A little goes a long way

Design expert, Rebecca Furse, explains how even the smallest improvements to the hospital environment can make a big impact on people with dementia

Displays of memorabilia from the era in which they grew up can help people with dementia

Even the smallest alterations to the environment in hospitals and care homes can have a positive impact on the lives of people living with dementia, according to design expert, Rebecca Furse.

An in-house environmental psychologist working for architectural practice DKA, Furse is a specialist in dementia-friendly design and her skills have been deployed across a number of healthcare projects, retirement villages and care home developments.

Speaking to BBH, she said: “Visiting hospital or moving into a care home can be stressful for any of us, but people with dementia can find the experience so unsettling that it impacts on their recovery.

“A well-designed environment can help to reduce falls, length of stay, and challenging behaviour while increasing staff productivity.”

She has recently worked on a number of DKA-designed projects, including the new Bridgwater Community Hospital.

A fresh approach

Furse said: “Designing a dementia-friendly hospital obviously requires a different approach to a residential environment, where we would aim to create familiar surroundings and encourage personalisation. However, whatever the size or type of building, the key principles remain the same.”

Priorities, she added, are an easy-to-navigate layout, control of unwanted noise, and access to the natural environment.

Clinical demands and needs of other patients must also be considered, although in many cases interventions that are helpful to a person with dementia also help others.

At Bridgwater, visitors enter into a large, airy waiting room with glazing offering views of specially-commissioned artwork celebrating the last 200 years of the area’s history. The colour scheme throughout is restful and the seating areas follow a simple colour coding scheme, allowing staff to direct patients easily.

Contrasting colours can help people to find their way around

The ward, positioned to avoid motorway noise and give bedrooms views of the Quantocks, has a straight corridor that allows for safe wandering, which is a common pastime among people with dementia, as well as aiding staff observation. The three staff bases allow nurses to stay close to their patients and these are highlighted in a contrasting colour to provide focal points for patients who need assistance. Each base also has a unique symbol helping patients to identify with the zone they are staying in.

“Wayfinding is crucial to dementia design,” said Furse. “It seems like common sense, but it is a key responsibility of designer to make sure people know where they are and where they are going.”

But that does not mean cluttering corridors and rooms with dozens of signs.

Colour and contrast

“It is about simplifying the environment, keeping what is important and playing down what is not,” said Furse.

“For example, notices on walls can be offputting, so if they are not relevant, take them down. It is about minimising confusion and anxiety through design interventions.”

It seems like common sense, but it is a key responsibility of designer to make sure people know where they are and where they are going

Colour and contrast are important too, including ensuring that exits and entrances are clearly marked.

And the onus is increasingly on product suppliers to work with architects and health and social care operators to come up with new innovations to help enhance the environment.

Furse said: “We are talking to manufacturers all the time and they are all much more aware of how products can impact on people with dementia.”

At Bridgwater patients are encouraged to leave their rooms and socialise with others in the dining room or in cosy patient lounges, where artwork promotes conversation. These rooms have large glazed partitions to the corridor, making their function clear, and coloured feature walls to make them easy to identify.

“All of these features contribute to creating a safe and enabling environment that will help people with dementia to retain some of their independence and reduce frustration borne of confusion and isolation,” said Furse. “This, in turn, will ease pressures on staff, benefiting all patients.”

At Bridgwater Community Hospital, nursing stations have their own identity to make them more visible to patients