Ageing- and Dementia-Friendly Design: Theory and evidence from neuropsychology can contribute to guidelines that minimise spatial disorientation

2020 ◽  
Author(s):  
Jan Wiener ◽  
Francesca Pazzaglia
Keyword(s):  
Older People ◽  
Environmental Psychology ◽  
Well Being ◽  
Design Guidelines ◽  
Living Environment ◽  
Care Homes ◽  
Sheltered Housing ◽  
Spatial Disorientation ◽  
People With Dementia ◽  
Age Related

Many older people, both with and without dementia, eventually move from their familiar home environments into unfamiliar surroundings, such as sheltered housing or care homes, and the age-related decline in wayfinding skills can make it difficult to learn to navigate in these new, unfamiliar environments. To facilitate the transition to their new accommodation it is therefore important to develop retirement complexes and care homes specifically designed to reduce the wayfinding difficulties of older people and those with Alzheimer’s disease (AD). Residential complexes that are designed to support spatial orientation and that compensate for impaired navigation abilities would make it easier for people with dementia to adapt to their new living environment. This would improve the independence, quality of life and well-being of residents, and reduce the caregivers’ workload. Based on these premises, the present paper reviews the existing literature on how neuropsychology and environmental psychology can contribute to ageing- and dementia-friendly design with a view to minimising spatial disorientation. After an introduction of the cognitive mechanisms and processes involved in spatial navigation, and the changes that occur in typical and atypical ageing, research from the field of environmental psychology is considered, highlighting design factors likely to facilitate (or impair) indoor wayfinding in complex buildings. Finally, neuropsychological theories and design knowledge are combined to suggest improved ageing- and dementia-friendly design guidelines that aim to minimize spatial disorientation by focusing on residual navigation skills.

scholarly journals Ageing- and dementia-friendly design: theory and evidence from cognitive psychology, neuropsychology and environmental psychology can contribute to design guidelines that minimise spatial disorientation

2021 ◽  
Author(s):  
Jan M. Wiener ◽  
Francesca Pazzaglia
Keyword(s):  
Cognitive Psychology ◽  
Older People ◽  
Environmental Psychology ◽  
Well Being ◽  
Design Guidelines ◽  
Living Environment ◽  
Care Homes ◽  
Spatial Disorientation ◽  
People With Dementia ◽  
Age Related

AbstractMany older people, both with and without dementia, eventually move from their familiar home environments into unfamiliar surroundings, such as sheltered housing or care homes. Age-related declines in wayfinding skills can make it difficult to learn to navigate in these new, unfamiliar environments. To facilitate the transition to their new accommodation, it is therefore important to develop retirement complexes and care homes specifically designed to reduce the wayfinding difficulties of older people and those with Alzheimer’s disease (AD). Residential complexes that are designed to support spatial orientation and that compensate for impaired navigation abilities would make it easier for people with dementia to adapt to their new living environment. This would improve the independence, quality of life and well-being of residents, and reduce the caregivers’ workload. Based on these premises, this opinion paper considers how evidence from cognitive psychology, neuropsychology and environmental psychology can contribute to ageing- and dementia-friendly design with a view to minimising spatial disorientation. After an introduction of the cognitive mechanisms and processes involved in spatial navigation, and the changes that occur in typical and atypical ageing, research from the field of environmental psychology is considered, highlighting design factors likely to facilitate (or impair) indoor wayfinding in complex buildings. Finally, psychological theories and design knowledge are combined to suggest ageing- and dementia-friendly design guidelines that aim to minimise spatial disorientation by focusing on residual navigation skills.

scholarly journals Decreasing spatial disorientation in care-home settings: How psychology can guide the development of dementia friendly design guidelines

Dementia ◽  
2016 ◽  
Vol 16 (3) ◽  
pp. 315-328 ◽  
Author(s):  
Mary O’Malley ◽  
Anthea Innes ◽  
Jan M Wiener
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Assisted Living ◽  
Care Home ◽  
Design Guidelines ◽  
Care Homes ◽  
Institutional Environments ◽  
Spatial Disorientation ◽  
People With Dementia

Alzheimer’s disease results in marked declines in navigation skills that are particularly pronounced in unfamiliar environments. However, many people with Alzheimer’s disease eventually face the challenge of having to learn their way around unfamiliar environments when moving into assisted living or care-homes. People with Alzheimer’s disease would have an easier transition moving to new residences if these larger, and often more institutional, environments were designed to compensate for decreasing orientation skills. However, few existing dementia friendly design guidelines specifically address orientation and wayfinding. Those that do are often based on custom, practice or intuition and not well integrated with psychological and neuroscientific knowledge or navigation research, therefore often remaining unspecific. This paper discusses current dementia friendly design guidelines, reports findings from psychological and neuropsychological experiments on navigation and evaluates their potential for informing design guidelines that decrease spatial disorientation for people with dementia.

Making the outside World Dementia-Friendly: Design Issues and Considerations

2003 ◽  
Vol 30 (4) ◽  
pp. 605-632 ◽  
Author(s):  
Lynne Mitchell ◽  
Elizabeth Burton ◽  
Shibu Raman ◽  
Tim Blackman ◽  
Mike Jenks ◽  
...  
Keyword(s):  
Older People ◽  
Urban Form ◽  
Best Practice ◽  
Current Knowledge ◽  
Well Being ◽  
Design Guidelines ◽  
Outdoor Environment ◽  
Walking Distance ◽  
Major Influence ◽  
People With Dementia

Design guidelines for dementia care homes have, in recent years, acknowledged the important role the internal environment plays in influencing the functional capabilities and emotional well-being of people with dementia. However, although the majority of people with dementia live in the community, similar guidance does not exist in relation to the outdoor environment. To identify aspects of design that should be considered in making the outside world dementia-friendly an analysis of the literature on the needs of older people with dementia and on current knowledge of best practice for internal environments was carried out. By drawing parallels with the outside environment this paper demonstrates that design solutions do potentially exist which would enable older people with dementia to continue to negotiate and use their local neighbourhoods. Familiarity, legibility, distinctiveness, accessibility, comfort, and safety all appear to have a major influence. Small street blocks with direct, connected routes and good visual access, varied urban form, and architectural features, and distinctive, unambiguous environmental cues could enhance successful orientation and wayfinding. Services and facilities within walking distance with adequate seating, lighting, shelter, and well-maintained, smooth, level, plain paving would ameliorate attending problems of physical frailty. The authors are now empirically testing these initial findings.

scholarly journals Understanding the Link between Family Caregiver Quality of Life and the Care Provided to Older People With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 153-154
Author(s):  
Afeez Hazzan
Keyword(s):  
Quality Of Life ◽  
Quality Of Care ◽  
Older People ◽  
Family Caregivers ◽  
Family Caregiver ◽  
Well Being ◽  
The United States ◽  
People With Dementia ◽  
The Impact

Abstract Dementia is one of the most rapidly growing diseases in the United States. In 2018, the direct costs to American society of caring for older people with dementia was approximately $277 billion. Primary informal caregivers are mainly responsible for the care of older people with dementia including Alzheimer’s disease. Caregivers perform a myriad of duties ranging from shopping for their loved ones’ groceries, helping with medications, and managing finances. The caregiving role becomes more demanding as the disease progresses over time, and studies have shown that the quality-of-life (QoL) experienced by caregivers of older adults who have dementia is lower than the QoL of caregivers for older people who do not have dementia. To the best of our knowledge, there has been no research conducted to investigate whether lower caregiver QoL affects the level or quality of care that caregivers provide to persons with dementia. In the current study, we interviewed family caregivers living in Rochester, New York to inquire about their quality of life and the care provided to older people living with dementia. Further, caregivers completed the 36-item Short Form Health Survey (SF-36) as well as a draft questionnaire for measuring the quality of care provided to older people living with dementia. Both quantitative and qualitative findings from this study reveals important relationships between family caregiver QoL and the care provided, including the impact of social support and financial well-being. The study findings could have significant impact, particularly for the provision of much needed support for family caregivers.

scholarly journals Sedative load of medications prescribed for older people with dementia in care homes

2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Carole Parsons ◽  
Jane Haydock ◽  
Elspeth Mathie ◽  
Natasha Baron ◽  
Ina Machen ◽  
...  
Keyword(s):  
Older People ◽  
Care Homes ◽  
People With Dementia

Heroines, villains and victims: older people's perceptions of others

2006 ◽  
Vol 26 (6) ◽  
pp. 883-900 ◽  
Author(s):  
JEAN TOWNSEND ◽  
MARY GODFREY ◽  
TRACY DENBY
Keyword(s):  
Older People ◽  
Old Age ◽  
Age Changes ◽  
Negative Stereotypes ◽  
Self Identity ◽  
People With Dementia ◽  
Age Related ◽  
Physical Limitations ◽  
Inclusive Society ◽  
People’S Perceptions

This paper examines older people's contrasting images of older people as ‘those like us’ and as ‘others’. It draws on data from a qualitative study about the experience of ageing that was undertaken in partnership with two local groups of older people in England. Whilst the informants acknowledged their chronological age, changes in appearance and physical limitations, most did not describe themselves as old. They challenged the idea of older people as being ‘past it’. Older people who personified their own values of inter-dependence, reciprocity and keeping going were seen as ‘heroines’ of old age, but negative stereotypes were ascribed simultaneously to others, ‘the villains’. Aspects of behaviour which evoked censure were ‘giving up’; ‘refusal to be helped’ and ‘taking without putting back’, and were usually attributed to acquaintances known only at a distance. The victims of old age were primarily people with dementia, who were perceived as ‘needing to be looked after’ and objects of pity and concern. The paper explores the ways in which these various images of old age related to people's self-identity and management of the ageing process; especially in a society that has ambivalent conceptions of old age. The findings contribute to an understanding of how people's values underpin their conception of ‘a good old age’ and how they shape their interpretation of societal stereotypes. They also indicate the importance of considering whose voices are heard in the context of exploring the identity and contributions of older people to achieve a more inclusive society.

Productivity among older people in The Netherlands: variations by gender and the socio-spatial context in 2002–03

2006 ◽  
Vol 26 (6) ◽  
pp. 901-923 ◽  
Author(s):  
MARIEKE VAN DER MEER
Keyword(s):  
The Netherlands ◽  
Older People ◽  
Activity Patterns ◽  
Well Being ◽  
Paid Work ◽  
Voluntary Work ◽  
Cross Sectional ◽  
Productive Activities ◽  
Age Related ◽  
Urban Rural

Productivity among older adults manifests in engagement in paid work, voluntary work, giving support to others, home maintenance and housekeeping. This paper reports an investigation into the extent to which levels of participation in the different productive activity types in The Netherlands are associated with age, gender and the settings in which older people live. The regional and urban–rural dimensions of variation are examined. The data were derived from the European Study of Adult Well-Being survey (ESAW). The results show that the oldest women tended to restrict their productivity to the private domain of housekeeping, while the oldest men were more often productive in the community, and that regional variations were stronger for women than for men. Traditional gender roles particularly affected the way in which older women living in a peripheral region participated in productive activities. In contrast, the urban–rural dimension was more important for men than for women, partly because a group of older men in the cities were not involved in paid work. Overall, strong gender influences on the variations in productive engagement were found. Processes of age-related contraction and convergence in patterns of participation in productive activities were imputed from the cross-sectional data. A full understanding of the ageing and cohort effects underlying the reported patterns would require much more detailed information on the spatial and temporal dimensions of older people's activity patterns.

Poisoning among older people with dementia: a wake up call

2015 ◽  
Vol 27 (11) ◽  
pp. 1755-1756
Author(s):  
Christopher D. Etherton-Beer
Keyword(s):  
Quality Of Life ◽  
Cardiovascular Diseases ◽  
Life Expectancy ◽  
Older People ◽  
Medical Care ◽  
Human Lifespan ◽  
People With Dementia ◽  
Age Related

Medical care can be both “a blessing and a curse”. The contributions of medicines to increased human lifespan and falling mortality from the major cardiovascular diseases are undisputed. However, in lockstep with remarkable extension of human lifespan has been increase in the numbers of people living with chronic age related neurodegenerative conditions and frailty. In frail, multi-morbid populations, with limited homeostatic reserve and life expectancy, the balance between the risk and harms of medicines can be in equipoise. In this context the number of older people living with dementia is increasing, and understanding threats to the quality of life of people with dementia is of growing significance. Among the myriad potential causes of harm to older people with dementia, in this issue of the journal Mitchell and colleagues present new Australian data reminding us of the importance of admissions due to both intentional and unintentional poisoning.

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