Design, Dignity and Dementia Report

Front cover of the Design Dignity Dementia Report.The field of dementia and the design of the built environment is not well understood. Until now. Comprehensive Australian research has resulted in two volumes on the topic. The research looks at current best practice in design, and regional and cultural aspects. It also covers the importance of including people with dementia in the design process. The impact of the pandemic is another discussion point. People with dementia have the same human rights as others and that includes being treated with dignity.

The first volume is about the approach to the topic, the thorny issues, design processes and the 10 principles they developed. The second volume presents 84 case studies from around the world. A collection of day care centres, residential care facilities, and public buildings illustrate good design principles. The case studies include architectural detail and photos illustrate some of the design points.

The title of the report is, World Alzheimer Report 2020: Design, Dignity, Dementia: dementia-related design and the built environment. Authors are Prof Richard Fleming, John Zeisel and Kirsty Bennett.

The report launch webinar gives a good overview. Unfortunately the captions are auto-generated so they aren’t the best. However you can increase the speed and still understand the content.

Principles of dementia 

    • Unobtrusively reducing risks: Minimise risk factors such as steps and ensure safety features are as unobtrusive as possible.
    • Providing a human scale: The scale of buildings can impact the behaviour of people with dementia, so provide a human scale to minimise intimidating features.
    • Allowing people to see and be seen: The provision of an easily understood environment will help to minimise confusion. A literal line of sight should be clear for both residents, and staff.
    • Reducing unhelpful stimulation: Environments should be designed to minimise exposure to stimuli that are unhelpful, such as unnecessary or competing noises and the sight of unnecessary signs, posters, spaces and clutter.
    • Optimise helpful stimulation: Enabling the person living with dementia to see, hear and smell things that give them cues about where they are and what they can do, can help minimise their confusion and uncertainty.
    • Support movement and engagement: Providing a well-defined pathway of movement, free of obstacles, can support engagement with people and opportunities.
    • Create a familiar place: The use of familiar building design, furniture, fittings and colours affords people with dementia an opportunity to maintain their competence.
    • Provide opportunities to be alone or with others: A variety of spaces, some for quiet conversation and some for larger groups, as well as spaces where people can be by themselves, gives people with dementia a choice to how they spend their time.
    • Link to the community: The more an environment enables visitors to drop in easily and enjoy being in places that encourage interaction, the more the sense of identity that comes from spending time with loved ones and others is reinforced.
    • Design in response to vision for way of life: The way of life offered needs to be clearly stated and the building designed both to support it and to make it evident to the residents and staff.

Design tool for dementia-friendly public buildings

A basic floor plan showing a meeting room, toilets, reception and lobby area. An interactive tool for dementia friendly public buildings.The online tool for Dementia Enabling Environments has a section on dementia friendly public buildings. It’s an interactive design tool. So clicking on a room in the floor plan brings up a 3D view of the room. Hovering the mouse over question marks in the room brings up more detailed information about design ideas that are good for people with dementia. Of course, these designs are usable for almost anyone else who is ambulatory, including people with other cognitive conditions.

This is an excellent resource that takes accessibility beyond the access codes which don’t cover this level of design. The Dementia Enabling Environments tool also covers homes, care settings, and gardens and nature. There are links to other resources as well.

Cognition and inclusive design

Practitioners and researchers are seeking more solutions for people with sensory and cognitive impairments, particularly dementia. But our building standards are silent on this growing issue. Time to think about cognition from an inclusive design perspective.

The value of designing an age-friendly environment is discussed in an article by Hadjri, Afacan, and Gadakari. As with all universal design features, the authors argue inclusion needs to be embedded in the early stages of design. See the abstract below for more on the content.

Front cover of the bookIt is good to see the topic nestling between chapters on passive design and energy efficiency. The chapter “Inclusive Design” unexpectedly appears in ZEMCH: Toward the Delivery of Zero Energy Mass Custom Homes, and is available from SpringerLink and ResearchGate.

You will need institutional access for a free read, otherwise purchase the chapter. You can also try ResearchGate to ask for a free read. 

From the abstract

This chapter will explain and discuss the principles, role and importance of Inclusive Design particularly in the context of an ageing society. It will review the changing and complex user needs and requirements through case studies and current work of leading organizations.

Current standards do not take account of cognitive needs and more needs to be done by policy makers. Findings of recent research on users’ needs and requirements will be reviewed and Inclusive Design will be examined to assess the use of technology in embedding accessibility during the design stage.