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Seeing as others see is key to designing for dementia

With ever-growing numbers of people affected by dementia, there is expanding evidence showing the impact of physical environment on wellbeing. Whilst legislation sets out design principles; in reality, seeing as others see and designing with empathy are key to effective design.

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By Mark Johnstone, Head of Commercial – UK, Middle East and Ireland, Altro

With the introduction of legislation and expert guidance for designing for dementia over recent years, care homes and healthcare environments are becoming more aware and applying best practice principles more often – 70% of people in care homes have dementia or severe memory problems so this is extremely relevant for them. However, when you consider that two thirds of people with dementia live in the community, it’s clear that better understanding of these issues throughout the whole design sector is needed to change the way people with dementia are engaged with in the environments they live.

Altro has worked to develop products to offer those designing for dementia choices in suitable, practical and effective solutions. Altro works with several partners, all directly involved in improving the lives of those living with dementia. One of these is the Dementia Services Development Centre (DSDC) at the University of Stirling. The DSDC is the world leader on the design of services and environments for people with dementia. who Altro worked with when developing new shades of Altro Aquarius to ensure carers and those with dementia can be safer in wet environments, and when developing the colour palette for Altro Suprema.

Altro’s latest CPD on designing for dementia shares learnings and recommendations developed through this work and focuses on empathetic design: understanding how dementia affects those living with it, what that looks like to them and why and how you can make improvements through design choices, and meet legislation and guidance for dementia design.

The Department of Health’s Health Building Note 08-02 – Dementia-friendly Health and Social Care Environments, was published in 2015 and is still current. It outlines design principles to aid design of new build and redevelopments and incorporates expert research and guidance from the DSDC and The Kings Fund amongst others. Within this there are 12 design principles. This is where ‘seeing as others see’ becomes highly effective, and for that we must understand more about visual impairment.

Visual impairment is experienced by many people as they age. However, dementia can add to the challenge of living with sight changes, or someone’s eyes may be healthy, but their brain has trouble interpreting what is seen.

Visual impairment often means lower contrast sensitivity, poorer colour vision, less spatial awareness, and poorer perception of depth. It can lead to misperceptions – when a person sees one thing as something else, for example mistaking a coat hanging up for a person - and disorientation – for example misinterpreting reflections on shiny walls as an intruder.

Altro’s Designing for Dementia CPD uses practical examples to demonstrate the impact of design decisions. Let’s look at image 1. What works well in this room is having a consistent flooring or floor tone, as this encourages a person to go through into the next room. Consistent flooring doesn’t attract attention. Use consistent flooring materials and finishes across areas where those with dementia should be encouraged to move freely – a day room to an activity room for example. However, the choice of skirting in this example is problematic, as when viewed from another room it could give the perception of a barrier, as it does across the door in this example. Additionally, the floor in this image is shiny, making it appear wet - it should be matt.

When looking to achieve a homely, non-clinical feel, it may be tempting to opt for patterned flooring, but as image 2 shows, someone with visuo-perceptual difficulties may mistake the pattern for objects to be picked up or to be avoided, and in doing so could result in a fall. Similarly, with wall coverings, heavy patterned wallpaper could be picked at and damaged.

Although a lot of the guidance around design for dementia considers visuo-perceptual difficulties, acoustics and sound also play a part. In fact, dementia affects, and is affected by, all of the senses.

Disorientation and bewilderment are a common experience for people with dementia - exacerbated by noisy communal and activity spaces, repetitive sound, noise transfer to bedrooms. People with dementia need environments that are easy to interpret. Altro’s CPD on sound reduction explores these issues and solutions in detail. There are many practical examples like these in Altro’s new edition, designing for dementia CPD. There is also a new CPD on sound reduction which encompasses elements of design for dementia from acoustic perspectives. To book, call Julie Hillhouse, Altro Housing Consultant, Scotland on 07831 232815 or email jhil@altro.com.

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