Designing for dementia

Dementia-friendly environments are created using a flexible approach that maximises people’s freedom and involvement through supportive, familiar, meaningful and safe surroundings.

Dementia-friendly design works to maximise independence and safety using intuitive and ergonomic design. It supports people with a broad range of functional needs such as reduced mobility, sensory losses and a wide variety of complex conditions.

The design approach carefully considers both physical and social environments. It looks at people’s unique needs and abilities, and how they maintain a sense of purpose through familiarity and connection.

A homelike environment is key to dementia friendly design. While home environments can take many forms, they all share certain domestic qualities.

A homelike environment:

• allows people to continue the tasks of daily living
• uses their existing skills
• gives choice and independence with familiarity and comfort.

Richard Blight is a Director at Blight, Blight & Blight – the architecture firm who designed the $3.2 million dementia-friendly unit at Creswick Nursing Home. Richard explains how their team engages with residents to establish what home means to them.

When building an aged care facility, design strategies to create a homelike environment include:

• a small household model
• private bedrooms that can be personalised
• easy access to outdoor areas
• a diverse range of common areas.

Small household model

The completed $55.57 million St George’s Hospital aged care facility (Berengarra) was the first stage of the Victorian Government’s Modernisation of Metropolitan Melbourne Public Sector Residential Age Care Strategy.

The 90-bed facility is made up of two separate three-storey houses, with pitched roofs and brickwork to create a homelike feel. Each floor is divided into small households, creating a familiar environment that is easier to navigate. Key facilities such as dining and lounge areas are close by – also assisting those who cannot travel long distances due to frailty.

Private bedrooms

Individual bedrooms and bathrooms provide dignity and independence to residents in aged care. The $6.3 million Edenhope and District Memorial Hospital redevelopment included the construction of 18 private rooms and ensuites. This replaced the existing shared rooms, allowing providing privacy to residents.

Easy access to outdoor areas

Easy access to outdoor areas is important when creating a homelike environment. These areas need to be welcoming, engaging and safe.

At the dementia-friendly unit at Creswick Nursing Home, rooms are clustered around a central courtyard that can be sealed off from the rest of the facility. This allows residents to circulate freely and safely. Two outdoor seating areas encourage residents to spend time outdoors, while raised wheelchair-accessible garden beds allow residents to garden.

The outdoor space provides residents with choice. They can enjoy the outdoor space actively, or simply spend time on their own. The courtyard design also means that outdoor areas are visible from indoors, increasing a sense of connection to the natural environment.

A diverse range of common areas

A diverse range of common areas facilitate choice and lifestyle options for residents. It also supports them to maintain family and community connections.

For example, once construction of the $81.58 million new Wantirna residential aged care facility is complete in 2022, the facility will include multipurpose common areas, as well as a community room, sacred space and café. This will give residents greater choice, with access to areas for socialising, activities or quiet time alone.

Making public sector aged care facilities dementia-friendly is part of the Victorian Government’s work to modernise public residential aged care facilities.

The interim report released on 31 October 2019 by the Aged Care Quality and Safety Royal Commission signalled the need for fundamental system reform to better support quality and safety. This includes a focus on building design.

We’re working with the Department of Health’s Aged Care Branch to update our Public sector residential aged care (interim) facility design guidelines to respond to some of the recommendations from the Royal Commission. The updated guidelines will also be informed by our recently released Universal design policy and charter.

The Department of Health will also be updating its dementia-friendly environments guidance and resources in consultation with a broad cross-section of stakeholders, including people living with dementia.

Continued investment in aged care

As part of the Modernisation of Metropolitan Melbourne Public Sector Residential Aged Care Strategy, the Victorian Government is investing:

• $81.58 million for a new 120-bed facility in Wantirna
• $134.6 million for a 150-bed facility at the Kingston Centre in Cheltenham
• $900,000 to deliver the first phase of designing and planning a new 90-bed public residential aged care facility in Coburg.

For rural and regional Victoria, $65 million was announced as part of the 2021-22 State Budget to modernise and upgrade public residential aged care services:

• $57.11 million to redevelop the Glenview Community Nursing Home in Rutherglen
• $4.95 million to design and plan a 36-bed facility within Camperdown Hospital.
• $2.93 million to design and plan a 16-bed residential aged care facility as well as eight acute beds in Cohuna.

The Victorian Government has also established the $10 million Rural Residential Aged Care Facilities Renewal Program. The program enables rural and regional residential aged care services across Victoria to invest in modern infrastructure and equipment.

By delivering dementia-friendly residential aged care facilities, we’re ensuring access to high quality public aged care close to home. This will support older Victorians to remain independent and keep well for as long as possible.

This article was originally published on 17 March 2022.