Designing homes for mental disability

When it comes to creating residences for people with dementia it helps to look at things through the eyes of those with the condition, says Dominic Waters, Development Director at Waters Homes

Open the property pages in any national newspaper and chances are there’ll be a comment piece about building care homes.

The UK has an ageing population so it’s high up on the political agenda to cater to this increasing demographic – and rightly so.

What you don’t see, however, is a balanced approach to consider designing for every single age-related disability. The UK’s construction and design industries are very good at incorporating features to ease physical ills, be it wheelchair suitable door frames, hand rails, or ramps. But, building for mental disability is nowhere near as widely covered in the media.

In 2014, the BBC reported that in just seven years, the number of people in England diagnosed with dementia has rocketed by 62 per cent. So there’s a demand – and arguably, a responsibility – for appropriate residential schemes. The health problems of those with dementia might be less immediately obvious, but have a huge impact on their quality of life

As a small, family run firm of developers, we have to look for new opportunities to get involved in. We first started in 1997 with small residential schemes in the heart of Leicester, but today we work with housing associations on much bigger projects across the Midlands.

Most recently, we worked with a borough council in Nottinghamshire to build a pioneering scheme of specially adapted bungalows for residents with dementia. The scheme taught us a lot about what worked well when building for this very specific client group.

The market has changed. We’ve taken a step away from the impersonal, functional, practicalities of the residential tower blocks, and we’ve seen the need for smaller communities, with personality and character. This makes it more interesting from a design perspective – no standard boilerplate here – but of course, trickier too.

In some cases, building residential schemes for people with mental health problems is really no different. In any project, it’s down to the involved parties to understand the end-user’s needs completely.

For the architects involved in the Nottinghamshire adapted bungalows project, it was crucial to get under the skin of the real, day-to-day obstacles that made residents’ lives that little bit trickier. It’s not just forgetting where you’ve put your keys – it can be incredibly isolating, disorienting and confusing.

A house is where you should feel safe, and when building schemes for those with mental disabilities, this should be the first thing to think about. Mental health problems don’t exist in isolation. So, carefully looking at access, floor plans and elevation is crucial, particularly as the majority of residents dealing with dementia tend to be older, and therefore more likely to be susceptible to other age-related conditions which have a knock-on physical impact.

Structure aside, architects need to carefully consider interior design. The doors, light fittings and toilet seats in the adapted bungalows are a dark finish, so they contrast significantly with their surroundings and are easy to distinguish. Inside, rooms are painted in different pastel colours, to make them easily identifiable to the residents, even if they are confused or disorientated. Interior textures and patterns are also given careful consideration, as people with dementia can struggle with depth perception and any patterning can cause confusion. Take something as innocuous as a doormat, for example.

To most people, a dark doormat isn’t worth noticing, but for someone with dementia, it could look like a hole in the ground, and an obstacle between getting in and out of their safe place. Building residential schemes with healthcare considerations don’t just involve the live-in residents either. Creating a sense of security with natural surveillance (access points overlooked by neighbours, for example) is important peace of mind for families and health care professionals, who are usually heavily involved in the care of residents with mental health problems.

Demand for considerate design for residents struggling with mental health issues is growing. It will require close partnership with public and private sector organisations to get it right, but looking at what is needed through the eyes of those actually living with the condition is the first step in recognising what is needed.