The world-renowned Dementia Services Development Centre (DSDC) at Stirling University has issued design guidance for creating supportive environments in care homes for people living with dementia.

It states that: “A well-designed environment can help feelings of comfort and security by promoting independence, personal identity, enhancing confidence and self-esteem, while allowing required care tasks to take place in a dignified way.

“This might sound like an overwhelming list, but it is easily achievable.”

Avoid change

To start with, DSDC recommends avoiding creating often-favoured ‘dementia wings’ or ‘households’, stating: “It’s likely that many residents who arrive without dementia will develop it during their stay.

“You want to avoid moving rooms for people with a dementia; they should ideally retain one bedroom throughout their residency.

“A dementia-inclusive design is best to be incorporated throughout the building: this will cater for residents who may not have dementia but have impairments of ageing such as sight and hearing or mobility issues.”

Instead, the guidance favours creating spaces which ‘draw on a sense of homeliness and familiarity’.

A balancing act

While this can be a balancing act, avoiding clinical environments is best, the experts said, as they can be distressing or evoke negative feelings which bring back bad memories.

“Allowing residents to bring their own furniture and meaningful items will aid familiarity and helps them to settle in,” they state.

Designers should reinforce personal identity through personal objects and familiar fixtures and fittings. For example, focusing on personalisation of the bedroom entrance to differentiate from a corridor of similar doorways and aid wayfinding.

Bedrooms

And, when it comes to fitting out bedrooms, the obvious place to start is: does the room look comfortable?

The guidance states: “It needs to be welcoming in addition to the other well-thought-out elements.

“For instance, it’s worth thinking about the flooring in wetrooms. Stippled safety floors in wet rooms can be very uncomfortable underfoot for the thinning skin of an older person.

“What about acoustic comfort? The right flooring, ceilings, wall panels, artwork, and soft furnishings help absorb reverberation, avoid auditory overstimulation, and aid conversation.”

A room with a view

For those who are not able to move around, it is important to provide a room with a view, something absorbing to look at such as a busy streetscape or garden.

And there should also be a choice of spaces available within the home, such as an activity room, a quiet room, and outdoor space.

“Residents need to be able to continue to take part in hobbies and interests as well as daily living activities,” it states.

“This could be anything from a baking or gardening group through to being able to hang up the washing.”

To support this, care home designers and operators need to ensure they reduce physical and perceived barriers to allow free movement and access throughout the care home.

“Residents shouldn’t have to be escorted through a restricted access point into a lift to go down a level to enjoy some outdoor space,” it adds.

It concludes: “Dementia design does not need to cost any more to achieve practical levels of finishes. Plus, what is good design for an ageing population is good design for everyone.

“It’s worth remembering that while creating a space that is inclusive for people living with a dementia, you also need to have staff who are appropriately trained in dementia and the building, too.

“Only then, when you have an inclusive space and well-trained staff, will they work in harmony to provide residents with true comfort and care while retaining all of the required practicalities.”