Gardens more caring for them.5 The number of


people living with dementia is forecast to triple by 2050. Most people with dementia will


experience memory problems, especially recent memory, and they may have other impairments, for example with problem solving. Some dementias cause loss of inhibition. Not surprisingly, many people with dementia can be agitated or irritable. In term of design, events such as the


recent pandemic, lock down affected most of us, particularly those for whom there was no outdoor spaces that could be easily and independently accessed. Sadly, this was the case for many people in care homes. This adds to importance of thinking about outdoor spaces at early design stage.


Design of the building and outdoor spaces n Provide outdoor space associated with


individual rooms. This could be a private patio or access to a communal outdoor space on upper floors – in addition to the communal garden. This will allow people to be outdoors, even when there may be the need for isolation due to illness.


n Design a care home with small wings, e.g. flats with say 8-10 residents. This can enable a household model, which, as well as being more ‘familiar’, allows a wing to be isolated if an infectious illness were to break out, rather than isolating all residents in a care home in their own room, which proved to be so very devasting to people’s health, physically and mentally, during the pandemic.


n Another possibility is to provide outdoor garden rooms and defined outdoor spaces for particular activities such as games, gardening, and places where people can find peace. Such spaces can also enable culturally appropriate activities.


Air pollution and climate change In addition to thinking about ‘inclusive design’ and concerns linked to health and disability, there is now an increasing awareness of air pollution and climate change, both of which are major and urgent considerations for the future of the world as we know it. It is worth noting that indoor air


may contain 2-3 times the pollutants of outdoors. Some sources of these pollutants are listed in a report by the United States Environmental Protection Agency (EPA) and include everyday items such as cleaning supplies, combustion sources, and some building and furnishing items6


– so being 40


outdoors and also opening doors and windows can help the indoor environment. In respect of climate change and gardens, we need to consider: n Sustainability – providing outdoor space that is easy to maintain with the potential to thrive in our changing climate.


n Plants – choosing shrubs and trees can help to absorb pollutants, stabilise the soil, and provide shade and shelter. Using more climate tolerant species can safeguard our gardens and other outdoor spaces, allowing outdoor areas to thrive.


Summer 2023 was the hottest on record, yet also saw heavy rainfall, and this leads to an even greater need for maintenance as some plants have grown faster than one might normally expect. What can be grown outside rather than


in a greenhouse may well change with the climate. We may have to change our thinking and choose more hardy plants that can adapt to change – this will be a process of ‘trial’ and experiment’.


Outdoor air pollution


A study by Michael Mosely some years ago found that planting silver birch trees outside houses along a busy road, significantly reduced airborne pollution. The results were amazing, showing that the fortnight’s pollution in houses with trees was 50-60 per cent lower than in those without.7 Similarly, hedges can trap particulate matter emitted by vehicle exhaust, and evidence shows that this can reduce pollution around school playgrounds,


Designers need to understand clearly who they are designing for


applicable also to housing, care homes and other residential buildings.8


This photo above


shows new planting around a care home beside a busy road – trees with hedging, which should, as they grow, mitigate against pollution from the busy road. However, it is important to note that planting does not generally absorb the noise pollution associated with heavy traffic.


Wayfinding


As long ago as 2006, a set of six principles was suggested by Mitchell and Burton.9 This research was about neighbourhoods, but the principles can also apply to outdoor spaces such as parks and gardens. It relates to the particular wayfinding challenges experienced by many of us (I, for one, have never had a sense of direction) and, in particular, for people with cognitive issues such as dementia. These are good to keep in mind during any place-making process. They are:


1. Familiarity: If the environment is familiar, this makes it easier for people to find their way around.


2. Legibility: The environment should be easy for people to read and navigate.


3. Distinctiveness: Distinctive features capture people’s attention and help with spatial orientation.


4. Accessibility: People of all abilities should be able to reach the places they need or want to go.


5. Comfort: People should be able to use the space without discomfort.


6. Safety: People should feel safe using the space.


All of these are strongly interlinked – but of course, the devil is in the details. A recent reference developing these is Dementia and the Outdoors Guidance Note produced by Paths for All.10


www.thecarehomeenvironment.com November 2024


© Annie Pollock


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