With the ever increasing numbers of the aging population in Australia, there is an imperative to ensure that all future ‘independent living’ housing caters to the needs of the elderly and their diminishing capabilities. Tim Burke discusses how this can be achieved.
The concept of universal housing design is being pro moted as being the bench mark to ensure conformity to AS1428, including the concepts of ‘visit-ability’ and adaptability. Universal housing is described as referring to “homes that are practical and flexible, that meet the needs of people of different ages and abilities over time”.
Additionally, the recently released Livable Housing Design Guidelines (LHDG) by the government present ‘voluntary performance levels’ for future housing. The LHDG “recom mends the inclusion of key easy living features that aim to make homes eas ier and safer to use for all occupants, including people with a disability, ageing Australians, people with temporary injuries, and families with young children”.
As stated above, design for the elderly is design for people with diminish ing capabilities, amongst which are mobility, balance, dexterity, hearing, vision and, for a smaller group of people, cognition. Coupled with the burgeoning numbers of aged persons, there is going to be a corresponding increase in the numbers of people with dementia required to live in the general community for as long as possible due to limited numbers in purpose-built special needs facilities.
For the past 13 years or so I have been involved in the design of special-needs accommodation for people with dementia. For people who are unfamiliar with this area, it is one of the most complex areas of design and perhaps the most challenging for any designer of any built environment discipline.
Designing for people with dementia is design for completely depend ent people who rely on the expertise and good sense of the designers — designers have to do the ‘thinking’ for such totally dependent people.
Over the past 20 years or so there have been numerous design guidelines published and there are many hundreds and likely thousands of journal articles from the environmental and health sciences disciplines advising of various methods and strategies to design appropriate environments for people with dementia. There are so many publications because this area of design is a frontier.
All of the answers as to what constitutes appropriate dementia (friendly) design are still not known — and may never be known. So where does this leave the built environment and project management disciplines who may be involved in the design of special-needs environments or independent living environments?
The many guidelines and principles that have been published over the last 20 years or so can be distilled into just two basic ‘physical’ design fundamentals:
1. Maximise independence of the person
2. Minimise the risk of potential harm to the person
These same two principles can be applied to any designed environment — not just for the aged or for those with dementia.
The two design fundamentals can be applied to every single element, feature or facet in the physical design of an exterior or interior environment. In the interior, the two fundamentals can be applied to the design of a bed, the arm of a chair, a table, a door handle, a door jamb, a light fitting, the joins between adjacent floor coverings, the edge of a kitchen bench, a window frame, etc. In many cases it is just a matter of excluding a particular feature or detail or re-designing those features or details which do not conform to the two principles.
Some of the numerous details or facets that can potentially cause harm to the aged (including those with dementia) who are highly susceptible to cuts, skin tears and bruis ing are sharp edges, sharp corners, burrs on screws and nails, protruding nails, screws or staples and unfinished or poorly finished surfaces (seen or unseen). None of these potentially dangerous details need occur in these environments if care is taken during the specification, manufacture and fabrication processes.
As an example, one of the simplest hazards to exclude from independent living design is 90° right-angled sharp corners on kitchen benches and vanity units. Just changing that one detail to chamfered, radiused, half-round or bull-nose can mean the difference between a major injury requiring medical or hospital treatment and relatively minor bruising if someone happens to stumble, slip or trip and fall onto the corner of such a benchtop.
Another easily excluded hazard con cerns door jambs, architraves and skirting boards. Potential injuries to the head, shoulders, knees, ankles or feet can be minimised by specifying profiles that do not present sharp edges. Where profiles are routed for decorative effect then those routings should have rounded corners or edges.
The built environment should be thought of as a partner in the care of people in independent living environments — particularly for those who live alone or who are highly dependent. A few years ago a need was identified to have a systematic approach to the assessment process of elements in independent living environments. Subsequently, a system was developed called the Silent Care Physical Design Principles, which include:
1. To be considered appropriate for inclusion in a design, an element or combination of elements needs to satisfy both of the physical design fundamentals i.e. it maximises the independence of the person and minimises potential harm to the person
2. If an element or combination of elements satisfies one physical design fundamental and can be modified to satisfy the other than it can be included in the design
3. If an element or combination of elements can satisfy only one physical design fundamental and cannot be modified to satisfy the other then it is inappropriate to be included in the design
Adhering to these principles will ensure that independent living environments eliminate as far as is possible potentially harmful elements and include, as far as it is possible, assistive or benign elements in the design.
Of course, the bottom line here is that the resultant designs should look as ‘standard’ as possible and be visually appealing, and that is the challenge for the built environment disciplines.
Good design is not necessarily more expensive — it is simply more thoughtful, more careful and good sense. Careful thought in design will provide for thoughtful care in the built environment.
Tim Burke is principal of Wayfinder Design, a consultancy which for 13 years has focused on aged care, independent living and special needs environments. Burke regularly presents at conferences and writes articles canvass ing the many design issues in this area.
