Inclusive Design for Dementia

Perspective

By 2037 it is estimated that over 25% of the UK population will be aged 65 or over. By 2070 the over 65 age group population will have grown by over 8 million.  The trend towards an increasingly aging population is clear. It presents multiple complex challenges across several aspects of society, not least the increasing prevalence of people suffering from the effects of dementia, and dementia related diseases.

In the UK there are currently 800,000 people living with dementia, but this figure is set increase to around 2 million by 2050. Worldwide this increase is magnified, with a 3 fold increase from a current total of 50 million, to 150 million by 2050.

In terms of hospital care, currently 1 in 4 hospital beds in the UK are occupied by dementia sufferers. The financial impact of dementia is forecast to double in the next 25 years from £26 billion to £55 billion. These figures are more than those of cancer and heart disease combined.

Whilst these statistics highlight the scale and prevalence of dementia within our population, people’s perceptions of dementia are less informed, with many incorrectly accepting that dementia is simply an inevitable part of growing old.  Ironically, these misconceptions contrast with statistics that show dementia is the single most feared health condition in older life.  

Architect’s and designers have a pivotal role, and a real opportunity, to address many of these issues. Good design and designing for dementia is increasingly becoming an essential aspect of the Architect’s skill set.  Holmes Miller have embraced this need and have invested in upskilling staff through dedicated Dementia Design training courses and have also engaged with the University of Stirling, supporting them in their ‘Healthy Ageing Challenge Social, Behavioural and Design Research Programme’, which will focus on sustainable design improvements to homes.

Intergenerational Living

We believe that the overarching design philosophy should be one of inclusion. Designs should create multi-generational environments that allow people to genuinely feel part of a community, allowing them to ‘age in place’. How we design places to live and work on a daily basis is key, as more often than not it’s the physical environment that is the root of many aspects of dementia, such as anxiety, isolation, and disorientation, amplified by reduced sensory capability.

A true sense of community creates familiarity and confidence, which in turn contributes to increased independence, personal identity and increased engagement. Thoughtfully designed neighbourhoods which encourage a rich and diverse mix of inhabitants promote inclusion, stimulation and interaction. Our designs need to remove barriers and promote genuine wellbeing for elderly generations, delivering follow on benefits to carers, staff, and those who live with dementia sufferers. Design which responds to Dementia really is design for everyone.

Building Design

To create fully inclusive communities, it is vital that public buildings should be designed to meet the varied needs of older age groups. This applies to all areas of design, from the macro to the micro, encompassing building layouts that promote legibility and familiarity where welcoming, engaging and therapeutic environments encourage interaction and independence, to detailed design of signage and colours and textures of surfaces which aid wayfinding and navigation, reducing stress.

Our designs focus on addressing all of the senses; acoustics, lighting, materiality, ventilation, visibility and sound. It also focuses on how spaces and experiences should be enjoyable in use, therapeutic in nature, and balancing stimulation with comfort. Even simple design decisions, which can be all too easily overlooked, need to be considered with an understanding of the positive effects they can have on people with sensory impairment.

Memory is also a fundamental aspect, whether it be the ability to relate back to earlier life through familiar, recognisable design features, or as a wayfinding and legibility aid through a person’s journey within a building. Creating feature character points and strong relationships with external landscape throughout buildings enrich people’s experience, reducing stress and anxiety.

External Landscape

For Holmes Miller, the external landscape and how we encourage its use is an interlinked element of the overall design. Being able to spend meaningful time in quality outdoor spaces is a recognised aid to mental and physical wellbeing. It offers real opportunities for community connections and activities, through community gardens, sensory experiences and a varied range of informal uses. Design that maximise time spent outdoors is proven to increase independence and self purpose, contributing positively to how people express themselves. Increased sensory stimulation and the introduction of fun activities, animals, water, wildlife, children at play all contribute to living quality.

Links between buildings and outdoor spaces offer real opportunities to enhance the lives of occupants. Well designed terraces, balconies and gardens offer aspect, shelter, privacy and comfort, even for less mobile occupants.

Designing Better Buildings

The overarching  benefit of successfully designing buildings that are dementia friendly is that they will inevitably result in better buildings for all users. Creating buildings that are a joy to experience, and will positively contribute to the lives of all age groups within the community.

Our current portfolio of projects includes a growing number of sensitively designed care homes throughout Scotland and beyond, increasingly becoming a significant sector. Elsewhere, we have designed mixed-use facilities which include provision of flexible adult day-care facilities with a strong community focus, and Our Primary Health Care projects are also benefiting from this inclusive design approach.

The key focus however for Holmes Miller is that ALL our Architecture should be designed with the principles of designing for dementia embedded. Adopting the philosophy of prevention by design rather than treatment, of community integration and relationships, and that truly good design is first and foremost inclusive design

Allander Leisure Centre and Adult Day Care Centre

Livilands Care Home, Stirling