Bright shades cut confusion in Alzheimer’s and dementia patients

With natural light flooding in and bouncing off its walls, Rubicon’s Memory Care Ward is a cheerful place. The facility provides a haven for up to 19 Alzheimer’s and dementia patients and follows a unique colour-coding system.

Nursing Services Manager Sister Suzanne Osberg is passionate about the elderly and believes divine guidance steered her towards her profession. An expert in geriatric care, she serves as the Chairman of the Mpumalanga Branch of Alzheimer’s SA and has a soft spot for what she describes as the world’s “forgotten people”. Her service at Rubicon predates the ward’s inception in 2018.

Alzheimer’s is a degenerative brain disease caused by complex brain changes following cell damage. It leads to dementia symptoms which gradually worsen over time. The most common early symptom is trouble remembering new information, because the disease typically impacts the part of the brain associated with learning first. As it advances, symptoms get more severe and include disorientation, confusion and behaviour changes.

Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Alzheimer’s is the most common cause of dementia. Alzheimer’s is a specific disease, dementia is not. There are 10 warning signs for the disease:

1. Memory loss that disrupts daily life
2. Challenges in planning or solving problems
3. Difficulty completing familiar tasks at home, at work or at leisure
4. Confusion with time or place
5. Trouble understanding visual images and spatial relationships
6. New problems speaking or writing words
7. Misplacing things and losing the ability to retrace steps
8. Decreased or poor judgment
9. Withdrawal from work or social activities
10. Changes in mood and personality

Against this backdrop, it is easy to understand the bewilderment and panic memory loss patients might experience when confronted with the experience of an unfamiliar ward. “We follow a different approach based on a large amount of research,” Sr Osberg explains. “Alzheimer’s and dementia patients forget everything, literally who they are, but they don’t forget colour.”

When admitted, each person is allocated their specific shade and everything belonging to them is marked accordingly. “For instance, if it’s red, the blanket on the bed, the mat, lamp, everything is in red. There will be a red dot on their bedroom door and one marking their cupboard. In the dining room, they’ll have their red chair and utensils.”

Around the ward, pictures have replaced words. Bathrooms and other facilities are indicated in clear, understandable images. Many simple, and seemingly insignificant adjustments (like changing white toilets seats to blue), all contribute to a less alarming world for its fragile residents.

It is not a commonly used practice, and one which was introduced cautiously, but it works. “It cuts out confusion, as all they have to do is follow their colour. With the green and blue walls, it somewhat resembles an adult playschool,” Sr Osberg smiles.

COVID-19 put a stop to any visits and there has been no contact with anyone from the outside world since the end of March. For the ward’s residents, this hasn’t necessarily been a negative experience, as they thrive on a strict routine with no hustle and bustle.

Sr Osberg says they are having a post-lockdown rethink, based on the calm they’ve experienced during this period. She explains that there had been no incidents of any kind, and that residents are clearly benefiting from a highly regulated day with the minimum of disruption.

“Things happening at the same time on the exact same day is hugely important. “Don’t get me wrong, we encourage visits at any time, but it can be confusing. We might ask our visitors to come at a regular time in future and make a few other changes, as is practical. What we learned from the isolation period has been valuable.”