Design for people with dementia
What are requirements of the living environment for people with dementia in care facilities, for achieving optimal autonomy during each different phase of dementia? (For example, in Rotterdam)
N.F.H. van Dorth (TU Delft - Architecture and the Built Environment)
W.C. Yung – Mentor (TU Delft - History, Form & Aesthetics)
L.M. Oorschot – Mentor (TU Delft - Teachers of Practice / A)
F.R. Schnater – Mentor (TU Delft - Building Design & Technology)
M.J. van Dorst – Mentor (TU Delft - Urban Studies)
O.G.C. Trienekens – Mentor (Veldacademie)
A.H. Fitskie – Mentor (Veldacademie)
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Abstract
The Netherlands, in this case study, Rotterdam is dealing with a growing elderly population, a shortage of healthcare staff, and an increasing risk of dementia. These challenges are worsened by a housing shortage and the lack dementia-friendly housing and living environments. The municipality encourages elderly individuals to remain in their homes for as long as possible; however, current housing and living environment fails to meet the needs of those living with dementia. Moreover, policies such as “zorg en dwang” care and force, which is to protect people who are endangering themselves or others, is taking away the autonomy and freedom of movement of such a person. However, this clashes with the constitution policy that states that everyone is allowed to move freely.
This thesis explores the design of indoor and outdoor spaces that respect the autonomy and freedom of movement of people with dementia. The design vision seeks to integrate public, communal, and community functions with elderly housing, creating a seamless blend of private living spaces and shared environments. Enhancing nature to create a sense of freedom and autonomy. In the early stages of dementia, individuals can still maintain a level of independence but require assistance with daily tasks, which may be provided by family members or caregivers. During this phase, it is vital to support autonomy through well-designed spaces that facilitate social interaction and reduce confusion. As dementia progresses, the design must adapt to ensure environments remain familiar, safe, and accessible while avoiding elements that may cause distress. Personalized spaces, autonomy in decision-making (such as choosing where to eat), and the incorporation of social hubs, like cafes, help maintain identity and a sense of control.
Design guidelines emphasize safety, with wide entrances and corridoors, accessible outdoor spaces, and clear wayfinding to accommodate those with visual and mobility impairments. Community integration is important, with access to public transport, recreation, and services ensuring continued independence for as long as possible. Advocating for the autonomy of people with dementia, by shifting from traditional elderly homes and nursing homes to a design that allows individuals to have the perception of moving freely and remain part of a community while they still receive the care that they need. The importance when designing a building to include a view on nature and social interaction, creating spaces for community activities and social interaction to happen are crucial for autonomy and mobility freedom.