People with dementia occupy approximately two-thirds of all residential care beds available in the UK. Alzheimer's disease is the principal cause of dementia and admission. With friends and family caring for loved ones at home for longer, people with dementia are admitted into care homes with more limited mental capability.
Typically, 70 per cent of care home residents exhibit significant confusion and other cognitive impairments. The proposition behind this work is that a well-designed environment can provide better support through familiarity, clarity of purpose and minimising distraction.
This project addresses two important areas in the care home - dining spaces and bedrooms - both of which host activities fundamental to daily living. The aim was to create environments and products that maximise the existing abilities of the residents, promoting independence and improving their experience of living within the building.
An immersive research method was adopted, which recognised the difficulties of studying people affected by dementia and allowed the researchers to become part of the everyday routine. Numerous care homes were visited, where residents and staff were interviewed and observed. Focus groups were held with people in the early stages of dementia.
Best practice and emerging theories in dementia care were researched in order to establish which elements of the designed environment could be used to reinforce good practice.
A key insight was that the design of care environments directly impacts on a resident's ability to care for themselves and on their dependency on staff. By designing to help them complete basic tasks such as dressing or eating, their quality of life could be improved and staff workload reduced, thereby allowing time for more meaningful engagement between carers and residents.
"Seven out of ten care home residents exhibit cognitive impairment or some form of significant confusion..."
Being able to eat and drink in a dignified manner is very important. Building on work done in the first year of the project, the dining strand of the study looked to improve the care home experience by designing facilities to run food-related activities, furniture to improve physical access at the table and tableware to help maintain eating skills for longer.
Outputs include exemplar interior layouts that integrate meal services with the important amenities needed to run group events such as baking and gardening. A specially designed table and light work together to promote a better eating experience for residents. Tableware includes pieces that compensate for poor vision and dexterity, and improve the experience for those who can no longer feed themselves.
The bedroom is the one place in a care home that can be identified as a resident's personal space. It is a place of refuge where identity is reinforced through familiar objects. It is also a room where a range of tasks such as dressing and sleeping need to be conducted whilst taking account of the range of ability that different residents might have.
Design work for the bedroom environment has focused on developing new dressing furniture designed specifically for people with dementia. Drawers allow residents to see inside without the need to open them and whole outfits fit onto a single hanger design so clothing can be easily prepared and laid out by staff for a resident to dress themselves. Room layouts can be reconfigured as needs change, using rail and hook systems drawn from the retail sector.
The research findings and design ideas that have resulted from this project have been written up in a design sourcebook that can help designers, specifiers, managers and owners of care homes to make the many small improvements that can have a big positive effect on the experience of care homes for residents with dementia and the staff support for them.