Chapter Two: Colour as Indicators in Aged Care Facilities

Chapter Two: Colour as Indicators in Aged Care Facilities

The use of colour in health care facilities, particularly aged care facilities, is a significant factor within the design process which must be considered appropriately for the general user and in particular for those with degenerative colour perception. This chapter will cover three primary areas of colour indication within an aged care environment, detailing the need for their consideration and the ways in which they benefit a patient or users well-being and aid in the healing process. It is widely discussed that colour and light can be used to compensate for the visual changes, such as ‘reduced adaption, reduced retinal illuminance, reduced contrast and saturation discernment, and impaired colour vision associated with ageing, with studies suggesting that ‘appropriate colour selections and contrasts levels assisting in improving the way the elderly… visualise and understand the built environment’ (Hegde 2007: 22). When thinking about colour in the built environment, particularly health care environments, the idea of colour psychology is widely discussed as a way which benefits the users through colour selection and its assumed associations. However, as voiced by Mahnke, ‘health care facilities can aid the healing process by establishing an environment that contributes to the psychological and physiological well-being of the patient’ (Mahnke 1996: 146). Within these environments, each individual complex space, that according to Mahnke demand ‘a supportive visual milieu’ of their own, must be individually considered in terms of functionality, aesthetic and design, in order to create a space that aids wellbeing whilst preserving the unity and structure of the facility (Mahnke 1996: 147). The three main areas of focus indicators which this chapter will discuss as drawn from the analysis of the first chapter on colour perception, are colour as a movement indicator, behavioural indicator and a social indicator. By breaking down these three separate indication aspects within the healthcare environment, we can aim to establish the importance of colour in correlation with each indicator.

Colour as a movement indicator

A suggested usage for colour in healthcare environments is as a movement indicator or wayfinding device, which aids in the identification of physical elements such as door handles, levers, grab rails and signage (Leibrock 2000: 82). Way-finding refers to information systems which are used to guide individuals through a building or environment, providing them with information to gain a better understanding of their location and destination. Colour can typically be used within the built environment to assist in orientation through signage, symbols and directional indicators (seen in Figure 2.1) (Leibrock 2000: 82). However colour as a movement indicator can further provide wellbeing properties to elderly patients by generating physical activity which aides their overall physical health and mental well-being (Mozzer 2014). Way-finding and orientational cues are important factors which must be included in health care, particularly aged care facilities, in order to function

successfully and assist people in their daily activities. In aged care facilities, it is generally suggested that bright hues be used to allow for higher visibility for patients with vision deficiencies. This indicator association of way-finding through colour can also be extended to the use of colour as a physical environmental safety aspect (Borrie, Geiger, Gibson, MacLean 2004). The primary users of the space must be taken into consideration, in this case staff and elderly patients, as well as any physical or psychological disabilities. As previously discussed, the primary age associated visual degeneration issues are a result of yellow tinting of the lens and colour blindness. Each can impact the way an individual perceives colour or lack of colour, thus extreme consideration must be taken into effect when designing a space for affected users. In order for colour to be used as a movement indicator it must be understood what movements exist and should be accounted for within aged care. The movements of aged care residents depend on the age-affiliated deficiencies that may develop, however there is a common feeling of isolation, confusion and unsettlement (Fedderson et al. 2009: 33). In correspondence with behavioural indicators, dementia patients should be considered particularly for the common movement patterns they experience; these being wandering, feeling lost and searching for something (Fedderson et al. 2009: 33). Using colour to dictate movement through signage, symbols, direction or for defining space assists elderly patients by responding to these movements and providing navigation. Utilising colour as a movement indicator encourages patients to engage in physical activity which assists in the self-healing process along with their physical and psychological well-being. Colour as a movement indicator is primarily seen in corridors, public spaces and circulation spaces. However, Mahnke suggests that when using colour in hallways, consideration should be focused on creating a calm and inviting atmosphere. Colour should not be overwhelming, however a lack of colour can create ‘emotional sterility and may not be calming or attractive’ to its daily users (Mahnke 1996: 150).

Figure 2.1 Colour as a Way-finding Device, Carros Parking Lot & Urban Planning, Carros, France, N+B Architects, Photographed by Paul Kozlowski, accessed 14 November 2019, <https://www.archdaily.com/ 58437/carros-parking-lot-urbanplanning-nb-architectes>

Colour as a behaviour indicator

Behaviour refers to the way in which an individual ‘acts or conducts’ themselves, notably towards other people. Behaviour can be triggered by events or stimulus, particularly in social situations. Behavioural indicators within an aged care environment can refer to psychological and memory triggers which can affect the way in which individuals perceive a space. These indicators can ultimately affect whether an individual feels comfortable and safe within a space, a primary aim for aged care facilities (Mahnke 1996: 146). It is important to consider the visual deficiencies which may affect the way in which colour as a behavioural indicator is perceived, however the psychological condition of dementia is a principle factor which can influence which behaviours must be considered. Patients who suffers from dementia experience the loss of memory, social isolation and disorientation, this leads to a loss in ‘their sense of identity and will to actively control and shape their environment’ (Fedderson et al. 2009: 32). This loss of identity and control must be considered when designing an aged care space. By using constant colours and spaces that are reflective or provide a comforting aspect of their past, architects and designers can successfully create a consistent physical space that provides ‘dementia sufferers with a feeling of stability and security’ (Fedderson et al. 2009: 32). Colour as a behavioural indicator can be used both within private and social spaces to define boundaries and maintain a level of comfort for patients. Colour is most commonly applied to walls however it can be used as an indicator through decorative elements such as furniture and drapery. Natural colour can also be used to connect patients to the outside world, providing patients with the calming, beneficial properties of nature which can influence their behaviour. It is important to create a space that is consistent and features neither an ‘excess nor a lack or stimulation’. However, it is important to note that as dementia progresses, surroundings that may have previously been considered familiar can be suddenly perceived different and even ‘mutate to unknown nightmarish scenarios’ (Fedderson et al. 2009: 33). Fedderson explains that ‘from a neurological point of view, this change can be explained by the fact that our direct perception is not solely a real-time response but is also informed by long-term interpretive pattern from the past’, suggesting that the way these coloured spaces are interpreted can be affected by colour associations from an individuals past. Using colour to clearly define a social space from a private space assists in the patients way-finding process whilst moving through the space. The distinct use of different colours in a private space can be used to create an environment of comfort and security, one in which patients can easily navigate to retreat to when experiencing their feelings of disorientation or unsettlement. Creating a safe and comfortable space can assist in the lost feelings or desire to ‘go home’ that dementia patients may experience (Fedderson et al. 2009: 33). Thus, when considering colours within an aged care facility, it is important to keep them consistent throughout the space and not overwhelming, providing a sense of familiarity whether they are colours relevant to the patients past, home-life or pre-existing private space.

Colour as a social indicator

Human interaction, specifically socialisation, is an important part of life. The act of socialisation for elderly individuals who reside in health care or aged care facilities is important in order to promote well-being and create an environment that enables self-healing. Social isolation is a prominent behaviour that individuals experience in elderliness. Psychological conditions such as dementia and depression can heavily influence an elderly patients mental health and the way they interact with others, often leading to social isolation (Fedderson et al. 2009: 30). Social indicators within an aged care environment are points of reference that indicate spaces designated for socialisation and social activities. Socialisation is an important activity for elderly individuals generating a sense of belonging that attributes to their physical and mental well-being (Mozzer 2014). Social spaces within an aged care facility can include treatment and therapy rooms, waiting rooms, corridors ad designated leisure spaces (Mahnke 1996: 149). When designing social spaces for the elderly within the built environment it is important to differentiate them from private or functional spaces such as therapy and work. Colour can be applied to surfaces and furnishings to create this distinction. Figure 2.2 demonstrates the use of minimal soft colour in contrast to the bright, highly saturated hues pictured in Figures 2.3 and 2.4, successfully defining the two spaces of public or social and private. The use of considered colour allows general users, in particular patients with visual and psychological age-related deficiencies which may effect how they perceive colour, to interpret and associate selected colours with different spaces. Colour can further be used in signage and symbols to assist in the colour association, providing navigation towards the designated social spaces. Suggested colours that can be used for social spaces are bright, low saturated, non contrasting hues that emit a calming yet inviting atmosphere, for example pale green or blue (Mahnke 1996: 150). It is particularly important to create easily identifiable social spaces to aid people with further stages of dementia in order to generate interaction and avoid social isolation. The interaction assists patients with their physical and mental well-being, promoting movement to these social spaces whilst generating socialisation. Ultimately, using colour to define and indicate social spaces within a contemporary aged care facility assists patients with an association on the function of a space, allowing them to match it with a colour for easier distinction and recognition. It further provides them with a clear distinction between loud social spaces and their quiet private space where they can retreat to to feel comfortable, safe and ‘at home’ (Fedderson et al. 2009: 33)

Figure 2.2 Colour as a Social Indicator, Mixed-use building, Strasbourg, France, Dominique Coulon and Associates, Photographed by Eugeni Pons, David Romero-Uzeda 2015, accessed 14 November 2019, <http://coulon-architecte.fr/ projet/639/strasbourg>

Figure 2.3 Colour as a Private Indicator, Mixeduse building, Strasbourg, France, Dominique Coulon and Associates, Photographed by Eugeni Pons, David Romero-Uzeda 2015, accessed 14 November 2019, <http://coulonarchitecte.fr/projet/639/strasbourg>

Figure 2.4 Colour as a Private Indicator, Mixed-use building, Strasbourg, France, Dominique Coulon and Associates, Photographed by Eugeni Pons, David Romero-Uzeda 2015, accessed 14 November 2019, <http://coulon-architecte.fr/ projet/639/strasbourg>

The use of colour as indicators within contemporary aged care environments enables a specialised focus toward how staff and patients, particularly with visual and psychological deficiencies as a result of ageing, interact, perceive and use the space. The use of colour as a movement indicator, behavioural indicator and social indicator assists elderly patients with daily activities, helping them to navigate the space and feel comfortable. It is important to consider the visual deficiencies, particularly the discussed yellowing tinting of the lens and colour blindness, and the effect they have on colour perception, noting which colours and their properties are suitable and unsuitable to be used within a healthcare space (Mahnke 1996: 148). However it is also important to consider the psychological effects of dementia and how it too can influence how one perceives space and colour, particularly the memory and behavioural triggers they may be associated with (Fedderson et al. 2009: 33).