We know that people want to stay home as they age. This does not change for people with dementia. Staying safe at home also means staying safe in the neighbourhood, not just at home. That means we need a dementia-friendly outdoors.
Ash Osborne writes in the Access Insight magazine about dementia and outdoor environments. Although dementia is NOT a normal part of ageing, one in ten people over the age of 65 experience dementia. It is the single greatest cause of disability for this group.
Osborne takes us through the key design elements that support people with dementia as well as other groups. Depth perception often changes and that means strong changes in contrast can be perceived as steps or a hole. This can lead to falls.
Wiggly lines in paving and sun-cast shadows from a pergola are similar situations. A black mat at a doorway looks like a hole in the ground and pooled lighting can be confusing. So the images show what NOT to do.
Distortions of perception are not just experienced by some people with dementia. So, once again, think universal design.
Osborne’s article, Age and Dementia Friendly Outdoor Spaces is an informative introduction to the topic.
Dementia and urban design
In Improving the lives of people with dementia through urban design, Barbara Pani presents four brief case studies: a gated community, a dementia-friendly city, intergenerational housing, and health services at a neighbourhood level in a social housing estate.
The article provides technical information and in the conclusion raises several points. Retrofitting existing buildings could be better than a massive redevelopment.
Consideration of people with dementia could also be good for the wellbeing of people with mental health issues, and the importance of developing social spaces at the neighbourhood level.
Many people with dementia are able to live independently for several years before they need constant care and support. Studies are showing that the design of the built environment is influential in supporting people with dementia to maintain their sense of well-being and independence.
Out and about with dementia
Getting out and about is good for everyone’s physical and mental health. However, the fear of getting lost or confused when outside the home prevents many people with dementia from leaving home. Consequently, they tend to limit their time away from the house. But with good planning and community help, people with dementia can maintain the benefits of walking and taking a holiday.
“I am a person.
Sometimes people like to go for walks, even people with dementia. Sometimes people get lost, even people without dementia”
Taken from Kate Swaffer’s poem, ‘Wandering along the beach’. (2014)
Dementia Australia has two booklets, Walking safely with dementia, and Travelling and holidays with dementia. These booklets are designed for people with dementia and their families. However, the information is good for communities who want to make their places and spaces dementia friendly.
The walking guide features strategies people can take to make sure they stay safe and know what to do if they become lost. They can be as simple as carrying identification and establishing familiar routines and places. The section on safety involves avoiding crowds and disorienting entry and exits. Double entry and exits in shopping centres can cause confusion for people without dementia. Directional signage on the way out of the toilet is useful for everyone.
Dementia Australia has a Dementia-Friendly Communities program where people can learn more about dementia and how they can help. There’s a list of things you can do if you meet someone who may be lost.
“My mother has dementia, but her life continues to be enriched with fulfilment. We went on a cruise last year that provided us with uninterrupted time, gave me some time to relax and just be there for my mum while our needs were taken care of. It was difficult at times, but so rewarding to have shared this time together”
Travelling and holidays
Similarly to the walking guide, careful planning is key to success. The holiday booklet covers travel by sea, air, car and public transport. There’s a checklist of things to consider and how you can plan to optimise your level of capability. When it comes to accommodation, it’s useful to notify hotel staff. Some hotel accessible rooms might be more comfortable.
There is nothing in this booklet for transportation agencies for people with dementia. However, it gives travel and accommodation providers insights into the lives of people with dementia and their families.