When color, pattern and texture are used effectively, the spaces we design can stimulate and reassure people with dementia and create an atmosphere of warmth and comfort.

Most older people experience visual and auditory problems, and these problems are compounded when a person suffers from dementia. Balance and mobility can be severely impacted by patterns and textures. Some people will experience disorientation and vertigo in response to large, bold, geometric patterns. Sharp jutting patterns, stripes, and intertwining patterns can cause uneasiness. Undulating patterns can cause nausea. But the skilled use of pattern and texture creates a more stimulating environment. Patterned wallcovering adds warmth and contributes to a homelike atmosphere, but it’s important to be mindful of the pattern and colors used. Simple patterns are safer choices.

People with dementia have difficulty with spatial relationships which can impact their balance and lead to falls. Sharp contrast in color, such as the border design of carpet or the pattern of floor tiles may be misperceived as a step, a trench, or change in floor elevation. Large geometric or floral patterns in carpet and other floor covering can be equally confusing.

Texture stimulates thinking and responsiveness and can help recall memories. Quilts and soft surface wall hangings can provide opportunities for activity and touching. Pillows of various shapes and sizes in multiple colors and textures can provide something to hold or touch. Upholstery and drapery, bedspreads, and other touchable wall hangings, and pillows improve acoustical conditions as well as providing clues and cues for orientation.

Decreases in depth perception and color differentiation are common in normal aging. Visual memory is also reduced. Older people perceive colors and color combinations differently from younger people. Elderly people are best able to discriminate highly saturated colors at the warm end of the spectrum, and colors with a high degree of brightness, such as yellow, are particularly visible. Pastel tones, especially on the cool end of the spectrum are less easy to see. Pastel blues, lavenders, and pinks may appear very similar, and can appear as gray to many individuals over 70.

Color creates interest and variety which are needed to counteract sensory deprivation. A predominance of white walls is sterile and can create lethargy and deteriorating vision and ability to focus. Monotonous sensory environments cause impairment of color perception, hallucinations, and distortion of images.

For most elderly people, the colors and patterns they seem to enjoy and are more comfortable with come from the period when they were in their 40’s and 50’s when they were both financially and physically comfortable, so the colors that were popular around the 1980’s for most elderly people with dementia. People with dementia find it difficult to process a large number of stimuli at one time, so using too many colors in one setting can be disorienting.

Color greatly enhances ambience, but for the aging population, contrast takes on even more importance than color alone. Nothing is more effective at enhancing older people’s visual function than high contrast. Light entryways and dark door jams, for example, help people differential between the door and its frame. Light walls and darker floors, or lighter floor and dark furniture are also helpful. Tabletops and countertops should stand out strongly from floors. An edge band of contrasting color on a raised surface can help people see it more easily. A countertop that is a contrasting color from a sink helps the sink stand out better. A colored wall provides visual contrast with a white toilet, making it easier to see, and more likely to be used. Color can help in wayfinding. Staff should use color by name, referring to the “blue hall” or the color of the resident’s door.

Designers should avoid using pastel colors altogether and avoid placing white or gray against any color of similar lightness. Good color choices for contrast are: Dark colors against white, light yellow against dark blue, and dark red against light green. Poor contrasting color choices are: Dark green against dark red, yellow against white, blue against green, and lavender against pink.

Most people with dementia will eventually lose their ability to recognize colors, so color should be used only in connection with other cues such as large-scale doors and door frames. Color alone has less impact for people with dementia than other factors such as lighting, acoustics, shapes, smells, air currents or seating arrangements. Rooms with a view of green leafy trees speeds up recovery and reduces the need for pain medication. People respond very positively to nature. Smells travel to our brain faster than sight or sound. There is a strong association between smell and emotion, because the olfactory system is directly connected to the part of the brain associated with emotion and memory processing. Pleasant aromas are soothing. Aromatherapy can be used to increase alertness, decrease aggression, and stimulate the body’s natural defenses against disease.

To live in a static environment is unnatural. Where there’s no change in a space, sensory deprivation occurs, the ability to concentrate deteriorates.