Design for DementiaHow can design make a difference?

• Experiencing dementia

• The key principles

• The impact of design on behaviour

• Examples in practice

• What changes could you make?

Marney Walker, Senior Practitioner OT, Extra Care and Supported HousingHousing Commissioning Team, Adult Social Care

Experiencing Dementia

“My granny was not able to remember if she had any milk, or eaten her dinner, but she taught me some really complicated knitting patterns that she learnt when she was my age.”

DSDC (2010)10 Helpful hints for dementia design at home

Experiencing Dementia: Cognitive Processing and Sensory Impairments

• The ability to integrate visual, and auditory information is affected

• The physical and social environment can be perceived as unfamiliar and disturbing

Experiencing Dementia: Risk of Falls

People with dementia are:

•Twice as likely to fall

•3 x as likely to fracture

•Have a poorer prognosis

•Spend longer in hospital

•5 x more likely to become

institutionalized

Combined with factors typical in ageing:(weak muscles, joint pain, and poor eyesight)

Older people with dementia are more likely to have abnormalities in gait due to limited ability to compensate for the impact of mobility impairments

Experiencing Dementia: Behaviour

• Feelings of disorientation, frustration, bewilderment, humiliation are common

• Restlessness and Wandering can be due to:- Forgetting where you are going-Feeling lost, feeling hot-Being in pain-Needing the toilet

• Agitation at feeling imprisoned

• Humiliation : being unable to understand how to use toilet flush, or tap

• Withdrawal from noise

A sense of home

Way finding and signage

Access to outdoors

Lighting and tonal contrast

Design for dementia : Key principles

How can design make a difference?

• Improve quality of life

• Alleviate symptoms and reduce stress levels

• Maximise independence

• Reduce the need for supervision

What difference does it make?: Evidence

Case example in an acute setting

•Better lighting•Consistent flooring•Better contrast to skirting, hand rails, toilet seats•Emphasized and concealed doors•Signage

Results:•40% less falls•60% less near misses•No absconders •Calmer atmosphere•Less anti-psychotics

Visual perception : Things to avoid

Patterns that can be perceived as 3D or moving, on floor coverings, furnishings, crockery

Shiny reflective surfaces that create glare and create confusing reflections

Lighting and tonal contrast

• Light to twice ‘normal’ levels• Use domestic style fittings.• Use daylight wherever possible.• Expose people to the 24-hour cycle of light and dark

Tonal Contrast

Using tonal contrast

Highlight Disguise

Being able to find things: labels

Being able to find things: labels

Keeping things in view

• Glass fronted cupboards

• Cupboards without doors

• Shelves

• Clear see-through storage jars

• Open front or labeled drawers

Keeping things in view

Access to outdoors

•Exercise keeps bones strong and reduces likelihood of falls

•Exposure to natural light : Vitamin D deficiency is associated with: o Impaired cognition o Low mood

•Daily exposure to daylight can reduce disturbed sleep

Access to outdoors

Garden design blueprint :Design Research Centre Richmond University

What changes could you make?

Design for Dementia Virtual Home http://dementia.stir.ac.uk/virtualhomeDementia Services Development Centre, Stirling University

• What do you do already?

• What works well?

• What changes could you make?