People with dementia find new places and routines challenging. So when it comes to going to hospital they often experience increased anxiety and disorientation. The design of the hospital environment can have an effect on this group. That’s the finding of some new research carried out in hospitals where they interviewed patients and family members. “The voices of patients, particularly persons with dementia and their APs, are a crucial element in helping hospitals to fulfill their role as caregiving and healing facilities”.
Abstract Objectives: Research was conducted to investigate the impact of the hospital environment on older people including patients with dementia and their accompanying persons (APs). The article presents key research findings in the case study hospital.
Background: For many patients, the hospital is challenging due to the busy, unfamiliar, and stressful nature of the environment. For a person with dementia, the hospital experience can be exacerbated by cognitive impairment and behavioral or psychological symptoms and can therefore prove to be a frightening, distressing, and disorientating place.
Method: The findings are based on a stakeholder engagement process where the research team spent approximately 150 hr observing within the hospital, administered 95 questionnaires to patients and/or APs, and conducted 12 structured interviews with patients and APs. A thematic analysis was employed to analyze and generate key themes emerging from the process.
Results: Themes were grouped into overarching issues and design issues across spatial scales.
Conclusion: This research confirms the negative impact of the acute hospital setting on older people with cognitive impairments including dementia and delirium. The multiple perspectives captured in this study, including most importantly people with dementia, ensure that stakeholder needs can be used to inform the design of the hospital environment. The research points to the value of understanding the lived experience of the person with dementia and APs. The voices of patients, particularly persons with dementia and their APs, are a crucial element in helping hospitals to fulfill their role as caregiving and healing facilities.
The longevity revolution is here, but we haven’t prepared for it. The way cities are planned and homes are designed hasn’t really changed since mid 1900s. This lack of foresight is having a significant effect on people over 65 years who are not getting any younger. This is a common problem for most developed nations. The Design Council in UK tackled this topic in “The 100-year life: the role of housing, planning and design“. Their article contains some small scale but effective case studies, showing various ways to address the issues with inclusive thinking. It includes home modifications, ways to finance home and community upgrades, transportation, and the application of the WHO Guidelines for Age Friendly Communities. Educating designers and planners is of course paramount as well as involving citizens in the design and development processes. The article ends with a summary of recommendations. Their conclusions resonate with the principles of universal design:
“If we are going to be successful in creating homes and places which meets both fast rising demand, and the diverse and individual needs of older people, our thinking needs to be much broader. We need to consider how we help people afford better housing and plan their finances; how we develop long-term special plans and a workforce with the right skills; and how we use existing policy levers, such as expansion of personal budgets, to best effect. We need a whole-population, whole-place approach to planning for our future health, care, housing and support system at both the national and local levels.”
Building regulations stipulate certain access requirements, but what do people value most and will they be high cost, particularly in retrofits? Using Stated Preferences analysis and cost-benefit data, researchers found that some features suited a wide group, while others suited only a few. The question then is, if the feature for the few costs the most, should it be included or ignored in a retrofit?
The authors commented that by, “using the projects results and calculation tool in prioritising, more emphasis will be put on measures that improve the buildings’ quality for a wide audience. Such measures may easily be forgotten if one only focusses on the most obvious deficits.” Among high benefit features, were good lighting, visual and tactile markings, and stair handrails.
An interesting study that reveals the preferences of building users and the value they place on certain features and the related costs. This can be compared with features set down in access standards where the value for users is not assessed, nor the costs.
In most countries new shopping complexes must comply with current disability access standards. However, that doesn’t guarantee a comfortable, safe or convenient shopping experience for everyone. An article published in Sustainability discusses the adaptation of the classic principles of universal design to suit shopping environments. Usability, safety and comfort were seen as the key design elements. The article includes a literature review and a study of six shopping malls. Although the study was carried out in a developing country, Iraqi Kurdistan, the model and survey results are applicable anywhere. However, it provides useful information for those designing buildings in this context. It is good to see a detailed review of shopping complex design, and a model for design criteria.
The title of the article is an indicator that it contains some technical data, but most of the article is readable: “Using Structural Equation Modeling to Propose a Model for Shopping Complex Design Based on Universal Design Concept”. A very useful document for designers of all public buildings.
The picture is of the Family Mall, one of those included in the study.
It’s amazing what can be done when GPS data is linked to population data. The Danish study used satellite data to show a link between growing up near green space and issues with mental health in adulthood. They found that children under 10 years who had greater access to green space may grow up to be happier adults. The FastCo article goes on to say that data was correlated between the child’s proximity to green space during childhood and that same person’s mental health later in life. The more green space they had access to, the less likely they were to have mental health issues later.
Is there a link between an age-friendly urban environment and sustainability? This is a question posed by a group in Hong Kong. They carried out an on-street surveyto see what the links are, if any. They claim that “The empirical results suggest how the aging‐friendly factors have impacted the economic, environmental, and social sustainability to a certain extent”. Among other results, outdoor spaces were not found to be a planning factor, but community support and health services were. The abstract below gives more detail. This paper shows how it is possible to bring different disciplines together rather than having them compete for attention. That is also apparent when taking a universal design approach to planning.
The title of the article is “Does aging‐friendly enhance sustainability? Evidence from Hong Kong” You will need institutional access for a free read.
Abstract: The aging population is one of the demographic changes in the 21st century. World Health Organization defines an age‐friendly city as a place that has an “inclusive and accessible urban environment that promotes active aging.” It receives considerable attention in the field of gerontology and contains important aspects of sustainable urban development. Unfortunately, there have not much research that addresses the relationship between aging‐friendly and sustainability. There is a need to modify the market mechanism to achieve environmental objectives while striking a balance between social and economic considerations. This paper aims to empirically examine the integrated relationships between the dense urban environment and the social and emotional needs of the elderly in the Hong Kong context. The on‐street survey was conducted in eight districts in Hong Kong to collect the opinions about aging‐friendly criteria and sustainability indicators. It utilizes principal component analysis and multiple regression technique to unveil the mask of their intrinsic relationship. The empirical results suggest how the aging‐friendly factors have impacted the economic, environmental, and social sustainability to a certain extent. Notably, two key findings were revealed from the empirical results. (a) “Outdoor Spaces” is consistently found not to be a planning factor that can enhance three types of sustainability, irrespective of the age groups in Hong Kong; (b) “Community Support and Health Services” is regarded as a significant factor, with the exception of economic sustainability (age group ≤60).
Urban designers can be champions for improvements for population ageing. That is a key theme in an article that proposes ways for helping older people stay put in their home, and if not, in their community. The article discusses current innovations to make neighbourhoods and homes more supportive both physically and socially. These include: enriching neighbourhoods, providing collective services, building all-age neighbourhoods, creating purpose-built supportive housing, developing smallscale intergenerational models, and engaging mobility, delivery, and communications innovations.
The title of the article is, “Improving housing and neighborhoods for the vulnerable: older people, small households, urban design, and planning”. You will need institutional access for a free read from SpringerLink. Or you can access via ResearchGateand request a copy of the article.
Abstract: The number of older people who need help with daily tasks will increase during the next century. Currently preferences and policies aim to help older people to stay in their existing homes, to age in place, even as they become less able to care for themselves and, increasingly, live alone. However, the majority of homes in the U.S. and many other countries are not designed to support advanced old age or are not located to easily provide support and services. The paper explores the needs of older people experiencing frailty. It examines the existing range of innovations to make neighbourhoods and homes more supportive, physically, socially, and in terms of services. These include: enriching neighbourhoods, providing collective services, building all-age neighbourhoods, creating purpose-built supportive housing, developing smallscale intergenerational models, and engaging mobility, delivery, and communications innovations. Some will allow people to remain in their current dwelling but others focus on people remaining in a local community. Few are widely available at present. Urban designers can more fully engage with the multiple challenges of those who have physical, sensory, and cognitive impairments and living in solo households by becoming champions for a more comprehensive set of public realm improvements and linkages.
The principles of Design-for-All are used for the basis of an efficient and effective planning action tool in this academic paper from Italy. It brings together quality of life, multi-functional spaces, environmental sustainability, and inclusive urban planning strategies. The claim is that Design-for-All approach “represents a solution for matching people needs to urban environmental quality improvement”, and that inclusive planning strategies can support an ecosystem services network. You will need institutional access for a free read. The title is, Anthropic space and design for all. New knowledge paths for urban planning strategies. The paper originates from Italy which may account for some of the heavy language.
Abstract: Nowadays city environment shows the presence of a mixed variety of elements, as natural, semi natural and anthropic components that build up both structure and connections of the urban context. This specific structure shapes and directs space and its functions strictly connected with their sustainable potential uses and sustainable development opportunities. The lack of rules and proper planning methods produces inefficient use conditions by resident citizens, entropy, functions’ reduction of ecological networks and deep environmental impacts. The consequence comes out to be a great widespread life quality decrease in urban areas. These thoughts lead the authors to rethink the definition first and then the place concept own interpretation, as a theoretical reference approach and in a particular way of the urban place, as an anthropic action useful in a multidimensional relationship analysis. Based on these considerations, the aim of the paper is that to introduce design for all as an efficient and effective planning action tool able to get sustainable operating strategies to match both people needs and urban system quality of life protection and enhancement in a long term timeline analysis.
Although architects might propose universal design principles in designs, it seems that Australia is not the only country where clients are ambivalent at best and resistant at worst in terms of inclusive thinking. In Clients’ Approach to Universal Design – A Slow Change? Sidse Grangaard of the Danish Building Research Institute reports on the research into why clients are not interested in going beyond basic building regulations. It would seem the design and construction industries share much in common across the globe. A useful research project. The full paperis available from the link.
Abstract: When new buildings do not comply with the accessibility requirements of the Danish Building Regulations, the main reason is often attributed to a lack of knowledge and prioritization. It is the experience of architectural firms that clients decide their own focus on accessibility during the design process, and also whether the level of accessibility should be higher than that stipulated in the Danish Building Regulations. Post-occupancy evaluations point out that when the client is particularly conscious of, or ambitious about, accessibility/Universal Design (UD), the result is a building with an extensive level of accessibility. Thus, the client is a key figure for the project and the level of ambition. Based on interviews with 15 Danish clients, this paper presents a characterisation of their conception of Universal Design. It is significant that, as a concept, UD has not gained currency among the clients that let their ambition level be defined by the Danish Building Regulations. In order to capture differences between clients, a description of the client’s conception of users and designs is based on an analytical framework about the concepts of particular, universal, market and equality. The analysis shows that three conceptions about accessibility/UD can be characterized among the clients: 1) accessibility by design, 2) broad accessibility 3) added value. Above all, the findings show that a development is going on towards UD, although slowly.
The article is from the proceedings of the UDHEIT 2018 conference held in Dublin, Ireland, an open access publication.
Are high rise developments good for children? This is the key question in a study where children are included in the design of social spaces in high density living. The effects of high rise living on families with children are discussed; the methodology is explained; and tower blocks re-imagined. International examples are discussed and thoughtful design solutions are presented in the conclusions, both within buildings and in spaces surrounding them.
From the introduction: “The significance of the skyscraper typology persists as populations grow, land continues to become scarce, and to defy the detrimental social and environmental effects of urban sprawl. What this typology seems to have denied over many years is its relationship with the child. It has led to a rapid decline of children’s physical activity and independent mobility resulting in increased rates of child obesity and other health concerns as described by psychologists and medical professionals across the country.” The author is Suruchi Modi, an architect and urban designer with a specialisation in Tall Building Design from the University of Nottingham UK. There is a useful list of references at the end.