“How to make a dementia village?”
Several design techniques and spatial quality help us make a place for the dementia community.
Be Normal
Part of feeling a "normal life" under a supervised condition is that residents can do whatever they want as they feel. That does not only mean providing them with a barrier-free area to walk around or allowing everyone to wear their "personal" clothes without distinguishing among residents, staff, and visitors.
Being "normal" also means maintaining an ordinary day-to-day routine for the residents. Planning space for them to achieve those activities without outsiders' help is the basis of quality life.
Being able to fetch their meals or dining out is part of a "normal" life.
Residents who easily find their room and feel comfortable to chat or walking without outsiders' assistance are also part of a "normal" life.
Be Purposeful
"... because for the residents, they don't feel that they are running away. They are going somewhere, they want to go home, or shopping, or whatever. So they are not running away."-- Tobias Haeusermann (1)
Injecting meaningful activities and programs in a nursing home also helps residents adapt their behaviors. Especially the pacing and wandering that are often seen as problematic behaviors for nursing home staff.
Often designers might think as long as providing an eye-catching landmark; the residents will be able to identify where they are. However, making a meaningful destination for them is more important. Because they could arrange their daily activities around these "meaningful locales." As thoughtful planners, we need to remind ourselves not to repeat similar scenery and avoid residents wandering in circles because that will make them frustrated and exhausted.
This video categorizes four activity types that make a meaningful life for adults with dementia. These activities are
Productive activities,
Leisure activities,
Self-care activities
Rest/restoration activities.
Mixing those activities creatively at various "use locales" would make a meaningful place for dementia people.
Be Navigable
The ability to reach their destination is a "prerequisite" of personal autonomy and a basis for a quality life. A caring environment should help residents construct their mental map and navigate from point to point.
Therefore the architectural elements should have a strong wayfinding presence so the residents would know
where they are
how to get to the point
recognizing when they arrive at the destination
The wayfinding characters can happen on various scales. For example, a large scale clock could serve as a wayfinding symbol. but a small scale lamp and artwork could also serve as a wayfinding tool.
Providing a spatial narrative will also help residents orient themselves. In this image, for example, the staff will layout tables outside the restaurant in the common area. When teens visit during the afterschool program, they might bring something from the store and chat with villagers outside the bar. For some residents, a double-height ceiling space, a restaurant with a barn door, an entrance with a view of sunny outdoors, and the visiting children all become part of their mental map. (See sketches above.)
Everyone's mental map is different. However, placing these meaningful activity "nodes" is essential for the resident to construct/ reconstruct their mental map. When they begin pacing or wandering behavior, they would have a "purpose" to go and easily find their destination.
A self-sustained village block within the city’s blocks
Notes and reference:
Haeusermann, T. (2018). The Dementia Village: Between Community and Society. In: Krause, F., Boldt, J. (eds) Care in Healthcare. Palgrave Macmillan, Cham. SpringerLink.