Designing for Dementia

A dementia-friendly demonstration home will soon open in Watford, the UK. Heidi Vella hears from Dr David Kelly, group director of BRE Innovation Parks, about the project and how the industry as a whole can better meet the challenges of this debilitating disease.


A dementia-friendly demonstration home, which will be available to view from in October, is currently being constructed in The BRE Innovation Park in Watford, the UK. The result of a partnership between BRE and Loughborough University, the 100sq m house will be adapted to cater for different types and stages of the debilitating illness and is aimed at enabling suffers to stay at home for longer.

Dementia describes different brain disorders that can trigger a loss of brain function, such as Alzheimer’s disease. Symptoms, such as impaired memory, learning and reasoning, are typically progressive but will eventually become severe.

The Alzheimer’s Society says there are 850,000 people with dementia in the UK, and numbers are set to rise to over one million by 2025 and two million by 2051.

The disease can have a huge emotional, social, psychological and practical impact on a person and enabling suffers to stay in their home for longer can be a major comfort, but also more cost effective, as dementia care costs families around £18bn a year.

BRE hopes to help suffers live independently for longer by adapting a demonstration home at its Watford park that will encompasses the ‘design for dementia principals’ established by Dr Rob McDonald and Bill Halsall at Liverpool John Moores University, as well as incorporating insight from carers and nurses, as well as BRE’s own design expertise.

Group director of BRE Innovation Parks, Dr David Kelly, discusses the project and why he hopes building regulations will be changed so that more houses can be built and adapted for dementia sufferers.

Heidi Vella (HV): Why did BRE decide to build a dementia friendly home?

David Kelly (DK): The innovation parks always try and consider the future requirements for housing, and we had become increasingly aware of housing in relation to dementia through some of our work with the healthcare sector. Then the fire and rescue service also suggested it to us, so I started to investigate who was doing what in relation to housing and dementia.

I found there are a few different organisations doing things around design – from an architectural perspective or an interior design or technology development perspective – but what was missing was collaboration. There was no focal point for stakeholders to work together to create full solutions for housing.

We started to engage with Dr Rob McDonald and Bill Halsall at Liverpool John Moores University. They had used a living laboratory model to engage with suffers of early onset dementia to identify the challenges they faced in their homes, the streets, local communities and town centres. They then developed design guides.

We started exploring what these principles might look like within the innovation park concept and that is what led us to where we are now – building the demonstration home.

HV: What are some of the specific ideas you are working on?

DK: We have been working with Loughborough University to establish the typical symptoms of early onset dementia and what sufferers might find challenging. This is difficult as everyone’s experience is unique but there are some common things that can happen and considering those we have created potential design solutions within the home.

"For example, lines of sight are very important; making sure anyone who is occupying the house has full visibility."

For example, lines of sight are very important; making sure anyone who is occupying the house has full visibility of the kitchen, bathroom and bedroom, no matter where they are within that floor or area, so they are prompted to go to the bathroom, to eat, to rest.

We are looking at how to provide adaptive support within the home, as well. We want to develop fundamental principles that can be applied quickly and easily within a home. There will not necessarily be individual products but rather a principle of approach.

HV: What might these principles include?

DK: Colour, lighting, views to the outside of the building. We are going to create a sensory garden. It’s important to make sure areas are well lit and ventilated and heated appropriately as part of the design and functionality of the building. We are looking at how to control heating and lighting because often people with dementia will lose their sense of hot and cold and may forget when to put the heating on, which can acerbate certain health conditions.

We are also looking at using tonal colours, what kinds of floor coverings to use, textures and level access throughout a floor, trip hazards, making sure eating areas are close to cooking areas. There may also be memory boards with pictures from the past to stimulate sufferers with sight, as well as sound.

HV: Are you also looking at incorporating different technologies?

DK: Very much. Technology is moving quickly. There are Wi-Fi enabled products that can do pretty much anything in the home. We are looking at ways to remotely monitor behavioural patterns to note changing conditions.

For example, there are motion sensors for carpets to monitor how people are moving around the home – are they becoming less mobile or is their walking pattern changing? It could be their condition is worsening.

We can also monitor movement and patterns of behaviour; how long someone is sitting in a chair or in bed or cooking. We can create a behavioural pattern to identify when things are changing. There are so many products that could be used, from monitoring the temperature of bath water to monitoring the length of time cooking appliances are left on.

There are sensitivities around monitoring people, however, but we are not trying to tackle legal issues, but simply show what can be done.

HV: How much do you expect adapting a home for a dementia sufferer will cost?

DK: It is hard to say because the level of adaptation will depend on the individual person’s circumstances and needs. But we will try to do some costings through the demonstration building, but we wouldn’t want to give a definitive figure.

HV: What do you hope comes from this project in the future?

DK: What we are trying to do is create more awareness about how many people are affected by Alzheimer’s and dementia now and will be in the future – it is going to become increasingly important that we have a co-ordinated response to housing and dementia. We will need more funding, more case studies, more testimonials, more information that is corroborated and disseminated.

"But ultimately we would like to see an adaptation in housing which shouldn’t be as difficult as it is currently."

But ultimately we would like to see an adaptation in housing which shouldn’t be as difficult as it is currently. Building regulations in the UK are driven by energy, fire safety and so-on, but there are no provisions for designing accommodation for easy adaptation later on.

The UK has had a housing crisis since forever and housing for an aging population isn’t on the agenda currently, but perhaps a way to address this would be to have some fundamental principles embedded in regulations to make it easier for adaptation in the future, so people don’t have to invest significantly later on to adapt their homes for their health.

It would be good if that thinking was integrated into new build designs and regulations. That is quite a big challenge and aspiration, but when you consider other pieces of regulation, like the disability discrimination act passed in the 1990s that led to changes in building regulations for disabled people, it shows this can find its way into informing the building of new housing stock.

HV: If someone wants to find out more, can they visit the demonstration house?

DK: Yes, that will be one of the things we will actively do. We want to interact with user groups and people from the healthcare community to, I suppose, critique what we have done and the approach we have taken and the technology we are demonstrating.

We want people to comment, interact and hopefully take something positive from it. We’re sure there will be positive and negative comments but that is because everybody’s experience with Alzheimer’s and dementia is different – there is no one size fits all approach but hopefully we can identify some good principles that people can take back to their own homes and implement into their own projects.