1. Dementia Friendly Environments
Eve Oldham
Commissioner for Older People

2. National position
A national pilot, Dementia Friendly Environments (DFE), takes forward the Prime Minister’s dementia challenge
King’s Fund 2009/11 ‘Enhancing the Healing Environment’
Both talk about changes in the environment in hospitals and care homes:
Poor signage and lack of way-finding cues
Poor use of colour and contrast
Unhelpful lighting – glare and pooling
Shiny floors
Stark, unwelcoming spaces off long featureless corridors
No personalisation of space
Under-use of gardens and outside spaces

3. ‘You need to see inside my head..’ quote from someone with dementia
Someone with dementia may:
Be confused and agitated in unfamiliar environments
Become restless and distracted in environments that are visually over- stimulating or where there is competing visual information, such as highly patterned wallpaper or too many notices or signs
Have difficulty seeing handrails, toilet seats or doors, or the food on their plate, if these are the same colour as the background

4. Affect on quality of life
Someone with dementia may:
Avoid stepping on shadows or coloured strips on flooring because they may look like a change of level
Resist walking on shiny flooring because it looks wet or slippery
Misinterpret reflections in mirrors, windows and shiny surfaces
Have difficulty hearing or understanding conversation if there is competing background noise, for example, from the television
Have a reduced tolerance for sound and feel anxious in situations with unfamiliar or loud noises
Feel curious and want to walk around

5. Advantages of a DFE approach
The Kings Fund programme showed that appropriately designed environments can:
Reduce the incidence of agitation and challenging behaviour
Reduce the need for anti-psychotic medication
Reduce falls
Promote independence
Increase engagement in meaningful activity
Improve staff morale, recruitment and retention

6. Examples from the King’s Fund programme
changed colour scheme in wards in hospitals
improvements to gardens
improved area for therapies
improvements to the entrance of buildings
Improvements to a palliative care suite

7. Why we are interested in Hackney
Dementia one of the four priorities in 2013/2014 of the new Health and Wellbeing Board
Numbers of people with a diagnosis of dementia slowly rising in the locality
Carers expressing their concern at wanting to keep their loved ones at home for as long as possible
Opportunities for influencing new build
Opportunity for influencing move of Dementia Day Centre
Opportunity opened up by getting through Stage 1 of the national DH DFE pilot
New criteria for carer direct payments
2013/2014 Review of telecare and equipment services

8. DH DFE Stage 1 and 2 bids
Hackney got through to put in a Stage 2 application
Working with two partners, an RSL owned Supported Living Scheme (SLS) and one an Orthodox Jewish nursing and care home
Application for the SLS is to:
Convert a space rarely used into a sensory room
Improve lighting in corridors, vestibules and entrance
Change layout of garden to include coloured circular pathway
Application for the nursing home:
Convert existing conservatory into a sensory conservatory providing a Succoh roof
Change layout of garden paving to include colour circular pathway
Awaiting to hear !

9. Additional benefits
Working with architects on a new build for dementia taking into consideration the principles of DFE
Beginning work with our Private Sector Housing colleagues to ensure that any Disabled Facilities Grant applications will take on board DF
Working with Hackney Homes building and refurb section to raise awareness of DFE and influence estate landscaping, internal refurb etc
Working with our Hackney Parks section to influence their upgrading and design plans
Started working with our planning section to ensure planning applications take account of DFE