UNDERSTANDING THE TOPIC
How can we enrich the quality of everyday life for people with dementia through sensory experience?
Following the broader reading, I started with more topic-specific research. I first educated myself on the topic of dementia by reviewing various guidelines, interviews and articles about the condition of dementia, space design and activities for people with dementia, which all helped me familiarise myself the problems and more clearly define my Final Major Project.
The term ‘dementia’ describes progressive neurological disorders that affect the brain and present problems with thinking, mood, behaviour, and the ability to take part in everyday activities. According to the World Health Organization (2020), there are 50 million people living with dementia worldwide today, and the number is expected to grow to more than 152 million by 2050.
Far too often people with dementia experience discrimination and treatment that negates their human rights. According to the Care Quality Commission (an independent regulator of health and social care in England), more than 40 per cent of PWD experience poor care and disrespectful treatment due to lack of knowledge and understanding of their specific needs, insufficient training and shortage of staff, and inadequate coordination between services (Care Quality Commission, 2019). If no suitable activities are provided for people with dementia, they are much more likely to become increasingly withdrawn, isolated, frustrated, bored and depressed, which results in them wandering around, becoming agitated and emotionally distressed. Due to reduced sensory, cognitive and physical abilities of people with dementia, it is important to provide a safe environment that encourages intellectual and sensory stimulation, physical activity, socialization, and respects their privacy and dignity. Spatial design can help to provide a safer and more comfortable environment in which people with dementia can maintain a sense of independence and a better quality of life. Recently there has been a lot of focus on the design of the internal environment of care homes and dementia care facilities. Early findings show that small-scale, non-institutional layouts with domestic-style furnishings and fittings can help to reduce the level of disorientation, confusion and distress of residents.
Summary of primary research and the floor plan of the new care home.
The aim of this project is therefore to design a space that through sensory stimulation and design enhances the quality of everyday life for people living with dementia. The focus will be on the sensory room and two gardens in the middle of the new care facility, where I have been given full creative freedom. To learn about the problems first-hand, I will also collaborate with residents from different dementia homes and their caregivers that have been involved in the dementia care process for years.
Through the literature review I learned of many different aspects of how one can affect and enrich everyday life of people with dementia through design. Since many of the things I wanted to include in the sensory room and gardens already exist, I then proceeded to the interviews because I wanted to learn how the professional staff who work with people with dementia and use various sensory tools on a daily basis feel about these items, and which of them they find effective. In order to gather this information, I conducted interviews with ten employees: seven occupational therapists, an art therapist, a social worker and the director of the care home. I asked several questions about the challenges they face while working with people with dementia, about sensory therapy and different objects they use, and about possible improvements.
There were a lot of similarities among their answers. The majority felt that sensory objects are really helpful and of great importance when working with people with dementia (they also listed some of the more successful ones). Most of them emphasised the challenges of isolation, a shortage of staff and a lack of variety in activities for people with dementia. I was, however, quite surprised at how many workshops they run and how innovative they can be with everyday objects (e.g. making ornaments from fallen leaves, guessing objects in a bag, making cookies and jam, etc. ).
Care Quality Commission. (2019) The state of health care and adult social care in England 2017/18. London: CQC, 28.
Greasley-Adams, C., Bowes, A., Dawson, A., and McCabe, L. (2014) Good practice in the design of homes and living spaces for people with dementia and sight loss. London, UK: Pocklington Trust.
Hadjri, K., Faith, V. and McManus, M. (2012) Designing dementia nursing and residential care homes. Journal of Integrated Care.
Kitwood, T. M. and Kitwood, T. M. (1997) Dementia reconsidered: The person comes first (Vol. 20, pp. 7-8). Buckingham: Open university press.
Manthorpe, J. (2015) The abuse, neglect and mistreatment of older people with dementia in care homes and hospitals in England: the potential for secondary data analysis: innovative practice. Dementia, 14(2), 273-279.
Mitchell, L., and Burton, E. (2006) Neighbourhoods for life: Designing dementia‐friendly outdoor environments. Quality in Ageing and Older Adults.
World Health Organization. (2020) Dementia. Available at: <https://www.who.int/news-room/fact-sheets/detail/dementia> (Accessed 20 November 2020).