Lightwave team members recently attended a Dementia Design workshop run by Dementia Training Australia.
The workshop has been put together by the eminent Richard Fleming, a professor from the University of Wollongong who has spent a lifetime researching the role of the built environment in relation to people with dementia. As care philosophies move from medical to wellness models, (Salutogenisis) the role the built environment plays in the life of a person with dementia becomes paramount. The DTA has proposed ten Key Design Principals when designing spaces for people with Dementia.
1. Unobtrusively Reduce Risk
Ensure environments are safe and easy to move around.Provide step free accessProvide good contrast of objects to flooringEnsure safety features are unobtrusive – locked doors and high fences can lead to frustration, agitation, anger or apathy and depression.
2. Provide Human Scale
Building Scale will influence feelings and behaviourScale is influenced by the number of people the person encounters, the overall size of a building and the size of individual components.The fewer people and other typically “institutional activities” a PWD (person with dementia) has to deal with, the less confused they will be.Large port cocheres and hotel models of design are large in scale.
3. Allow people to be seen
Any housing or space for people with dementia should be planned so that the person can easily locate where they are, where they have come from and where they can go.The provision of good visual access increases levels of engagement and gives the PWD confidence to explore their environment and remain mobile.Good visual access will allow carers to unobtrusively maintain awareness regarding the safety of the PWD.Wayfinding research suggests that a simple environment should be supplemented with key markers and good orientation is assisted by a certain amount of explanation and training
4. Manage levels of stimulation – reduce unhelpful stimulation
PWD have difficulties filtering noise and visual stimuli and become overwhelmed and stress after prolonged periods of over stimulation.Design environments to minimise stimuli that are not helpful to the resident.Reduce levels of unnecessary noise, reduce traffic through a PWD’s space, reduce signage (especially clinical signage), reduce visibility of back of house areas.
5. Manage levels of stimulation – optimise helpful stimulation.
Sensory stimuli is important and can be used to give a PWD cues about where they are and where they can goProvide redundant queuing – ie. a number of different markers for the same intent as each person will experience different meaningsProvide opportunities for a PWD to recognise their own personal space through furniture, colour of walls, the design of light fittings and other such personal objects that may have meaning to the person.Doorways to bedrooms might be fitted with individual door handles or large printed photographs on the door that relate specifically to the occupants life.
6. Support Movement and Engagement
Encourage movement to maintain a person’s health, wellbeing and engagement.Provide pathways free of obstacles and complex decision points.Provide points of interest and opportunities to engage in activities or social interaction.Pathways should be provided both internally and externally.
7. Create a familiar place
A person with dementia strongly relates to places and objects from their early lifeEnvironments should use familiar furniture, fittings and coloursFamiliar and personal objects should be included, and where possible ensure the person with dementia is involved with the personalising of their environment
8. Provide a variety of places to be alone or with others – in the Unit
People with dementia need to be able to choose to be on their own or spend time with othersDesign and provide a variety of spaces that cater for individuals, small groups and larger groupsInclude internal and external spacesProvide spaces with different uses (eg. Reading, talking, looking out at the scenery, …)Stimulate different emotional responses
9. Provide a variety of places to be alone or with others – in the Community
Provide constant reminders to the PWD to help minimize their loss of sense of identityAllow for frequent & easy interaction with friends, relatives and visitorsDesign places that encourage such interactionUnit designed to blend and integrate with the existing communityIf possible, allow for a “bridge” between the Unit and the Community in the shape of a place shared by the Community and PWD.Coffee Shop near the Unit, easily accessible also without assistanceIf on a larger site, make sure access is easy all around
10. Design in response to vision for way of life
Design to suit the lifestyle choice / philosophy of care of the facilityDifferent facility may have different focuses (ie. Engagement with ordinary activities of daily living / full service and recreation / healthy lifestyle / spiritual reflection)Make sure the building is designed to support and state clearly the way of life offeredThe way of life is to be evident to the staff as much as the residentsWith the staff constantly reminded of the values and practices required, they need to be provided with the tools necessary for them to do their job