1. What we already know about design for dementia
© Dementia Centre, HammondCare 2015

2. HammondCare – who we are, what we do
A charity based in Sydney, specialising in dementia & aged care, palliative care, rehabilitation & older persons' mental health.
​Established 1995
Recognised internationally for research, teaching, consultancy, resources
Focused on improving lives of people with dementia, their families and carers
UK team undertakes research and delivers training, consultancy and evaluation of dementia design
The Dementia Centre is a service provided by HammondCare as part of its commitment to promoting excellence in dementia care, offering impartial
advice and support.

3. Most people with dementia are older
EuroCoDe calculations of % with dementia in each age group
Total population age range
% with dementia
60 – 64
0.6
65 – 69
1.6
70 – 74
3.5
75 – 79
7.4
80 – 84
15.7
85 – 89
26.2
90 – 94
41.0
95+
46.3
See Alzheimer’s Europe website

4. Which means…..
Complexity – the challenge of designing for frailty combined with dementia
People may have other debilitating conditions, e.g. MS, Parkinson’s, arthritis
Younger people with dementia may also have some of the same impairments of older people such as poor sight or hearing problems

5. Common impairments of frail older people:
1. Muscles and bones
E.g. shoulder and neck muscles may be weaker, so signs need to be lower
E.g. proprioception may be impaired affecting balance and positioning, so avoid cluttered environments

6. Common impairments of frail older people:
2. Lungs
Impaired lung function – plenty of oxygen is essential for the brain to work well
Poor air quality affects everyone, so ensure good ventilation, good maintenance and avoid using air fresheners

7. Common impairments of frail older people
3. Ears
Loss of ability to hear high frequencies
Harder to distinguish lower frequency sounds e.g. voices from other sounds
People can become overwhelmed by noise and either withdraw or get angry

8. Reduce noise by:
Locating noisy areas away from living spaces and bedrooms
Providing good sound insulation in the building
Using plenty of sound absorbent materials, e.g. soft furnishings, carpet, cushioned vinyl
Providing quiet spaces
Providing easy access to outside

9. Common impairments of frail older people
4. Eyes
Twice as much light needed to see clearly
Lens yellows with age and colours seem less vivid
Red, orange, yellow easier to see than blue and green
More time needed to adjust to changing light levels
Glare more difficult to tolerate
Decrease in sensitivity to contrast

10. Eye conditions of older age
Thickening lens
Cataracts
Macular degeneration
Glaucoma
Hemianopia

11. Twice the ‘normal’ level of light
Plenty of light fittings
Plenty of natural light

12. What does not contrast is invisible

13. Two hazardous spaces

14. Other possible impairments of ageing
The following need to be taken into account as well:
Needing to go to the WC frequently, e.g. 90% of men aged over 80 have an enlarged prostate
Homeostasis (the body’s ability to maintain a state of stability or equilibrium e.g. adjust to heat and cold)
Taste / smell can deteriorate

15. Impairments of dementia needing attention by designers are:
Impaired memory, especially recent memory
Impaired learning
Impaired reasoning
High levels of stress
Sensory challenges especially perceptual problems for many
Difficulty adjusting to the sensory/mobility impairment of normal ageing.

16. Designing for impaired memory
What does this mean?
Vital to be able to see important things and rooms if you cannot remember them…
Familiarity is key principle
Glazed doors and walls are very helpful

17. Designing for impaired learning
What does this mean?
People with dementia may not be able to learn where things are
People with dementia may get distressed e.g. finding the toilet
Good signs are vital

18. Designing for impaired reasoning
What does this mean?
Things need to be easy to understand e.g. taps, hand dryers, signs
Signs need to be easy to work out ? ?

19. Designing to minimise stress
What does this mean?
Reduce clutter – make sure important information is obvious
Provide views of nature
Minimise noise

20. Designing for perceptual problems
What does this mean?
Too much contrast between floors may look like a step
Wavy lines on wallpaper look as if they are moving
Some patterns look like insects or litter

21. Two hazardous floors

22. Key points Provide plenty of natural light
Provide twice the ‘normal’ level of artificial light
Ensure plenty of contrast to make things visible
But – avoid contrast between floor finishes
Provide a quiet and calm environment
Provide easy access to outside
Provide views of nature
Make sure everything is easy to understand
Keep important information, e.g. signs, low enough for easy vision
Avoid clutter

23. Designing for the future
The success of our job should be governed by the enhanced quality of life for people with dementia.