Discussions about the importance of the built environment for healthcare delivery extend at least as far back as Hippocrates 1 (400 BC). The iconic Florence Nightingale (1859) also strongly believed in the influence the indoor environment has on the progress of disease and recovery. Today, the role of the built environment in the healing process is of growing interest to healthcare providers, environmental psychologists, consultants, and architects. Although there is a mounting evidence 1 linking healthcare environments to health outcomes, because of the varying quality of that evidence, there has also been a lack of clarity around what can and cannot be achieved through design. Given the ageing of society and the ever increasing numbers of persons with dementia in the Western World, the need for detailed knowledge about aged care environments has also become increasingly important. The mental and physical health state of these persons is extremely fragile and their needs demand careful consideration. Although environmental interventions constitute only a fraction of what is needed for people with dementia to remain as independent as possible, there is now sufficient evidence (2, 3) to argue they can be used as a first-line treatment, rather than beginning with farmalogical interventions.
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Ageing-in-place is the preferred way of living for older individuals in an ageing society. It can be facilitated through architectural and technological solutions in the home environment. Dementia poses additional challenges when designing, constructing, or retrofitting housing facilities that support ageing-in-place. Older adults with dementia and their partners ask for living environments that support independence, compensate for declining and vitality, and lower the burden of family care. This study reports the design process of a demonstration home for people with dementia through performing a literature review and focus group sessions. This design incorporates modifications in terms of architecture, interior design, the indoor environment, and technological solutions. Current design guidelines are frequently based on small-scale studies, and, therefore, more systematic field research should be performed to provide further evidence for the efficacy of solutions. The dwellings of people with dementia are used to investigate the many aspects of supportive living environments for older adults with dementia and as educational and training settings for professionals from the fields of nursing, construction, and building services engineering.
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The development of an integrated ethical or normative model to design housing for persons with impairments and diseases, focusing on older persons with dementia.
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Purpose In order to facilitate ageing-in-place (AiP) with dementia, a digital consultancy tool (DCT) was designed to facilitate modifications to the home environment. In the Netherlands, about 65% of the 270,000 older adults with dementia live in their own dwelling. At the same time, 40% of the Dutch housing stock is not appropriate for older adults to live independently1 . Admission to a nursing home is usually caused by stress and a straining of the family carers. Caring for a person with dementia requires constant vigilance. Although admission to a nursing home cannot always be avoided, admission may be postponed by modifying the dwelling and through the use of technology. At present, persons with dementia are not able to adjust their dwelling to suit their needs. Therefore, it is important that carers and installers have access to information on how to design a dwelling in a dementia-friendly way. Method Based on publications about housing facilities2 , thermal comfort3 and dementiafriendly space plan4 , the design for a DCT for AiP was made. The design of the DCT will be discussed in focus group sessions in Alzheimer Cafés with persons with dementia and their family carers. First, sessions will be held about the requirements for the web tool for dementia-friendly design. After gathering the requirements and verification to (inter)national guidelines concerning the accessibility of webpages, focus group sessions will be held with user groups in order to test the usability of the preliminary DCT. Results & Discussion Results of this process are a webpage with descriptions of how to create a dementia-friendly dwelling for AiP with dementia. On the webpage dementia-friendly modifications of the living environment will be ordered by problem/function or space. Problems are categorized by (I)ADL tasks, behaviour, or cognitive problems. Adjustments of spaces are categorized by the combined model of WHO’s ICF and the Model of Integrated Building Design3,5.
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The research project Designing Environment conducts research into how a different mind-set can be brought about concerning people with dementia, by intervening in care processes, and from the perspective of the participating observer. The objective is to create an environment for people with dementia, together with those involved in their care, which is adaptable and where not care is the main focus, but consideration. The interventions that will be introduced come from the world of the arts and many have already been tested in various care environments. Mapping, different kinds of conversations, making portraits and taking pictures are examples of possible interventions. The interventions are chosen on the basis of participating observation. The project is innovative in its approach of the environment of the person with dementia. It will yield knowledge for personalised consideration and care of those involved, and it will give the designer in this setting an entirely new role.
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Ageing-in-place is the preferred way of living for older individuals in an ageing society. It can be facilitated through architectural and technological solutions in the home environment. Dementia poses additional challenges when designing, constructing, or retrofitting housing facilities that support ageing-in-place. Older adults with dementia and their partners ask for living environments that support independence, compensate for declining and vitality, and lower the burden of family care. This study reports the design process of a demonstration home for people with dementia through performing a literature review and focus group sessions. This design incorporates modifications in terms of architecture, interior design, the indoor environment, and technological solutions. Current design guidelines are frequently based on small-scale studies, and, therefore, more systematic field research should be performed to provide further evidence for the efficacy of solutions. The dwellings of people with dementia are used to investigate the many aspects of supportive living environments for older adults with dementia and as educational and training settings for professionals from the fields of nursing, construction, and building services engineering.
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Designing solutions for the various issues that are faced by people with dementia requires that specific needs be met.
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Although there exist various product and services to support people with dementia in their everyday activities and challenges, people with dementia and their informal caregivers experience many unmet needs. In this paper, we present the ongoing development process of a decision aid that aims to reveal these unmet needs and match them with relevant support and care solutions. This entails investigating the needs of people with dementia and caregivers, making an inventory of the product and service solutions, co-creating the question articulation to be used in the decision aid and developing and testing three design concepts. We aim that the insights we gained from the tests will inspire interaction designers and researchers that investigate person-centered dementia care.
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BACKGROUND: At present, persons with dementia and their family caregivers in the Netherlands are not adequately supported to modify their dwellings to match their personal needs. OBJECTIVE: To facilitate aging-in-place for persons with dementia, a website was designed. METHODS: The website was designed with persons with dementia and their spouses. In consultation sessions existing websites were discussed. Based on this discussion, a demonstration website was created and then discussed with and judged by the participants. Visits to the website were monitored using Google Analytics. RESULTS: Participants prefer a website that is easy to print. In addition, the navigation menu should have a maximum of three levels, and the website menu should be positioned on the left. Participants dislike the use of meaningless photographs because these do not add any value to the information given. CONCLUSIONS: Participants prefer a website that is as accessible as reading a book. Some differences are related to culture, such as the participants dislike for the use of English terms. Therefore, preferences or dislikes of items on a website could not be generalized as such. However, the preferences and dislikes may provide useful input for the design process of an appropriate website.
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People with dementia are confronted with many decisions. However, they are often not involved in the process of the decision-making. Shared Decision-Making (SDM) enables involvement of persons with dementia in the decision-making process. In our study, we develop a supportive IT application aiming to facilitate the decision-making process in care networks of people with dementia. A key feature in the development of this SDM tool is the participation of all network members during the design and development process, including the person with dementia. In this paper, we give insight into the first phases of this design and development process in which we conducted extensive user studies and translated wishes and needs of network members into user requirements
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