— Two weeks ago, Mary McCreesh got the kind of news
that makes your heart sink: Her 82-year-old father was
officially diagnosed with Alzheimer’s.
McCreesh, of Wayne, Pa., spent that Friday afternoon at,
of all places, the Philadelphia Home Show. She figured
she can’t change her father’s diagnosis, but she can
make it easier for him to stay at home, in the house
McCreesh grew up in.
can see the house through his eyes and find ways to make
it easier for him, not knowing what’s ahead."
was there for a presentation by Theresa Clement, an
Ambler designer and aging-in-place specialist whose own
father succumbed to Alzheimer’s disease in September.
Clement learned along the way that her line of work was
surprisingly relevant to managing certain symptoms of
I had known at the start what I know now, my dad would
have been able to live at home with my mom a year or so
longer than he did," Clement said. So, consulting
with experts including Dylan Wint, a neurologist and
psychiatrist at the Cleveland Clinic, she’s developed
what she calls Design Prescription.
giving people some simple things that are inexpensive to
do that can save so much stress, so much time, and make
you be able to enjoy your loved ones even as they start
to fade away," she said. "If you’re living
with someone with Alzheimer’s, you don’t have time
to read all the scholarly research to say, for example,
‘What can I do to stop my loved one from peeing in the
trash can?’ So I try to distill it down."
in three senior citizens dies with dementia, according
to the Alzheimer’s Association.
it doesn’t affect just memory. Many people with the
disease also have challenges perceiving colors,
contrasts, and depth, and organizing visual information.
brain takes things the eye sees and executes a
wonderfully complicated task of telling us how far one
thing is from another and knowing where one thing ends
and another begins," said Jason Karlawish, a
professor, physician, and associate director of the Penn
Memory Center. "As Alzheimer’s disease affects
the part of the brain that organizes visual images,
people have a hard time understanding that."
some, those are the first symptoms of the disease;
others don’t suffer visual-spatial challenges until
later. Either way, caretakers can help.
lot of the challenges people face with Alzheimer’s
disease could perhaps be more easily solved with design
choices as opposed to medication," Wint said.
the Home Show, Clement pointed out an area rug on the
rug is a big trip hazard. This beautiful modern pattern
can be an optical illusion," she said.
in flooring, like a light rug on a dark wood floor,
might appear to be an elevation change. A patterned rug
might appear as uneven terrain, and small tiles might
appear as scattered objects to be picked up. On the flip
side, people may have trouble distinguishing actual
elevation changes between rooms, or judging the height
of a step; in those cases, a ramp might be helpful.
in the bathroom, the lack of contrast can have messy
white toilet on a white floor with a white wall — that’s
what all the pictures on Houzz show, and it’s a
beautiful look," Clement said. "But for people
with Alzheimer’s, it can be hard to see white on white
on white. So a hamper is often used, or a trash
a contrasting color behind the toilet can be an easy
fix, she said.
ideas she learned from her father: Keep essentials in
plain sight. "If you take a door off one cabinet
and put the plate, bowl, spoon, and cup there, they can
try to maintain even lighting throughout the day,
because changes in lighting can be confusing, and dark
shadows can appear as an abyss. (Although, Karlawish
noted, some special-care units use that to their
advantage, placing black rugs in front of exits to
prevent patients from wandering away.)
who is collaborating with the University of Nevada-Las
Vegas’ architecture program on a new health-care
interior-design program, said research on the issue so
far is scarce. For now, much of his advice to caregivers
is about things like avoiding multipurpose tools, which
can be hard for people with dementia to identify and
navigate. He also prescribes minimizing clutter—including
the visual kind. At mealtime, that means avoiding
patterned plates, which can get confusing, and even
serving one food item at a time.
mostly, said Clement, it’s about "having giant
learned to look at things through her father’s eyes,
to recognize what might be strange or confusing to them.
day, I went to visit my father and he was so agitated.
The nurses couldn’t calm him down. I went into his
room and I noticed that across the way there was an
ambulance with its light flashing. So I pulled the shade
down, and within a couple minutes, he was fine,"
been giving presentations at home shows, senior centers,
and conferences, and hopes to start offering one-on-one
consultations. She wants to prove that accommodations
don’t have to be hospital-like, especially in an era
when grab bars, for example, can be disguised as stylish
towel racks, soap dishes, or toilet-paper holders.
think the process of updating your house is absolutely
crucial," she said. And the sooner the better.
"Introducing these things and creating a safe
environment in stage one, where they can participate in
what happens in the house, is really important."