practical living
A better way
The new Aged Care Quality Standards
state that organisations must
provide a safe, comfortable service
environment that promotes the
consumer’s independence, function and
employment. How do they best do that
for people with dementia?
Designing for a full life
with dementia.
Kirsty Bennett interviewed by Conor Burke
L
atin is not a dead language when it
comes to dementia design.
The phrase salutogenesis is a word
that guides the philosophy of Dementia
Training Australia (DTA) and is derived from
the Latin for health, salus, and for source,
genesis.
It was coined by sociologist Aaron
Antonovsky, who believed health is
relative on a continuum and that the key
research question is what causes health
(salutogenesis), not what are the reasons
for disease (pathogenesis).
DTA has taken this idea and applied it
to living with dementia. The organisation
holds that “a salutogenic approach is
about finding opportunities for people with
dementia to live as full a life as possible”.
One way it believes that this is
achievable is through dementia-friendly
design.
To find out more about this, DTA’s
dementia design resource, and how
the new Aged Care Quality Standards
can facilitate better design, Aged Care
Insite spoke to Kirsty Bennett, architect
and manager of environmental design
education services at DTA.
ACI: What is dementia-friendly design?
KB: It’s actually good design for everyone,
but we know that if we apply certain key
design principles, it will be of particular
benefit to people living with dementia.
22 agedcareinsite.com.au
We’re delighted to say that the physical
environment is recognised in the new
Aged Care Quality Standards. I think while
Standard 5 is the obvious one, and I’ll come
back to that, it’s also worth just noting that
Standard 1 – which is about community,
dignity and choice – is one that I find really
exciting. One of the consumer outcomes is
‘I can lead the life I choose’.
If we were able to provide environments
that enabled people to do that, we would
really make a difference. That absolutely
ties in also with one of our key design
principles, which is about designing in
response to a vision for way of life.
But coming back to Standard 5, some
of the ways that I think it is significant
is because it talks about someone
feeling that they belong, feeling safe and
comfortable. We know that some of the
ways to do that is to create a small-scale
environment, one of our key design
principles. How do we create a familiar
environment? How do we manage
stimulation so that the important things
are emphasised, and those that aren’t
relevant are not? That means I can focus
on what matters to them, rather than
the person being distracted, confused or
overwhelmed by all this stuff that can be
irrelevant.
Another thing that’s really important
is how do we support movement and
engagement? I think that makes a big
difference too. One of the things in that
Standard 5 is how does the environment
promote consumers’ independence,
function and enjoyment?
How do we encourage people to be
active, to use the skills and abilities they
have? Again, this is another key principle
that we have: unobtrusively reducing risk.
It’s a really great design opportunity to
create environments that are enabling,
that do allow people to use their skills
and abilities. In particular, one of the
requirements in the standard is enabling
consumers to move freely both indoors
and outdoors.
We’re passionate about designing well,
so people can spend time outside. We
understand from our work that staff often
have a number of concerns about that. We
really believe that if we design well we can
alleviate those concerns, and so people
can have a better quality of life.
You’re an architect, so what would
this entail?
It’s not so much physical access that’s
important for everyone. But perhaps paying
greater attention to wayfinding would be
a good place to start. So, when we think,
“How do I know where I am?”, one way
we can do that is by designing to see and
be seen, so I don’t have to remember
where the loungeroom is – I actually can
see the loungeroom or the way to the
loungeroom.
That’s to do with building layout. But,
for example, if you have an existing facility,
it could be that you consider the type of
doors you have on the loungeroom. Are
they glazed? Which means even if they are
closed because something’s happening
inside and you’re creating a more private
environment, I can look in and I can see,
“Oh, Conor’s sitting there, I might go and
join him.”
There are simple things we can do with
the detailing of doors and windows, using
colour, using decoration, that really assist a
person’s ability to use the environment and
to be engaged in the opportunities that it
can offer.
What are the features of DTA’s
environmental design services and
support system?
We’re an onsite design education service
and that’s really important. It means that
we’re able to go onsite and talk to people
in their context, where they are around the
people they are caring for and supporting.
We’re a national team. We’ve got
consultants in Victoria, NSW, Queensland,
South Australia and Western Australia.
Typically, we would go onsite and talk to
a group of people from the facility with a
range of experience. We bring in the skills
of everyone who’s already there, whether
you work in maintenance, whether you’re