Dementia Day Care Centre Design A Virtual Tour of Contemporary Best Practice Presenter Claudia Kennedy Manager, Program Policy NSW Department of Disability Ageing and Home Care Alzheimer s Australia National Conference Perth 30 May 2 June 2007 July 07 Web Version
The NSW Department of Ageing, Disability and Home Care: is one of NSW s largest human service organisations delivers services to: older people people with a disability carers provides services directly and also funds more than 900 non-government organisations to deliver services has more than 12,000 staff and a budget of $1.5 billion in 2005-06
The object of the NSW Home and Community Care (HACC) Capital Strategy is the Provision of 16 purpose designed dementia day care facilities
Dementia Design Guidelines: Home and Community Care Capital Works Program
Picture of Home Modification Website
9 Design Principles for Dementia Day Care facilities Day centre front Front view of an adult day centre
The design needs to: 1.Support independence, autonomy and control 2.Support functionality through meaningful activity 3. Provide an atmosphere that is soothing, pleasant and non- threatening 4. Highlight helpful stimuli and provide orientation cues 5. Reduce extraneous stimuli 6. Provide for wandering 7. Be highly negotiable 8. Be safe and secure 9. Meet the needs of staff
No 1 Design Principle The design needs to support: independence, autonomy & control
Choice An optimum environment provides options for clients. A design that allows for staff to be able to view clients without having to physically present. Clients talking outside at table environment that provides options Man at raised garden bed Man working with wood Principle 1 Autonomy, independence and control
Flexible spaces Spaces that can be: Cleared easily, and Made large enough for physical and musical activities provide for a greater range of activities. Chair dancing/exercise at day centre Lady playing piano Principle 1 Autonomy, independence and control
Operable walls Turn large spaces into smaller, less threatening spaces. Concertina walls not soundproof may fall into disuse Operable walls Principle 1 Autonomy, independence and control
No 2 Design Principle A design that affords meaningful & culturally appropriate activity
Cultural differences are important Need to be considered in Design Decor Aboriginal art menorah AFL Examples of cultural differences: -Aboriginal art -AFL -Menorah Chinese tea set Principle 2 Enables meaningful activity
Provide access for clients to enjoy previously engaged in activities A table height kitchen servery can enable clients to safely participate in food preparation. A movable bench can be used to secure a kitchen with an island bench. Table height servery Lockable Castors Principle 2 Enables meaningful activity
Activities room Needs to provide: A flexible space where a particular group of clients may engage in an array of meaningful activities. Main activities room Principle 2 Enables meaningful activity
Raised garden beds Provide accessibility to an activity that may have been enjoyed previously and is therefore meaningful to the clients. Raised garden bed Principle 2 Enables meaningful activity
No 3 Design Principle The design provides interior and exterior detailing that is familiar, calming & non-threatening
Non-institutional design to centre The design of the centre should be noninstitutional, both internally and externally. This can be achieved by designing to make the centre feel home-like and domestic. Images of domestic and home-like nature of centres Principle 3: Pleasant, calming & non threatening
Décor that is familiar As clients recall their distant past, décor from a distant era may be more familiar, comforting and less threatening than newer appliances and modern furnishings. Furnishings and décor should reflect a familiar era Principle 3: Pleasant, calming & non threatening
Quiet room Provision of a quiet room for agitated or tired clients provides a calming environment. Principle 3: Pleasant, calming & non threatening Quiet room
No 4 Design Principle A design that Highlights helpful stimuli and provides orientation cues
Signage to assist orientation Signage is most effective when: Symbols and Pictures Toilet with sign in word and picture are combined. Principle 4: Helpful stimuli & provision of orientation cues
Colour contrasting A door or room, may be highlighted by a stark colour contrast to the environment around it. Toilet door colour contrasted from wall Principle 4: Helpful stimuli & orientation cues
Landmarks such as: Paintings, A piano or a Grandfather clock Grandfather clock as an example of a landmark to assist orientaion may assist clients to orient themselves in the environment Principle 4: Helpful stimuli & orientation cues
Appropriate lighting For certain tasks, clients may need plenty of light eg over a kitchen bench area. Overhead light Principle 4: Helpful stimuli & orientation cues
Clocks and Calendars Provision of clocks and calendars may help clients orient to the time and day. Wall clock calendar Principle 4: Helpful stimuli & orientation cues
No 5 Design Principle A design that eliminates unnecessary complexity & reduces extraneous sensory stimuli
Hide staff only doors Blending doors that clients don t use into walls prevents clients from becoming agitated. Concealed doors Principle 5 Reduced Extraneous stimuli
Appropriate storage Key locked cupboards blended into walls can prevent clients from becoming agitated with handles and locks. Principle 5 Extraneous stimuli is reduced by design Cupboards blend with walls and locked al ed e c n o C s d r a o cupb
Shade structures A shade structure protects clients from UV and makes an outdoor area more comfortable. A vergola can can be shut in summer to reduce glare and opened in winter. Principle 5 Reduced Extraneous stimuli
Glare minimisation Glare can be reduced by: Translucent blinds, Window tinting, Non-reflective flooring, and Providing an intermediate space between bright external light and less intense light interior light by the provision of an alcove. Examples of glare minimsation Principle 5 Reduced Extraneous stimuli
Noise minimisation Rubber seals around a door can prevent unhelpful banging. Sophisticated seals can make a room virtually soundproof. Principle 5 Reduced Extraneous stimuli
Mirrors may cause disorientation Clients may not recognise themselves or other reflected objects. Mirror with cross thru it Principle 5 Reduced Extraneous stimuli
No 6 Design Principle The design provides opportunities for safe wandering
Wandering route Circular with no dead ends. Meanders through secure internal and external areas. Takes the client past activities in which they may wish to participate. Well lit and hazard free. Principle 6 Provision for wandering
Toilet obvious from wandering route A toilet should be easily found and accessible from anywhere on the wandering route. Principle 6 Provision for wandering Accessible toilet
Seating along wandering route Seating should be provided along both the internal and external areas of the wandering route. Seat along wandering path Principle 6 Provision for wandering
No 7 Design Principle A design that is highly negotiable
Reduce environmental complexity Environmental complexity can be reduced by: Concealing locks on accessible doors, and storerooms and staffroom doors Eliminating long corridors Sliding door with lock Principle 7 Highly negotiable
Direct highlighting Facilitates a client seeing the area they intend to go. Makes the environment easier to negotiate because the client doesn t have to remember where they are going. Outdoor area with line of sight inside Principle 7 Highly negotiable
Approach to centre made easy Providing access for vehicles to drop clients on the doorstep prevents exposure to the weather and makes arrival and departure easier. Front view of day centre Covered easy access Principle 7 Highly negotiable design
No 8 Design Principle The design is tolerant of user related error i.e. safe & secure
Safe participation Providing safety features such as: An induction stove, Lockable drawers, and Safety switches Induction stove permits safe participation in activities meaningful to the client. Principle 8 Safe and secure design
Ambulation safety features Having to step over this door track may: cause clients to trip, and be awkward for clients dependent upon: wheelchairs and walking frames Principle 8 Safe and secure design
Secure and unobtrusive fencing Security can be maintained in a pleasant manner. Climbing plants on pool type safety fencing can virtually conceal a fence. Principle 8 Safe and secure
Access and egress Proximity cards are an unobtrusive method to restrict entry and exit. Managing and controlling cards requires some expertise. Principle 8 Safe and secure design
Automatic release locks Need to automatically release in the event of fire If an area is subject to power failures then releasing because of power failure (rather than fire) may lead to clients wandering away. Principle 8 Safe and secure
Secure unobtrusive window mesh A window can be made secure and allow cross ventilation with the use of stainless steel fly wire (mesh). The mesh hardly affects the appearance of the window. It is strong enough to prevent exit (by clients), and forced entry. Principle 8 Safe and secure
Closed circuit television Principle 8 Safe and secure
Floor coverings have slip ratings. An appropriate rating is needed for people with a disability. For a person with a shuffling gait surfaces that are too tactile may cause a stumble. Non slip flooring Normal floor Abrasive floor Floor with varying degrees of Changing abrasiveness slip resistance image Principle 8 Safe and secure
Adequate storage Adequate non client accessible storage space for equipment prevents clutter & the risk of falls. Secure external storage for equipment is also an investment in safety. Principle 8 Safe and secure
Continuous coloured floor coverings Due to changes in depth perception carpet and floor tiles should be: a continuous colour without borders Uniform floor tiles Black and white check tile pattern crossed out Floor tiles with border crossed out Principle 8 Safe and secure
Spiky plants are cactus! Principle 8 Safe and secure design
No 9 Design Principle Spaces, access points, pathways and services meet the needs of staff
Staff afforded control over their working environment An environment that can be manipulated affords staff an element of control. Principle 9 Staff needs are met
Spaces for staff to utilise Working with clients suffering from dementia is very demanding. Staff need a comfortable staffroom and access to an outdoor area in which to chill out. Principle 9 Staff needs are met
The Guidelines include: A list of comprehensive references, and A detailed design checklist
Dementia Day Care Centre Design A Virtual Tour of Contemporary Best Practice Alzheimer s Australia National Conference Perth 30 May 2 June 2007