Understanding Thermal Comfort for Memory Care Residents

5 Things You Need to Consider:

As we age, our senses and perception of environments change. Thermal comfort is one of these key senses. It is the sense that helps us decipher hot and cold, and how to best adapt or adjust our environment to comply with changing temperatures. For older adults, and especially from those suffering from dementia, the understanding of thermal comfort can become altered with time.

Why is thermal comfort important?

Thermal comfort is described as "the state of mind, which expresses satisfaction with the thermal environment" (ASHRAE, 2004). Most of us are able to process this information and make the necessary adjustments such as putting on a sweater, opening a window, or adjusting the thermostat.However, what if you could not connect your discomfort with the surrounding thermal environment and instead spent your days being either too cold or too hot? Unfortunately, this is a reality for many people living with dementia. Combine that with an increased sensitivity to environmental conditions, and it starts to explain why those with dementia can become increasingly reactive to their environment rather than acting upon it (Weaverdyck, 1991). The simple connection of adjusting the temperature or grabbing a blanket has been lost and they need to rely on those with a deep understanding of HVAC systems to design an environment that can easily adapt and adjust as they require.

Designing for thermal comfort

Having a clear understanding of how thermal comfort can affect those with dementia played a large role in the recent design for an HVAC system for a facility specializing in memory care. Mechanical engineering is a specialized field that involves the design, production, and operation of machinery, including HVAC systems. Senior Mechanical Engineer, Maureen Kozel, took a lead role in creating an HVAC system that would meet the specific needs of dementia residents. While maintenance, accessibility and cost are realities we face and must discuss, the comfort and safety of residents is always the priority for our clients. With that in mind, Maureen had five suggestions to help keep resident safe and comfortable.

1. Understand the importance of thermostat location and controllability.

The thermal comfort of residents can vary drastically from one person to the next. To help maintain a comfortable setting, it’s important that each room have its own individual thermostat. However, because dementia patients can be unaware of dangerous levels of heat and cold, it is important that the adjustability of each thermostat be preset to minimize drastic swings in temperature. A simple dial marked from “cooler” to “warmer” will help keep residents safe and comfortable.

2. Use radiant heat to eliminate hot and cold drafts.

Radiant heat, whether incorporated in the flooring or ceiling, can help eliminate the hot and cold drafts that can come with forced air. Additionally, radiant heat gives spaces an overall feeling of warmth, much like the sun or a fireplace.

3. When using forced air, be thoughtful about the location of diffusers.

According to Warner (2000), “A person with dementia may not realize that a bathroom is too cold, only that he or she is uncomfortable, and may not associate the room’s temperature with the experienced discomfort or have the ability to communicate it to the caregiver.  This often results in frustration, anger or attempting to get away from the discomfort.” Thinking beforehand about the location of diffusers throughout a home can help avoid cold or hot air from blowing directly on a resident. For example, having cold air blow on a resident who may be undressed in the bathroom should be avoided.

4. Be thoughtful about the location of your major equipment.

There’s just no getting around it, large facilities require large pieces of mechanical equipment. And large pieces of mechanical equipment require maintenance and they make noise. Since we know that dementia patients do best when a solid routine is followed, it’s important that the design incorporate equipment maintenance practices that minimize disruptions to their daily routine. Mechanical equipment should be placed outside of resident rooms when possible. Large equipment can be installed in dedicated equipment rooms, behind fences or greenery, and should be selected with reduced sound levels. This will keep maintenance personnel out of view of residents, will maintain nicer views from rooms and will reduce noise levels for residents.

5. Provide functional window treatments.

Window treatments that can minimize glare and hot spots, without completely taking away a resident’s view will go a long way in controlling and maintaining thermal comfort. Window treatments, like curtains or blinds, should be functional and easy to use. Encouraging staff to close curtains at certain times throughout the year will also be helpful in maintaining thermal comfort.

References:

• ASHREA (2004) ANSI/ASHRAE Standard 55-2004, Thermal Environmental Conditions for Human Occupancy, Atlanta, GA, USA, American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc.
• Weaverdyck SE (1991a) Assessment as a basis for intervention. In Coons DH, editor. Specialized dementia care units. Baltimore, MD, USA: John Hopkins University Press. Pp 205-223
• Warner ML (2000) The complete guide to Alzheimer’s proofing your home. Purdue University Press, West Lafayette, IN, USA