Dementia-friendly design


James Botterill of HSSP Architects discusses the design ethos and biophilic principles that underpin his practice’s approach to designing “homes that care”

Making the decision to entrust the care of a family member to a care home is difficult, and often emotional. Particularly true in the case of dementia sufferers, families often find themselves choosing a home for loved ones without being able to establish much about their wishes and preferences – while trying to juggle a multitude of considerations.

It’s natural to look for assurances that 24-hour support is available, that staff have specialist training, and that residents are safe, secure and comfortable. Equally critical, but less frequently discussed, is the way the building itself is designed and equipped. Indeed, design can improve the health and wellbeing of people living with dementia by reducing symptoms of confusion, isolation and anxiety and help them live more independently.

With dementia cases on the rise, it’s critical we all work harder to better support our ageing population – tackling outdated care home design which can be detrimental to residents, and providing innovative, user-centric solutions. At HSSP, we’re leading projects that reimagine the care home setting, helping service users lead full, happy and comfortable lives.

Designing a home from home
The need for better design in care home provision demands a fresh look at the concept and purpose of the whole living environment. Critically, we need to address the hangover of ‘hospital-like’ design, which can be confusing and stressful for dementia sufferers. Instead, the most forward looking architects, designers and builders are striving to find ways to incorporate the heart of the home within a safe and functional building – realising that the right design approach can help provide residents with more comfort and stability.

Changing the layout within care homes can make an enormous difference. Best practice design, in line with the 12 principles set out by the Department of Health, avoids the creation of busy and crowded areas, unidentifiable spaces, noise and clutter that add to feelings of confusion and anxiety. There is an emphasis on easing the transition through ‘comfort design’ and a ‘home from home’ feel.

Harnessing the power of nature
Access to the outdoors is an important aspect of caring for people with dementia, providing fresh air, smells, birdsong, colours and natural light to stimulate the senses. However, accessibility is a barrier in many care homes. Traditional care home design only gives residents on the ground floor free flowing access; the majority of other residents have to manage with just a view and do not benefit from the enrichment of being outside.

At our newest project, a care home in Melton Mowbray, we are harnessing the health benefits of biophilic design – or design which supports the innate human instinct to connect with nature and other living beings – giving residents the ability to have safe, free-flow access to the outside. The building has been designed to create a series of south facing terraces, each connected to the open plan living area of each ‘family unit’ of between 10 and 12 residents.

The care home will make use of natural materials, textures and colours which promise to be highly therapeutic, as well as plenty of opportunity to interact with nature, both inside and out.

Light, bright & comfortable
At the Alysia Care Home in Rutland we focused on bringing year-round natural light into internal residential spaces, from bedrooms to corridors. Artificial patterns and lighting contrasts can confuse people experiencing sight loss and dementia, so we work on carefully balancing light and colours throughout. Orientation and feelings of wellness can be aided by a view of a building, landscape or garden, and here residents enjoy grand views of the Elizabethan manor, Burghley House, through large windows in the central communal building.

We aim to design with the watchwords ‘bright,’ ‘airy’ and ‘light’ – providing residents a simple but open living experience which will provide energy as well as comfort. At a new care home to be located towards Kirby Muxloe, we worked hard to deconstruct the traditional institutional layout into a cluster of six pods that form small self-contained communities within the care facility. By breaking down the long corridors and dispersing noisy communal living, entertainment and dining areas, we’ve in effect reduced the scale of the accommodation, making it quieter, more recognisable and easier to navigate.

Recreating childhood memories
Our memories of our childhood tend to be happy ones and are more easily recalled by dementia sufferers, who struggle with short-term memory loss. In Leicester, we designed a garden space in a care home that echoed an old-fashioned seaside resort with multi-coloured beach huts. The beach huts were used as a device to help residents remember care-free times and make them comfortable with their surroundings.

Visual comfort also extends indoors. Patterned walls and flooring or chaotic décor can increase confusion and stress, while soothing artwork, block colours and carefully chosen visual cues as to the purpose of each room aid recognition and comprehension.

Comfortable living to support all residents
From builds like our beach huts in Leicester which invoke childhood memories, to the latest ‘apartment style’ as seen in Melton Mowbray, supporting independent living, design is critical to supporting people with dementia and helping them to live comfortable, supported and happy lives. And it is not just the residents that feel the effect. Great design also impacts the mindset of staff and the quality of care they deliver.

We believe that the most important part of designing ‘homes that care’ is evolving the design approach to leave behind the institutional aesthetic of old, and recognise the benefits of concepts like biophilia. Indeed, biophilic design has been found to support cognitive function, physical health, and psychological well-being, which is vital in looking after our ageing population.

James Botterill is a director at HSSP Architects