Care home design for people with dementia: What do people with dementia and their family carers value?

Abstract

Objectives: To report on the views of people with dementia who live in care homes and their family carers on aspects of design that are important to them, and discuss these in relation to developing physical care environments that respond to the wishes of people with dementia and their family carers. Method: Six focus groups were held: two in Northern Ireland and four in Scotland. A total of 40 people participated in the focus groups. Twenty nine people were with dementia (24 female and five male), and 11 were family carers (10 female and one male). Results: Carers discussed the features of a building they took into account when selecting a care home, and discussed this in relation to 'bricks and mortar versus people'. Key themes reported by people with dementia and their family carers included how the space in the environment is used, for example, what happens in the building and the presence or absence of certain design features. Outside space and wayfinding aids were identified as positive features of the home, along with a general lack of concern about ensuite provision. Conclusion:The results demonstrate the complexity of building design as it must provide living space acceptable to people with dementia living there and family members who visit, as well as provide a workable environment for staff. The findings highlight areas that should be considered by care home teams involved in the build of a new home or the redevelopment of an existing care home.

Improving care home design for people with dementia

“…Residents had their personal belongings, some own furniture, pictures, cuddly toys which personalized the rooms very well. (care home 19) This corresponds with findings from Innes et al 16 of the importance for people with dementia and their families of having familiar or treasured possessions in residents' personal spaces. There was, however, variety in the individualization or personalization of communal spaces, that is, the extent to which they also felt homely:…”

“…16 Given the concern to promote continence 17 this is an area that care homes could address with relative ease and at a relatively low cost.…”

A randomised controlled trial to evaluate the impact of a human rights based approach to dementia care in inpatient ward and care home settings

“…It is notable, however, that the majority of publications are focused at a policy level 32 or are discussion papers reviewing a concept 33 as opposed to attempts to apply a human rights based approach in practice and evaluate its effectiveness. In 2016, Dementia Alliance International launched The Human Rights of People Living with Dementia: From Rhetoric to Reality.…”

Dementia care environments: Physical design, direct care delivery, and the wider context of care

“…The importance of use of spaces in care settings has been stressed by Torrington,12 who argues that quality of life and meaningful activities depend on the design of the physical environment. Recent research 13 reports on aspects of the physical environment that were raised by people with dementia and their family members, namely, how the space in the environment is used, for example, a choice of places to spend timein, having one's own possessions, and maintaining links with the community generally and with animals and children in particular. Outside space that is accessible and pleasant to spend time in and wayfinding aids, for example to find toilets and bedrooms, were identified as positive features of the home.…”

“…In his seminal work, Kitwood 13 presents a compelling case to improve the psycho-social care experiences of those with dementia. How to respond to people with dementia in a way that maintains their abilities, recognizes their personhood, and promotes well-being poses a challenge for those delivering care in resource-constrained environments.…”