Design for Dementia in Practice

6th May 2014

Damian Utton RIBAPartner, Pozzoni LLP Architects

www.pozzoni.co.uk

Principles of Dementia Design

Older people, and older people with dementia, can be very sensitive to the built environment

People with dementia may not remember or understand their surroundings. Design can compensate for these impairments

Design can facilitate the efficient delivery of care in a non-institutional way

Other impairments can be compensated in a straightforward way with established guidelines, but dementia affects people in different ways.

Principles of Dementia Design

Consensus that good design -

• should compensate for impairments

• should maximise independence

• should enhance self esteem and confidence

• should demonstrate care for staff

• should be orientating and understandable

• reinforce personal identity

• welcome relatives and the local community

• allow the control of stimuli (Marshall et al 1997)

Principles of Dementia Design

Evidence base

• Published research

• University of Stirling DSDC Publications http://dementia.stir.ac.uk/information/bookshop

• Housing and Dementia Research Consortium http://housingdementiaresearch.wordpress.com/

• Housing LIN www.housinglin.org.uk

• Post-Occupancy Evaluations

• Talk to people!!

How do these principles work in practice?

Whilst these photographs are from new build care home environments, the principles are applicable to all building types

Compensate for impaired memory, reasoning, learning

open plan - high levels of visual access

wc visible from bed

‘event’ at a dead end

Compensate for impaired memory, reasoning, learning

contrast between junctions

hidden service doors

visible cupboard contents

similar floor tone

Maximise independence

access to external space

accessible kitchen

graphic alsignage

shop

Enhance self-esteem and confidence

purposeful activity

lower worktop:kitchen activity

wardrobe

cue for doors

Demonstrate care for staff

dispersedstorage

open plan:discreet monitoring

break-out space

technologystaff base

Orientating and understandable

familiardomestichomely

Reinforce personal identity

Welcome relatives and the local community

cafe well-being hair and beauty

community room gym

Control of stimuli

daylight without glare

naturalventilation

sound absorbing

buffer from noisy areas

Conclusions

Current Practice

• Non-institutional environments

• Manage risks

• Community hubs

• Dementia friendly communities

• Conflict with other regulations (infection control, fire, food, etc)

• Emphasis on home adaptations and domiciliary care to keep people at home

• Government funding for extra care housing and to ‘pepper-pot’ people with dementia around a housing scheme

Conclusion – Key design points

1. Familiar environment, fixtures and fittings

2. High levels of lighting

3. Easy to understand built environment

4. Clarity and simplicity: where things are and where to go

5. Appropriate signage (1200mm above floor)

6. Contrast to increase visibility

7. Similar floor tones

8. External space is as important as internal space

Conclusion - Four Priority Areas

1. Improve lighting

2. Ensure good contrast

3. Similar floor tones

4. Ensure the toilet is easy to find

Design for Dementia in Practice

6th May 2014

Damian Utton RIBAPartner, Pozzoni LLP Architects

www.pozzoni.co.uk