The design of supportive settings for people with dementia

Judith Torrington University of SheffieldKT EQUAL conference 27 January 2011St Marys Conference Centre Sheffield

Extra care housing for people with sight loss

Thomas Pocklington Trust

EVOLVE : Design evaluation of older people’s

extra care housingUniversity of Sheffield, PSSRU, Department of Health Care Services Improvement

Partnership Housing Learning and Improvement Network, Elderly Accommodation Counsel

INDEPENDENT: Investigating Enabling Domestic

Environments for People with Dementia Universities of Liverpool, Bath, Sheffield, Dementia Voice, Northamptonshire County

Council, Sheffcare, Huntleigh Healthcare

Design in Caring Environments (DICE)Universities of Sheffield and Loughborough, Sheffield City Council

Physical environments in relation to

people with dementia

• Universal needs – what everyone needs in the design of the home

• Older people’s needs – support for ageing

• Support for dementia

Design for well-being

• People with dementia have low levels of participation in enjoyable activity

• Interactions between a person, and their social and physical environments are complex and change over time

• Methods are needed to support activity that address this complexity

• Social contact, conversation, communication, relationships• Reminiscence• Activities of daily living• Pottering in the house, or garden• Music (listening, singing, social participation, dancing,) • Getting outside, the natural environment• Community participation• Laughter • Physical activity, walking & exercise• Creative activity• Mental stimulation• Meals & food• Television

Wish list – favourite activities

Barriers to using a computer

communication device in different

living environments

6-Private home

14-Sheltered flat

54-Care home lounge53-Care home bedroom

Supporting social engagement

Private home

Sheltered flat

Care home lounge

‘When there’s about 10 or 15 of you in one room, you can’t suit everybody, can you really?

So you don’t put music on for yourself…‘No.’ Not here. ‘Not here. Oh no, no.’ Why not? ‘I know it’s not my place, is it really’

Ownership and belonging

Meaningful spaces

• Misinterpretation of space can inhibit participation in activity

• Mixed messages often given out in purpose-built settings

Reinforcing meaning

Spatial hierarchy

Light/ dark

Upstairs/ downstairs

Visual processing – ‘what’ and ‘where’ pathways

Physical memory

Behaviour

Physical support and accessibility

Good physical support was associated with better quality of life in the DICE study

Finding the way

Walking routes

Circuit routes

Seating areas

Incidents

Doors – inviting access or not

Gradmann HausHerrmann and Bosch with Demenz Support Stuttgart

‘street’

Safety and health

The DICE study found buildings with high scores for safety and health had low scores for quality of life

Security concerns frequently prevent people from accessing gardens

Daylight and sunlight

Seasonal Affective Disorder and daylight

Circadian rhythms

A diurnal cycle of darkness and bright light

Contact with the natural world

Ownership

Seasonal variation

Access

Changes in vision

Glare and dazzle

Contrast

Colour

Floor finishes

Visual prompts

Colour and texture

Soft colours

Red/orange part of spectrum

Tactile surfaces

Familiar furniture

Guidance to

Activity in

Dementia Care

A checklist and design guide to promote

enjoyable activity for people with dementia

www.atdementia.org.uk

toolkit

http://www.dhcarenetworks.org.uk/IndependentLivingChoices/Housing/Topics/type/resource/?cid=7997