Designing for dementia

Lisa Pilley of Dulux Trade discusses how colour is an intrinsic part of any health-focused design project, and can have a powerful impact on dementia patients in particular

Globally, the number of people living with dementia is predicted to increase from 50 million in 2018 to 152 million in 2050, a 204 per cent increase. The cost of dementia in the UK is expected to more than double in the next 25 years, from £26bn to £55bn in 2040. However, the UK is taking steps to minimise the impact of this growing trend and progress is being made to help people to age well and live in their homes for longer, thereby reducing the pressure on public services.

As part of this response, an increasing number of commercial and industry thought-leaders are collaborating to unify their research in order to deliver ‘actionable’ insights, informing ways in which to create more supportive environments for those living with dementia. It is hoped that just by fine-tuning some basic approaches to design, which may include incorporating solutions that are cost neutral to implement, designers can create life-enriching spaces. Perhaps even more crucial, these relatively small adjustments to design techniques are able to produce environments that minimise harm to the occupants, where perhaps sight or mobility is impaired. What these groups all agree on is the importance of prioritising the avoidance of sterile or clinical environments, instead advocating homely and personalised spaces that are interesting and can inject a sense of familiarity and security.

Educational institutions are developing new approaches to understand the impact of dementia on occupants within the built environment, and the industry is seeing collaborative work across multiple fields to try and distill the insight into guidelines for architects and designers. Examples of design guidelines include allowing for clear lines of sight and the use of colour throughout a home to help guide people towards specific rooms and reduce the risk of slips and trips.

Increased natural lighting has also been shown to help people stay alert during the day (and to sleep better at night). In addition, using materials that help with noise reduction can support a decrease in stress and agitation. When it comes to colour, the guidelines are slightly more fluid. Colour is a highly individual and subjective matter, but it does have impact beyond the aesthetic. While intense colours can work brilliantly in a big retail, leisure, healthcare or even domestic home environment, such colours need to be used sparingly in environments primarily supporting people living with dementia. Inclusive design encourages the application of colour to enable occupants to more readily identify different areas of the entire living space ­– balancing their needs alongside the needs of their carers or family, and giving them greater confidence to move independently within their living spaces. Highly contrasting colour combinations can work well.

Careful considerations of colour combinations are central to a designer’s accessibility palette. Colour has also been used within a design solution as a way of reinforcing positive personal connections and to provide stimulation within the space. When designing for dementia, it is important to remember that we are all individuals and we all like different things, so this is why one scheme will work for one client but not for another. There is seldom a one size fits all approach. We know that up to 75 per cent of people over 75 will have vision problems. Research from Kingston University suggests that as our eyes age they become more opaque, so colours become ‘washed out’, making it harder for people to differentiate between different substrates. Designers can then compensate by using stronger or brighter colours than they might normally choose. Two colours that appear contrasted to someone with normal vision may not be perceived well by those with sight deficiencies, colour deficits or dementia.

While the effects of Alzheimer’s on colour perception are not yet understood, recognition time is notably faster if colour is used as a cue. There are some simple key design tips we consider when designing for dementia. These include using warmer hues to give the impression of warmth, maintaining contrast in colours between the furniture and the floor to help highlight chairs, handrails and anything that could be an obstruction; feature walls opposite key entrances to help with navigation, and avoiding gloss finishes which can be off-putting to people living with dementia for fear of slipping. Equally, careful thought to lighting will prevent unevenly lit spaces, creating shadows that can be alarming to those with impaired vision.

Within residential care homes, colour can have other benefits as well. Residents with dementia have for example, demonstrated more interest in food if it is served from coloured plates that have a large degree of contrast to the table surface. Colour can likewise be used to de-emphasise areas that have restricted access, such as back of house locations like offices, sluices and cleaning cupboards. In these cases, doors to exits or other zones, which are for staff only, are usually painted to match the surrounding wall colour, minimising standout and thereby reducing unauthorised access.

Working with the BRE Trust, BRE, Loughborough University, Halsall Lloyd Partnerships and Liverpool John Moores University, Dulux Trade has supported the development of a demonstration home, Chris & Sally’s House, to present evidence-based design, adaptation and support solutions that allow people to ‘age well’ at home. A summary of inclusive design advice has been gathered within the evidence-based Dulux Trade Dementia Friendly Colour Palette, developed specifically for care homes and buildings in the health sector. It is a useful tool in designing spaces for dementia that deliver significant benefits – not just for those living with the condition, but also for those who are caring for them.

Lisa Pilley is colour consultant at Dulux Trade