What does this mean for care providers?
A safe, well designed living space is a key part of providing the best care for people living with dementia. Good design and the use of assistive technology can help people to be as independent as possible for as long as possible, and has been shown to reduce hospital stays and care home admissions. It can also help to compensate for impaired memory, learning and reasoning skills and can reduce stress levels.
For people living in their own homes, care providers have a responsibility to ensure everyone has an awareness of the important role the environment can play and are able to provide basic advice if they feel changes might help. Very simple things, such as labelling cupboards and rooms, or changing the colour of the toilet seat, can make it easier for people living with dementia to continue to find their way around independently and reduce anxiety. It is also crucial to be aware of organisations in the area that may be able to provide advice on adapting housing, and pass on that information to people and their families.
For people being supported within a care home or specialist extra care housing, the care provider has the ability to control and change the environment to a much greater extent. They should be aware of the value of creating homely settings that enable people to participate in day to day living activities; of having simple layouts that are easy to follow; of the impact that contrasting colours, good signage and effective lighting can have; and of the benefits that a secure garden can offer.
And assistive technology has a role to play too, particularly as a preventative measure that can help maintain an individual’s independence. Using alarms, movement detectors, reminders, and specially adapted appliances can enable someone living with dementia to stay at home safely, and reduce the stress for carers. Care providers should understand the contribution assistive technology can make, know where and how it can be accessed, and be aware of any organisations in the locality that can provide advice.
Why is this important for carers?
Whether a person with dementia is living in their own home (alone or with a carer), in sheltered housing, extra-care housing, or a care home, what matters is that the housing is suitable and meets their needs. This may well change over the course of the illness. There is a lot that can be done to improve the suitability of a person's housing – and, once again, carers have a key role to play in facilitating these improvements.
What sorts of practical and design changes can help make a home more dementia-friendly?
There are many different things that can be done to living spaces – in a person’s own home or in a care setting – to improve how a person with dementia can live and move in that space.
Some key areas include lighting (making sure this helps rather than hinders movement), signs (making clear the purpose of a room or an item), colour (using colour to improve visibility), and design (encouraging independence). Start with the SCIE Dementia Gateway’s section on Dementia friendly environments to find out more.
Some of these changes can be made quite simply and at low-cost. Others involve more professional input – for example from a physiotherapist or an occupational therapist (for example, for installing a hoist for personal care). A physiotherapy or occupational therapy assessment may arise from a community care assessment – if either or both of these are identified as being necessary by the social worker.
I have heard that some types of assistive technology can be helpful for people with dementia. Can you explain more?
Assistive technology encompasses an enormous range of devices, aids and adaptations. Some are suitable for individuals’ homes; others are designed to work in care homes. Some work well for people with dementia (but not all), and again this will depend a lot on the individual and how they manage their day-to-day life.
Some examples include sensors that can detect movement: such as someone getting out of bed or opening the fridge or front door. The sensor then triggers a message or alarm. Other devices can display messages that remind a person with dementia of the things they need to do. A special plug can be installed in the bath to detect if the bath is too full.
These devices may help a carer to feel reassured and to offer both the person with dementia more independence – and the carer too.
A good starting point to find out more about assistive technology for people with dementia is the website AT Dementia.
Is there funding for assistive technology?
If a person with dementia is living in their own home, the local authority may agree to fund the costs of assistive technology – if this is considered a suitable way of meeting the assessed needs of the person (for example after an occupational therapy assessment). Some people are using personal budgets or personal health budgets to purchase assistive technology (see Statement 4).
Many care settings now incorporate some element of assistive technology into their design and infrastructure.
Otherwise, assistive technology can be purchased from commercial companies.
What else can I do as a carer to improve the housing for my relative with dementia?
There is a lot that can be done to maintain and support the continuity of a person’s housing – and as ever carers can play a vital role in this regard. Some examples include facilitating good links with neighbours so that they can keep an eye out for the person with
The time may come when the person with dementia may have to consider moving – and the support of carers in facilitating these discussions is critical. A decision like this may have huge implications for the carers – so getting as much support as possible in preparing for and living through this transition is vital.
The Environment section on SCIE's Dementia Gateway provides practical ideas about how to make living spaces safe, user-friendly and enjoyable for people with dementia.
Acknowledging the importance of care staff understanding the opportunities offered by assistive technology, Skills for Care have developed a learning and development framework and a resource hub.
Stirling University has developed an online resource demonstrating dementia-friendly design in care homes or people's own homes.
The Kings Fund Enhancing the Healing Environment programme encourages teams to work in partnership with those they support to improve the environment and provides a number of helpful resources.
The dementia environment at home shows how simple changes to create a more dementia friendly environment can have a positive impact on a person with dementia's emotional wellbeing and independence
AT Dementia is a website that brings together information about assistive technology that can support the independence and leisure opportunities of people with dementia. The site includes the AT Guide: a self-help guide to how technology can help people to live well with dementia. It covers a vast range of daily living activities and gives advice and product suggestions. AT Dementia is the work of the Trent Dementia Services Development Centre.
The National Housing Federation, the University of Stirling Dementia Services Development Centre, the Housing Learning and Improvement Network and Foundations grouped together to produce this 2013 report, setting out what is possible if people with dementia are supported to remain living independently in decent housing. The report looks at broad issues such as improving the rate of diagnosis, preventing hospital admission, and promoting independence at home.
SCIE’s Dementia Gateway has resources to help support people with dementia, including written information, films, activities and e-learning. This section of the SCIE Dementia Gateway looks at a range of living areas (kitchens, bathrooms, bedrooms, gardens) in both private homes and care homes, and makes suggestions for how to make them more dementia-friendly – usually at low cost and with minimal intervention. It also covers lighting and assistive
This 2012 report from the Alzheimer’s Society presents a broad overview of the key housing issues facing people with dementia and their carers. The report summarises housing policy and how this relates to dementia, looks at where people with dementia live now, reviews information and adaptations, and considers principles of design. It makes a series of recommendations for those working in housing and social care.
The Housing Learning and Improvement Network website has a section on Housing and Dementia – this has been developed to serve as a gateway to all matters relating to housing and dementia. It brings together information on all aspects of meeting the needs of people with dementia and their carers in housing settings – particularly, but not exclusively, extra care housing.
This resource explains design features that can support people with dementia to continue to live in independent houses and flats, as well as looking at issues arising in communal internal spaces in specialist care housing. It is published by the Dementia Services Development Centre at the University of Stirling and is free to download.
This checklist lists key design considerations for developing dementia-friendly environments: it considers both internal and external spaces primarily in communal care settings (including extra care housing), and neighbourhood level design issues.
The King’s Fund’s Enhancing the Healing Environment (EHE) programme ran from 2009 until 2012 – its overall aim to improve care environments for people with dementia. The EHE assessment tools – one for care homes, one for hospital wards and clinical areas, and a final one for areas in hospitals such as outpatients – are all free to download. Each contains seven overarching criteria and a set of questions to prompt discussions between clinical/care staff, estates colleagues, patients and carers. The King's Fund recommends that a lay person – ideally a carer of a person with dementia – participates in the assessment process.
The Dementia Services Development Centre at the University of Stirling has developed a Virtual Care Home – an online resource that demonstrates dementia-friendly design in care home settings or people’s own homes. The interactive site features seven individual rooms (such as kitchens, living rooms and so on). Users click on elements within each room to reveal information about how these features can make a difference for people with dementia.