Common Areas: 40
Toilets and Bathrooms: 45
Kitchen and service areas: 45
Staff work areas: 40
Corridors and lobbies: 40
Bedrooms should not open directly onto common areas such as the dining room, activity areas or large social spaces. Generally, the residents will be older and unable to open and close heavy acoustic doors fitted with acoustic seals. Tile flooring should not be used as residents can slip and fall and it increases noise should something fall on the floor. Timber or our floor mats can be used to reduce noise transmission and decrease the risk of a fall for staff and residents.
Did you know that textured floors can also assist with planned wondering? Acoustic Panels and Floors can be designed in bright colors and textures to assist with people diagnosed with Dementia to make a less confusing environment.
Having an acoustically absorbent ceiling recommended along with soft furnishings such as curtains and upholstered furniture can also control Reverberation. Keep in mind your HVAC equipment and ductwork and the recommended design sound levels mentioned above. Bigger isn’t always better. Smaller rooms can assist with lowering reverberation. Remember, most of your residents will have hearing aids. So increased television noise is a common occurrence.
Dementia Care Facilities typically have two types of kitchens, domestic style, and commercial style. Commercial style tends to be the loudest. You can reduce this with a Slip Resistant Rubberized flooring instead of tiles, and acoustic absorbent ceiling tiles. Incorporate acoustic attenuation into the exhaust systems and purchasing low noise equipment like the dishwasher and blenders.
This paper was created to assist you with Acoustic Design for those diagnosed with Dementia. If you have any questions, please feel free to give us a call on how we can assist you with your design and prototype needs.