Dementia and Design

The importance of design in the environment for people who have dementia cannot be overstated.

Dementia is the name given to the set of symptoms when people become less able to care for themselves because of gradual cognitive deterioration, usually in old age. It is often described as a memory problem, but research shows that people with dementia and their carers find memory the least of the issues. They are more concerned about agitation, wandering, aggression, distress, and practical problems like nocturnal disturbances and incontinence.

When journalists call the Dementia Services Development Centre (DSDC) at the University of Stirling for comment on whether a new care home is “dementia friendly” or built on “dementia principles” it can be embarrassing. Developers frequently make these claims when they’ve only adopted a few superficial, unproven ideas - “colour coded corridors”, a mocked up “pub”, and an “olde sweetie shoppe” are recent examples. In reality, they are following fashion not science, while trying to give the impression they are making a difference to dementia. Even if they are challenged, others copy them. Some buildings have won design prizes when they would not reach bronze level in the DSDC dementia design audit process.

Research supports the right lighting, flooring, signage, and design of spaces to reduce the problems for people with dementia. That’s truly dementia friendly design. Furniture, crockery and other features should be traditional in design and able to help a person with dementia make the best of the strengths they have. It should be aesthetically pleasing and not childlike or embarrassing or stigmatizing to use.

Designers need to take care when making claims – this is about science, not just style. All designs should work on the assumption that the people with dementia will have difficulty in working things out, so making the space easy to read is very important. Which way do I turn when I leave my room? How do I find my way back? How does this shower work? What time of day or night is it? Where can I go for exercise and daylight? How can I get away from noise and stress? Do I belong here? Where are my clothes? Where is the toilet? Can I eat something now? Assume their eyesight is poor and they tire easily. Try to make life interesting and rewarding. Use classic design and don’t assume anyone is frozen in a particular time warp.

There is as yet no regulatory standard for dementia design. The DSDC has 25 years of experience in this area, but can’t check every claim that a building or other feature is based on “Stirling” principles. Our website offers free advice and low cost publications and courses at http://dementia.stir.ac.uk/design, including a virtual dementia-friendly care home http://dementia.stir.ac.uk/design/virtual-environments/virtual-care-home. People can self assess or can use the DSDC design tool, but the University has no capacity to verify every assertion that is made in their name, so caution is needed about claims.

The DSDC principles are laid out for all to see, but in truth, any design solution that would help to answer these needs would be in line with the fundamental idea. If any manufacturer wishes to be associated with the Dementia Services Development Centre, you know where we are. Faced with an item of furniture, or a service, everyone has to ask himself or herself whether it answers the needs of people with dementia and whether you are qualified to judge. Just carrying a label does not in itself carry any weight. The one exception is the DSDC design audit certificate that is based on research evidence of what makes a difference. You can find more about that here at www.stir.ac.uk .

Professor June Andrews Dementia Services Development Trust – our work is dependent on your generous donations https://www.justgiving.com/dementiaservices/