Design for Dementia Care

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Objectives of creating and enabling environment- Dementia

Dementia care principles have been used to show how FIND's dementia care products have been designed to help improve care home environments.

1: Unobtrusively Reduce Risks

Living with dementia demands internal and external environments that are safe, secure and easy to navigate so reducing unnecessary stress and challenges. However, obvious safety features and barriers will lead to frustration, agitation and anger so potential risks should be reduced unobtrusively

2: Provide A Human Scale

The scale of a building will have an effect on the behaviour and feelings of a person with dementia. The experience of scale is determined by three factors; the number of people that person encounters, the overall size of the building and the size of the components, such as doors, rooms and corridors. A person should not be intimidated by the size of the surroundings or confronted with a multitude of interactions and choices. Rather the scale should help the individual feel in control.

3: Allow People To See And Be Seen

The provision of an easily understood environment will help to minimise confusion. It is important for people with dementia to be able to recognise where they are, where they have come from, and where they are going. If they can see key places, such as a lounge room, dining room, their own room, the kitchen or an outdoor area, it is easier to make choices and move around independently Buildings that provide these opportunities are said to have good visual access, and this increases opportunities for engagement and gives the person with dementia more confidence to navigate their living space.

4: Reduce Unhelpful Stimulation

Dementia reduces the ability to ‘filter’ stimulation such that prolonged or over-stimulation can be very stressful and have negative effects. An environment should be designed to avoid stimuli that are not helpful or needed. Furthermore, the full range of senses must be considered so auditory stimulation (i.e. too much noise) can be at least as distressing as too much visual stimulation

5: Optimise ‘good’ Stimulation

Enabling someone to see, hear and smell things that provide cues for orientation and what they may be looking for can help minimise confusion and uncertainty. Consideration needs to be given to providing redundant cueing i.e. providing a number of cues to the same thing, as well as recognising what is meaningful to one person will not necessarily be meaningful to another. Someone may recognise their room, for example, because of a view, the presence of furniture, or colour of the walls etc Cues need to be carefully designed so they only provide information which is useful or needed.

6: Support Movement And Engagement

Aimless wandering can be minimised by providing a well defined ‘journey’, free of obstacles and complex decision points, guiding people past points of interest and offering opportunities to engage with activities and where possible, incorporating the outdoors too

7: Create A Familiar Space

People are more likely to use and enjoy spaces and objects that were familiar to them at some point earlier in their life. The environment should afford opportunities to maintain competence through the use of familiar objects (internal and external) furniture, fittings and colours. This requires a degree of understanding of the backgrounds of those living in the environment so involving residents in decision making should be pursued whenever possible.

8: Provide Opportunities To Be Alone Or With Others

Just like all of us, someone with dementia needs to be able to choose to be on their own or spend time with others. This requires the provision of a variety of spaces suited to all potential requirements. These should include internal and external places, places to sit or read quietly, ideally with windows and suited to someone’s emotional circumstances.

9: Provide Links To The Community

Without links to the community and their surroundings, someone with dementia can quickly lose their sense of identity. Maintaining interaction with friends and family can help to maintain that identity and sense of self, and this is easier to do when they originate from the local area. So it’s important the environment includes spaces which make it easy for visitors to interact with the community within the home and maintain that vital contact. Homes need to be attractive and comfortable to encourage visitors to want to spend time there. If the home has an institutional feel, it wont be inviting to visitors. A good way to encourage links with the community is to provide a ‘cross-over’ area, a café for example, which can be used by residents and the community alike, bringing people together within the same space.

10: Respond to a Vision of a Way Of Life

The environment should support someone to lead a life that has meaning and value to them. Choice of this life style or philosophy of care will vary between facilities. Some choose to focus on engagement with the ordinary activities of daily living with fully functioning kitchens for example. Others may focus on full service and recreation whilst yet others may bias towards a spiritual way of life. Whatever it is, it should be clear and supported by the design of the environment such that it supports that way of life and the staff who help facilitate it. The building plays a significant role in the embodiment of the philosophy of care and contributes to supporting the requisite standards and values that underpin that lifestyle.

Source of information

See Dining room principles for more information