Nov 19, 2017 Last Updated 2:18 PM, Nov 16, 2017

Leonard Design unveils its most recent dementia care project

Published in Talking Point
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It’s common for public sector care facilities to be treated as purely a clinical space, prioritising the practical over the personal. When it comes to dementia care, this approach can be detrimental to the resident, impacting their sense of independence and making the move from familiar surroundings even more stressful, writes Becky Smith, Part II Architectural Assistant at the Nottingham office of international agency, Leonard Design.

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A successful design will support the work of time-pressed staff as well as doing everything possible to create a happy and healthy environment for residents. Like many public sector projects, the current approach to architecture is often heavily focused on meeting budgets. However, with the over 65s population projected to increase by nearly 60% in the next 25 years, intelligent solutions are vital to meeting demand.

Church Farm at Skylarks, located in Nottingham, already has a reputation for providing outstanding care. This stems from Patrick Atkinson, who owns Skylarks and other care homes in the region, and his personal view that investing in the living environment is crucial to the health and wellbeing of residents. Patrick took inspiration from the Dutch who are renowned for their pioneering approach to dementia care.

The architectural approach of Hogewey in the Netherlands focused on creating a self-contained village structure. Crucially, the stigma of such a facility was cleverly broken by making it accessible to the wider community, while residents are grouped in living areas based on their ‘stage’ of dementia and preferred ‘lifestyle’. This relates to elements such as hobbies and interests, personal beliefs and cultural background, rather than their condition alone.

I am now bringing inspiration from Hogewey, as part of the wider Leonard Design team, to Skylarks through extensions to both the ground and first floor. It was important for the Skylarks design to help friends and family feel at ease, which, in turn, encourages them to visit more regularly and stay for longer as well as the getting the general public to come and use the swimming pool. As with Hogewey, this normalises access to the facility and helps residents feel that they are still part of the surrounding community.

The result is a plan that prioritises communal spaces, providing privacy while encouraging socialisation. This mix is crucial in making visits a positive experience, as well as providing flexible areas for daily use. This avoids the traditional care home format of a separate common room with a number of seats that centre on a single focal point, which is commonly a television.

In a similar approach to Hogewey, Skylarks' residents are grouped based on the progression of their disease, creating like-minded communities. Groups are kept as small as possible, with a staff-to-resident ratio of one to three, which is much higher than the UK average.

Currently, the hallways at Skylarks are the traditional long pathways you would expect. There are a number of sharp turns, making it difficult to differentiate which area of the building you are in. This can make it challenging for residents to get back to their room and feel confident and comfortable ‘wayfinding’ through the home.

The new plans include walkways with curved walls and edges to increase visibility; a simple change that instils confidence and helps with improved recognition. The addition of increased levels of daylight also prevent the hallways from feeling like an enclosed maze.

The new plans for Skylarks also implement an open-plan approach, prioritising visibility to encourage socialisation and independence. Open-plan schemes are often seen as quite radical in the care sector where the focus is commonly on minimising disturbances and helping staff to have the maximum amount of control.

Our suggested solution is sliding partitions, which are particularly useful for closing off areas used by the public when not in use. These are complemented by half-height walls which provide some control over movement but with the added benefit of a clear and wider view.

The prevalence of visual impairment increases exponentially with age. Those living with dementia typically see colours several shades darker but busy, bold patterns can cause hallucinations. It’s not unusual to see the use of traditional patterned wallpaper which has been chosen to feel familiar and nostalgic. However, the result is often dark and detailed prints that are not suitable. Therefore, a balance between the right colour and the use of daylight is essential.

Consistency in materials such as carpets is also important as any change in colour or texture will potentially be seen as a threshold, deterring the resident from walking further. Plus, artificial lighting and signage must all be taken into consideration.

When it comes to private living areas, a sense of individuality and space is crucial to wellbeing. Therefore, creating a room that feels as personal as possible is really important. All too often, this is where care homes try to save money by squeezing in as many rooms as possible.

One area that struck me as simple and quite obvious, and yet commonly ignored, is the personalisation of these areas. After all, the living quarters are the home of the resident, not a rented or temporary space. And, even if it is a short-term stay, personalisation can help with comfort and recognition.

This can be achieved as easily as adding colour to the front door or adding memory boxes next to the door which can be filled with personal items and mementos to spark recollection.

By looking at the Dutch approach to architecture in the care sector, it’s clear that there are benefits to residents that can easily and affordably be put in place.

While budget will always shape an architectural brief, the sector needs to recognise that an intelligent approach can be taken to achieve a balance that benefits everyone.

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