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Consider cognitive impairment and the psychiatric environment

May 17, 2016
by Kevin Turner
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I have had several people ask for a better explanation of the overall issue of cognitive impairment.  While I will humbly acknowledge that you are probably better qualified to explain the clinical concept, I will aim to put the designer’s spin on it.

Many patients who spend time in a behavioral health environment are dealing with cognitive impairment.  I personally find the word “impairment” a bit off-putting. Like most things we try to understand about the brain, it isn’t a simple yes or no symptom, but rather a gradated curve. 

One person’s “impairment” is another person’s “quirk.” Basically the person’s ability to process information might be outside of the norm, as defined by the fat middle part of a bell curve. 

Minimize the impact

This cognitive impairment is most likely not the actual issue for which your patients are seeking treatment, but is a common symptom of psychiatric diagnoses. It might mean that they are overprocessing information or underprocessing information. It could be a symptom of their disease directly or a side effect of their medication. 

It is also important to remember that many patients are not experiencing significant issues with their cognitive processing. Also remember that many people who are not psychiatric patients are dealing with significant issues with their cognitive processing.

Why you should care: Such cognitive impairment can become a trigger for the patient’s symptoms, and of course, one of the goals of a psychiatric care setting is to avoid triggering those symptoms so the patient can begin to experience wellness. We need to understand the range of cognitive impairments that are likely to be experienced by patients in a unit and create architecture and interior design strategies to minimize triggers and symptom impact. 

That is why I often talk about flooring choices and why you should avoid "black holes" and sparkles underfoot. It is also why choices of colors, patterns, artwork, signage and furniture are equally important to view through the care strategy lens.



Some people overprocess the info and some underprocess the info. It could lead to stress and depression in some cases. Cognitive Behavioral Therapy is a very useful tool with this problem and avoid psychotic episodes.

Kevin Turner

Principal, Perkins+Will

Kevin Turner

Kevin is a recognized leader in the design and operations of behavioral healthcare facilities. ...

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