always had a strong focus on housing, until recently it had mostly been from a quality/performance perspective. What is apparent through all of that work, however, is the impact that housing, and the overall built environment, have on every aspect of our lives – including our health and wellbeing. With people now living longer, and their health requirements changing, we have thus begun asking: ‘Does the quality of the existing built environment reflect these trends, and still provide the support function we need it to for us to maintain good levels of health and wellbeing?’” Dr Kelly showed a slide from the United Nations Department of Economic and Social Affairs to highlight just how fast the world’s population is ageing. This showed that while in 2017 one billion people were over 60, by 2050 this figure is expected to rise to 2.1 billion, and by 2100, to 3.1 bn. Against such a backdrop, it was interesting to speculate on ‘what our homes and communities might look like in 2025, 2050, and 2100’. He said: “The first date, 2025, is not very far away, and there are things we are looking at already that can inform some of the decisions we make going forward. “There are examples in Chris and Sally’s House. In the longer term, however, what will things look like in 2050? We will undoubtedly be looking at more autonomy in transport, and greater deployment of devices to manage our own health and wellbeing within the building stock, while in 2100 there will be over three billion people across the world aged over 60. There are thus some big questions, but we can start the conversation now.”

An unstructured market “There are already,” he continued, “some solutions available which can contribute to supported accommodation – technology, products, and approaches, that can support people in their own homes.” While some of these ‘solutions’ could potentially benefit quite a lot of people, he said little of this was ‘evidence-based’, with research to substantiate claims. Dr Kelly said the BRE’s position is that the market and approaches are currently ‘very unstructured’, explaining why it had placed increasing emphasis on housing and dementia over the past 2-3 years. He added: “Although a broad range of stakeholders is working to address the key issues, to date there seems little communication or collaboration between them. In developing Chris & Sally’s House it was thus key for us to bring together a multidisciplinary team using an evidence- based approach to help shape it, and indeed to inform and guide our wider work on housing and dementia. The result is a focus on all the aspects within a building that can contribute to health and wellbeing.”

The right argument

More broadly, Dr Kelly said he believed that while ensuring a good ongoing stock of high quality housing with sufficient ‘inbuilt’ adaptability to meet an ageing population’s


A daytime view of the living area of the BRE/Loughborough University Living with Dementia Home at BRE’s site in Watford.

needs should be a priority, if BRE and its partners began telling policy-makers or housebuilders that every new home should be dementia-friendly, the reaction could be ‘quite negative’. Instead, he said, they needed to focus on how to embed adaptation capacity in new-builds to accommodate people’s changing circumstances as they age. “If we don’t,” he warned, “the 300,000 homes we are looking to build annually in the UK will have an inbuilt problem that we will have to look at some way down the line.” When seeking to identify ‘what good looks like’ in the design of an ‘ideal’ dementia-friendly home, Dr Kelly said there was an extensive range of elements to consider. He explained: “The question of what constitutes a really good such home is something we want to address as part of this project, but we can’t do it alone, so we are actively seeking further collaboration, plus feedback on the design of the new home and the elements within it.”

No ‘miracle pill cure’

In an interesting address touching on some of the ageing population-related challenges facing health and social care providers, DiMHN President, Joe Forster,

An evening view of the lounge of ‘Chris and Sally’s House’, showing good levels of artificial lighting.

argued that, with ‘no miracle pill on the immediate horizon to cure dementia’, addressing the condition and finding effective ways to support those living with it was ‘not primarily a medical problem’. He explained: “Dementia is not susceptible to any immediate solution. It is rather a problem of social care; that is where the interventions that really make a difference will happen. It is also a problem of education; understand the condition, and get to know more about it, and we will be better able to deal with it.” It was also ‘an architectural problem’. “If we can design better ways of our environment giving us help to deal with it, then we will be able to manage it better,” he explained. Joe Forster emphasised that those with mental healthcare issues – including those living with dementia – were not ‘abnormal’ in their psychology; rather their illness was very often a result of earlier life experiences, or, in the case of dementia, physiological change, to which their distress and subsequent illness were ‘a quite normal reaction’. He added: “We are thus not asking architects to design buildings for the mentally unwell because of something that is abnormal. This is the new ‘norm’, and good accommodation for such individuals is badly needed, not just as an ‘add on’ in little boxes for where people might be.”

More detail on the demonstrator home

An area (left of shot) to accommodate a wheelchair and carer lift (to be installed later), providing access to the upper storey. The upper floor is laid out to show how ‘Chris and Sally’ can continue to live in the house as Chris’s condition deteriorates further.

At this point attendees were able to hear more about the Living with Dementia Home from Eef Hogervorst and Bill Halsall. The former began by discussing some of the research she and the team had undertaken on dementia at Loughborough University; the University helped fund the ‘Chris and Sally’s House’ to showcase the research. Eef Hogervorst said: “I will be talking about how the research relates to design, and how we have tried to implement that in the demonstrator home, principally to promote independence in older people, and improve their quality of life, but also to ensure that we don’t exacerbate existing impairment and cause further difficulties.” Among the spectrum of issues for those living with dementia, she explained, were memory loss, problems dealing with financial planning, language and communication problems, (visual)





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