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Top 10: design principles for dementia-friendly environments

Kirsty Bennett

Kirsty Bennett

Making an environment more dementia-friendly didn’t necessarily have to involve calling in the builders, and can be as simple as rearranging furniture, says expert.

Dementia-friendly design not only enhances the wellbeing of residents living with dementia but enables aged care providers to create sustainable environments.

That’s according to architect Kirsty Bennett, manager of environmental design education services at the NSW/ACT Dementia Training Study Centre (DTSC), who said it was a myth that providers had to be simplistic when it came to designing dementia-friendly environments.

“Bland, boring, repetitive environments are actually really confusing for a person with dementia,” Ms Bennett told the Leading Aged Services Australia Tri-State conference last week.

Instead, she said providers needed to design environments that were relevant and meaningful for residents living with dementia. A well-designed environment considered resident’s stories – such as their lifestyle, cultural and socio-economic backgrounds and interests, said Ms Bennett.

However, she also stressed that environments needed to keep recognisable characteristics, considering what residents were familiar with.

Often when providers discussed design they talked about capital costs, but Ms Bennett advised not to silo budgets, noting improvements to environmental design could help with long-term operational sustainability.

Making an environment more dementia-friendly didn’t necessarily have to involve a new build – it could be as simple as rearranging furniture, she said.

The DTSC developed 10 design principles to help create dementia-friendly environments, which Ms Bennett said offered a starting point for innovative and sustainable design.

Research had shown these principles reduce negative outcomes for people with dementia, such as agitation, confusion and wandering behaviours, and increase positive outcomes in areas such as mobility, wayfinding and activities of daily living.

The 10 key design principles are:

Too much stimulation for people with dementia, such as excessive signage, may be stressful.

Too much stimulation for people with dementia may be stressful

1. Unobtrusively reduce risk: Safety was important, but it was also key to enable people at the same time. For example, if creating a fence around a facility, using a material such as wire will allow people to see through and enjoy the view beyond the site.

2. Provide a human scale: Group size was important for people with dementia, with more people meaning potentially more distractions, which can affect behaviour.

3. Allow people to see and be seen: It was important to allow people with dementia “visual access” to clearly see where they are in the environment. This might mean setting up a lounge room so people can see through an open door into the hallway or other rooms, and having a window to look outside.

4. Minimise unhelpful stimulation: Unhelpful stimulation may distress and confuse those with dementia, and this includes all of the senses. Solutions to this may include painting murals to hide doors that are not to be used and reducing excessive signage.

Using cues such as colour may assist wayfinding for those with dementia

Cues such as colour may assist wayfinding for those with dementia

5. Optimise helpful stimulation: Environmental cues such as colour, objects or a view enable people with dementia to better find their way around and made environments more meaningful.

6. Support movement and engagement: Arrange environments in ways that encourage people to use them. This might mean rearranging chairs around a table to make a clearer point of interest and better create an invitation to sit down.

7. Create a familiar space: Furniture, finishing, colours and fittings should be selected based on what someone is used to in order to make them feel comfortable.

8. Provide opportunities to be alone own or with others: Provide a range of environments that allow people to have both privacy and social interaction, both inside and outside.

9. Provide links with to the community: This might include a community garden or inviting people to the facility to enjoy a movie night.

10. Respond to a vision for way of life: Facilitate environments that respond to people’s stories and allow them to continue with interests such as sewing or gardening.

Main image: Peak Multimedia 

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One Response to Top 10: design principles for dementia-friendly environments

  1. Rosemarie Speidel March 4, 2016 at 7:13 am #

    We know more and more about the built environment and its impact on physical and emotional wellbeing. Sadly the quality standard only focus on safety rather than amenity and wellbeing for residents. With the changes to residential age care funding, many small operators either are forced to close down, redevelop into larger facilities or new private operator build new large scale residential aged care facilities with 100 plus single rooms. Unfortunately there is little evidence available yet on how consumers (residents and future residents) are engaged in the design to ensure they meet their physical but also emotional needs. I am concerned that some of the residential aged care homes built today will not meet the needs of the baby boomers when they require care. Ensuites are important for privacy and dignity but mental wellbeing needs stimulation, ability to be able to maintain everyday tasks and independence including cooking and eating when desired not at time convenient for the operator and ability to have a partner stay overnight.

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