Abstract
Providing care for people living with dementia includes considering the impact of the architectural design of their environments on the person’s physical-social-mental well-being. Designs that support physical function and take into account sensory loss lessen the stress on the mind and lower the distress experienced by persons with dementia. Acute illness, requiring hospitalization, is known to lead to considerable distress and behaviors that can lead to lower physical and mental function. One solution is for architects and interior designers of these facilities to follow the design principles postulated for dementia-friendly architecture. Emerging dementia-friendly designs of (health) care facilities create supportive environments for everyone, including visitors and staff. In the future, designs will also need to accommodate the challenges and changes that lay ahead, with buildings that perform well to disasters, disruptions, and adverse events. By elucidating the design answers to demographic change, climate change, and recurring epidemics, it is shown that following dementia-friendly design criteria contributes to building resilient structures for the future.
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References
AARP. (2021). AARP nursing home COVID-19 dashboard. https://www.aarp.org/ppi/issues/caregiving/info-2020/nursing-home-covid-dashboard.html
Belala, N., Maier, C., Heldmann, P., Schwenk, M., & Becker, C. (2019). A pilot observational study to analyze (in)activity and reasons for sedentary behavior of cognitively impaired geriatric acute inpatients. Z Gerontol Geriat, 52, 273–281. https://doi.org/10.1007/s00391-019-01644-x
Bickel, H., Hendlmeier, I., Heßler, J. B., Junge, M. N., Leonhardt-Achilles, S., Weber, J., & Schäufele, M. (2018). The prevalence of dementia and cognitive impairment in hospitals: Results from the general hospital study (GHoSt). Deutsches Ärzteblatt International, 115(44), 733.
Binette, J., & Vasold, K. (2018). Home and community preferences: A national survey of adults age 18-plus. AARP Research. https://doi.org/10.26419/res.00231.001
Briggs, R., Dyer, A., Nabeel, S., Collins, R., Doherty, J., Coughlan, T., O’Neill, D., & Kennelly, S. P. (2017). Dementia in the acute hospital: The prevalence and clinical outcomes of acutely unwell patients with dementia. QJM: Monthly Journal of the Association of Physicians, 110(1), 33–37. https://doi.org/10.1093/qjmed/hcw114
Bueter, K., & Marquardt, G. (2020). Dementia-friendly hospital building. Construction and design manual. DOM Publishers.
Calkins, M. P. (1988). Design for dementia: Planning environments for the elderly and the confused. National Health Publishing.
Calkins, M. P. (2018). From research to application: Supportive and therapeutic environments for people living with dementia. The Gerontologist, 58(Suppl 1), S114–S128. https://doi.org/10.1093/geront/gnx146
Chaudhury, H., Hung, L., Rust, T., & Wu, S. (2017). Do physical environmental changes make a difference? Supporting person-centered care at mealtimes in nursing homes. Dementia, 16(7), 878–896. https://doi.org/10.1177/2F1471301215622839
Chaudhury, H., Cooke, H. A., Cowie, H., & Razaghi, L. (2018). The influence of the physical environment on residents with dementia in long-term care settings: A review of the empirical literature. The Gerontologist, 58(5), e325–e337. https://doi.org/10.1093/geront/gnw259
Cohen, U., & Weisman, J. (1991). Holding on to home: Designing environments for people with dementia. Johns Hopkins University Press.
Cunningham, C., Galbraith, J., Marshall, M., McClenaghan, C., McManus, M., McNair, D., & Dincarslan, O. (2011). Dementia design audit tool. University of Stirling.
Davis, R., & Weisbeck, C. (2016). Creating a supportive environment using cues for wayfinding in dementia. Journal of Gerontological Nursing, 42(3), 36–44. https://doi.org/10.3928/00989134-20160212-07
de Boer, B., Hamers, J. P., Zwakhalen, S. M., Tan, F. E., Beerens, H. C., & Verbeek, H. (2017). Green care farms as innovative nursing homes, promoting activities and social interaction for people with dementia. Journal of the American Medical Directors Association, 18(1), 40–46. https://doi.org/10.1016/j.jamda.2016.10.013
de Boer, B., Beerens, H. C., Katterbach, M. A., Viduka, M., Willemse, B. M., & Verbeek, H. (2018). The physical environment of nursing homes for people with dementia: Traditional nursing homes, small-scale living facilities, and green care farms. Healthcare, 6(4), 137. https://doi.org/10.3390/healthcare6040137
Dodds, W. (2019). Disease now and potential future pandemics. In W. Dodds (Ed.), The world’s worst problems (pp. 31–44). Springer. https://doi.org/10.1007/978-3-030-30410-2_4
Dyer, S. M., Liu, E., Gnanamanickam, E. S., Milte, R., Easton, T., Harrison, S. L., Bradley, C. E., Ratcliffe, J., & Crotty, M. (2018). Clustered domestic residential aged care in Australia: Fewer hospitalisations and better quality of life. Medical Journal of Australia, 208(10), 433–438. https://doi.org/10.5694/mja17.00861
Feddersen, E. & Luedtke, I. (2014). Lost in Space. Architecture and Dementia. Birkhaeuser.
Fleming, R., Zeisel, J., & Bennett, K. (2020a). World Alzheimer report 2020: Design dignity dementia: Dementia-related design and the built environment (Vol. 1). Alzheimer’s Disease International. https://www.alzint.org/u/WorldAlzheimerReport2020Vol1.pdf
Fleming, R., Zeisel, J., & Bennett, K. (2020b). World Alzheimer report 2020: Design dignity dementia: Dementia-related design and the built environment (Vol. 2). Alzheimer’s Disease International. https://www.alzint.org/u/WorldAlzheimerReport2020Vol2.pdf
Fritze, T. (2020). The effect of heat and cold waves on the mortality of persons with dementia in Germany. Sustainability, 12(9), 3664. https://doi.org/10.3390/su12093664
Fung, J. C. (2015). Dementia design sourcebook. Design guide + design elements. Centre for Advanced Studies in Architecture (CASA), Department of Architecture, National University of Singapore.
Gradmann, C. (2018). From lighthouse to hothouse: Hospital hygiene, antibiotics and the evolution of infectious disease, 1950–1990. History and Philosophy of the Life Sciences, 40(1), 1–25. https://doi.org/10.1007/s40656-017-0176-8
Grey, T., Pierce, M., Cahill, S., & Dyer, M. (2015). Universal design guidelines dementia friendly dwellings for people with dementia, their families and carers. Centre for Excellence in Universal Design. http://universaldesign.ie/Web-Content-/UD_Guidelines-Dementia_Friendly_Dwellings-2015-full-doc.pdf
Grey, T., Fleming, R., Goodenough, B. J., Xidous, D., Moehler, R., & O’Neill, D. (2019). Hospital design for older people with cognitive impairment including dementia and delirium: Supporting inpatients and accompanying persons. Cochrane Database of Systematic Reviews, 11. https://doi.org/10.1002/14651858.CD013482
Harrison, S. L., O’Donnell, L. K., Milte, R., Dyer, S. M., Gnanamanickam, E. S., Bradley, C., Liu, E., Hilmer, S. N., & Crotty, M. (2018). Costs of potentially inappropriate medication use in residential aged care facilities. BMC Geriatrics, 18(1), 1–10. https://doi.org/10.1186/s12877-018-0704-8
Heiss, O., Degenhart, C., & Ebe, J. (2010). Barrier-free design: Principles, planning, examples. Birkhäuser.
Holup, A. A., Hyer, K., Meng, H., & Volicer, L. (2017). Profile of nursing home residents admitted directly from home. Journal of the American Medical Directors Association, 18(2), 131–137. https://doi.org/10.1016/j.jamda.2016.08.017
Jegodka, Y., Lagally, L., Mertes, H., Deering, K., Schoierer, J., Buchberger, B., & Bose-O’Reilly, S. (2021). Hot days and Covid 19-unusual heat stress for nursing professions in Germany. Med Rxiv. https://doi.org/10.1101/2021.01.29.21250592
King’s Fund. (2014). Is your ward dementia friendly? EHE environmental assessment tool. The King’s Fund. https://www.kingsfund.org.uk/sites/default/files/EHE-dementia-assessment-tool.pdf.
Kirch, J., & Marquardt, G. (2021). Towards human-centred general hospitals: The potential of dementia-friendly design. Architectural Science Review, 1–9. https://doi.org/10.1080/00038628.2021.1933889
Kirchen-Peters, S., & Krupp, E. (2019). Praxisleitfaden zum Aufbau demenzsensibler Krankenhäuser. Robert Bosch Stiftung.
Kok, S. J., Heuvelen, M. J. G., Berg, I. J., & Scherder, E. J. A. (2016). Small scale homelike special care units and traditional special care units: Effects on cognition in dementia: A longitudinal controlled intervention study. BMC Geriatrics, 16(1), 1–8. https://doi.org/10.1186/s12877-016-0222-5
Lawton, M. P., & Nahemow, L. (1973). Ecology and the aging process. In C. Eisdorfer & M. P. Lawton (Eds.), The psychology of adult development and aging (pp. 619–674). American Psychological Association.
Liu, J., Hlávka, J., Hillestad, R. J., & Mattke, S. (2020). 2020 Alzheimer’s disease facts and figures. Alzheimer’s Dement, 16, 391–460. https://doi.org/10.1002/alz.12068
Marquardt, G. (2011). Wayfinding for people with dementia: A review of the role of architectural design. HERD: Health Environments Research & Design Journal, 4(2), 75–90. https://doi.org/10.1177/2F193758671100400207
Marquardt, G., & Schmieg, P. (2009). Dementia-friendly architecture: Environments that facilitate wayfinding in nursing homes. American Journal of Alzheimer’s Disease & Other Dementias, 24(4), 333–340. https://doi.org/10.1177/2F1533317509334959
Moellers, T., Stocker, H., Wei, W., Perna, L., & Brenner, H. (2019). Length of hospital stay and dementia: A systematic review of observational studies. International Journal of Geriatric Psychiatry, 34(1), 8–21. https://doi.org/10.1002/gps.4993
Moore, K. D., Geboy, L. D., & Weisman, G. D. (2006). Designing a better day: Guidelines for adult and dementia day services centers. JHU Press.
Motzek, T., Bueter, K., & Marquardt, G. (2017). Investigation of eligible picture categories for use as environmental cues in dementia-friendly environments. HERD: Health Environments Research & Design Journal, 10(4), 64–73. https://doi.org/10.1177/2F1937586716679403
Palmer, L., Wallace, K., & Hutchinson, L. (2021). Architecture for dementia. Stirling gold: 2008–2020. University of Stirling.
Parke, B., Boltz, M., Hunter, K. F., Chambers, T., Wolf-Ostermann, K., Adi, M. N., Feldman, F., & Gutman, G. (2017). A scoping literature review of dementia-friendly hospital design. The Gerontologist, 57(4), e62–e74. https://doi.org/10.1093/geront/gnw128
Phillips, N. (2021). The coronavirus is here to stay-here’s what that means. Nature, 590(7846), 382–384. https://doi.org/10.1038/d41586-021-00396-2
Pollock, A., & Cunningham, C. (2018). The room outside. Designing outdoor living for older people and people with dementia. HammondCare Media.
Rao, A., Suliman, A., Vuik, S., Aylin, P., & Darzi, A. (2016). Outcomes of dementia: Systematic review and meta-analysis of hospital administrative database studies. Archives of Gerontology and Geriatrics, 66, 198–204. https://doi.org/10.1016/j.archger.2016.06.008
Regnier, V. (2018). Housing design for an increasingly older population: Redefining assisted living for the mentally and physically frail. John Wiley & Sons.
Shepherd, H., Livingston, G., Chan, J., & Sommerlad, A. (2019). Hospitalisation rates and predictors in people with dementia: A systematic review and meta-analysis. BMC Medicine, 17(1), 1–13. https://doi.org/10.1186/s12916-019-1369-7
Smith, M., Gerdner, L. A., Hall, G. R., & Buckwalter, K. C. (2004). History, development, and future of the progressively lowered stress threshold: A conceptual model for dementia care. Journal of the American Geriatrics Society, 52(10), 1755–1760. https://doi.org/10.1111/j.1532-5415.2004.52473.x
Sourdet, S., Lafont, C., Rolland, Y., Nourhashemi, F., Andrieu, S., & Vellas, B. (2015). Preventable iatrogenic disability in elderly patients during hospitalization. Journal of the American Medical Directors Association, 16(8), 674–681. https://doi.org/10.1016/j.jamda.2015.03.011
Strøm, B. S., Ytrehus, S., & Grov, E. K. (2016). Sensory stimulation for persons with dementia: A review of the literature. Journal of Clinical Nursing, 25(13–14), 1805–1834. https://doi.org/10.1111/jocn.13169
Toot, S., Devine, M., Akporobaro, A., & Orrell, M. (2013). Causes of hospital admission for people with dementia: A systematic review and meta-analysis. Journal of the American Medical Directors Association, 14(7), 463–470. https://doi.org/10.1016/j.jamda.2013.01.011
Tsekleves, E., & Keady, J. (2021). Design for People Living with dementia: Interactions and innovations. Routledge.
United Nations. (2019). World population prospects 2019: Highlights. https://population.un.org/wpp/Publications/Files/WPP2019_10KeyFindings.pdf
Waller, S., Masterson, A., & Evans, S. C. (2017). The development of environmental assessment tools to support the creation of dementia friendly care environments: Innovative practice. Dementia, 16(2), 226–232. https://doi.org/10.1177/2F1471301216635829
Whear, R., Coon, J. T., Bethel, A., Abbott, R., Stein, K., & Garside, R. (2014). What is the impact of using outdoor spaces such as gardens on the physical and mental well-being of those with dementia? A systematic review of quantitative and qualitative evidence. Journal of the American Medical Directors Association, 15(10), 697–705. https://doi.org/10.1016/j.jamda.2014.05.013
World Health Organization (2020). The top 10 causes of death. Factsheet. https://www.who.int/news-room/fact-sheets/detail/the-top-10-causesof-death
Xidous, D., Grey, T., Kennelly, S. P., McHale, C., & O’Neill, D. (2020). Dementia friendly hospital design: Key issues for patients and accompanying persons in an Irish acute care public hospital. HERD: Health Environments Research & Design Journal, 13(1), 48–67. https://doi.org/10.1177/2F1937586719845120
Acknowledgments
The authors gratefully acknowledge funding of their work by the German Research Foundation, DFG (Gz. MA 5384/1-1), and the Robert Bosch Foundation Stuttgart, Germany. Further, they would like to extend their thanks to the hospital staff and patients who supported the quasi-experimental study at the Diakonissenkrankenhaus in Dresden, Germany.
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Marquardt, G., Bueter, K. (2023). Extending the Continuum of Care for People with Dementia: Building Resilience. In: Ferdous, F., Roberts, E. (eds) (Re)designing the Continuum of Care for Older Adults. Springer, Cham. https://doi.org/10.1007/978-3-031-20970-3_12
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