Dementia Doesn’t Discriminate – The Importance of Tailored Design

“At BLP we design buildings for all, regardless of their age or ability – recognising that people come first, and that a healthy, safe and secure, balanced and motivated life is what everybody has a right to.”

Emily Gilfillan – Principal, Seniors Living Sector Lead

The complexities of Dementia are not easily defined as it presents differently within everyone. It affects people from all walks of life who are diagnosed with the disease. According to Dementia Australia, Dementia affects close to half a million Australians, and that number is set double in the next 25 years.

During Dementia Action Week 2020 Dementia Australia will demonstrate people living with dementia can continue to live active and rich lives many years after diagnosis. It is our role as a community to do the best we can to support people living with dementia live well for as long as possible.

Dementia is not just one single disease and it is not just about cognitive functioning; it is the term used to describe the symptoms of a sizable group of illnesses which cause a progressive decline in a person’s functioning. It is not a normal part of ageing.

The elderly is not a homogenous population; and each person’s needs change as they age; a ‘one size fits all’ approach is not suitable for those suffering from dementia.  This disease can attack different components of the brain, resulting in different symptoms presenting in individuals.

Our challenge is to design dementia specific residences that can suit all residents living with dementia.  As Dementia is a progressive disorder and affects people in different ways, the approach to design needs to vary and be flexible so that it can cater to a broad cohort.  A residence must be able to be modified and adapted over time to respond to the needs of that cohort.

A dementia friendly home must be designed so that it is legible, and it can be easily understood resulting in minimal confusion.  It shall enable residents with dementia to see their destination while still being seen and observed by staff.  Good visibility and visual access promote resident engagement with activities and the exploration of the surrounding spaces.

It must have a hierarchy of space so that residents can choose to participate in group activities or withdraw and experience some quiet time alone or with loved ones.

The design of a dementia friendly residence needs to be easily negotiated by its residents through integral wayfinding techniques as signage dependent on words can be challenging.  Stepless thresholds are of utmost importance because as the disease develops, mobility and gait are affected, and the risk of falls increases.  Outdoor terraces and courtyards need to be designed so that they allow purposeful wandering and provide a safe and secure space for residents to navigate.

Visual connections to the outside are of equal importance as it has been shown that these types of connections can reduce over-stimulation, stress, and agitation in residents, they can also have a positive impact on the carer’s wellbeing too.

Stimulation is considered both supportive and unfavourable in dementia friendly homes.  The wrong stimulation can result in agitated behaviours, whereas providing sounds and music that resonates with the residents can provide impetus for memory recall, and is considered positive.  Activity benches and other features should be included to enhance residents intrigue, creativity and activity.  Similarly, acoustics must be carefully considered within common areas as well as within the bedroom areas.  This approach reduces extraneous noise that leads to a greater sense of resident wellbeing.

Lighting and lux levels; although needing to comply with the Building Code of Australia and relevant Australian Standards; should have higher colour rendering indexes to compensate for the effects of aging eyes.

Our recently completed Bulli Hospital and Aged Care Centre was guided by best practice dementia design with the goal of developing a built environment that supports a new model of care.  This centre was delivered in harmony with the Bulli Hospital and the Northern Illawarra community and enables residents to move seamlessly between different areas of the facility as their needs change.

Part of our MannaCare project, The Banksia House component included the delivery of 30 dementia friendly single rooms with private ensuites and associated communal spaces including a dementia sensory garden with an indoor/outdoor walking loop.  The garden offers a sensory experience for residents with dementia and provides a place of peaceful beauty resulting in feelings of wellbeing.

Similarly, the BlueCross Springfield development provides Care with a focus on wellness and healthy ageing.  This project was designed to enhance the lives of residents from non-English speaking families, people from culturally and linguistically diverse backgrounds and people with dementia for whom BlueCross’ specialist STARlife dementia program offers a purpose-built, safe environment to improve their quality of life through meaningful engagement.

Stage 2 of The Mornington Centre delivered a 30 bed dementia friendly long stay in-patient unit (IPU) that provides a less-clinical feel for patients who suffer symptoms associated with dementia.  The approach to both interior and exterior spaces resulted in a progressive ward layout.  This model allows dementia patients to roam freely in a continuous figure eight pattern around a couple of indoor courtyards expanding the scope for patient wandering (in close visual and physical proximity to staff) and therapy rooms.  This model brought flexibility and diversity to the spatial experience and atmosphere for the patients.  The outdoor spaces provide places to sit and ponder, with a garden shed, BBQ, work bench, post box, a clothesline, and other references of ‘home’ to promote patient comfort. 

We continue our work with Peninsula Health in preparing a concept for their Stage 3 Mental Health Care facility with much smaller households to ensure enhanced wellbeing for this cohort.  Furthermore, and as a result of the current COVID-19 pandemic, BLP are investigating ways in which we can design and deliver seniors living environments; in particular dementia friendly Care settings; that make it more safe for residents, staff and visitors alike.

This week is Dementia Australia’s, Dementia Action Week. “A little support makes a lot of difference”, so please join us by showing your action by donating to

Dementia Doesn't Discriminate - The Importance of Tailored DesignAdelaide Bell