The Dementia Enabling Environments website has a page on home designideas. Some of them are simple and cost nothing, but might not be obvious to the casual observer. The Adapt a House page has a floor plan of five rooms: living room, kitchen/dining, bedroom, bathroom and laundry. It’s interactive, so clicking on a room brings up more detail. For example, in the kitchen they suggest see-through doors on wall cabinets. If replacing an appliance, match it closely to the existing one. In the bedroom colour contrasts are important for finding the bed and other furniture. Block-out blinds on the windows help differentiate between day and night, especially in the summertime. There is lots more information and resources on the website.
The Dementia Enabling Environments web tool was developed by Alzheimer’s WA.
An article on an American home builder’s website has some good information and dispels many myths. The one about “ugly and costly” is dealt with well. While they are American designs, the principles apply elsewhere. The title of the article is, How Great Aging in Place Design Prepares you for a Llifetime. There are lots of examples on the website of kitchens and bathrooms. There is also a section titled Universal Design.
Editor’s comment: Few older people will use a wheelchair at home, but they might like to sit to do some tasks. So the idea of lower benches could be a mistake unless you know all home occupants are either of short stature or wheelchair users. All family members have to be catered for in a workplace such as the kitchen. Lower bench sections or adjustable height benches help here. A pull-out workboard in the drawer section of the cabinetry is also another way to provide a low workspace for children and others who might need it. Also, in Australia and elsewhere, few homes have the kind of space shown in the pictures to allocate to a kitchen, so designs need to be considerate of all likely kitchen users. Creativity is required. Lowering benches and not having under bench cupboards is the easy solution.
Australian Network for Universal Housing Design put out a call for good examples of universal design in housing. They haven’t vetted them, but they have put them into three categories. This is because people also submitted projects related to retirement living and specialist disability accommodation. You can decide for yourself if they meet universal design principles. ANUHD advocates for mainstream homes to be to Gold level of the Livable Housing Design Guidelines. The three categories are:
Renovations are an important part of the home building industry and it seems older people in the US might finally be realising that they need to choose designs that will allow them to stay put as they age. But are builders on board with this? It’s no good waiting until a client actually needs the features because by then, they will often not have the wherewithal to organise it. So it could be institutional care or a restricted lifestyle from there on. The 2018 Houzz Bathroom Trends Study is a comprehensive report that has some interesting statistics about the age at which people might start thinking of their future needs and doing something about it. It also shows what they are actually doing in terms of renovation design. An interesting and easy to read study which supports the idea that these features should be designed into the home in the first place.
Another useful design guide for including people with dementia. This one is from Aalborg University in Denmark and has a focus on people remaining in their own homes. The article discusses the similarities and differences between institutional settings and home settings to see which elements are the most useful. Of course, dementia-friendly design follows the general principles of universal design, so is good for everyone. The title is, Designing lifetime homes for people in the early stages of dementiaand can be found on page 195 of the larger publication, Safe and Inclusive Housing for an Ageing Society, which contains the proceedings of a conference held in Rome in 2018.
Abstract: As both the number and share of elderly people is increasing in western countries, the number of persons with dementia (PWD) is also increasing. ‘Dementia’ covers more than 200 diseases of the brain, and symptoms include memory loss, difficulties with wayfinding and problem solving and changes in behavior. Dementia is a progressive condition. In the beginning, the symptoms are small and yet can affect daily life. At this stage, most PWD still live independently or with support from relatives in their own homes. As the symptoms get worse, more professional care is required as well as a physical environment adapted to their needs. Several research studies highlight important aspects regarding the design of the physical environment in care homes for PWD. However, due to increasing demand, there are not enough care homes, and more importantly, most people strongly wish to remain living in their own homes. This raises the question: Is it possible to adapt design solutions for care homes for PWD to ordinary housing and in this way postpone the need for a nursing home? This paper discusses options that enable PWD to stay longer in their original homes and familiar surroundings by incorporating recommendations regarding the design of care homes for PWD to upgrade ordinary housing into lifetime homes that are also suitable for elderly with dementia. This paper is based on previous research, partly conducted at SBi, on the design of care homes for PWD. The findings of the research will be applied to a specific case; a Danish residential area for the elderly. The discussion is based on a UD perspective (Lid, 2013) and focuses on whether the needs of the few (PWD) will be beneficial for the many. Results indicate that by respecting the needs of PWD in designing housing, this type of housing may be turned into lifetime homes. A broad group of people, including PWD, will benefit from this design strategy as it improves architectural quality, wayfinding, social interaction and the quality of life of all residents.
Richard Duncan takes a look at doors and entrances to homes to show the various ways in which universal design thinking can make doorways more convenient for everyone. The article covers every aspect of doors in detail and has several pictures that illustrate how thoughtful door design and door handles can make a world of difference for all members of the family and for visitors too. A nice presentation of practical detail for this one home element. There will be some things not everyone will have thought about. Worth a look.
Housing for Life: Designed for Living was developed for the South Australian Government with an emphasis on population ageing and supporting active ageing policies. The reportdocuments the features and factors that older people themselves identified as important as well as industry perspectives. It also outlines the economic arguments for considering the housing needs of older people. Examples of floor plans are included. The key principles identified through the co-design process are:
Choice: Older people want to have choices about how they live, and scope to personalise their homes. Quality: It is better to invest in quality fixtures and fittings now for better efficiency and maintenance in the long term. Wellbeing: Wellbeing is a direct result of connectedness with community and home. Design: The concept of passive and flexible design that adapts to people’s changing requirements, needs to be central to new Housing SA builds. Cost: Older people prefer smart investment and the ability to personalise their homes, to ensure cost efficiencies are retained, but without sacrificing good design. Smart: The integration of smart technology and renewable energy ensures these homes stand the test of time and remain affordable. Access: Proximity to transport, services and the community is fundamental to living and ageing well, as are neighbourhoods that are easy to get around and foster active travel choices.
The report concludes: “There is significant economic opportunity to be gained by addressing housing, social and ageing related needs through innovative design. > Technology has a critical role to play in meeting unmet needs for independent living, connected living and well-designed housing. > Older people are an extremely diverse group and no single design will meet all needs. Age friendly housing options should be as diverse as the people who will live in them. However, there are core principles that apply across this population group and from these, flexible design can be developed. > Co-design between the housing sector and end-users is essential for accurate and relevant design. > Quality design and product are highly valued and of equal importance to design features that address ageing-related challenges. > Features that are valued in age friendly housing and neighbourhood design are energy efficiency, natural lighting, connection between indoor and outdoor spaces, walkability, proximity to transport and services, connection to community balanced with privacy and security, and capacity for personalisation.”
Habinteg is a provider of accessible homes in the UK. They have developed a Web-based Toolkit for Planning Policy that includes accessible housing. There are several tabs including one on the cost benefit arguments.
A review of Part M of the UK building code was commissioned to see what the costs would be to upgrade Part M of the building code. It was calculated at an additional £521, which is about 0.2% of a new house. Habinteg claims that no attempt was made to weigh anyadditional development costs against cost savings in other areas. For example, avoidable hospital admissions due to falls, impact on social care costs, and long stays in hospital due to no suitable home to return to. The calculated additional £521 for improved access standards would be more than met by avoiding one week in residential care.
The Centre for Excellence in Universal Design in Ireland has a comprehensive set of guidelines for creating dementia friendly dwellings, both new and existing. They have also published the extensive research that underpins the guidelines. Although the resource has a focus on conditions in Ireland, there is good information for everyone. It includes useful examples and design checklists. The key point is that dementia friendly dwellings are not exclusive – taking a universal design approach means that anyone can live in them.
Apart from some of the other issues of ageing (although dementia can be experienced at any age), here are some of the key factors that need to be considered in the design:
● Impaired rational thinking, judgement, and problem-solving. ● Difficulty with memory (initially short-term but progressing over time to long-term memory difficulties). ● Problems learning new things. ● Increasing dependence on the senses. ● Fear anxiety and increased sensitivity to the built and psycho-social environment.