Architecture for people with dementia must accommodate the individual’s life story
Rethinking the familiar is one of the architect’s most important tasks in working with future care centres for people with dementia. Here, homeliness and security are important keywords, and using familiar shapes and healthy materials matters when creating new homes and environments that are accommodating of the individual’s life situation and life story.
When cognitive skills fail as a result of illness, and the ability to cope with everyday life alone declines, it may be necessary to move into an assisted-living facility. This can feel like a huge change – especially for people with dementia. Therefore, it is important to create a safe environment to ensure their well-being and quality of life.
Architecture that supports elderly people with a dementia diagnosis is a growing field. It is very much about dignity, quality of life and respect for the elderly person. The starting point is the individual, and the architecture must be based on an understanding of the individual’s life situation and needs. Jonas E. Andersson is an architect, PhD and associate professor of architecture and urban design at the Department of Urban Studies at Malmö University, and for many years he has worked with and researched architecture for elderly people with dementia. In his view, catering for individual needs is what makes a difference in practice.
“Understanding the individual is crucial when designing for this target group. We need to think in terms of architecture that supports rather than stigmatises. In the past, buildings for people with dementia were hidden away, while today there is more focus on integrating them as a natural part of the rest of society. It is extremely important for elderly people with dementia to see people around them, if they are to thrive,” he explains.
He is supported by Kristina Møller Hansen, an architect and segment specialist in care at the design studio Friis & Moltke. In recent years, she and her colleagues have designed several care centres for people with dementia, including Huset Nyvang in Randers and Tornhøjhaven in Aalborg, both of which take as their starting point residents with dementia.
“Good architecture for people with dementia must be able to accommodate the life stories and daily life of the residents. It is their home and their daily life, but it is our responsibility as architects to create architecture that supports the residents in mastering their daily lives, and which supports the formation of meaningful communities, as well as encompassing the entire dementia spectrum and maximising the quality of life of the individual,” she says.
Photo: Huset Nyvang, a combined care centre and children's daycare institution in Randers, Denmark
Limited stimuli
Too many new impressions can cause feelings of unease and insecurity in people with dementia. For the same reason, architects working in this field are aware of the importance of choosing familiar shapes, materials, textiles and furniture that can create a degree of familiarity and homeliness for the residents.
“As far as possible, we try to work with familiar and textural materials that tone down the institutional feel and instead add a feeling of home. Instead of living on the blue ward, perhaps you live by the big tree or the pond. In this way, we create a sense of security around the housing units,” Kristina Møller Hansen explains and continues:
“Materials can have many functions. For example, when it comes to acoustics, sound greatly affects the residents, and therefore it plays a key role in buildings where some residents can sometimes be loud. With Troldtekt acoustic panels, we can capture the sound waves, reduce the reverberation time and screen those that are very sound-sensitive or hearing-impaired. In addition, the tactile surface of the Troldtekt panels adds warmth to the room.”
Jonas E. Andersson also points to interior design as an important factor for well-being – and sees scope for improvement in Swedish dementia care homes:
“The ambience as a whole is important, and therefore both colours and furnishings can have an impact on the residents. In Sweden, care centres are often very white and clinical, because the issue of hygiene is very important, but hospital-like environments are uncomfortable for people who do not understand that they are sick,” he says.
Homelike > hospital-like
Jonas E. Andersson has great insight intothis paradox. In his thesis Architecture and Ageing: On the Interaction between Frail Older People and the Built Environment, he presents three concepts based on how Swedish care centres for elderly people with dementia are often perceived:
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Homelike
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Hotel-like
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Hospital-like
The concepts are based on how shapes, materials, furniture and textiles contribute to creating a unified environment. Swedish research shows that elderly people with dementia thrive best in a homelike environment, while a hospital-like environment confuses them.
“It goes without saying that special architecture is needed to cater for elderly people needing extra care, and where accessibility and usability become crucial. There is a need for wider doors, larger bathrooms and space for hoists, but at the same time it must feel like a home,” he explains, before continuing:
“We should strive for homelike to create the best environments for both residents and their relatives. Denmark is a bit better at this than Sweden, where senior housing and nursing homes are often very hospital-like. I think we in Sweden can do better in the future once we start looking at the potential for development and the changed needs post-COVID-19.”
Friis and Moltke have successfully added homelike and done away with hospital-like – at least as a disturbing element for the residents.
“With this type of construction, we always start by looking at the flows of food, medicines, clothing/linen and depot items, and the logistics concepts. Because there are always practical aspects to factor in. In addition to designing homes for the residents, we are also designing a workplace for the staff. By making sure that the logistics concepts are situated as far away as possible from the residential units, we make sure that there are as few disturbances for the residents as possible, and at the same time the staff has the space they need to deal with their practical duties – although still in close proximity to the residents,” explains Kristina Møller Hansen.
However, both architects agree that we are moving in the right direction and that we have a solid foundation for the future.
“Both politicians and society have realised that if we are to be able to take care of the growing proportion of elderly people, we need to start taking some action. There’s no template for what senior housing should look like, but we have lots of good elements to build on. However, the most important thing is that we remember to put the needs of the elderly first when designing architecture,” Jonas concludes.
