he largest growing segment of the population in the United States is the over-65 generation. Elder care is a huge segment of the healthcare economy and is growing everyday with the graying of America. Nursing homes and senior living facilities with continuum of care design account for a large portion of construction today..
The elderly are among the most vulnerable and least able to deal with environmental stressors. Many of them are living in environments not of their own choosing. The physical, emotional and psychological obstacles of growing older frustrate and challenge them in all aspects of daily life. All of these things impact the choice of art that can be used successfully in facilities for seniors.
For example, many older adults have vision problems. Vision may be blurred as a result of cataracts or of a stroke, so abstract and impressionistic images can be difficult for these viewers to see. In addition to being difficult to focus on, patterns that are too busy or that have a kinetic quality can over-stimulate the elderly viewer.
The ability to see color diminishes with age. With a condition called lens sclerosis, the lens of the eye changes color from clear to a yellowish brown, thus affecting color perception. Since we use only 2% of our vision to see blue and green, even a small reduction in clarity dramatically affects the ability to see them.
The ability to see red, yellow and orange is affected much less by lens sclerosis. So, a picture with high contrast colors – yellows, reds, whites, oranges – is much easier to see than one with subdued blues and greens.
Nursing home patients benefit when appropriate stimulation is added to their environment. Art is an excellent way of lessening sensory deprivation experienced by older patients in a custodial setting. Several studies have suggested that images that represent everyday life are more preferred over landscapes – for example, pictures of friendly animals and people, especially children, images of home and familiar objects, things that are reminiscent of “their time, the old days.” These are the type of images that hold significant meaning for older adults. The thing that all of these images have in common is that there is evidence of life in them.
When designing residential projects for elderly patients, use a variety of art images throughout the facility instead of repeating only a few as in hotel design. This approach fosters a more homelike environment that deinstitutionalizes the setting and promotes the worth of the individual resident. It also helps with wayfinding when a patient can associate a certain piece of artwork near his room. Bedrooms that are cookie-cutter identical down to the artwork under-stimulate and reinforce the utter lack of Independence these frail individuals have in the real world.
Even cognitively impaired patients, such as those with Alzheimer’s and dementia, respond to images that stir a spark of remembrance. An image of young children could bring to the surface deeply embedded memories of the patient’s own childhood or of his children when they were young. And while it is not fine art per se, a framed picture of the patient at a younger age placed next to his room door is a common wayfinding tool used with dementia and Alzheimer patients.
There are some practical considerations for framing and mounting art for the elderly that need to be understood. Older adults are troubled by glare much more so than younger people. While using non-glare glazing for art may diminish the color of the art somewhat, it will eliminate the bigger problem of glare. Compensate for the color loss by using images that are a little more colorful than you would normally chose. This is particularly important for artwork that is placed at the foot of an elderly person’s bed or opposite a chair where he might spend long periods of time sitting.
Shatter-proof or non-breakable glazing such as Plexiglas and Lexan is advisable for spaces being used by geriatric patients and residents. The elderly are more susceptible to falls, increasing the probability of glass on artwork being broken accidentally and someone being injured. Patients with dementia may become violent as their illness progresses with the passage of time. Non-breakable glazing, coupled with four-point locking security hardware, will protect the patient from harming himself or someone near him.
Even the placement of art in elder care environments differs from that of the typical hospital setting. A good rule of thumb is to hang art at 60 – 62″ on center in an acute care setting. However, in facilities for aide adults, artwork should be lowered to 58″ on center to accommodate residents in wheelchairs or whose up gaze has been restricted by shrinking stature or range-of-motion problems.