Voca highlights the importance of considering dementia-friendly design, which will likely only become more prominent within our cities and neighbourhoods, given rise to an ageing population and increased urbanisation (Fitzgerald & Caro, 2014). Voca questions what could we do to improve the life quality for those suffering with dementia. I would like to further explore ways our neighbourhoods can become not just dementia-friendly but age-friendly.
A Shrinking World
Research has found moving people with dementia to unfamiliar environments can have negative effects, and when seeing dramatic changes within their lives it is beneficial they have stability within their surroundings, with many preferring to live at home (Blackman et al; 2003).
Dementia sufferers become restricted, needing to give up driving and with many reluctant to use public transport they often experience a ‘shrinking world’. How those suffering with dementia perceive the immediate environment is therefore highly important and they increasingly rely on legible neighbourhoods (Mitchell et al; 2004, Ward et al; 2007). Just beyond their front door is very much the public realm and plays a vital role in their viability to live at home successfully (Mitchell et al 2004).
Wayfinding and Orientation
The legibility of local areas is key in enabling dementia sufferers to understand where they are and where they need to go. Research by Mitchell et al (2004) investigated how those with dementia perceive their neighbourhoods and highlighted various characteristics influencing wayfinding and orientation. Short, well connected fairly narrow streets laid out in a hierarchy were positively received and maintained peoples concentration. Streets of varied urban form and architectural features were useful tools for successful navigation. Preference was geared towards modern, lively, mixed-use places providing interest and environmental cues that felt welcoming and safe whilst supporting navigation. Environmental cues were preferred to signage and included; historical buildings, distinctive structures, activity places, places of personal significance, attractive gardens and street furniture. These findings demonstrate outdoor environments can be designed to enhance orientation and wayfinding abilities of people with dementia and prevent them becoming housebound through fear of being lost (Mitchell et al; 2004).
Some of the experiences faced by those suffering with dementia (Source: Housing Lin)
Not only is the physical built environment important, but also social support. In recent years age-friendly communities has become of interest, inclusive places where older people are active in community life (Fitzgerald and Caro, 2014). A five year initiative ‘Neighbourhoods: Our people, our places’ is exploring the meaning and experience of neighbourhoods for people effected by dementia, and in many ways its findings demonstrate age-friendly elements (Ward et al; 2017).
Cleadon Park Redevelopment, South Tyneside. Bungalows integrated into mixed developments. (Source:Housing Lin)
The neighbourhood offers immediate opportunities for a person to participate in social activity. The study found those with dementia referred to their relationship with the neighbourhood; what they saw through windows, with gestures such as a smile, acknowledging the presence of a passer-by enabled a sense of connection and belonging. Participants also referred to their relationship with neighbours and how they would look out for one another, enabling a degree of independence and to participate in public life. Regular interaction with the same people in the same places also built familiarity and provided confidence to navigate spaces (Ward et al; 2017).
The neighbourhood is not just physical characteristics but also how people feel and identify with place and it would seem this is highly important for dementia sufferers. Although a small sample of research has been considered within this comment, I would suggest both the built environment of age-friendly neighbourhoods and relations with people in the neighbourhood can play an important role in benefitting all ages, especially those with dementia, enabling social health to flourish.
Blackman, T., Mitchell, L., Burton, E., Jenks, M., Parsons, M., Raman, S., Williams K. (2003) The Accessibility of Public Spaces for People with Dementia: A new priority for the ‘open city’ Disability & Society, 18: 3, 357-371
Fitzgerald, K.G. & Caro, F.G. (2014) An Overview of Age-Friendly Cities and Communities Around the World, Journal of Aging & Social Policy, 26:1-2, 1-18,
Housing Lin (2016) DESIGN for DEMENTIA: Volume 1 – A Guide. Accessed at: https://www.housinglin.org.uk/Topics/type/Co-produced-and-research-based-Dementia-Design-Guide/
Mitchell, L. Burton, E, Raman, S (2004) Dementia‐friendly cities: designing intelligible neighbourhoods for life, Journal of Urban Design, 9:1, 89-101,
Ward, R. Clark, A, Campbell, S. Graham, B. Kullberg, A. Manji, K. Rummery K. Keady, J. (2007) The lived neighborhood: understanding how people with dementia engage with their local environment. International Psychogeriatrics 2:1-14