As Australia’s population continues to age, designing for aged and health care has become a significant priority. And as a disease (or umbrella term for a group of diseases) that more commonly affects older people, designing for dementia is becoming a growing consideration in the way we craft spaces for care.

“We're the peak body for dementia in Australia,” says Karen Cmiel, Learning Designer and Facilitator at Dementia Australia. “We've been representing people with dementia and their carers for a long time. So we represent the needs of more than 472,000 people living with dementia at the moment in Australia. But we also support 1.6 million people who are involved in the care of people living with dementia, and that's paid and unpaid carers as well.”

Karen has been working in the Aged Care sector for over 20 years. She has qualifications in Community Leisure and Health, Community Services Management, Dementia care and Education and Training. In her current role with Dementia Australia, she advises and educates architects and builders in dementia-friendly design, and what constitutes meaningful design for people living with dementia.

“People in this space should be asking three really important questions,” she says. “The first one is, who is the space for? So who are you designing the space for? The second question is, what is the function or the purpose of the space, and is it going to be obvious as to its functionality? And the third question, then is, does the design fulfil the purpose and the needs of who you're designing the space for?”

Karen notes that in the past, the sterile, hospitalised environments of dementia care have not contributed as positively to the wellbeing of those in care, than they perhaps could have. Similarly, those that look too modern or design-ified may also be confusing for someone who is suffering from memory loss or other cognitive impairment.

“A lot of modern builds are not necessarily designed best for the person who's going to be living there, but are geared more to the family who will admit their relative to live there. So if it looks nice, or fancy, or pretty, then perhaps they're more likely to actually look at admitting their loved one there,” says Karen. “But I was recently at a facility and overheard an elderly lady in the dining room asking people who she had to pay for her meal, and getting quite upset as the staff were telling her she didn’t have to pay. But the dining room didn’t look like a house, it looked more like a restaurant or a hotel - and what do you do at a restaurant? You pay for your food. So we're designing to actually cause confusion rather than setting up a space that's really familiar.” 

But the picture is far from bleak - Karen is seeing growing numbers of well thought-out, considerately-designed spaces. “At Dementia Australia, we recommend the small house model of no more than 15 people with dementia in a space so it's more intimate, and easier to find things,” she says. “And some geriatric wards have been rebuilt - so they've been gutted and then they've looked at the whole design, and included some single rooms, they've divided the bigger wards into smaller spaces.”

“We’re also seeing facilities using another approach called salutogenesis, which is about creating an environment that fosters wellbeing rather than disease. A great example is the Royal Melbourne Hospital for Children where they have these big fish tanks, they have meerkats on display. And a lot of places that I have done reviews for have actually taken on that approach and have looked at ways of bringing in certain artwork or different features that actually promote health rather than concentrating on disease.”

Karen elaborates at length upon numerous other methods and design frameworks - including Dementia Australia’s 10 Dementia Enabling Environment Principles, and reiterates just how positive the outlook is within the space, for creating built environments that support sufferers of dementia and ageing people.

This article is written from a snippet of a longer podcast. You can listen to the full podcast here.

This podcast is brought to you in association with Caroma LiveWell, proud sponsors of the Aged Care Series of podcasts.