Dementia is a disability characterised by impaired memory and reasoning; impaired ability to learn; high levels of stress; and sensitivity to the social and built environment.
These disabilities must be compensated for when considering the design of a residential care home for people with dementia. HammondCare strives to do this and more – we also want the building itself to improve the symptoms of someone with dementia. We want the building to be prosthetic and therapeutic in order to promote dignity, self-esteem and autonomy.
Enduring design principles for dementia-specific buildings
Small in size.
Large buildings are confusing and alienating. Our homes are divided into small cottages with small numbers of residents.
Familiar, domestic, home-like environments.
Kitchens that produce sight, smell and sounds of cooking are a feature of all good dementia services. They provide excellent orientation of time and place. Personal identification with space is also important and can be achieved by decorating a resident’s room with their precious and familiar belongings.
The environment must be legible.
This means a resident must be able to see or sense where they are and where they want to go. They must be able to read – not remember – the environment. Good visual access and good passive “cueing” is important. Cueing is to people with dementia what runway lights are to pilots. It can be achieved by using different timber panels for doors; artwork or furniture; natural lighting or more active cueing involves putting picture frames of collectables at bedroom doors. We try to use the building as a language to communicate.
Promote self-esteem and autonomy.
This is achieved in many small ways and can start with making every choice a “right” one. This means there are no dead-ends and any locked doors are unobtrusive. Different rooms have different daily activities and are welcoming and encourage visitors and family.
Controlled stimuli, especially noise.
Noise is to people with dementia what stairs are to people in wheelchairs. Good dementia design controls the stimuli by promoting sounds that assist cueing and by reducing noise. Unfamiliar noises from plant and equipment and unfamiliar faces are “back of house”.
A safe environment.
This does not mean creating high perimeter walls and padlocking doors. Protecting residents from external intrusions and from internal wandering is achieved and managed unobtrusively with a minimum of locked doors. Colour-coded taps, non-slip floors, remote switches for kitchen appliances, and nurse alert and paging systems that promote calmness not confusion are all elements of a safe environment.