Hospitals can be distressing places at the best of times. If you have dementia or other cognitive condition it can be a frightening and disorienting place whether a patient or a visitor. Stressed patients stay longer and need more medication.Taking a universal design approach can provide a better experience. Academic research and consumer input underpins this comprehensive guide to designing dementia-friendly hospitals from a universal design approach. In Ireland, where the guide was developed, they estimate almost one third of patients have dementia and as the population ages this will increase. Of course, dementia friendly design using a UD approach is good and inclusive for everyone. The guidelines are available to read online using Issuu software.
Below is a short video that provides an overview of the design factors that need to be considered in creating a dementia friendly hospital.
There is also a media release that provides an overview of the development of the guidelines and the project partners.
A shiny floor may not be wet but it could look that way to someone with dementia. A black mat isn’t a hole in the ground either. And shadows of lattice through a window can look like steps. Mono coloured features are hard to distinguish too. These design details can easily be overcome with some extra thought about perception at the early design stage, or adapted in existing homes and buildings. The Guardian has an excellent article about these issues. It discusses how virtual reality software can bring more awareness to designers about these issues as well as the concepts of universal design.
Editor’s note: taking photos of places and seeing them in two dimensions instead of three really highlights the perception differences.
The Sage Gateshead is a really good example of a building and venue that has gone beyond basic compliance when it comes to accessibility, and that means it goes beyond building access. Well trained staff are comfortable with all customers and performers, and this is what makes it inclusive as well as accessible. Surrounding businesses are also involved and they benefit from the extra customers. As a result The Sage has won several awards including the Royal Institute of British Architects Inclusive Design Award in 2005 and the Business Tourism Excellence Gold Award at the VisitEngland 2018 Awards Ceremony. The video below uses the preparation and delivery of the MS Life conference in 2009 to explain their approach to inclusion. There are interviews with staff, outside event organisers, the PR company and the Hilton Hotel. The video was shot by a colleague of Chris Veitch, who will be a keynote speaker at the upcoming Australian UD Conference in Brisbane.
Editor’s note: I attended a conference at The Sage in 2010. It is a truly amazing building. The design pays homage to the Newcastle shipyards that used to occupy the site. I was fortunate to capture the building at twilight when the roof dome blends into the sky and reveals the internal structures of balconies that make it look like ships at sea. Photos, Jane Bringolf.
Roadways take up a lot of land. Time to make that land more flexible for more than just vehicles. The video below shows how closing down a residential street for two hours can produce a lot more activity just for people, not people in cars. The video explains how this has reduced obesity and social isolation. It also shows how it can become an inclusive space for everyone. When there is an inclusive communal space at your front door there is no excuse not to get involved. See the video for how this idea got started. Would be good to see more of it. But as always, it takes a leader to get it going. Would, or do councils in Australia support this initiative? This looks like a cost effective method for tackling childhood obesity.
Wayfinding requires designers to organise and communicate the dynamic relationships of space and the environment. Basically, it requires the naming and marking of places, identifying destinations, and providing directional information. The Cooperative Research Centre for Construction Innovation has produced a comprehensive, if somewhat technical, set of guidelines for wayfinding.
The guide covers basic principles, and very detailed design solutions and strategies, covering topics such as arrival point, main entry, internal arrival point, graphic communication, restrooms and toilets, lifts, and signage design. Sign legibility, system design criteria, and viewing distance to signs are all covered, plus much more. Wayfinding is a key element of accessibility for everyone. Making signs and systems universally designed for everyone requires additional thought and planning.
AS 1428.4.2 Wayfinding Standard, is expected to be published very soon.
The Center for Health Design based in California has produced an excellent checklist that focuses on design features specific to older people. Of course, such features will generally benefit others. The checklist is meant to support a universal design approach to environments for ageing populations. It is not meant to be used as a list of comprehensive specifications, but a “thought starter”. It is probably best used to guide the discussion of design teams at the outset of a project. The checklist covers Home and Community including residential, Healthcare and design of clinics and emergency rooms, and Workplace designs and strategies.
The checklist matrix lists the strategy or goal, design considerations for the built environment, and the universal implications (benefits for everyone). For example, the goal of ageing in place in one’s home requires (among others) features that are easy to clean and maintain, and the universal implication is that it increases the suitability of housing for a wider range of users and potential buyers. The checklist has a comprehensive reference list to support the content and for further reading.
In this case study, landscape architect Johan Østengen, explains the problem of adapting a city space and a heritage wall and gate on a sloping site into a pleasant place to walk, and to have informal get-togethers. The height difference of seven metres was the main challenge, but with some universal design thinking to drive the design they were able to come up with a successful inclusive and accessible design. For more of this story about this universally designed open space and the difficulties they had to overcome, go to the Inclusive Design Norway website for the article on the Schandorff Walkway. Several photos illustrate the final design.
Editor’s Note: Norway has almost no flat land and is at the forefront of rolling out universal design everywhere. So the myth that you can’t do UD on sloping sites is put to bed.
Getting out and about is part of staying active and connected within the community, but some people find that more difficult than others. Inner Sydney Voice has an article explaining the 8 Goals of Universal Design and how they can be applied in the urban environment. The examples given are not exhaustive, but do help with thinking about including everyone. The 8 Goals of Universal Design extend the concepts of the classic 7 Principles of Universal Design that are most often quoted in academic articles. You can download the PDF of the article.
The 8 goals are: Body Fit, Comfort, Awareness, Understanding, Wellness, Social Integration, Personalisation, Cultural Appropriateness. They were devised by Steinfeld and Maisel (2012).
The Property Council of Australia has released a report, A Common Language for Social Sustainability. It has five broad themes, one of which is mobility and access. The report goes on to give examples under each of the themes, showcasing what their members are doing. The examples under the access and mobility theme include Stockland rolling out LHA Silver Level features in their retirement villages (but unfortunately not in mainstream housing yet). Stockland has also supported inclusive play spaces through the Touched by Olivia Foundation. See the report for the examples in this section, most of which have yet to hit mainstream. But it is a good start.
A non-jargon version of social sustainability: Everyone can live, participate, and enjoy activities on an equal basis with others. If you want the jargon – the Property Council of Australia defines social sustainability as, “Social sustainability combines the design of the physical realm with design of the social world (including social infrastructure) to support social and cultural life, social amenities, systems for citizen engagement and spaces for people and places to evolve. Communities that are socially sustainable are equitable, diverse, connected and democratic – and they provide a good quality of life for all those who reside in them.”
Alternative to what? you might ask. An Alternative Age-Friendly Handbook, with acknowledgement to the WHO’s work on age-friendly cities, takes a different approach to creating age-friendly urban places and spaces. Focusing on small scale age-friendly urban actions the handbook takes the reader through some useful thinking processes. First, it avoids the language of “apocalyptic demography” where an ageing population is described in terms of disaster and catastrophe. Then it moves on to the participatory approaches that have evolved over the last ten years. “This handbook is, thus, intended for these ‘Other’ urban practitioners who have not, as yet, necessarily engaged with the ‘urban ageing agenda’ and is offered here less as a prescriptive guidance (a how-to on Age-friendliness) and more as a portable reference to inspire critical reflection, action and possible intervention.”
A refreshing presentation of a handbook – not the classic “how to” format. Rather a creative “think about…” While this is from the perspective of older people, much of the thinking and many of the processes apply to all age groups. It looks like a long document, but that is because it is in large print. An easy and engaging read. Published by the University of Manchester Library.