safety alert

If you are in danger, please use a safer computer, call 911 or your local hotline or call the National Domestic Violence Hotline: 1-800-799-SAFE (7233 voice), 1-800-787-3224 (tty). There is always a computer trail, but you can click ESCAPE to leave the site quickly.

Physical Environment & Cognition

For background information on the characteristics of cognitive abilities and limitations, a description of who is affected, and the types of issues functional limitations in cognition create, please refer to Cognitive Abilities & Limitations.

Issues Related to the Physical Environment

Physical environments can be the source of stress, anxiety and confusion to a woman with cognitive limitations.

Noise, harsh or confusing lighting, movement, clutter, and patterns are all forms of distraction and, for some, confusion and misperception. Any major changes in the physical structure can cause increased stress for people with cognitive issues (e.g., a woman with early onset Alzheimer’s Disease may be fearful of a change in flooring and perceive it as a hole around which she must make her way.)

Some survivors with global psycho-social functions like autism need a choice of standing or sitting somewhat apart from the group (but still in sight of the group) until she is ready to join in.

Examples of Problems

A provider leads the survivor down a long narrow hallway. The provider is in front her and talks to her during the length of the walk. The survivor cannot walk and process what the provider is saying at the same time. She only has the capability of processing one task at a time.
A support group meets in a room next to a street where truck noise is loud. Glare from the windows reduces the visibility and light contrast in people’s faces. Everyone is edgy but a person with cognitive limitations is having a lot of difficulty focusing and cannot listen to what others are saying.
Poor signage indicating the way to meeting rooms is a stress for anyone trying to attend to something in a new place and get there on time.
A survivor with a recent head injury keeps trying doors to rooms that she shouldn’t go into. The providers perceives this as willfully irritating behavior.

Minimize Distractions

Important discussions with survivors should be in quiet rooms without loud background noise, or visual distractions like traffic outside windows or people walking by.
Room temperature should be managed. If an independent room control thermostat is available, give the survivor the opportunity to adjust it to help give her a sense of control over the environment.
Consider adjustable lighting that the survivor is encouraged to set to a level that is bearable for her.
Reduce clutter in the room.
Minimize patterns on walls, floors, and furniture.

Minimize Background Noise

Do a review of your facilities at different times of day and during the different seasons. Identify the sources and paths of noise in your buildings.
Consider acoustical ceiling tile You can also drop ceilings in places that have excessive reverberation. Playrooms and other group activity rooms are high priority areas to reduce reverberation. A homasote wall in a meeting room with cork on one side can reduce noise and add a place to post things.
In group activity rooms, consider adding self-adhesive pads to the bottom of chairs that make loud noises when they slide on floors. Low-pile carpeting adhered with low-VOC adhesives is another option.
Consider sound-absorbing panels high on walls and in corners of group activity rooms for additional noise control.
Add storm windows to old windows that are poor at blocking out street noise. Makes sure areas around window frames are sealed well. If replacing windows, consider what level of sound protection makes sense given the kinds of outdoor noise exist.
Avoid having seating next to heating and cooling systems with loud fans and compressors.
Consider options for reducing the noise of ventilation and cooling systems.

Reduce Glare and Create Even Illumination

People with traumatic brain injury, fatigue, and people with Asperger’s syndrome can be hypersensitive to lighting. If at all possible, provide individual control over the level of light in order to give people a sense of control over the environment.

Use Timer-Switches

Install a fan-delay timer switch or an automatic humidistat control that automatically turns the fan on and off in restrooms. For someone who is absent-minded and having trouble paying attention, a humidistat control is ideal.

Provide A Comfortable Environment for Sensitive Activities

Providers understand the sensitive nature and difficulty of performing a successful sexual assault examination. Generally, it is assumed that the more natural the environment is for questioning and examining, the less anxious the survivor may be.
Provide a livingroom-like atmosphere in the room where the exam will take place. Place the exam table behind a wall divider to keep it out of site until it is needed.
Giving the individual personal control over lighting, temperature, placement of chairs, having soft pillows, an afghan, and something to eat, all can help reduce the anxiety of the experience.
Plants can be a nice amenity and can help in improving air quality but should be kept to one or two.
See Noise, Color, Lighting, and Temperature in Waiting Areas, Intake, and Individual Counseling.

Make the Kitchen Safer and User-Friendly

Store toxic substances in a separate location from food and drink.
Mark dangerous items such as cleaners with Braille tape, large print & skull & crossbones.
Establish and enforce a rule about putting sharp utensils back in the same place each time.
Post list of rules to be followed in the kitchen. See Information Environments for strategies for using text. Use a color-coded label system for where items go into storage. Mark cabinets with the color codes and have what the codes mean on a wall.