PROPERTY & CONSTRUCTION,dementia%20or%20severe%20memory%20problems,dementia%20or%20severe%20memory%20

Homes That Care

James Botterill, Director of HSSP Architects, highlights the importance of design in improving the health and wellbeing of people living with dementia.

When I started my career over 30 years ago, dementia was a condition that people rarely discussed openly. Today, 1 in 6 over 80-year-olds live with its devastating impact. Dementia, and how best to care for and fund those affected, is part of public and political debate. Supporting people that live with dementia is one of the greatest health and social care challenges of modern times. Around 225,000 people will be diagnosed with dementia this year – that’s one person every three minutes and at least one million will suffer with the terminal disease by 2025.

The care home market has grown significantly to keep pace with the demands of the UK’s ageing society. Yet, while it is estimated that 70% of care home residents now have dementia or similar challenges, the ‘standard’ building design has evolved little from early institutional architecture. Care homes with long corridors, open communal living and busy internal and external spaces are ill-equipped to support the physical, cognitive and sensory needs of people living with this condition.

In fact, evidence has shown that the environment in which care is delivered has an enormous influence on its effectiveness. It can also significantly improve quality of life for residents and offer benefits for families, friends and staff.

Here, we explore three aspects of architecture and design highlighted by the Department of Health in its study, Dementia-friendly Health and Social Care Environments, and see how it can be delivered in practice. We show h

A HOME FROM HOME The need for better design in care home provision spans

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further than a few cosmetic tweaks – it demands a fresh look at the concept and purpose of the whole living environment. Critically, we need to address the hangover of institutional design and incorporate the heart of the home within a safe and functional building.

Changing the layout within care homes can make enormous differences. Best practice design, in line with the 12 principles set out by the Department of Health, highlights the need to avoid busy and crowded areas, unidentifiable spaces, noise and clutter that add to feelings of confusion and anxiety. There is an emphasis on easing the transition through ‘comfort design’ and a ‘home-from-home’ feel.

Our interpretation of this guidance is to deconstruct the traditional institution into a cluster of six pods that form small, self-contained communities within the care facility. Breaking down the long corridors and noisy communal living, entertainment and dining areas in this structure reduces the scale of the accommodation, making it quieter and easier to navigate. People living with dementia can choose where they want to go and be more independent within a smaller, more accessible living space.

Overall, this familiar home-style layout helps people to transition into care and enhances quality of life thereaſter.


A connection to outdoor space, nature and natural light is especially important for residents’ mental and physical well- being. Plants, flowers, water and wildlife are all recognised for their contribution to therapy treatment by lowering stress, stimulating the senses and aiding relaxation, while access to

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