Guiding design of dementia friendly environments in residential care settings: Considering the living experiences

TLDR

The physical and social environment is increasingly recognized as vital for supporting people with dementia, yet institutional settings still dominate, limiting individuality and choice. The article argues that design and care philosophy should be framed by the lived experience of people with dementia, shifting focus from condition to experience to enable active participation. The authors developed a resource for Australian residential and respite facilities that identifies seven living experiences—self‑presentation, eating, personal enjoyment, bedroom, family/community connections, end‑of‑life, and staff experience—to guide design. By discussing each experience, the authors demonstrate that incorporating living experiences into design can practically support people with dementia and address a broad range of environmental challenges.

Abstract

In the past twenty years, the importance of the physical and social environments in supporting the person with dementia has gained a much higher profile in dementia care. Despite efforts to move aged care away from the medical model to a more balanced social model of care, we still struggle with the dominance of an institutional context which impedes individuality and choice. This article argues that the experience of the person with dementia should frame the perspective brought to built design and the philosophy of care — in essence, `looking out from the inside'. Shifting the emphasis from condition to experience encourages the culture change needed to create environments that allow the person with dementia to be an active participant in everyday life rather than a passive recipient of care. Based on the development of a resource for residential and respite facilities in Australia, seven living experiences are identified: the presentation of self-experience, eating experience, personal enjoyment experience, bedroom experience, family and community connections experience, end-of-life experience and the staff experience. Each is discussed to show how consideration of the living experiences provides a way to focus thinking for design of the built environment to practically support the person with dementia, thereby addressing the wider spectrum of issues in creating a dementia friendly physical and social environment from the perspective of the person with dementia.