Supportive design for people with dementia

Sarah Waller, CBE, RGN, FRSA, who, as programme director, leads the King’s Fund’s Enhancing the Healing Environment programme team that evaluated the schemes’ impact and benefits, describes the main outcomes, and suggests some of the practical ways that estates and facilities staff can support clinical colleagues in improving the care of people with dementia.

The Prime Minister’s Challenge on Dementia (Department of Health, 2012),2 which builds on the National Dementia Strategy (Department of Health, 2009),3 recognises that dementia is one of the most significant challenges facing us as a society, and sets out an ambitious plan to deliver by 2015 major improvements in dementia care, including health and care delivery, and research. Dementia is an ‘umbrella term’ used to describe loss of memory and other cognitive abilities that are severe enough to interfere with daily life. It is caused by changes in the brain, and is more common in older people. Normal ageing has an impact on the senses, particularly sight and hearing, and this is exacerbated by additional damage to the senses and perception associated with dementias such as Alzheimer’s disease. Many people with dementia will have visuo-spacial problems It is likely that over 25% of people accessing general hospital services are likely to have cognitive problems or dementia, which may well be undiagnosed, and in certain wards, notably female orthopaedic units, the figure may be nearer 40%. The Alzheimer’s Society has done much to highlight the detrimental effect of hospital stays on the independence of people with dementia. However, research into the impact on clinical outcomes of the environment of care on people with dementia is sparse, both nationally and internationally, and most of the existing research has been undertaken in care homes, rather than hospitals.

Growing recognition