Accessible design and dementia: A neglected space in the equality debate

Abstract

This paper addresses the issue of accessible design in the context of dementia. It is not difficult to design buildings and outside spaces for people with dementia but you do have to follow clear design principles and values. However, unlike other disabilities, accessible dementia design is still viewed as an added extra and not a vital component of facilitating citizenship. In 2015, the World Health Organisation published guidance on human rights and dementia. People living with dementia are frequently denied their human rights even when regulations are in place to uphold them. This paper will focus on accessible design from a human rights perspective using the PANEL principles. PANEL stands for Participation, Accountability, Non-Discrimination and Equality, Empowerment and Legality. We will then conclude with recommendations for policy, practice and research to ensure that accessible design for people living with dementia does not continue to be a neglected space in the equality debate.

Age-Friendly Built Environment

“…There are different approaches towards increased accessibility and adaptability of housing and buildings such as universal design, inclusive design, design for all and accessible design [19][20][21]. Despite the lack of consistent terminology, the rationale behind accessibility is quite similar, highlighting the importance of non-discrimination, social inclusion and equity [22].…”

Hearing Assessment and Rehabilitation for People Living With Dementia

“…PwD report that when environments are poorly adapted to cognitive and perceptual difficulties that occur in dementia, the environment can feel hostile and has a negative impact on the person’s mood, causing stress and anxiety ( Houston et al 2020 ). Problematic features of the environment include settings with medical equipment and staff in laboratory coats that may make someone who is not aware of where they are fearful about experiencing unpleasant medical procedures ( Waller & Masterson 2015 ).…”

“…Although a detailed discussion of dementia-friendly design (e.g., Calkins et al 2011 ; Fleming et al 2012 ; Van Hoof & O’Brien 2014 ) is beyond the scope of this document, there are resources to support dementia-friendly design available, such as the Dementia Services Design Centre’s audit tool ( https://dementia.stir.ac.uk/ ). Hearing care service providers could also consider inviting comments from PwD on the design and layout of clinics ( Houston et al 2020 ). Local and national organizations (Appendix, Supplemental Digital Content 1, http://links.lww.com/EANDH/A985 ) may be able to assist with putting clinicians in touch with people who could provide the perspective of PwD.…”

Social Citizenship Through Out-of-Home Participation Among Older Adults With and Without Dementia

“…There are structural and contextual aspects that influence the living environment; thus, opportunities for out-of-home participation may vary among different countries (Townsend et al, 2021). Structural and contextual aspects include city planning, urban design and walkability (Biglieri, 2018; Houston et al, 2020), proximity to nature (Sturge et al, 2021), socio-economic status (d'Orsi et al, 2014; Gaber et al, 2020; Wallcook et al, 2021), access to public transport and transport services (Kizony et al, 2020; Mouratidis, 2018), access to health care services including diagnostic and support services for older adults living with dementia and other age-related or disabling conditions (Gan et al, 2021).…”