Design for Dementia How can design make a difference?

1. Design for DementiaHow can design make a difference? Experiencing dementia The key principles The impact of design on behaviour Examples in practice What changes could you make? Marney Walker, Senior Practitioner OT, Extra Care and Supported Housing Housing Commissioning Team, Adult Social Care

2. Experiencing Dementia “My granny was not able to remember if she had any milk, or eaten her dinner, but she taught me some really complicated knitting patterns that she learnt when she was my age.” DSDC (2010)10 Helpful hints for dementia design at home

3. Experiencing Dementia: Cognitive Processing and Sensory Impairments • The ability to integrate visual, and auditory information is affected • The physical and social environment can be perceived as unfamiliar and disturbing

4. Experiencing Dementia: Risk of Falls Combined with factors typical in ageing:(weak muscles, joint pain, and poor eyesight) Older people with dementia are more likely to have abnormalities in gait due to limited ability to compensate for the impact of mobility impairments • People with dementia are: • Twice as likely to fall • 3 x as likely to fracture • Have a poorer prognosis • Spend longer in hospital • 5 x more likely to become • institutionalized

5. Experiencing Dementia: Behaviour • Feelings of disorientation, frustration, bewilderment, humiliation are common • Restlessness and Wandering can be due to: - Forgetting where you are going • Feeling lost, feeling hot • Being in pain • Needing the toilet • Agitation at feeling imprisoned • Humiliation : being unable to understand how to use toilet flush, or tap • Withdrawal from noise

6. Design for dementia : Key principles Access to outdoors A sense of home Way finding and signage Lighting and tonal contrast

7. How can design make a difference? • Improve quality of life • Alleviate symptoms and reduce stress levels • Maximise independence • Reduce the need for supervision

8. What difference does it make?: Evidence Case example in an acute setting • Better lighting • Consistent flooring • Better contrast to skirting, hand rails, toilet seats • Emphasized and concealed doors • Signage Results: • 40% less falls • 60% less near misses • No absconders • Calmer atmosphere • Less anti-psychotics

9. Visual perception : Things to avoid Patterns that can be perceived as 3Dor moving, on floor coverings, furnishings, crockery Shiny reflective surfaces that create glare and create confusing reflections

10. Lighting and tonal contrast • Light to twice ‘normal’ levels • Use domestic style fittings. • Use daylight wherever possible. • Expose people to the 24-hour cycle of light and dark

11. Tonal Contrast

12. Using tonal contrast Disguise Highlight

13. Being able to find things: labels

14. Being able to find things: labels

15. Keeping things in view • Glass fronted cupboards • Cupboards without doors • Shelves • Clear see-through storage jars • Open front or labeled drawers

16. Keeping things in view

17. Access to outdoors • Exercise keeps bones strong and reduces likelihood of falls • Exposure to natural light : Vitamin D deficiency is associated with: • Impaired cognition • Low mood • Daily exposure to daylight can reduce disturbed sleep

18. Access to outdoors Garden design blueprint :Design Research Centre Richmond University

19. What changes could you make? Design for Dementia Virtual Home http://dementia.stir.ac.uk/virtualhome Dementia Services Development Centre, Stirling University

20. What do you do already? • What works well? • What changes could you make?