Better dementia outcomes by design

The aged care sector’s signature clinical-style design is set for a major overhaul, according to architect Ali Devellerez, who says providers are increasingly seeking to create a more-homely environment.

Besides the visual appeal, the SPH architecture + interiors director said tailoring the design of these environments could positively impact residents’ wellbeing, particularly those living with dementia.

Ms Devellerez, who has completed formal qualifications in design for dementia at the UK University of Stirling, said this design concept had been around for a number of years, but due to the growing prevalence of dementia and people entering aged care systems at a later age, SPH was now applying these principles across entire facilities.

According to Dementia Australia, more than 400,000 Australians are living with the condition, with this number expected to increase to more than 500,000 by 2025.

“Design is a powerful tool,” Ms Devellerez told Business News.

“An architect’s role is to shape design for specific needs. 

“Historically, care has been delivered in a very institutional environment, but we’ve reached a point now where clients have realised they don’t want to do that anymore.

“For people living with dementia, traditionally you would have had secured lockdown wards; now we’re trying to open it up and allow people to wander freely and access outdoor areas in a safe way.”

SPH specialises in aged care design, with clients including St Ives, Juniper and Amana Living.

Rustic design at SPH’s Narrogin project (above) and Kings Park theming at MKDC’s MercyCare refurbishment (below) help evoke memory. Photos: SPH and MKDC

Its latest project, Narrogin Cottage Homes, a $6 million, 20-bed addition to an existing 35-bed facility, was completed earlier this month.

Ms Devellerez said it embodied a number of design principles that encouraged residents’ independence by creating an enabling environment.

This included designing the floorplan to create a wandering loop – an area for a resident to wander down a corridor, through the lounge, into the courtyard garden and back round again.

SPH architect and interior designer Cherie Kaptein, who has a nursing background, said the team had used colour as an unobtrusive means to guide residents through the building and to form boundaries.

“We’ve got a dark floor over the nurse’s station because we don’t want the residents to wander in there,” Ms Kaptein told Business News.

“When you’re vision impaired you can perceive that as an obstacle or a hole in the ground, so it stops people from walking over that space.

“Dementia affects people differently; there are some who wander and if you try to restrict what their bodies are telling them to do they can get distressed, so you’ve got to give them freedom.

“In one project in Holland, the use of antipsychotic drugs went down because they allowed people to roam around,” she said.

Ms Kaptein said the Narrogin project also featured timber and white wardrobes designed by Alzheimer’s WA; the timber is visible but the white, for the resident, blends in with the wall so they don’t access that section.

Transparent memory boxes have been built into the walls at the entrance of each bedroom in which residents can place personal items such as photographs or other memory-stimulating objects, enabling them to better identify their room.

The Narrogin project includes building materials designed to evoke familiarity and memories of the environment outside the facility by incorporating a stonewall fireplace, rustic fittings and timber beams reminiscent of the local farming community, as opposed to modern steel.

Perth-based interior design practice MKDC has opted for a Kings Park theme at its latest refurbishment project for MercyCare’s Wembley site as a way to stimulate memory. 

Jacqui Williams, who heads the practice’s aged care division, said Kings Park was chosen for its familiarity but also for its intergenerational appeal.

“For over 100 years people have gone to Kings Park for picnics, people can relate to it,” Ms Williams told Business News.

“We marry two aesthetics – the clinical criteria needed for dementia design and the fact we’ve got to create appealing environments that encourage families to come visit, because socialisation is an important part of people’s wellness.

“Nature is also important to wellbeing, and we’ve put in auto doors and low-grade thresholds so there’s no step, to access outside.”

As part of the Kings Park theme, Ms Williams said MKDC had curated prints from Perth-based botanical artist Philippa Nikulinsky to create a gallery trail for visitors and residents and, like SPH, was aiming to replace the institutional interior with a residential look.

The firm also used colour schemes to guide residents and reduce falls, keeping colour saturation and patterns low for the three-dimensional junctions of finishes, creating distinct delineations between walls, floors and furniture. 

“Small patterns can be misconstrued as insects and they would read a beige carpet, curtain and chair as one,” Ms Williams said.

To further aid mobility, MKDC scattered tactile sensory stations throughout MercyCare’s building. 

“It might be a table with a basket of scarves, or half-done knitting they can pick up,” Ms Williams said.

“It’s about the programming of space, making it obvious in their wayfinding what they can do next.

“Whatever we can do to let people understand their environment and make a choice on what they can do next takes away (their) frustration.

“We try to keep residents safe unobtrusively so that they don’t feel limited or locked in.”

Ventilation was another key focus for MKDC’s refurbishments, with garden and cooking smells additional sensory triggers, as was providing greater access to natural light.