Designing homes with dementia in mind

A brick house showing small pane windows and window boxes with a green hedge in frontAnother 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 dementia and 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. 

Doors Opening, Doors Closing

A chrome lever door handle with the door ajar. The door is timberRichard 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 Design Guide from South Australia

Photo used for front cover of guide. It shows an outdoor area similar to a veranda.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 report documents 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.”

The report is 16 pages in PDF.

Planning policy for accessible housing: costs and benefits

picture of Habinteg's report with two older people standing by a tree against a block of units in the backgroundHabinteg 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 habinteg logo - accessible homes, independent liveswas calculated at an additional £521, which is about 0.2% of a new house. Habinteg claims that no attempt was made to weigh any additional 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. 

You can download Habinteg’s response to the review from the Toolkit webpage. The website also has some informative videos.

Dementia friendly home design

Front cover of UD Dementia Friendly homesThe 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.

There are five sections to the guidelines that can be downloaded separately: Introduction, Location and Approach, Entering, Exiting and Moving Around, Spaces for Living, and Elements and Systems. Or you can download the sizeable guide in one go.  

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. 

UD principles for Australia’s aid program

DFAT UD guidelinesThe Department of Foreign Affairs and Trade stipulates that all overseas aid programs must follow the Principles of Universal Design. They have produced a comprehensive guide to all types of development projects including water, health, education and the built environment. It is useful to see how thinking universally about design can produce such a clear guide to inclusive practice and accessibility. This document was updated with a 2016 brochure with ten tips for promoting universal design in aid projects. There is also the companion document Development for All: 2015-2020 Strategy.  

Heavenly stairways

A man sits on the stairs in a home. The stairs are timber but there are no handrails only glass sides. The stairway is open to the living area.There is much to think about when designing and fitting stairs in a home, whether a new home or a renovation. Denver architect Doug Walters has 12 tips for safer stairways in his web article, “Beautiful Hazard”. Home stairway design should be both good looking and safe. The article uses photos to illustrate points.There is a link to some elegant solutions. I note that nothing is said about extending the handrail to the final tread in some examples.

UD in housing: Better Living Design webinar

A single storey home with a footpath out front. Caption underneath says, " Change how consumers perceive great design".Richard Duncan from the RL Mace Universal Design Institute presents a 50 minute webinar on universal design in housing. The first 20 minutes covers the basics such as demographics. At the 19 minute mark he starts to show the misconceptions about how some people think UD might look in a home and then goes on to show what UD should really be about. It’s a bit long winded, but you can forward the video to the parts you want. One of the key messages in the video is the comparison of wheelchair specific design, which is what some people think UD is, and mainstream family home design with UD features. This is part of their Better Living Design project.


Accessible Housing Options Paper

Front cover of the Options Paper. Dark blue with white text. The Australian Building Codes Board’s (ABCB) Options Paper on Accessible Housing is open for comment. The document is about including accessible features in the National Construction Code for new-build mainstream housing in the future to make them mandatory. Submissions close 30 November 2018. Visit the ABCB webpage to get an overview and download the Options Paper in either PDF or Word. Community forums will be held in capital cities between 15 October and 1 November. For more information see the Australian Network for Universal Housing Design Webpage and Facebook page. 

Editor’s Comments: The term “accessible” is currently used in building legislation specifically for people with disability in the public domain. In my opinion, the same assumptions are underpinning this proposed review of housing – it is focused on people with disability. As a follow-on, it discusses the issues in terms of a problem that might or might not need to be resolved rather than a community need with benefits for everyone.

This approach makes the benefits for others invisible and consequently discounts them. This leaves it open to interpretations such as a the demands of a few outweighing the choices of the many. Considering the costs and benefits is an important part of the Options Paper. There are several research papers on this topic that have previously been ignored and this is an opportunity to put them before the ABCB. Please read the Options Paper carefully and consider the holistic view of accessible, universally designed housing for all when making a submission. Case studies are also welcome along with personal stories. Jane Bringolf, Editor. 


Housing Design Guidelines from South Australia

South Australia Housing Design-Guide-2_3With the upcoming ABCB Options Paper for Accessible Housing about to be released, the South Australian Housing Trust Housing Design Guidelines. are worth a visit. It points out that the Adaptable Housing Standard (AS4299) is now outdated and can be replaced by the Livable Housing Design Guidelines as both of these are voluntary. There are detailed drawings to show dimensions of circulation spaces and placement of fixtures and fittings.