Design for Dementia

1
Design for Dementia

• David Parry
• Operational Aspects

2
Our design thoughts.

• Small units for flexible care, i.e. younger
  people with dementia, men /women only units/ care
  for people with functional mental illnesses.
• Ability to adapt to the needs of people with
  dementia rather than people fitting around the
  design.
• The ability to respond to the needs of
  purchasers.
• Minimise the effects of instiutionalisation.
• Creating as much personal space as possible to
  emphasise the individual nature and impact of
  dementia, this is not a homogeneous disease or
  group of people

3
Principles

• Physical environment assists rather than
  detracts from well being.
• Environment should be small
• Environment should be familiar
• Each persons concept and understanding of a home
  is radically different to anothers.
• Home is obviously more than just a building -
  furniture and fittings etc emotional
  experience, people, memories, and stimuli
  smells.

4
Potential home-like environments -

• Simple non-labyrinth floor plan
• Short domestic scale corridors
• Study rather than a nurses station
• Kitchen as a focus and activity area
• Fireplace as a conversational focus
• Choice of rooms for socialising or privacy

5
The Effect

• The most observable feature of dementia causing
  inward and emotional response is boredom
  through lack of activity and opportunity for
  stimulation.
• Personal identification with the environment
  significantly enhances the sense of familiarity
  and feeling that the place is indeed home

6
Visual Access

• The capacity of residents to see or sense where
  they are or want to go to - area.
• No dead ends, or kept to a minimum. If a
  decision point in way finding has to be made,
  every decision is a right one.
• If visual access is the means by which residents
  get to communal living or external areas, cueing
  may be the means to getting back.

7
Cueing

• Active cueing includes land marking such as a
  framed collection of memorabilia or a decorated
  name at a bedroom door.
• Ensuring that the toilet can be seen from the bed
  in rooms with en-suites, with en-suites having
  down lights to direct attention to them.
• Toilets in living rooms areas must be land-marked
  or distinctively land-marked
• Different spaces or rooms for different functions
  will assist legibility

8
Design

• For most people with cognitive impairment,
  changing the use of a room works against
  orientation.
• Design must enhance orientation by highlighting
  important stimuli and reducing the impact of
  extraneous stimuli.
• The design challenge is to ensure that the
  environment is engaging without being confusing
  directive without being manipulative supportive
  whilst still promoting autonomy.

9
Environment

• It has been said that noise is to people with
  dementia what stairs are to people in
  wheelchairs.
• The environment should promote self esteem,
  autonomy and individuality. There must be plenty
  of capacity to fulfil activities of daily living