New guidelines launched by the sight loss charity, Thomas Pocklington Trust and the University of Stirling, reveal how clever design of living spaces can improve the lives of people who are living with two common conditions - dementia and sight loss.
The evidence-based guidelines help make homes more accessible for people with both conditions and were developed after researchers gathered the views and experiences of people living with dementia and sight loss, their families and carers and a wide range of professionals.
Dr. Lynn Watson, Head of Housing Research, Thomas Pocklington Trust, says: "The combination of these two conditions is increasingly common yet guidelines for designing homes - both individual homes and care homes - have tended to focus on one or other of the conditions. We wanted to review existing research and add to it the real experiences of people living with both dementia and sight loss. The result is an important new set of guidelines that can make a real difference to people's lives."
Sight loss and dementia are both associated with ageing. One in five people in the UK over the age of 75 is living with sight loss; one in 14 people over the age of 65 is estimated to have a form of dementia. Different causes of visual impairment have differing effects on what people can see, from blurred or complete loss of areas of vision to loss of detail and colour. Some conditions may also be linked to optical illusions, misperceptions or 'visual mistakes'. The consequences of such visual mistakes can be serious for people with dementia who may not realise or remember that they have made a mistake or be able to rationalise or 'reality check' what they believe they are seeing.
There has been little research into design for concurrent dementia and sight loss. In a review of existing evidence the researchers at the University of Stirling found only three sources that focused on people living with both conditions while thirty others looked at the conditions separately. They also found that existing design recommendations are not completely focussed on improving people's independence and ability to carry out tasks. Where dementia is concerned, the aim has often also been to 'control and contain' dementia behaviours.
Professor Alison Bowes, who led the Stirling research, says: "Our research focuses on the person, their individual needs and rights, and the ways in which their independence and capacity can be improved. The new guidelines consider the individual first and show that simple measures can make their homes more accessible and supportive. We believe these are among the first such guidelines to begin to address this important issue of promoting independence and capacity for people with both dementia and sight loss."
The guidelines were compiled after an evidence review and wide consultation with people with dementia and sight loss, carers, relatives, care home staff and managers, and other professionals. They highlight key areas in the home that could be improved with better design. Simple measures such as the use of colour and contrast, clever lighting, the design of cupboard doors and audible and tactile control panels are among those suggested to help improve the lives and independence of people with both dementia and sight loss. Other recommendations cover fixtures and fittings; layout and design of kitchens; good bathroom design; entrances and exits; gardens and outdoor areas. The measures can be used to adapt existing homes to a person's changing circumstances or incorporated into new buildings.
Before being finalised the guidelines were reviewed in an online survey of 360 specialists working in the field of dementia and/or sight loss. There was strong agreement with most of the elements and this is reflected in their final format.
Dr. Watson says: "These guidelines will help people with dementia and sight loss to live their daily lives with more independence. We also hope that they will trigger a greater awareness of the problems caused when these two conditions are combined and the importance of considering sight loss alongside issues of dementia."
In a new online resource all the evidence gathered for this research, including the literature review, interviews and focus group feedback, will be available to search, providing an invaluable tool for researchers, professionals and all those interested in dementia and sight loss. The guidelines are also summarised in an easy to read booklet and are available in audio and podcast formats.