Supportive living environments: A first concept of a dwelling designed for older adults with dementia

The vast majority of older adults want to remain living independently at home, with or without a sufficient amount of professional home care, even when overall health is starting to decline. The ageing of society and the increase in the number of very old elders goes together with an increase in the number of people with dementia. About two thirds of the diagnosed people in the Netherlands live at home. Dementia has severe implications to the quality of daily life, in particular to independent functioning. This sets extra demands to living environments. Older adults with dementia and their partners ask for living environments that support independence, compensate for declining vitality, and lower the burden of family care. For this purpose, a first concept of a design for a dementia dwelling is presented in this paper, which incorporates modifications in terms of architecture, interior design, the indoor environment, and technological solutions. These design features were derived from literature search and focus group sessions. Current design guidelines are frequently based on practical experience only, and therefore, more systematic field research should be carried out to find evidence for the various design modifications. Also, it needs to be studied how the design features of the dementia dwelling can be incorporated into the existing housing stock.

[1]  K. Day,et al.  The therapeutic design of environments for people with dementia: a review of the empirical research. , 2000, The Gerontologist.

[2]  R L Rubinstein,et al.  The home environments of older people: a description of the psychosocial processes linking person to place. , 1989, Journal of gerontology.

[3]  D. Knopman,et al.  Practical approach to managing behavioral problems in dementia patients. , 1990, Geriatrics.

[4]  Knut Engedal,et al.  Development of a Protocol for the Assessment of Assistive Aids for People with Dementia , 2004 .

[5]  C. Nugent,et al.  Review of ICT-based services for identified unmet needs in people with dementia , 2007, Ageing Research Reviews.

[6]  J. V. Hoof,et al.  The indoor environment in relation to people with dementia , 2008 .

[7]  M.S.H. Duijnstee De belasting van familieleden van dementerenden , 1992 .

[8]  A. Desai,et al.  Recognition and Management of Behavioral Disturbances in Dementia. , 2001, Primary care companion to the Journal of clinical psychiatry.

[9]  Roger Orpwood,et al.  The installation and support of internationally distributed equipment for people with dementia , 2004, IEEE Transactions on Information Technology in Biomedicine.

[10]  Mpj Mariëlle Aarts,et al.  Ambient bright light in dementia: Effects on behaviour and circadian rhythmicity , 2009 .

[11]  P. Ebersole,et al.  Toward Healthy Aging , 1981 .

[12]  H. S. M. Kort Smart technology at home : A multidisciplinary challenge , 2008 .

[13]  Donald T. Stuss,et al.  The Dementias , 1996, Brain and Cognition.

[14]  M. Mirmiran,et al.  Indirect bright light improves circadian rest-activity rhythm disturbances in demented patients , 1997, Biological Psychiatry.

[15]  Hoof van Joost,et al.  Healthy living environments for older adults with dementia [8th international conference healthy buildings, 4-8 juni 2006, Lissabon, Portugal] , 2006 .

[16]  Mpj Mariëlle Aarts,et al.  Field study of visual and biological light conditions of independently-living elderly people , 2005 .

[17]  Jlm Jan Hensen,et al.  Thermal comfort and older adults , 2006 .

[18]  U. Cohen,et al.  Contemporary environments for people with dementia , 1993 .

[19]  K. Moore,et al.  Designing a Better Day: Guidelines for Adult and Dementia Day Services Centers , 2006 .

[20]  Torhild Holthe,et al.  Technology, Ethics and Dementia: a guidebook on how to apply technology in dementia care , 1999 .

[21]  van F Dijken,et al.  Healthy buildings for older adults , 2006 .

[22]  J. Cohen-Mansfield,et al.  The Spatial Distribution of Agitation in Agitated Nursing Home Residents , 1990 .

[23]  J. van Hoof Forty years of Fanger's model of thermal comfort: comfort for all? , 2008, Indoor air.

[24]  M O'Brien Keeping in time with your body clock , 2005, British Journal of Sports Medicine.

[25]  Laura N Gitlin Guidelines for environmental adaptations and safety at home , 2007 .

[26]  P. Topo,et al.  User Involvement in Dementia Product Development , 2004 .

[27]  M. Lawton,et al.  Environmental correlates to behavioral health outcomes in Alzheimer's special care units. , 2003, The Gerontologist.

[28]  P C Hughes,et al.  Lighting for the Elderly: A Psychobiological Approach to Lighting , 1981, Human factors.

[29]  A. van Berlo,et al.  Ethics in domotics , 2005 .

[30]  C. Mathers,et al.  Global prevalence of dementia: a Delphi consensus study , 2005, The Lancet.

[31]  J Leikas,et al.  Security alarm system supports independent living of demented persons. , 1998, Studies in health technology and informatics.

[32]  A. Abbott Restless nights, listless days , 2003, Nature.

[33]  A. Devlin,et al.  Health Care Environments and Patient Outcomes , 2003 .

[34]  Panos Markopoulos,et al.  Ambient intelligence, ethics and privacy , 2007 .

[35]  A van Berlo,et al.  Technology for dementing persons: a relief for informal carers? , 1998, Studies in health technology and informatics.

[36]  T. Voordt Housing and care variants for older people with dementia: Current trends in the Netherlands , 1997 .

[37]  Torhild Holthe,et al.  Ethical Considerations in the ENABLE Project , 2004 .

[38]  S. Tomura,et al.  Factors affecting the mental health of residents in a communal-housing project for seniors in Japan. , 2005, Archives of gerontology and geriatrics.

[39]  P. Rabins,et al.  Dementia , 2008, Annals of Internal Medicine.

[40]  Brian R. Bryant,et al.  Assistive Technology , 1998 .