Reform is about using what we know to inform innovation, design and new ways of thinking. Colin from Bruach Design reflects on changing architectural practice around designing care homes for dementia
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The considered design of care homes can hugely improve residents’ wellbeing, comfort and quality of life.  Over the past decade or so best practice design for care homes has changed dramatically, building on new research into dementia and other age-related conditions, so care homes today provide some of the best living environments for those who need residential care.
There are a few key principles which as architects we always bear in mind to make the living environment as comfortable for residents as possible.  Firstly, there is natural light – it is such an important factor to feeling healthy and happy (even if the Scottish skies are overcast!).  Careful design of windows and rooflights should allow light to flood into communal spaces and corridors wherever possible, and windows should always allow a view from a seated position – there are few things more frustrating than a window frame just at eye level.
Colour, tone and texture are other important factors, particularly when designing for residents with dementia.  Studies by the Dementia Services Development Centre have found that when the brain suffers from dementia it does not process colours and shapes the same way it used to.  Strong changes in tone (from light to dark) can appear to be a step or a hole, so colours for flooring and walls should be chosen carefully.  Patterns and images can also be confusing, for example wallpaper with flowers may be confused by the brain to believe they are real, and lead to frustration when they cannot be smelled or touched.  Texture of flooring can also be misunderstood by the brain, for example vinyl flooring with sparkles (often the harder parts in the floor that provide grip when the soft part of the floor is compressed) can look like water as the light shimmers across it, so flooring in wet rooms should avoid reflections or strong patterns.
It’s not just the indoor environment that plays a part in the wellbeing created by good building design, gardens and other outdoor spaces are equally important as the benefits of fresh air and sunlight are well known.  Designing accessible and engaging outdoor spaces is essential to increasing residents’ comfort, with a variety of plant species providing flowers at all times of the year and a range of fragrances to engage all the senses!  We often work with experienced landscape architects to ensure the design of the planting is as good as it can be in these courtyards and gardens.
Understanding how the brain processes its environment is key, and as architects we are trained to consider the quality of spaces, but when we design specifically for those with dementia and similar conditions, we have to consider additional factors.  For example, designing memory triggers to aid navigation through the building, distinct colour schemes to differentiate different areas, or customising the residents’ own door to be more familiar to them.  Corridors should also lead somewhere, so residents can walk around without the confusion of reaching a dead end, and communal rooms should be easily visible and attractive, with vision panels to encourage residents to walk in and feel at home.
Most recently research has found that care homes adjacent to children’s nurseries has proved beneficial for both elderly residents and children.  Taking the lead from various international examples, this intergenerational approach has found residents enjoying the companionship of the children, as the young people learn from the residents through games and play.
We have and are working with a number of care home providers across Scotland, and really enjoy using our design skills as architects to improve the quality of spaces and the quality of life for residents in care homes.  We are passionate about good quality design and believe it can improve the lives of residents, staff and visitors.
Colin Hastie
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