Deep dive into dementia design

What makes a space dementia-enabling? How can new designs incorporate those ideas? And how can existing spaces be brought up to scratch?

These are questions on the mind of every residential aged care leader in the country, ahead of July’s introduction of the National Aged Care Design Principles and Guidelines.

This new advice aims to create more accessible, dementia-friendly and homelike environments, thereby improving quality of life for older people – especially those with dementia – living in residential aged care.

Fortunately, there are architects and designers who’ve been thinking about these questions for decades, with several organisations leading the way and, in fact, setting the standards that the government is now advocating.

One of these is Bickerton Masters, which has been designing for the sector since 1997. Architect Jonathan Chew is an associate with the firm and sector lead for aged care and seniors living. He’s also a design consultant for The Dementia Centre. I recently sat down with Chew to dig deep into dementia-enabling design for the following Q&A.

First of all, tell us a bit about how you came to be designing for the aged care sector.

I studied architecture in Brisbane, and then landed with Bickerton Masters in 2014. I knew about them through a family friend, and at the time I was finding it tricky with what architecture had to offer – a lot of it was very aspirational, aimed at people with a lot of money. I thought, ‘Is that all we have to offer?’ I wanted something more meaningful. I was very lucky to find a firm that prioritised using architecture for good purposes.

What are some challenges and opportunities the rollout of the new principles and guidelines will bring?

I think the interesting thing will be about application. It’s got a good foundation, but finding people and organisations who have history and experience in knowing different ways to apply it will be crucial. They will need to be able to adapt the guidelines to individual settings. There’s also a challenge in relation to who we’re designing for. There’s a public perception of what good looks like in an aged care residence. For a family member that might be something grand or modern, and not actually what good dementia design recommends. So, we need to raise awareness of what good dementia design really looks like.

Do you think the wider design world needs to know about this? The people designing shopping centres, parks, theatres and libraries?

Definitely. As much as we can do in residential care, the majority of people living with dementia are living in the community, in their own homes still. Good dementia design shouldn’t be limited to the residential care space. As an example, the first thing that comes to mind is around noise, and this is something that anyone can tap into. We’ve all been in a restaurant and it’s just too noisy, you barely hear the person you’ve come in with – it’s so frustrating. Now think of how much that is elevated for someone with dementia. And yet that can be easily managed by thinking about the arrangement of furniture in the space and the kinds of surfaces you use. But it’s a big challenge to get people to see that it’s important.

There’s power in incremental change

So, what needs to happen to take it more mainstream?

There’s a lot of advocacy that’s still needed, and I think there’s still work to be done with the public perception of dementia. Dementia design is just one tool in the kit to get that advocacy and education right. To be able to say to someone, ‘There are a lot of organisations who do it really well, and this is what good dementia care looks like in the built environment,’ means we’re changing the way people perceive dementia, one person at a time.

What advice would you give to anyone wanting to build or refurbish a residential aged care facility?

There’s power in incremental change. A small change is still worth doing. We don’t have to adopt all of this at once, and you don’t have to look just like that other organisation over there. Every little bit helps, and every conversation with someone informed in this space helps because it gives you a better idea of what other applications are out there. It gives you more agency to see what works for you and what you can build on for the future.

Marie Alford is head of professional services at The Dementia Centre

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