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| TX: 15.11.05 - Dementia: Design and Layout PRESENTER: LIZ BARCLAY |
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| THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE BBC CANNOT VOUCH FOR ITS COMPLETE ACCURACY. BARCLAY About a third of people with dementia live in residential homes, another third live with their families and a third live alone. Evidence is growing that the design and layout of a home can have a significant impact on the wellbeing of people with dementia. Something which, until recently, hadn't been fully appreciated. We sent Philippa Budgen to investigate. SELF One of the things you'll have noticed is that there's no change in the colour of the carpets on the corridor into the actual activity room. BUDGEN Cinnmon Court in Deptford, Southeast London. It's run by Housing 21, a housing association specialising in accommodation and care for older people. SELF I'm David Self, I'm a dementia services advisor for Housing 21. BUDGEN David takes me into the day centre where the 40 odd residents mix with day visitors. Up to a quarter of the older people here have dementia, so it's essential the design helps them as much as possible with their memories and orientation. Even something as simple as carpet makes a difference. SELF There's no pattern, because very often people with dementia have an impairment of perception, so if there was a change in the threshold, often with a gold strip or something like that, and it might contrast the floor from the corridor into the day activity room, that can actually be perceived by someone with dementia as a step and that increases the risk of falls. Likewise with curtains, it's very important in your curtains to try and keep the patterns not too busy, they might actually misunderstand the patterns and see faces at the window. BUDGEN And that would then make them scared. SELF It can do, also it could be presented as a visual hallucination, whereas in fact maybe they're not having that hallucination but what they can see is the pattern in a curtain or fabric. But the same goes for lighting, it's really important in terms of shadows. So down lighting creates a lot of shadows and that can confuse someone. So if you have up lighting, minimise the shadows, that again helps with their environment and their general wellbeing. ACTUALITY Oh look what you've done, isn't that lovely. Have you made this craft? BUDGEN Eight four year old resident Rose Newby is doing craft in the activity room. She's living on her own in a flat upstairs. Her daughter-in-law Annette shows me round. ANNETTE Rose had an incident where she let someone into her flat where she used to live, this guy robbed her. She couldn't remember and we realised there was something not right and it was diagnosed as Alzheimer's. Rose is very safe here, the doors are extra wide so she can't knock herself. It's just all on one level. BUDGEN And safety is often a high priority for concerned relatives, especially as people with dementia have a tendency to wander. Judy Torrington is an architect who specialised in buildings for older people and is now an academic at Sheffield University. In her research she's found that residents with dementia living in nursing and care homes can be distressed by an overemphasis on security. TORRINGTON The worst possible case is if you've got a two-storey building and you've got a unit above the ground floor and very often people actually can't go outside at all and they're quite often actually locked in with a keypad into their particular suite of rooms. So their actual contact with daylight and sunlight and wind and rain becomes very limited. BUDGEN You would have thought that would be something that people would realise would make people feel imprisoned wouldn't you, I mean I would have thought that was fairly basic. TORRINGTON Yeah you would really, yes but comes from real concern. MARSHALL Stress, as it is for all of us, is a huge factor in people with dementia's ability to cope. BUDGEN Mary Marshall, of the Dementia Centre at Stirling University, trains professionals on good design. She says bad design can hinder people further. MARSHALL They become agitated, they become restless, they become upset and what capacity they had to cope is diminished. BUDGEN And they therefore lose their independence quicker. MARSHALL Indeed and become quite unnecessarily dependent on other people. TALKING COOKER The cooker needs attention. BUDGEN One of the most common reasons for a person with dementia to leave their own home and move into care is concern about their safety with the cooker. In this flat in Cinamon Court newly designed technology has been installed to prompt the person with early stage dementia. TALKING COOKER The cooker needs attention. BUDGEN No one's living in the flat yet, so I asked Annette Newby, daughter-in-law of Rose, to give it a test run. NEWBY For someone who's got the onset of dementia and wants to stay independent this is perfect. TALKING COOKER I turn the cooker off. BUDGEN And what about that voice reactor there, warning her ... NEWBY ... wondering where the voice came from but she be looking for the person but no that would prompt her as well that the cooker has been switched off. I mean with my mother-in-law she is quite advanced but when you first get the dementia or Alzheimer's your memory's good, it's not perfect, but it would prompt you to do things and remind you to do things, whereas once it gets advanced the reminding doesn't really work. TALKING COOKER I think you should go back to bed now. SELF It's all about enabling the person to remain in control of their environment for as long as possible without the feeling of being monitored. TALKING COOKER I've turned the catch off. BUDGEN In future there are plans for this technology to be made available to people who want it in their own home. It costs £5-6,000 to install a full system like this, that's the cost of about 10 weeks in a conventional residential home. TALKING COOKER I don't think you should go out at the moment. BUDGEN So David Self we're now on the second floor of Cinamon Court. Every door seems to have a slightly different colour around it David, what's that about? SELF Well the doors are recessed, so that you break up the effect of having then a corridor because often corridors can affect someone's orientation, so if you try and break up the straight lines and then they can be coloured or personalised, it helps the person to remember where their flat is. BUDGEN And why when you're talking about the design of accommodation for people with dementia is colour such an important facet? SELF There are particular colours in the spectrum that are retained in the memory for longer than other colours. BUDGEN Like what? SELF So the reds and the oranges tend to be held by the memory for longer. So thinking about colour schemes could be quite important. BUDGEN There's wide consensus amongst professionals that something as simple as colour coded doors and carpets can make all the difference to orientation. Mary Marshall of the Dementia Centre at Stirling University wants to see such principles applied generally. MARSHALL If you're looking at wider buildings like hotels and museums and restaurants and shopping centres far too little is being done, we need cognitive impairment to be part of the access process, so that people with dementia can go to hotels, can use airports, can go shopping, just like the rest of us, without being totally overwhelmed and bewildered. BUDGEN Amongst all the other considerations that designers of buildings and the people who fund them have to come up with is it really realistic for them to be taking into account the needs of people with dementia? MARSHALL It's so simple, it just requires designers and people who own and run buildings to think how would someone who wasn't coping too well intellectually make sense of this building. And most people would say that if you get it right for dementia it's actually better for all of us. BARCLAY Mary Marshall ending that report by Philippa Budgen. And we've just heard from Rose Newby's daughter-in-law Annette, who featured in that report, that sadly since that was recorded Rose has died. If you want to hear more about dementia, at nine o'clock tonight on Radio 4 Building a Healthier Britain presented by Richard Hanniford examines what is currently known about dementia and what we need to find out to help provide better services for people with the condition. Back to the You and Yours homepage The BBC is not responsible for external websites |
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