Have you ever been in a country where a language foreign to you is spoken and tried to use the phone or to get on the right train, or driven through the day and night and tried to follow oral directions to the nearest motel or gas station? Or have you ever arrived in a room and forgotten what you came to do, or stopped in the middle of a sentence because you have lost your train of thought? Or tried to assemble a new acquisition and found the instructions incomprehensible? How about using a new remote or computer?
This user group includes anyone with limited comprehension or memory, some confusion or reduced reasoning. A few of the contributing factors include injury, illness, learning disability, stroke, general aging, using a foreign language, or youth/limited vocabulary and reasoning skills. With a client who has cognitive impairments, safety is a primary concern, and involving caregivers in the design process is critical.
Some memory loss or occasional forgetfulness, as opposed to overall mental decline, is very common as we age. The ability to learn does not decrease with age, but stereotypes cause many to fear the loss of mental ability as one ages. Reaction time generally is longer. Reduced physical and reaction abilities cause many to prefer home where things are familiar, allowing for a sense of security.
At the other end of the age spectrum, children are in the process of developing cognitive skills, often having needs in common with those of us advancing in age, and deserve attention as well. A child’s language and reasoning skills are only just beginning to develop. Children see the world differently than adults and often do not understand danger or the consequences of their actions. In addition, they have a short attention span and, occasionally, a lack of body function or control. In designing spaces they will inhabit, it is critical to acknowledge their limited awareness of risk/ safety factors and lack of understanding.
A concern in planning for children arises when placing items within reach of an older child, which are still off-limits to a younger child or toddler. Detailed conversation with the supervising adult is needed to determine what responsible safety precautions must be taken. Children will be completing the same activities at the lavatory as adults. Small children will be learning to brush teeth, and wash hands and face, so it is important that the grooming center be planned to stimulate and enhance their learning experiences. Another concern in planning for any client with cognitive issues
is clarification as to how involved the client will be in the design and use of the space. Will he/she use the space independently, and are there unique opportunities to enhance the living experience for the client? Or will a caregiver be involved at all times, and are there unique safety concerns? Are there aspects of the space that should be made more accessible and some that should be off-limits?
Pay attention to design concepts such as security, lock-out for off-limit medications, judicious use of contrast, provision for visual ordering of fixtures and items to be used, simple communication, preprogramming for controls or one-step operations, and creating familiar spaces. These and other design considerations are detailed in the sections that follow.
Some key examples of the universal design principles in chapter 4, "Universal Design and Human Factors," that become more critical when responding to a client with cognition issues include:
• Eliminate unnecessary complexity,
• Be consistent with user expectations and intuition,
• Accommodate a wide range of literacy and language skills,
• Arrange information consistent with its importance, and its order of use.
• Provide effective prompting and feedback during and after task completion.
• Use different modes (pictorial, verbal, tactile, auditory) for redundant presentation of essential information,
• Arrange elements to minimize hazards and errors.
• Provide fail-safe features.
