1. Design for Dementia in Practice 6 th May 2014 Damian Utton RIBA Partner, Pozzoni LLP Architects www.pozzoni.co.uk

2. Principles of Dementia Design Older people, and older people with dementia, can be very sensitive to the built environment People with dementia may not remember or understand their surroundings. Design can compensate for these impairments Design can facilitate the efficient delivery of care in a non-institutional way Other impairments can be compensated in a straightforward way with established guidelines, but dementia affects people in different ways.

3. Principles of Dementia Design Consensus that good design - should compensate for impairments should maximise independence should enhance self esteem and confidence should demonstrate care for staff should be orientating and understandable reinforce personal identity welcome relatives and the local community allow the control of stimuli (Marshall et al 1997)

4. Principles of Dementia Design Evidence base Published research University of Stirling DSDC Publications http://dementia.stir.ac.uk/information/bookshop Housing and Dementia Research Consortium http://housingdementiaresearch.wordpress.com/ Housing LIN www.housinglin.org.uk Post-Occupancy Evaluations Talk to people!!

5. How do these principles work in practice? Whilst these photographs are from new build care home environments, the principles are applicable to all building types

6. Compensate for impaired memory, reasoning, learning open plan - high levels of visual access wc visible from bed ‘event’ at a dead end

7. Compensate for impaired memory, reasoning, learning contrast between junctions hidden service doors visible cupboard contents similar floor tone

8. Maximise independence access to external space accessible kitchen graphic al signage shop

9. Enhance self-esteem and confidence purposeful activity lower worktop: kitchen activity wardrobe cue for doors

10. Demonstrate care for staff dispersed storage open plan: discreet monitoring break-out space technology staff base

11. Orientating and understandable familiar domestic homely

12. Reinforce personal identity

13. Welcome relatives and the local community cafewell-beinghair and beauty community roomgym

14. Control of stimuli daylight without glare natural ventilation sound absorbing buffer from noisy areas

15. Conclusions

16. Current Practice Non-institutional environments Manage risks Community hubs Dementia friendly communities Conflict with other regulations (infection control, fire, food, etc) Emphasis on home adaptations and domiciliary care to keep people at home Government funding for extra care housing and to ‘pepper-pot’ people with dementia around a housing scheme

17. Conclusion – Key design points 1.Familiar environment, fixtures and fittings 2.High levels of lighting 3.Easy to understand built environment 4.Clarity and simplicity: where things are and where to go 5.Appropriate signage (1200mm above floor) 6.Contrast to increase visibility 7.Similar floor tones 8.External space is as important as internal space

18. Conclusion - Four Priority Areas 1.Improve lighting 2.Ensure good contrast 3.Similar floor tones 4.Ensure the toilet is easy to find

19. Design for Dementia in Practice 6 th May 2014 Damian Utton RIBA Partner, Pozzoni LLP Architects www.pozzoni.co.uk