Search results

This paper summarises research funded by the EPSRC EQUAL programme from 2000 to 2003 to examine how neighbourhoods could be made dementia‐friendly. Design for dementia generally focuses on the internal environment of dementia care homes and facilities, but most people with dementia live at home. Unless they are able to use their local neighbourhoods safely, they are likely to become effectively housebound. There is also increasing awareness of the role the outdoor environment plays in the health, independence, well‐being and cognitive function of people with dementia. The research defined dementia‐friendly neighbourhoods as welcoming, safe, easy and enjoyable for people with dementia and others to access, visit, use and find their around. It identified six design principles: familiarity, legibility, distinctiveness, accessibility, comfort and safety. A number of recommendations for designing and adapting neighbourhoods to be dementia‐friendly arose from the research.

This study seeks to appraise the design of nursing and residential care homes for people with dementia in Northern Ireland using the design audit checklist developed by the Dementia Services Development Centre – DSDC.

The appraisal used postal questionnaires, based on the DSDC essential design criteria, that were sent to facility managers. This was conducted in order to establish the level of compliance with these criteria to achieve a dementia‐friendly home, and to ascertain whether there are any noticeable differences between nursing homes and residential care homes.

The study identified the types of homes that were seen as failing to meet most of the DSDC design criteria and, in particular, which criteria are not met according to their managers. Results from this sample suggest that nursing homes align better with DSDC criteria than residential care homes. The study concludes that the majority of managers perceive their care homes to meet over 50 percent of the essential criteria, with just over 5 percent below the 50 percent mark.

Given that this study used postal questionnaires more research is needed in order to validate results. Behavioral and policy implications are crucial aspects that will be the subject of future research which will involve post‐occupancy evaluation.

More attention to dementia‐friendly building design needs to be taken into consideration by residential care homes, and more improvement would still be required by nursing homes not meeting all criteria.

The paper highlights the importance of dementia‐friendly building design and the requirements for more care in designing and fitting care environments for people with dementia.

This paper aims to describe the outcomes of the use of the Quality Outcome Measure for individuals with dementia (QOMID) within a dementia pathway for people with Down’s syndrome (DS). The QOMID is a tool for clinicians to use with 17 outcome domains, each with descriptors for early, mid and late stage dementia, rated on a four point scale from rarely achieved for the person (1) to consistently and completely achieved for the person (4).

Data from first time use of the QOMID with 49 people with DS and dementia was analysed to determine if specific outcome domains are more achievable than others, if this differs by stage of dementia and what recommendations are suggested.

Results suggest that there were significant differences in achievability across the domains but that achievability did not vary between early and mid-stages of dementia. The themes with most recommendations were: quality of paperwork and documentation; improving communication with the person with DS and dementia; and working together with health and social care professionals.

Results suggest that outcomes which fall outside of the typical learning disabilities skillset and are dementia specific are being achieved less often. Primarily, recommendations focused on practical solutions such as using visual timetables to communicate with the person and adapting their environment. Further work on integrating the QOMID and stage-related team training for care staff is underway.

To the best of the authors’ knowledge, this is the first detailed analysis of the use of the QOMID in clinical practice with people with DS and dementia.

This chapter aims to provide an overview of the ethical framework and decision-making in clinical dementia research, and to analyze and discuss the ethical challenges and issues that can arise when conducting clinical dementia research.

Informed consent is the most scrutinized and controversial aspect of clinical research ethics. In clinical dementia research, assessing decision-making capacity may be challenging as the nature and progress of each disease influences decision-making capacity in diverse ways. Persons with dementia represent a vulnerable population deserving special attention when developing, implementing, and evaluating the informed consent process. In this chapter, particular attention will be given to vulnerability categories and how these influence decision-making capacity. Ethical frameworks with a pragmatic contour and implication are needed to protect vulnerable patients from potential harms and ensure their optimal participation in clinical dementia research.

In addition, this chapter analyses important ethical challenges and issues in clinical dementia research. If handled thoughtfully, they would not pose insuperable barriers to research. But if they are ignored, they could slow the research process, alienate potential study subjects and cause harm to research participants. Ethical considerations in research involving persons with dementia primarily concern the representation of the interests of the participants with dementia and protection of their vulnerabilities and rights.

A core set of ethical questions and recommendations are drawn to aid researchers, institutional review boards and potential research participants in the process of participating in clinical dementia research.

This paper aims to investigate the impact that building design has upon the quality of life for residents of a care home who have dementia. To present a balanced perspective, carers within the care home also participate in the research.

A case study methodological approach was adopted using one care home, ten residents and five staff as a sample frame. During interviews conducted, participants were asked semi-structured questions on how building design features impact upon the quality of life of residents. Questions posed focussed upon key design principles that emerged from a detailed review of extant literature.

Building design for people with dementia must consider a complex array of features to provide a safe and habitable living space for residents and family members who visit. This living space must also be suitably utilitarian and provide a workable environment for staff. Hence, an appropriate balance between these two competing requirements must be attained, and often a tailor-made solution is required that fits the individual’s level of dementia. Three prominent areas that study participants expressed a desire for were a safe environment; support for wayfinding, orientation and navigation; and access to nature and the outdoors.

The work reports upon the rarely discussed issue of building design for people with dementia and could be used by policymakers and construction firms to enhance their knowledge capabilities in this area. The research concludes with direction for future research which should seek to provide more evidence-based research vis-a-vis perception enquiry and extend this seminal work to a larger sample of care homes or people with dementia living at home.

There is increasing interest in the UK in developing environments that support people who are neurodiverse. This paper aims to report on a project to develop a cognitively supportive environmental assessment tool to improve the design of health centres, where the majority of National Health Service consultations take place, for all users, including people living with dementia and those who are neurodiverse.

A three-stage process was used: a literature review; the development of a matrix of key design features for people living with dementia, autism and other neurodiverse conditions; and the development of an environmental assessment tool and guide for users, which included easy-to-read versions to maximise service user involvement.

The overarching concepts of dementia-friendly design can be adapted to create designs for everyone, including those who are neurodiverse.

There is a paucity of research in environmental design for primary care from the patient’s perspective, and, more generally, further research on design for adults with learning disabilities and autism is needed.

The tools are free to download. With adaptation, they have potential applicability across health and care settings.

This project has confirmed that the principles of dementia-friendly design are applicable, with modifications, to a wider group of neurodiverse people. Critically, each person’s response to sensory stimuli is individual rather than determined by their condition.

The purpose of this paper, practice-based mixed methods small-scale study, is to explore the design features of a “dementia friendly” acute ward environment and, staff views on the implications of daily activity engagement for patients with dementia.

Eight staff members of the multidisciplinary team who work full time on an acute “dementia friendly” ward completed semi-structured questionnaires. Thematic analysis explored responses to the open-ended questions, and a further environmental assessment tool rated features of the “dementia friendly” ward design, on promoting aspects of well-being in patients with dementia.

Six overarching themes were found. These included: contrasting ward colours; clear ward signage; positive staff interaction; memorabilia, and activity rooms and items, had a positive influence on patient interaction, well-being and engagement in daily activities. The audit scores were rated highly for various aspects of the ward design. These included: the ward design promoting patient interaction, well-being, mobility, orientation, continence, eating and drinking and calm and security.

This practice-based small-scale study highlights the importance that a “dementia friendly” ward environment may have on patient engagement and well-being, from a daily activity perspective. Further research into the key aspects of design that enable meaningful daily activity engagement is required.

This study supports staff perceived views of the positive influence that “dementia friendly” design may have for patients with dementia. Both the physical design modifications of the ward and staff interaction were highlighted as positively influencing patient well-being, and daily activity engagement. Staff members also felt that they needed to balance the clinical ward priorities, with the contextual requirements of patients with dementia, to establish an effective “dementia friendly” ward.

The value of this research is the combined consideration of an environmental assessment tool and qualitative interviews with members of the multidisciplinary team.

Preserving our built heritage from the onslaught of weather, pollution, development and the effects of tourism is a complex endeavour. Appended to this is the need to ensure that heritage buildings are inclusive to all users. Thus, built heritage is plagued with contradictions and conflict between conservation goals and those to support inclusivity given the limited resources often available. Dementia has been purposely selected for this study as numbers of diagnosed sufferers are increasing at an alarming rate, and enagement with heritage has been proven to support well-being. The paper aims to discuss this issue.

This research review draws on systematic principles and presents an analysis of the available literature on well-being programmes designed for people living with dementia and their care supporters, with particular reference to programmes in heritage settings, and the resulting impact for users.

This review critically evaluates the available evidence from published literature on the role of the heritage setting, on how it impacts on the experience of dementia participants. In doing so, it draws on findings from the experiences and well-being of people living with dementia and their care supporters; assesses the current state of knowledge, identifies support implications and makes recommendations for future research. In doing so, it highlights a dearth in the literature on research related to the physical environment setting, particular addressing any cognitive impairments that may arise that can alter psychosocial processes, such as lighting, temperature, acoustics and materiality, so that they can be understood and suitably adapted to support the well-being of those living with dementia.

The scant lack of financial resources to support inclusivity in built heritage, and the argument that some heritage cannot be adapted, often leads to only limited opportune for people with dementia. Thus, there is an inherent need for an understanding of current research and well-being programmes so that it can be focalled in the future to support built heritage tourism in a way that it is inclusive to all.

The purpose of this paper is to understand factors that affect viewing of television news programmes by people living with dementia, and to identify dementia-friendly design principles for television news programmes and factors for personalising object-based media broadcast.

Extensive public involvement comprising two discussion groups with people with dementia and family carers informed the study design and provided supplementary secondary data. Primary data collection comprised a focus group interview with people with dementia (n=4) and family carers (n=4). Past viewing experiences and perceived barriers and facilitators to viewing television were explored. Participants commented on an array of video clips comprising varying segments of fictional news programmes, plus control versions of each segment.

Four themes were identified: content (general comments, context, type of media and pace); presenter (body language, clothing and accent); background (location and studio appearance); and technical aspects (graphics, sound, colours, camera, transitions, general issues).

Limitations included a modest sample size which is offset by exemplary public involvement in informing the study design.

Measures ensured research involvement and participation was made accessible to people living with dementia.

Participants benefited from sharing views with peers and expressed enhanced wellbeing from knowing their participation could lead to improved television viewing, an important social occupation, for people with dementia in the future.

This study is the first to be published which focusses on dementia-friendly television news programmes.