Dementia is the single greatest cause of disability in Australians aged 65 years or older, with more than 321,600 Australians currently living with the disease. There are approximately 1,700 new cases each week, which is expected to grow to 7,400 new cases weekly by 2050*.
According to the latest Census report, there is a need for significant investment in aged care. Residential aged care is moving towards providing ‘ageing in place’ so that people don’t have to move accommodation as they progress from low to high-level care.
Residents who enter care with dementia are initially quite mobile but can exhibit agitated and aggressive behaviors borne out of frustration and confusion with unfamiliar surroundings.
smith+tracey architects, experts in aged care design, recently held a think tank to explore how design can better cater for dementia sufferers. Ten concepts were developed, which focus on improving the quality of life of dementia sufferers. Dementia specific accommodation requires a very human approach to design, with therapeutic elements integrated into secure indoor and outdoor spaces that help ease behavioural issues, said Fran Curtis, smith+tracey interior design expert.
Fran said that smith+tracey’s approach to design aims to aid communication and connection, and to provide health professionals with appropriate spaces to solve issues, said Fran.
“Our design concepts make ‘navigating home’ easier, which is especially important because confusion and disorientation is a major source of agitation for people with dementia.”
Navigating signs include personalised visual cues at a bedroom’s entrance and in private spaces. “Placing objects and images familiar to residents, which have personal meaning from their home or childhood helps them navigate their way around and remember where their bedroom is,” she said. Transitions from one room to another are eased with individual front doors, which enable easy differentiation.
Fran explained that even as a person with dementia loses their ability to communicate through language, they maintain their sense of smell, taste and touch.
“Two-thirds of care home residents are women from a generation that was generally responsible for running the home and getting meals ready for the family. We design spaces that can provide scope for activities, like a kitchen that is not just a serving space, but a place people gather around and engage in normal activities that they have been doing for years. This helps continue their daily life routines.”
Eat-in kitchens offer opportunities for interaction between staff and residents and provide a permanent and useful area to run activities, such as baking groups, using space within the facility that is often redundant between meal times.
One of the strengths of people with dementia is the wealth of memories they possess that can be accessed if the right opportunities present themselves. The layout of the kitchen/dining area provides a direct similarity to a normal domestic home which, when partnered with everyday activities such as cooking will improve quality of life for residents.
The internal courtyard garden enables residents to experience the elements from inside, and offers those unwilling or unable to venture outside the opportunity to interact with nature. It will also act as a source of natural ventilation.
Outside healing gardens act as a place of refuge and renewal, the landscaping will include paths with clear destination points to kerb aimless wandering. Covered external activity spaces will provide areas for events and group gatherings, while also offering space for a men’s shed, picnicking, potting and food growing areas.
Centralised staff areas allow maximum discrete observation and passive interaction across the entire communal floor, from the entrance to the garden areas. Although effectively designed as open plan, the relationship between the bedrooms, central courtyard and dividing wall create the feeling of individual areas.
Communal living areas are designed to help carers create spaces that facilitate connection and engagement for residents with their surroundings.
“Rooms and zones have single functions so that residents can choose the activities they want to be a part of, and can tailor sensory information to improve recognition of what is going on,” said Fran. “Furniture and spaces can be moved around to make cosy corners or to create rooms of purpose, like a library.
“Understanding a person and understanding dementia are integral concepts that need to be used to inform design which provides the right type of care for all residents. Our Navigating Home Concepts have been developed with ease of interaction and improved quality of life in mind, not only in regards to those suffering from dementia, but carers and other aged-care facility residents also.”