Ramps for wheelchairs and prams. Accessible toilets. Wider doorways.
Over the last 20 years, the design world has come a long way in the realm of inclusivity, with the examples above just the tip of the iceberg, and much of it now mandated by Australian standards and building codes.
But while we may be comfortable incorporating physical disability and diversity into our thinking, there’s still a long way to go when it comes to cognitive and sensory impairments.
The Dementia Centre, an arm of aged care provider HammondCare, is hoping to change that.
Head of Dementia Professional Services, Marie Alford, pointed out that more than 800,000 people are expected to be living with dementia in Australia by 2050.
“Most of them are still at home and part of the community,” she said, “so there’s a pressing need to make sure our public, residential and commercial spaces are mindful or their needs.”
How does dementia affect people’s experience of a space?
The cognitive and sensory impairments people living with dementia may encounter can affect their experience of the world.
The low vision and hearing of normal ageing may be exacerbated by problems with memory, spatial awareness and perception.
“People living with dementia may be disoriented by highly reflective surfaces, struggle to use unfamiliar appliances and find patterned surfaces confusing, or even frightening,” said Daniel Jameson, Design Lead at The Dementia Centre.
“Stripes could appear to be moving like snakes, a dark rug on a plain floor might look like a hole, and high gloss tiles can give the impression of water.”
How can good design help?
Well-designed spaces are easy to see, intuitive to use and pleasant to look at. If designers and outfitters meet this mainstream brief to a high level, they nail it for people living with dementia as well.
“This is the guiding principle The Dementia Centre has held at the centre of our expert design advice for 30 years,” said Daniel.
“Dementia-enabling design is just good design. It just makes sense!”
About 65% of people with dementia live at home —using the local shops, attending medical appointments, going to cafes and visiting the library.
So, people with cognitive and sensory impairments are already in these spaces, struggling with aspects that aren’t designed to be universally useful, and perhaps choosing to go elsewhere, when possible.
For those living with dementia, the design of the environment plays a crucial role in supporting safety, comfort, and quality of life.
“Thoughtful interior and exterior design can help reduce confusion, minimise anxiety and foster a sense of security, enabling individuals with dementia to visit the pharmacy, grab some groceries and relax with a cup of coffee, just like everyone else,” said Marie.
Since the mid-1990s, The Dementia Centre has researched and put into practice this approach to physical spaces that supports better engagement for people living with dementia, leading to better care and wellbeing.
“We apply the knowledge bank of The Dementia Centre and work with architects, designers and manufacturers to improve spaces and products so they can be used and enjoyed by more people – because good design is better for everyone,” said HammondCare’s Head of Design – Property and Capital Works, Katie Formston.
With new aged care design guidelines introduced last year, designers of all kinds have even better guidance regarding how their skills can support cognitive, sensory and age-related impairments.
Of course, applying it to your individual circumstances can take a little more support.
“There’s always a negotiation, from a design perspective, between competing project requirements and objectives but overarching is the desire to support all the people who are going to use a space,” said Katie.
“You need to fit out a shop or an office for a purpose, but also make it accessible, welcoming and attractive, not institutional.
“We have years of experience at getting that balance right, and the expertise to work with other businesses, within their own circumstances, to meet their objectives.”
How good design helps
1. Contrast
Dementia can make it harder to perceive contrast, so spaces with little variation, such as a fashionable white on white kitchen, can be very disorientating. The Dementia Centre recommends 30% light reflectance value (LRV) to define elements in a space – for example, between the floor and the wall, then the wall and the door, and again between the door and the handle. Conversely, an LRV contrast of less than 10% is required to minimise confusion at flooring transitions, to avoid misinterpretation as steps or level changes.
2. Luminosity
Poor lighting can increase confusion and the risk of falls. Maximise natural light where possible and ensure that artificial lighting is evenly distributed throughout the interior. Our designers recommend double the recommended level of lighting in most interior spaces, and lights should be positioned to avoid glare and sharp distinctions between shadows and pools of light (which can have a strobe effect). Glossy and reflective surfaces should be avoided.
3. Wayfinding
Visual cues play a significant role in helping people with dementia navigate their environment. Highlighting objects that don’t move as landmarks in a space can be helpful, such as a reception counter or a doorway. Contrasting tones (as above) for walls, floors, and furniture can make it easier to distinguish different areas and objects. The layout should be clear and easy to navigate. Rooms should be organised logically, with furniture and items signalling their purpose, and visible sightlines from one space to the next.
4. Acoustics
Good design can help lower the background noise of a space, so that proper attention can be given to conversation and other important sounds. Noise can be absorbed by soft surfaces such as carpets, window dressings and fabric on furniture. Choose doors and cupboards that have a soft close option, or fit dampeners to avoid loud banging. Free phone apps provide a decibel meter for measuring sound levels. This is useful for assessing if noise levels are above the recommended safe level. (Aim for 35dB(A) in bedrooms, 40dB(A) in common areas and 45dB(A) elsewhere.) As a final resort, you may want to consider the addition of acoustic panels.
Find out more about how your designs can start making sense for the growing number of people living with dementia.
The Dementia Centre is offering a free, exclusive webinar and a bespoke Dementia Design School to readers of Interior Fitout, tailored to the fitout industry.
Visit dementiacentre.com/dementia-design-school to learn more.