This page contains a Flash digital edition of a book.
industry comment

How dementia-friendly is your building... really?

    


Architects make a difference to how people live their lives, and they care about quality of life and how their art and science contributes. The importance of architects for people who have dementia cannot be overstated. Dementia is the name given to the set

of symptoms appearing when people become less able to care for themselves because of gradual cognitive deteriora- tion, usually in old age. It is often described as a memory problem, but research shows that people with demen- tia and their carers are more concerned about agitation, wandering, aggression, distress and practical problems like noc- turnal disturbances and incontinence. The majority of people with dementia

live at home in the UK, about half of them alone. With adaptations and support they can stay home until the end of life. Designed features in the house help. The cost is high; often the family has to give up work, or pay someone to provide home care. Moving to a care home is even more

expensive, though the local authority or the NHS sometimes cover the cost. People say they’d prefer to stay at home as long as possible. Government policy wants that as well, not least because of the expense. There is not enough money and there are too many affected people. Nevertheless, around 400,000 people

live in care homes. Unsustainable old-style adapted care home buildings are closing because of changes in regulation and rising costs. New care homes open every week and should be

designed with dementia in mind – up to 90 per cent of care home residents already have the condition.


When journalists call the Dementia Services Development Centre (DSDC) for comment on whether a new care home is ‘dementia friendly’ or built on ‘dementia principles’ it can be embarrassing. Developers frequently make these claims when they’ve only adopted a few superficial, unproven ideas – ‘colour coded corridors’, a mocked up ‘pub’, and an ‘olde sweetie shoppe’ are recent examples. In reality, they are following fashion not science, while trying to give the impression they are making a difference to dementia. Even if they’re challenged, others copy them. Some buildings have won design prizes when they would not reach bronze level in the Stirling dementia design audit process!

Why does it matter?

Real dementia-friendly design reduces the lifetime cost of running a care facility by reducing adverse incidents and staff burden. It improves quality of care and staff morale by ironing out predictable dementia-related problems in the building. That gives staff more time for interactions that matter. If the research-based principles are ignored, cost and quality benefits will not be achieved. Colour coding a facility to help wayfinding requires a resident to learn a

new ‘language’ at a time when their capacity to learn is much reduced. Why would you? Instead, research supports well-designed, well-positioned signage. Incontinence is really expensive in

laundry, cleaning and staff time, not to mention the discomfort for the person affected. The right lighting, flooring, signage, and design of toilet spaces can reduce the problem. That’s truly dementia-friendly design.

How can dementia-friendly design be verified?

There is as yet no regulatory standard for dementia design. The DSDC has 25 years of experience in this area, but can’t check every claim that a building is based on Stirling principles. The website offers free advice and low-cost publications and courses at, including a virtual dementia-friendly care home virtual-environments/virtual-care-home. People can self-assess or can use the Stirling design tool, but Stirling has no capacity to check every assertion that is made in their name, so caution is needed about claims.

What should architects do?

Architects and developers need to take greater care when making claims, particularly if the operator has not followed the advice. This is about science, not style. Failure to ensure this is unprofessional.

Continued overleaf...


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52