Design of care facilities for people with Alzheimer's disease

Abstract

This poster will provide an overview of insights coming from: 1) the experience of architects, planners and designers of residential and nursing homes, 2) those involved with identifying the knowledge base for, and developing the professionalization of dementia care, and 3) progress in the neuroscience understanding of visual (visuoperceptual) difficulties of people with Alzheimer's disease (AD), 4) understanding of how visuoperceptual difficulties (mistakes) translate into certain types of ‘visual phenomena’ in AD; 5) understanding how visual perceptual difficulties combine with other cognitive difficulties. Information about a Dutch, large and small-scale care settings is presented, including recently opened small-scale living groups within large, multi-storey buildings, complete with phased levels of domotic monitoring technology, for different levels of dementia and safety risk assessment.The literature on dementia care home design contains a range of advice: from choosing locations, example blueprints of buildings, care and management models to activity considerations and décor and is extensively reviewed. Considering the difficulties that normal elderly can have (and visual pathologies will not even be mentioned in this review), it is likely that most elderly people in care settings could benefit from design that takes visuoperceptual difficulties into account; not just those with AD, especially from visual cues that are highly visible, familiar, and salient. Given that people with AD are increasingly cared for in the community as long as possible, admission into specialist dementia care settings often occurs in Behavioural Stages 2 or 3 when significant, permanent visual and time perception difficulties exist. Design of dementia care facilities has gone through a considerable evolution, ranging from large care institutions to residential hotel-type settings and services and small-scale homelike living groups. Specific knowledge about ‘visuoperceptual difficulties' in AD provides new opportunities for designers of care environments to anticipate these, and to enhance features of the physical environments so as to increase the likelihood that particular features will be accurately or symbolically perceived.