Making therapeutic kitchens more like home aids Alzheimer's patients

November 14, 2002

GAINESVILLE, Fla. --- A well-designed kitchen may be the key to entertaining party guests, but a University of Florida researcher has found it's even more important for another group of people: those with Alzheimer's disease and other forms of dementia.

In nursing homes and assisted-living facilities, where institutional kitchen décor is the norm, simple touches such as installing side-by-side refrigerators and adding real houseplants create a homey ambience that puts residents at ease, said John Marsden, an assistant professor in the UF College of Design, Construction and Planning. Mardsen's study was published in the summer issue of the Activities Directors Quarterly for Alzheimer's and Other Dementia Patients.

The right design also gives those residents a comfortable - and safe - place to sharpen their mental abilities.

"There's been a lot of talk and emphasis on domestic or therapeutic kitchens," Marsden said. "The purpose of this research was to gain an understanding of physical features that typically comprise therapeutic kitchen design, and to explore how these features support activities programming and food-service systems in assisted-living and nursing-home facilities," said Marsden, who is affiliated with UF's Institute on Aging and has co-authored two books dealing with making dementia-care facilities more like home and supportive of residents.

Nursing homes and assisted-living facilities, where half of residents are estimated to have some form of dementia, often provide kitchen-based activities to aid social interaction and keep residents involved in meaningful tasks. The kitchens in such facilities, however, may lack the physical features and familiarity necessary to provide therapeutic benefits.

People with dementia experience problems with memory, reasoning or judgment, disorientation, loss of language skills and a decline in the ability to perform routine tasks. They also may undergo changes in their personalities and behavioral problems, such as agitation, anxiety, delusions and hallucinations, according to the Alzheimer's Association.

Research has shown it is important to keep patients with memory loss-related diseases active. In the early to middle stages of Alzheimer's disease, patients may become very passive, sitting in of the television for hours, sleeping more than usual or not wanting to do usual activities. Kitchen activities have been used by assisted-living and nursing-home facilities to aid in activities programming and facilitate resident interaction, Marsden said.

Lynda Everitt, director of the North Central Florida Alzheimer's office, said one of the first signs of dementia is forgetting how to do routine tasks such as cooking and dressing.

"The more a person can be in a familiar place, the calmer they are and the better the quality of life they will have," Everitt said. For their study, Marsden and his colleagues conducted site visits to four nursing homes and assisted-living facilities in Ohio, where they interviewed staff and created a checklist of physical features in the kitchens being used by residents. Marsden's study, funded by the Extendicare Foundation, was conducted in conjunction with Rebecca Meehan with the Myers Research Institution and Margaret Calkins of I.D.E.A.S. Inc.

Using the information gathered, they developed a two-page questionnaire asking the types of activities and kitchen design features that should be incorporated to support popular activities. The survey was sent to 631 nursing homes and assisted-living centers nationwide.

Based on the 116 responses they received, the researchers developed a series of recommendations for making kitchens in these facilities a more comfortable and reassuring homey environment, such as using standard-size appliances instead of large, bulky commercial equipment; growing real plants and flowers instead of using silk substitutes; and incorporating wood cabinets and tables and other natural materials.

Although the study focused on nursing homes and assisted-living facilities, some of the design and safety recommendations also can be applied in kitchens in single-family homes, Marsden said. Installing automatic turn-off switches for stoves, placing sharp or other dangerous utensils in high cabinets and installing faucet scald guards for controlled water temperature are all features that can be used in both private houses and nursing homes to aid those with memory-loss illnesses, he said.

The researchers also found it is important to keep kitchens accessible by varying counter heights to accommodate shorter residents, those in wheelchairs and those who must be seated to take part in group activities. Side-by-side refrigerators/freezers also are easier for shorter residents to access.

Marsden said architects do not always investigate user needs before designing a building and instead may make decisions based primarily on intuition.

"I cannot help but wonder how architects in their 20s, 30s or 40s can effectively design for people in their 80s without some kind of knowledge base," he said.

University of Florida

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