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Research for Dementia and Home Design Research for Dementia and Home Design in Ireland looking at New Build and Retro-Fit Homes from a Universal Design Approach: Key Findings and Recommendations Report 2015 Centre for Excellence in Universal Design To download this Research & Recommendations Report please go to; www.universaldesign.ie/housing Research for Dementia and Home Design in Ireland looking at New Build and Retro-Fit Homes from a Universal Design Approach Key Findings and Recommendations Report 2015 Revision A March 2015 Centre for Excellence in Universal Design Authors; Maria Pierce, Suzanne Cahill, Tom Grey, and Mark Dyer TrinityHaus and DSIDC’s Living with Dementia Research Programme, School of Social Work and Social Policy, Trinity College Dublin, 2015 Living with Dementia (LiD) Programme, School of Social Work and Social Policy, 3rd Floor, 3 College Green, Trinity College Dublin, Dublin 2 - http://livingwithdementia.tcd.ie/ TrinityHaus, 16 Westland Row, Civil, Structural and Environmental Engineering, Trinity College Dublin, Dublin 2 - http://www.trinityhaus.tcd.ie/ Disclaimer The Centre for Excellence in Universal Design at the National Disability Authority commissioned the Living with Dementia (LiD) Programme and TrinityHaus, Trinity College Dublin, to conduct this research. The views expressed in the report are those of the authors and do not necessarily reflect the views of the Centre for Excellence in Universal Design at the National Disability Authority. Research for Dementia and Home Design in Ireland looking at New Build and Retro-Fit Homes from a Universal Design Approach: Key Findings and Recommendations 2015 Centre for Excellence in Universal Design Creating an environment that can be used by all people, regardless of their age, size, disability or ability. The National Disability Authority’s Centre for Excellence in Universal Design has a statutory role to promote the achievement of excellence in universal design in: ● the design of the built and external environment ● product/service design ● information and communications technologies (ICT) ● the development and promotion of standards ● education and professional development ● raising awareness of universal design More information and updates on the website at: www.universaldesign.ie Research for Dementia and Home Design in Ireland looking at New Build and Retro-Fit Homes from a Universal Design Approach: Key Findings and Recommendations 2015 CONTENTS MINISTER’S FOREWORD V NDA CHAIRPERSON’S FOREWORD VI ACKNOWLEDGEMENTS VII AUTHORS BIOGRAPHIES VIII EXECUTIVE SUMMARY X Chapter 1: Introduction i 1 1.1. Introduction 1 1.2. Rationale For The Study 2 1.3. Population Ageing In Ireland And Dementia 3 1.4 Carers Of People Living With Dementia In Their Own Homes 5 1.5 Universal Design To Promote Ageing In Place 9 1.6. A Universal Design Approach 12 1.7 Housing Stock And Universal Design 14 1.8 The Place Of Specialised Design In Universal Design 15 1.9 Universal Design As A Person-Centred Process 17 1.10 Universal Design And Sustainability 17 1.11 Universal Design And Life Cycle Costs 20 1.12 Universal Design Guidelines In Ireland 20 1.13 Methodology 22 1.14 Scope Of The Study 25 1.15 Report Structure 26 Chapter 2: Disabling And Enabling Environments 28 2.1. Introduction 28 2.2. Person–Activity–Environment Relationship 29 2.3. Designing For The Whole Person 31 2.4. Conclusion 34 Chapter 3: Universal Design Approach For Dementia Friendly Dwellings - Goals And Principles 35 3.1. Introduction 35 3.2. Universal Design – Principles, Goals & Guidelines 36 3.3. Design Of Buildings For People Living With Dementia – Design And Design Issues 41 i 3.4. Conclusion 67 3.5. Key Recommendations 68 Research for Dementia and Home Design in Ireland looking at New Build and Retro-Fit Homes from a Universal Design Approach: Key Findings and Recommendations 2015 Chapter 4: ‘Living In Place’ With Dementia 69 4.1 Introduction 69 4.2. The ‘Lived Experiences’ Of People With Dementia, Their Families And Carers In The Home 69 4.3. Understanding Dementia: Designing For Its Effects 76 4.4: Family Caregivers’ Concerns About People Living At Home With Dementia 82 4.5 Summary 87 4.6 Key Recommendations 89 Chapter 5 – The External And Internal Design Of The Home 90 5.1. Introduction 90 5.2 Universal Design Of Dwellings 92 5.3 Sustainable Dwelling Design 93 5.4 Home Location And Approach 96 5.4.1 Home Location 96 5.4.2 Approaches To Entrances 100 5.5 Entering, Exiting And Moving About The Home 101 5.6 Spaces For Living 107 5.7 Interior Design In The Home 115 5.7.1 Colour And Contrast 115 5.7.2 Surface Finishes 116 5.7.3 Floor Finishes 116 5.7.4 Wall And Ceiling Finishes 117 5.8 Internal Services In The Home 118 5.8.1 Lighting 118 5.8.2 Thermal Climate And Controls 122 5.8.3 Outlets, Switches And Controls 129 5.8.4 Acoustics 129 5.8.5 Signage And Information 130 5.8.6 Safety Features 131 5.8.7 Assistive Technology 131 5.9 Flexibility And Adaptability 134 5.10. Specific Design Considerations For Existing Dwellings 135 5.11. Construction Costs Associated With Universal Design For Dementia Friendly Dwellings 140 ii 5.12 Key Recommendations 144 Research for Dementia and Home Design in Ireland looking at New Build and Retro-Fit Homes from a Universal Design Approach: Key Findings and Recommendations 2015 Chapter 6 – Case Studies 145 6.1. Introduction 145 6.2. The Case Studies In Outline 146 6.2.1. Dementia Model House 148 6.2.2. Barn Halt Cottages 155 6.2.3. St. Paul’s Court 162 6.2.4. Anam Cara 167 6.3. Conclusion iii 173 6.4. Key Recommendations 174 Chapter 7 – Stakeholder Engagement 175 7.1. Introduction 175 7.2. Stakeholder Interviews 176 7.2.1. Awareness And Knowledge Of Dementia And Perspectives On Universal Design For Dementia Friendly Dwellings 176 7.2.2. Familiarity As A Key Principle In Universal Design For Dementia Friendly Dwellings 178 7.2.3. Dementia Friendly Design In Different Tenure Types 180 7.2.4. Design Features To Support The Universal Design Of Dementia Friendly Dwellings 180 7.2.5. Planning Ahead For The Future 183 7.2.6. People With Dementia And Their Family Caregivers Are Not Homogenous 185 7.2.7. Safety Issues And Fear Of Exploitation 186 7.2.8. Involving People Living With Dementia 188 7.2.9. Sustainability And Energy Efficiency In People’s Homes 189 7.2.10. Costs And Cost Savings 190 7.2.11. Funding For Adaptations 191 7.2.12. Universal Design For Dementia Friendly Dwellings Undermined When Community Care/Support Services Are Lacking 192 7.2.13. Universal Design Guidelines For Dementia Friendly Dwellings 193 7.3. Stakeholder Workshops 194 7.4. Conclusion 196 7.5. Key Recommendations 197 iii Research for Dementia and Home Design in Ireland looking at New Build and Retro-Fit Homes from a Universal Design Approach: Key Findings and Recommendations 2015 Chapter 8: Conclusions 199 8.1. Introduction 199 8.2. Discussion 203 8.2.1. Awareness And Understanding 205 8.2.2. Support For Families And Carers 206 8.2.3. User Engagement And Understanding People’s Needs 207 8.2.4. Familiarity 207 8.3. Recommendations 208 8.3.1. Practice 208 8.3.2. Policy 210 8.3.3. Research 211 8.4. Conclusion 212 9. References 214 Appendix 1: Project Steering Committee 225 Appendix 2: Stakeholder Workshop Attendees 226 Appendix 3: Scenario A: John Living Alone In Ballina, Co. Mayo 228 Appendix 4: Scenario B: Mary Living With Her Adult Daughter And Grandchildren In Dublin 229 Appendix 5: Scenario C: Joe & Bridget Living In An Apartment In Dublin City 230 Appendix 6 Scenario D: Kathleen Living Alone In A Rural Cottage In Wicklow 231 iv Research for Dementia and Home Design in Ireland looking at New Build and Retro-Fit Homes from a Universal Design Approach: Key Findings and Recommendations 2015 Minister’s Foreword It is important that people with dementia are facilitated to remain living at home and in their community independently and safely for as long as possible. The research commissioned by the National Disability Authority’s Centre for Excellence in Universal Design and the related design guidance will be key to informing the design of dementia-friendly housing, using the Universal Design approach. I believe that this research and associated design guidelines can inform national policy and can be used in practice by all stakeholders – those who commission, design, build, provide and occupy housing. Designing and building new homes or making alterations to existing homes that are in line with a Universal Design dementia-friendly approach will support the aim of the Irish National Dementia Strategy to facilitate people with dementia to live well for as long as possible. This approach will also support family members and carers to sustain the caring relationship, particularly if these carers are older people or they themselves have a disability. I would hope to see this information and guidance reach the widest possible audience, and that it is being acted on. Ireland is unique in having a statutory Centre for Excellence in Universal Design, part of the National Disability Authority, which promotes the design of environments, products, services and technologies that take account of human difference, and can be used by anyone regardless of age, size, ability or disability. We all have a role to play in ensuring the universal design approach is adopted in practice, making our environment easy for all of us to use. I would like to thank all the individuals and organisations who have engaged with this work and whose feedback has informed the outcome.
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