Caregivers, Let's Design a Richer Environment For and With Care Receivers

Post #28

The sheltering in place required during the pandemic has made many people more empathetic to those who are “shut in” day after day because of health reasons. If you have a place to call home that you enjoy, then it is probably much easier to be content within the four walls where you live.* Many people I know have taken a good look around at the house they spend almost every hour of their life in now and have realized that they want to change a few things. Some have been redecorating, others planting more flowers, and almost everyone reorganizing for appearance and convenience. For most people sheltering in place will end, and they will again spend much of their time away from home. However this is not true for many people who have disabilities or health conditions that prevent them from leaving—either because of their vulnerabilities to Covid19 or due to experiencing other health issues that have made it difficult for them to get out much— even before this new coronavirus.

I’ve visited a number of nursing homes, memory care units, and other health facilities, as well as the homes of individuals, where the environment felt as dreary as a week of nonstop rain. I admit that I may be more sensitive than many people, but I always come away from these places thinking if only someone would take the time to spruce the place up, it would surely help both care receivers and caregivers feel less stressed . . . more cheerful . . . refreshingly energized.

Before sheltering in place took effect, my husband participated in a house cleaning/organizing/refurnishing project for a disabled veteran who had lost much of his mobility and wasn’t able to pick up after himself or to move around the house much. The whole environment was unhealthy and unsustainable. He needed friends to come in and scrub all surfaces, wash mountains of clothes, and rearrange/refurnish the house so that he could move around easily to take care of himself. His friends managed to accomplish this while he was in the hospital having an amputation, so he came home to a welcome surprise—which no doubt helped his mood while adjusting to a missing limb. In this case it wasn’t decoration the man needed to live a happy, healthier life, but a practical and clean environment. In addition, he continues to need friends to drop in and help with the upkeep of his environment.

A person’s environment does not have to be dirty or impractical to need a redesign. If a care receiver has been living in the same place for over a year, they will often benefit from a change of scenery. Another reason to redecorate the environment is when a care receiver is moved to a new home. Adjustment is usually quite difficult in any case, but being surrounded by colors and items they enjoy, especially those that connect them to well loved memories, will usually bring some sense of being at home.

Counting the time Mom moved into my home the first time, I decorated 6 different rooms for her to live in. I felt that using colors she loved, as well as including personal items and family photos would help her to be more content. I knew from experience that mom hated what she considered “ugly” things, and that she had grown to dislike dark and drab colors. I paid attention to the colors and other items that she reacted to positively, even if I felt they were more like the choices of a child. (She had Alzheimer’s so her brain was remembering enjoyable things from childhood.) Unfortunately, there was no time to paint the first room; fortunately, it was white, making it easy to add color. So I took her shopping and we chose a set of twin bed comforters—paisleys of purple, pink, and turquoise—her favorite colors. These comforters remained a part of the decor of each of the six rooms she lived in from 2012-2016, providing a continuity in her environment.

Another staple in the plan I used for Mom’s decor when she lived away from us was a card table where she could work puzzles, color, and play games. It was useful when she was alone or if she had a visitor. Along with the card table a bookshelf was important —its shelves contained a few books and games, but mostly photos, memorabilia, and small stuffed animals. Of course these were very specific to what brought Mom joy-- and each care receiver's room would be different. We had a friend whose room always reflected her love of carousels. My uncle’s room held paintings that my aunt had painted . . . It is important to know the person’s past life, along with their present likes and dislikes, in order to create an enjoyable environment.

Our experience trying Mom in an unlocked assisted living facility required that we fill a little more space than a normal sized bedroom. So we took mom shopping for a small couch. We had discovered previously, when we purchased her mattress, that she didn’t like people spending large sums of money on her--she would get very upset and try to leave. . . Yet we needed to see if her short legs would be comfortable on the couch, and to know if it was appealing to her. So we went to a large warehouse where there would be plenty of choices and pretended to be shopping for ourselves. Fortunately, we found a small white couch that would wipe off easily and that Mom enjoyed sitting on. Then I distracted Mom while my husband made the purchase. (There are a lot of things you learn to do differently when the care receiver has dementia.)

In the assisted living facility, Mom would have more alone time. I wanted her to really love being in her room so that she wouldn’t be worried about “going home.” So I requested to have the rooms painted bright turquoise—Mom’s favorite color. She did love the color and loved being with me as I spent the first week with her, but unfortunately even her favorite color didn’t prevent her from trying to leave the facility when I went home. I had gone to a lot of effort and extra expense, and in the long run she was only there about three weeks because of safety issues. Proof that there is only so much a good design can do.

After this experience, I found another memory care facility for Mom—one in which painting the walls was not an option. They didn’t even allow hanging pictures. However, they did encourage me to use clinging wall-decals. I hadn’t heard of these before, but was quite impressed when I found many varieties on Amazon. This turned out to be a wonderful option, both cost effective and an activity that Mom could participate in. The decals can also be removed and used again—except for the large butterfly, which didn’t store well because of its size.

Another discovery I made that was very helpful with designing Mom’s rooms is that by using an app (on tablet or computer) I could rearrange the furniture several times to decide on the design before we arrived on the scene. Of course I had to visit first and measure the walls and any existing furniture, as well as measuring the furniture I was bringing. By doing all this preliminary planning, I saved the backs and attitudes of my moving helpers. Because of Mom’s high anxiety level, she never participated in the moving stage, but she reaped the benefits of a good plan. The app I use is “Roomplanner,” but there are others available.

I’ve shared a few examples of the way the environment can be improved to benefit the care receiver, especially one who spends most of their time at home. I recommend that the care receiver be involved as much as possible, according to their physical and/or mental capabilities. In fact, some individuals may love the redesigning/redecorating process so much that they want to change things frequently. If this becomes a problem, you might find ways that they can use their newly discovered love of design that don’t require big changes:

• A small space can be rearranged, such as a table or shelf. Perhaps a placemat or small table cloth can be changed frequently and items of their choosing be placed in a pleasing pattern.

• The clinging wall-decals I mentioned can be easily rearranged or placed on a different wall.

• Design coloring books

• Drawing designs--by hand or tablet

• Design apps —this will depend on the person’s ability, but there are free apps available for a variety of developmental stages. My favorites are Redecor and Design Home. (Be aware of app purchases, and if necessary, block.)

• Various types of crafts require creating a design

Of course what I’ve been describing is mainly for people who are staying in one place under your care for a length of time. However, I think that environment design is important for everyone. Those who are in a private home (i.e.temporary foster care) or facility (i. e., short term rehab) for a limited time will feel more comfortable if you have planned ahead with decor that appeals to the person’s age group or culture. It would probably be helpful to research color and consider the placement and type of furniture and lighting that are both comfortable and relaxing. If these things are not in your power, perhaps you can purchase sheets, comforters, and curtains that will make your care receivers feel at home. Prints and paintings can do wonders even when other types of decorating isn't possible.

Providing a personalized environmental design can create a new attitude within the care receiver and within yourself. You are not only changing the environment, but also deepening the relationship between yourself and the care receiver(s) by showing that you are aware of their personal needs—physical, emotional, and aesthetic.

*Note from first paragraph: I realize that personality plays into ta person’s contentment while sheltering in place as well, but I don’t have any suggestions as to how we can change extroverts into introverts, nor would I want people to lose their natural outgoing trait.)