Mental Health & Dementia Facilities Forum. 21 st September The Association for Dementia Studies & The King s Fund

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1 Mental Health & Dementia Facilities Forum 21 st September 2017

2 Association for Dementia Studies (est. 2009) Developing evidence-based practical ways to help people live well with dementia Multi-professional innovative research centre inclusive of people directly affected by dementia Education and practice development. PhD studentships Practical publications and on-line resources

3 Therapeutic environment People say the effect is on the mind. It is no such thing. The effect is on the body too. Little as we know about the way in which we are affected by form, colour, by light, we do know this, that they have a physical effect. Variety of form and brilliancy of colour in the objects presented to patients is the actual means of recovery. Florence Nightingale Notes on Hospitals 1885

4 Dementia - An umbrella term Alzheimer's Disease Multi-infarct/vascular dementia Mixed dementia Dementia with Lewy Bodies Parkinson s dementia Frontotemporal dementia eg Pick s disease Hydrocephalus Huntingdon's Disease Wernicke-Korsakoff syndrome

5 What impact does that have? Not being able to remember things Having trouble understanding words and finding the right words Become disorientated and can t find your way around familiar places Have ideas and/or perceptions that aren t real Become frustrated easily Have a short attention span Sundowning and sleeplessness Your ability to discriminate colours is affected (particularly blue and green, less so red and yellow)

6 People with dementia are likely to: Be confused and agitated in unfamiliar environments Become distracted when faced with competing information e.g. signs and notices Not to be able to see things if they are the same colour as the background e.g. handrails Resist walking on shiny floors as they may appear wet and think shadows may represent a change in level Want to walk

7 Hospitals and Care Homes common issues of: Poor signage and lack of way-finding cues Poor use of colour and contrast Unhelpful lighting glare and pooling Shiny floors Clutter and distractions Stark, unwelcoming spaces off long featureless corridors No personalisation of space Under-use of gardens and outside spaces Little engagement in meaningful activity

8 Housing common issues of: Poor entrances and bells/entry phones Lack of natural light and views of nature Uneven internal lighting Poor signage, wayfinding and orientation cues Little use of colour contrast Lack of seating areas to rest while walking around Non domestic scale of dining and social areas Little personalisation of front doors Poor sight lines/lack of transparent door panels Poor toilet, bathroom and kitchen fixtures and fittings

9 Key principles for dementia friendly design

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11 Overarching design principles

12 The Association for Dementia The Association Studies for Dementia Studies & The King s Fund

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16 Dementia Friendly Environments What has made most difference? Staff education - understanding of dementia - impact of the environment - what makes good design leading to changes in attitudes and behaviours Multidisciplinary approach - clinical, estates and managerial - people affected by dementia

17 The EHE teams biggest challenges Developing a clear vision - be 100% behind your ideas Education and staff engagement Make it a priority for the organisation Strike a balance (control of infection/ health and safety) Consultation Resources Incorporate in estates/design strategy PFI

18 Although we know key determinants - more research is needed Scale of housing developments and care homes Use of external materials e.g. bricks internally Patterned wallpapers & furnishings Use of floor to ceiling images (wallpapers and artworks)

19 Good design enables well-being Challenges Lighting General décor use of colour and contrast Wayfinding, signage and artworks Furniture, fixtures and fittings Toilets and bathrooms General maintenance

20 Association for Dementia Studies University of Worcester