It is with great pleasure that we dedicate this month’s blog to a retrospective from one of our clients. Understanding the impact, benefit and outcomes from working with clients is very important to us and we’re grateful to Nicoll Russell Studios for their willingness to share their experiences of ‘dementia-friendly’ design.
What’s in a name? Dementia Friendly Housing: an architect’s perspective.
When Nicoll Russell Studios were appointed as architects for Rosemount Gardens in Bathgate, the brief from West Lothian Council (WLC) was to design a Dementia Friendly Housing-with-Care development. “Dementia Friendly” is a simple catch-all phrase, but of course covers a vast array of complex and increasingly important issues for architects as we design buildings and shape communities for an ageing population. So, what did it mean in the context of this development… and just how friendly is friendly?!
Research & Design Guidance: DSDC Influence
Research (past project review, building visits, published literature, and reference to multiple sources of design guidance) underpinned our design approach. It also provided a common framework for discussions between client, architect, and delivery partner Hub South-East Scotland / Graham Construction . Building on this work, early collaboration with DSDC, including discussions over the emerging design, was extremely helpful. It provided reassurance on design direction, validating design decisions while also highlighting areas for further exploration with the client. Most significantly, it brought further research informed expertise and an authoritative voice to the table, supporting many design “moves” when competing pressures might have otherwise taken priority.
Location: Community & Connectivity
Dementia friendliness started with the site location. As well as 30 flats for older people, a central Hub of shared facilities was to be provided. Importantly, this was to invite the wider community into the building, aiming to encourage the growth of a vibrant and socially inclusive heart to the development. Location was therefore critical. A brownfield site in a town centre location, off a quiet side street, with various older persons housing developments nearby, was identified. Despite the budget challenges such as the site requiring significant remediation, WLC pursued this option as they recognised the potential for the location to nurture a vibrant and inclusive age and dementia friendly community.
Site Layout: Streets & Courtyard Garden
A private, secure, south-facing garden courtyard is defined by a protective L-shaped building plan, reinforcing and addressing street edges. The sloping site has generous covered entrances at two levels that lead directly from the adjoining streets to a central organising and gathering atrium, allowing clear orientation and navigation to social areas, the garden courtyard, or two “wings” of flats.
Appearance: Housing, not “Care Building”
The building’s recognisably residential tenement-like exterior appearance, common in this part of Scotland, is deliberately ‘ordinary’ to avoid being viewed as a special care building somehow set apart from the rest of the community. Internally, the ambience draws influence from simple, light filled, modern domestic and hotel architecture.
Internal Layout & Detail: A Discrete Level of Assistance
There was much discussion about what “dementia friendly” really meant in the context of housing. There were questions on how this might differ from a more specialist care environment. How far could, or should, we go in designing for dementia in this context? Could we go too far, and what (if any) risk was there of ending up with a setting that looked institutional, rather than the homely domestic setting that one might, and indeed should, expect?
Of course, many aspects of dementia friendly design improve the quality and use-ability of environments for everyone without “signalling” a dementia focus. This became a useful guiding principle in developing the dementia friendly strategy. In practice, this meant avoiding an indiscriminate “checklist” approach to design decisions; questioning and thoughtful value judgements were applied. A discrete layer of design thinking that supports, enables and assists in an almost “invisible” manner is therefore provided; an approach readily transferrable to “non-specialist” housing and other building types.
Corridors as Streets
Although “double-loaded” corridors were required for economic reasons, they have been treated almost like streets. Each flat has a set-back “frontage” with front door, “external” wall light, and window from the kitchen offering visual connectivity with those passing by. A handrail detail at each door doubles as a “memory shelf”- a discrete provision that if not utilised does not look “empty”. Service doors are disguised, and the corridor 'streets' swell to incorporate highly glazed informal seating (and rest) areas, overlooking landscaped gardens and helping orientation. Kitchen windows generally coincide with these areas giving double-aspect orientation and additional natural light to flats, and promoting neighbourliness along the 'street'.
Flats: Layout and Detail
Within the flats, well proven design features offer support and assistance. Kitchens are open plan (DSDC’s advocacy and a WLC-led tenant consultation helped with this during design development); room arrangements allow the WC (with a night-time reassurance light) to be visible from bed; white sanitaryware contrasts with adjacent surfaces; varying door types lead to different spaces; finishes carefully consider tone and contrast; deep (and low) window cills allow more space for personal items; high window-heads allow deep natural light penetration; artificial lighting levels are high; telecare systems are provided; door locks sit above handles, and so on. Simple, small details improving usefulness for all.
Atrium “Hub”: Indoor/Outdoor Space & Busy Place
Each corridor 'street' is reached via a central space that spatially links all 3 levels for clarity of orientation. This indoor/outdoor space is conceived almost as a small town square, off which there is direct access to a restaurant, a hairdresser salon, a laundrette, and 2 multi-purpose activity rooms, as well as to the 'streets' themselves.
This 'square' is also inhabited by a café. As all tenants, visitors and staff pass through the space it becomes a place to meet and interact, reducing isolation and encouraging community life. Crucially, facilities such as the restaurant, café and hairdresser salon are also open to the general public, while the multi-purpose rooms can be hired, and services provided, by external organisations. A hotel-like guest room is available for family/visitor overnight stays.
The restaurant and café relate directly to the garden, orientated to provide shelter and capture sunlight throughout the day. The garden itself is a key part of the design, incorporating 'wander' routes, seating spaces, raised planter beds and the like to promote activity and well-being. The multi-purpose rooms and the principal entrances to the building relate closely and very deliberately to the surrounding streets, reaching out to the wider community within which the building sits.
Improvements can always be made, and we are currently setting up a post-occupancy evaluation exercise at Rosemount with WLC, focussing on the experiences and feelings of residents, visitors and staff using the building. Feedback to date has been extremely positive. On a recent visit, I chatted over cups of tea with several people who had moved in several months earlier. It was an absolute joy to hear them variously describe how “happy” they found the atmosphere, how they weren’t lonely “like before”, how much they enjoyed the “light, airy, modern” feel, and just how “comfortable” they found their new homes. As architects, we feel we have been part of a team that has made a difference. Attendance at DSDC’s recent International Masterclass on Design for Dementia and Ageing has opened further avenues of thought, and we want to do more.
Scott Turpie – Director – Nicoll Russell Studios