A quarter of UK hospital patients have dementia. The recent, and heart-breaking, BBC2 programme ‘Nowhere to Go’ told the story of Evelyn, a patient with advanced dementia. She found the hospital disorientating and was becoming aggressive, at one point being restrained by security guards. Visiting hospital can be stressful for any of us, but patients with dementia can find the experience so unsettling that it impacts their recovery. A well-designed environment can help to reduce falls, length of stay, and challenging behaviour whilst increasing staff productivity. To offer the best outcomes to its patients, Bridgwater Community Hospital facilitates social engagement and independence alongside nursing.
Designing a dementia-friendly hospital obviously requires a different approach to a residential environment, where we would aim to create familiar settings and encourage personalisation, however the key principles remain the same: an easy to navigate layout; use of contrast to direct attention; careful use of colours and finishes; lots of natural light; control of unwanted noise; and access to the natural environment. Clinical demands and needs of other patients must also be considered, although in many cases interventions that are helpful to a person with dementia also help others.
Visitors to the new hospital enter into a large and airy waiting room. Glazing allows views of a specially commissioned artwork that celebrates the last 200 years of Bridgwater’s history, providing a conversation point and distraction from patients’ worries. The colour scheme throughout the hospital is restful, calming visitors whether they have dementia or are simply anxious, and the seating areas follow a simple colour coding scheme, allowing staff to direct patients to the right area.
The ward, positioned to avoid motorway noise and to give bedrooms views of the Quantocks, has a straight corridor which allows safe wandering and aids staff observation. The three staff bases allow nurses to stay close to their patients and are highlighted in a contrasting colour to provide focal points for patients that need assistance. Each base also has a unique symbol helping patients to identify with the zone they are staying in.
The majority of patient accommodation is in single bedrooms, providing high levels of privacy and reducing noise irritation, and two rooms allow a carer to stay overnight for additional reassurance. For those uncomfortable on their own there are 4-bed wards where patients can recuperate in a more social setting.
Patients are encouraged to leave their rooms and socialise with others in the dining room or cosy patient lounges, where reminiscence-inspiring artwork promotes conversation. These rooms have large glazed partitions to the corridor, making their function clear, and have coloured feature walls to make them easy to identify.
All of these features contribute to creating a safe and enabling environment that will help people with dementia to retain some of their independence and reduce frustration borne of confusion and isolation. This in turn will ease pressures on staff, benefiting all patients.
With 1 in 3 over 65s developing dementia, it is not just an issue for care homes or hospitals. We consider the impact of dementia when designing any public building, helping people to live well with dementia and contributing to creating genuinely dementia-friendly communities.