Aging in place, defined as “the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level,” is increasingly seen as a preferred alternative to institutionalized care.
While the physical and emotional aspects of aging in place such as maintaining independence and community connection are well-known, acknowledging changes in cognition is also vital for a comprehensive approach to older adults’ well-being.
The SimTigrate Design Lab (SDL) at Georgia Tech has developed the “Cognitive Aging in Place” concept, exploring how home environments can be adapted to improve the daily lives of individuals with mild cognitive impairment (MCI). SDL researchers also have written a booklet called “Home Design Guidelines,” which is available online and details how to create an environment that is safe for someone aging with cognitive impairment, and might allow them to remain in their home for a longer period of time.
Cognitive aging in place focuses on preserving and enhancing the mental faculties of older adults facing cognitive decline while living at home. It covers memory, functional independence, problem-solving, decision-making, and overall mental agility. We view the concept of Cognitive Aging in Place as a necessity because it:
- Preserves Familiarity and Independence, allowing older adults to maintain identity and independence in familiar environments, which can trigger positive memories and improve quality of life.
- Provides Mental Stimulation and Engagement, encouraging mental stimulation through familiar routines, social interactions, and activities that challenge the mind, which are crucial for delaying cognitive decline and promoting well-being.
- Reduces Emotional Stress, by minimizing the life disruptions, stress and anxiety that come with transitioning to new living environments, thus maintaining emotional well-being in a comforting and known environment.
SDL’s “Home Design Guidelines” helps individuals experiencing cognitive decline and their loved ones integrate evidence-based design strategies into their homes. Key strategies include:
Maximize Natural Light: The benefits of natural light extend beyond aesthetics to an ability to focus when completing tasks. Positioning workspaces near windows maximizes natural light exposure, improving visibility and positively impacting mood, sleep quality and overall well-being.
Bright, Cool Lights for Daytime and Warm, Low Lights for Evenings: Adequate lighting is crucial for older adults, and can be achieved by installing bright, cool lights in areas where daylight is insufficient during the day for visibility, and using warm, low lights in the evening for relaxation and a good night’s sleep.
Motion-sensor Amber Night Lights: Illuminate key areas used during nighttime movement or bathroom visits with motion-sensor amber night lights. This minimizes the risk of falls, providing enough light for safe navigation without disrupting sleep patterns.
Motion-sensor amber night lights minimize the risk of falls.
Choose Textured, Non-Slip Flooring: Textured and non-slip flooring materials reduce the risk of slips, trips, and falls. This is especially important in high-traffic areas and spaces prone to moisture, such as bathrooms and kitchens.
Keep Floors Free of Tripping Hazards: Regularly check and clear floors of tripping hazards, such as wires, cords and loose mats or rugs. A clutter-free environment is essential for preventing falls, and simple measures like securing loose items can make a significant difference.
Avoid Patterns and Shiny Surfaces on Flooring: Flooring with patterns, shiny surfaces, or abrupt color changes can be disorienting for older adults due to vision decline. Select solid, matte-colored flooring to provide a clear visual path and reduce the risk of confusion.
Ensure Wide Entryways: Ensure all doors and entryways are at least 32–36 inches wide to accommodate mobility aids such as wheelchairs and walking equipment. This simple adjustment enhances overall accessibility throughout the home.
Arrange Furniture for Accessibility: Arrange furniture to allow for clearances that provide enough navigation space and are accessible for wheelchairs and walking equipment. This can involve creating wider pathways and strategically placing furniture to facilitate easy movement.
Install Auditory Cues on Exit Doors: Enhance safety by installing monitoring devices on exit doors that provide auditory cues each time the door is opened. This is especially beneficial for caregivers or family members who may need to monitor the comings and goings of older adults.
Contrasting Color for Sockets and Switch Plates: Choose sockets and switch plates with a color that contrasts with the wall to enhance visibility. Consider elevating outlets to 24 inches or higher from the floor for improved access, reducing the need for bending or reaching.
Label Drawers and Consider Open Shelving: Improve organization by placing labels on drawers with words and symbols indicating their contents. Consider open shelving for frequently used items to reduce the need for extensive searching and reaching.
Use Bright Tape on Frequently Used Items: Enhance the visibility of frequently used items by adding bright yellow or orange tape with labels to items such as toothbrushes, hairbrushes, pens, and kitchen utensils. This simple visual cue can make daily tasks more manageable.
These Guidelines offer practical ways to adapt every space in the home to support cognitive aging in place, available in detail at https://simtigrate.gatech.edu/cognition-built-environment.
Elahn Little, MPH, is a research scientist with the SimTigrate Design Lab, working with the Cognitive Empowerment Program at Emory University providing research support to the Innovation Accelerator and Built Environment cores. Eunhwa Yang, PhD, directs the Workplace Ecology Lab and is an assistant professor in the School of Building Construction, College of Design, at Georgia Tech. Both are in Atlanta.
Photo caption: Multiple lighting fixtures in the bedroom illuminate the entire space.
Photo credit: From "Home Design Guidelines."