A study published by Day, Carreon and Stump (2000) found that the nursing home design plays an important role in the aid and care of those with Alzheimer’s disease and other types of dementia, with design “regarded as a therapeutic resource to promote wellbeing and functionality among people with dementia.”
The design of the physical environment is beneficial for not only those who are living with dementia, but also the wellbeing of other patients, family members and staff, as well as increasing mobility, way finding and functionality.
According to Alzheimer’s Australia, there are more than 353,800 Australians living with dementia. This number is expected to increase to 400,000 in less than five years. SPH architecture + interiors believe it is essential that aged care providers and their developments recognise how design can have a long-term impact on residents living with dementia.
The Design Phase
SPH will use the following resources during the design phase to ensure this is achieved:
- Dementia Facility Environmental Checklist (published by Dr Richard Flemming + Ian Forbes)
- DesignSmart: The rating tool for environments that work for people with dementia (developed by HammondCare’s Dementia Centre)
- Benchmark the design against the Dementia Enabling Environment Principles (DEEP)
- Consult with Alzheimer’s Australia WA and have a design review undertaken
Environmental assessment tools are not only useful for auditing existing built environments, they can also be used to review design proposals. SPH adopted this approach when consulting on the retirement village design for the Narrogin Cottage Homes project, auditing the design using an environmental assessment tool. Dementia-enabling design principles were also captured in the brief and Alzheimer’s WA undertook two design reviews, one during the briefing phase and another during schematic design.
Small Changes, Big Differences
Through peak bodies like Alzheimer’s Australia WA, SPH is able to keep abreast of new technology, furniture, fittings and equipment that support people living with dementia. Examples include appropriate selection of artwork, with a preference for representative as opposed to abstract styles; dementia specific wardrobes designed to reduce confusion; memory boxes to aid way finding and provide a gateway for conversation; and the use of a night light over the toilet which detects movement making it easier for residents to locate the toilet at night.
Recent studies have shown that increasing positive outcomes in areas such as mobility, wayfinding, and activities of daily living for people living with dementia, helps to reduce stress and agitation, as well as slow further decline.
The 10 Design Principles
The Dementia Training Study Centre (DTSC) developed 10 design principles to help create dementia-friendly environments that reduce negative outcomes for people with dementia, such as agitation, confusion and wandering behaviours. These include:
- Unobtrusively Reduce Risk: Incorporate ways of producing a safe environment without impeding on the sense of freedom and autonomy.
- Keeping Groups Small: Smaller groups of people feel safer and provide less stimuli.
- Visual Access: Provide good visual access of their environment by providing things such as clear visual access to the ensuite from the bedroom.
- Minimise Unhelpful Stimulation: Large amounts of stimuli may distress those living with dementia. An example of reducing stimuli might be to hide doors within the design that are not to be used, and only having necessary signage about the facility.
- Optimise Helpful Stimulation: Important aspects of an environment should be highlighted using colour of visual prominence. For example, areas such as bathrooms, emergency aids and exits to safe areas outside should be highlighted.
- Support Movement and Engagement: Environments should provide visual interest and rest points for recollection. Designs should allow wandering to take place safely, but at the same time, avoid actively encouraging it.
- Create a Familiar Space: Environments should reflect what is familiar to the person living with dementia and what they are used to, as dementia patients remember the distant past far more easily.
- Provide Opportunity for Privacy and Community: Provide a diverse range of environments that allow people to sit quietly by themselves or engage with others.
- Provide Links to the Community: The opportunity to remain connected to the community should be maximised in order to retain social support networks and provide a sense of purpose.
- Facilitate Home Like Environments: Environments should feel as home like as possible to avoid a sense of institutionalisation and to promote wellbeing.
SPH architecture + interiors are experts in designing home like, dementia-friendly environments. If you are looking to develop or revitalise an aged care or healthcare facility that cares for those with dementia, look no further than the team at SPH architecture + interiors.