Special Report by Graham Francis, SwanCare CEO
Worldwide, around 50 million people have dementia, and there are nearly 10 million fresh cases every year. In Australia, close to half a million people are living with dementia and they estimate this number to double in the next 25 years. With over 50 percent of residents in Australian residential aged care facilities having dementia, increasing attention is being given to the design of the residential facilities needed in coming years.
There are few examples where architecture or interior design can markedly affect one’s health and wellbeing more than with someone living with dementia in a residential care facility. Design is incredibly important; the layout and superficial interior design all having the capacity to affect an individual’s wellbeing.
Dementia not only affects memory, it can cause issues with sleep, vision, perceptions, emotions, behaviour and movement—the list is vast. Someone with dementia might see a dark-coloured floor as a hole in the ground, and therefore may feel fear and show aversion to the area. They may confuse shiny or blue surfaces as wet, or shadows as steps, patterns as barriers1.
A recently opened SwanCare facility—SwanCare Ningana—was built using the latest research in dementia care into account with its design.
Ningana has been designed with a circular layout, offering few decision points, reducing possibilities for confusion and allowing residents to wander around safely throughout the day.
The fundamental design concept of the building is to emulate familiar concepts of home within a community, where rooms are homes within a street that connect to a wider neighbourhood. Each “street” is unique with a theme for each, helping residents to know where they are. Each level within Ningana is also colour-themed to allow for easy floor recognition.
Sleep is a major factor for someone with dementia, with dementia disturbing the body’s day-night circadian rhythm more than the general aging population. In fact, sleep disturbances are the principal cause of institutionalisation in those with dementia2.
Research shows that within many aged care homes, limited natural and bright light as well as noise are implicated as being precursors for sleep disturbances3.
SwanCare Ningana’s design allows direct sunlight in—there are large glass windows on the sides of the building, with the interior of the building circulating an outdoor landscaped space. Sun-loving residents can “chase the sun” with daylight infiltrating various parts of the building over the course of the day.
For noise reduction, staff work from concealed operational corridors that provide behind-the-scenes workspaces that allow everyday equipment storage and laundry collection areas.
Promoting humanised support
A very common dementia-related phenomenon known as ‘sundowning’ and can cause agitation and restlessness in the late afternoon and evenings. Our staff often report anecdotally that some residents with advanced dementia “revert” to life 50-60 years ago during sundowning. They feel the need to get family meals ready or to bathe children. For those who prefer to keep busy or wander to walk off the restlessness, the circular design comes into play. Resident-use kitchenettes also allow residents to busy themselves if they feel like it.
The timing of activities and meals are set with sundowning in mind and tailored for each individual.
For some people with dementia, spouses or other important family members are integral to their wellbeing, so we encourage partners to stay together.
Double rooms allow for partners to stay permanently and specially designed armchairs that convert to overnight beds for visitors.
Technology supporting independence
Or course, there are many partners who care for loved ones from the comfort of home, which is becoming increasingly easier to do thanks to modern technology. SwanCare assists independent living residents with modern assistive living technologies—such as the Sofihub—that can reduce wandering and support the individual to reduce reliance on carers. Such technology can vocalise a range of important messages—from when to take medication to texts sent from loved ones—and can notify family if a fall or other incidence may have occurred.
It is important to recognise that home-based carers of those living with dementia are also cared for, as their health and wellbeing are equally important. There are several respite and support organisations, such as Dementia Support Australia, that can make a world of difference.
It is also important to recognise that each individual with dementia is unique and will have unique needs and wants, so it’s never a one-fits-all approach. For loved ones, trial and error is sometimes warranted, and that’s OK, we are always learning and growing.
Who is SwanCare?
SwanCare is a multi-award winning not-for-profit industry organization behind Bentley Park, Western Australia’s largest integrated aged care and retirement organisation, established 1961. Over 1,000 residents call Bentley Park home, across its independent living and residential care facilities.