Housing: Designing for dementia
Can you design a home that delays the onset of dementia? That’s the aim of a new housing pilot. Will Mann explains.
Open-plan layouts, glass doors on cupboards, contrasting colours – some of the design ideas trialled in a new “demonstration house” for dementia sufferers, which opens later this month.
There are over 850,000 dementia sufferers in the UK, and it affects one in six people over the age of 80. State care costs £40,000 per person on average. In an ageing population, this terminal condition will become an increasing strain on the NHS and society as a whole.
The £300,000 pilot project at the BRE Innovation Park near Watford involves refurbishing an existing house and partners include architect Halsall Lloyd and Loughborough University.
“There is clinical evidence that the dementia process can be slowed down if sufferers stay in their own homes, whereas the condition is likely to accelerate if they are moved,” explains David Kelly, BRE group director. “So if this design template proves successful, it will be beneficial for dementia sufferers, their families and the National Health Service. Everyone wins.”
The terraced house being refurbished by local fitout contractor Bracey & Clark is an old stable block. “We opted for a refurbishment rather than a new build as the whole idea is to keep people in their existing homes,” says Kelly.
The house is designed around a couple dubbed “Chris and Sally”. “It is based on a series of dementia personas, created by healthcare ergonomics specialist Sue Hignett, which run from A to D according to severity, where persona A – Alison – has the initial signs, and D – David – is the most severely affected,” explains Jacqui Glass, professor in architecture and sustainable construction at Loughborough University.
Design for dementia house: ground floor
1. Open plan living area 2. Downstairs bathroom (clearly visible from living area) 3. Option of downstairs bedroom 4. Extra windows for added natural light 5. Lift
“The idea is to show how the house can be adapted for all stages of dementia,” she says. “So symptoms in the A persona are likely to be mental function – people feeling confused, forgetting where things are, so interventions will be subtle design changes. At the other extreme, for the D persona, the house has been adapted for people with serious mobility issues, so the floors are smooth for wheelchair use and there is space for a lift.”
The principles from Design for Dementia, a book researched by Bill Halsall, partner at Halsall Lloyd, and Rob MacDonald from Liverpool John Moores University, have informed the approach to Chris and Sally’s home.
“The biggest physical interventions are the creation of an open-plan downstairs area, the addition of a ground floor toilet and shower, and the lift,” says Halsall. “The open-plan layout helps give visibility of, for instance, the bathroom from a sitting position in the lounge. It stops people getting disorientated.”
In the decor, there is method in the colours and their intensity. “Light reflectance value is very important,” Halsall explains. A black doormat, for example, could be perceived as a hole. Dark fittings could become trip hazards.
“The light reflective values of the interior fittings have been calculated so a dementia sufferer can see a clear difference between them.”
Bill Halsall, Halsall Lloyd
“The light reflective values of each of the interior fittings have been calculated so that a dementia sufferer can see a clear difference between them. The walls and floors and doors all have different values, as do kitchen units and worktops. The curtains have a different colour to the leading edge so people don’t get confused when trying to draw them.”
The design resists the temptation of garish institutional colours. “Sadly, for the ageing eye, colour fades to grey – it loses the blue and green end of the spectrum before the red and orange end,” says Halsall. “However, we don’t want people to feel like they’re living in a care home – they wouldn’t have an orange front door in their own home. So the Chris and Sally house will be mostly pastel colours.”
Cupboard doors are glass-fronted – an aide-memoire for what’s inside them – and there is plenty of natural light and colour-coded “wayfinding”. There are simplified services controls and, longer term, smart home technology – a neighbouring BRE project – could be incorporated, says Kelly.
“The house will act as a show home and allow developers, care providers and families to see options for adapting homes to help people with dementia,” he adds. “Eventually we would like the design principles to be incorporated into standards for new-build housing.”