Dementia Friendly Design For Lifts

A guide on specifying lifts for dementia-friendly design, the principles and a helpful dementia design checklist for your lift…

Dementia: An introduction

Dementia remains one of the biggest problems facing our ageing population, causing more disability in later life than cancer, heart disease or strokes. It costs the UK an estimated £34.7 billion a year, which is set to rise sharply to £94.1billion by 2040.

The Alzheimer's Society reports around 850,000 people with dementia in the UK currently. This is projected to rise to 1.6 million by 2040, so it’s hardly surprising that this now needs to be a key consideration for existing and new buildings.

Studies have shown that cognitive impairment, which affects people suffering from dementia, can be aggravated by certain building designs, which with careful planning, can easily be avoided at little extra cost.

Stairs in particular can cause issues for those with dementia, as perception of both depth and colour contrast can be affected. This makes it hard for those affected to judge where they are stepping and makes accidents a far more likely occurrence. 

Dementia-friendly design

The challenge of designing buildings that are suitable for use by everyone, including senior living. Increasingly NHS trusts, private nursing care providers, local authorities and housing associations are looking to design spaces for dementia care.

The Dementia Services Development Centre (DSDC) works to improve the lives of people living with dementia, with an ethos to make communities more dementia-friendly through design, and they offer a dementia design course (RIBA CPD) on the subject.

Over 25 years of research by the DSDC shows that buildings following dementia-friendly design guidelines can significantly help minimise the disorder's psychological effects, as well as physical symptoms such as falls and incontinence.

Dementia-friendly hospital lift design

7 bed lifts refurbished over two sites four bed lifts at Scunthorpe General and three at Diana Princess of Wales-1.jpgModern hospitals are busy, noisy places. People with dementia can find this environment extremely difficult to navigate, and the raft of different specialisms and terms can be confusing. As a result, it may not always be obvious to dementia sufferers where the hospital lift is, and there are not always staff on hand to assist with this.

The Health Technical Memorandum 08-02 (HTM) gives comprehensive guidance and advice on hospital lifts and escalators within new builds and on upgrading and modernising existing buildings. There are no specific references to creating dementia-friendly hospitals within the HTM.

However, the DSDC Virtual Hospital shows how the careful consideration of design elements within a building can make a hospital setting dementia-friendly, including hospital lift design.

Dementia care home design for lifts

Nursing home Pass Lift 009sm.jpgTo accommodate care home dementia design, every interior design aspect must be considered. From the signage used throughout to the style of taps and plumbing in bathroom facilities, even patterns on the floor or a mixture of colours can cause momentary confusion - leading to trips or falls.

The dementia design guide gives clear information on design within new care buildings and a useful reference tool for owners. The guidance is based on addressing the symptoms of the illness and understanding the changes associated with dementia. This can help to prevent falls and give residents greater freedom and independence for longer.

Dementia sufferers often have visuospatial problems and cannot see 3D, an issue which, if not addressed through design, can lead to an increased risk of trips and falls. As many dementia sufferers often struggle to negotiate stairs and there is an increased risk of falls due to confusion, having adequate and suitable lift facilities within care homes is essential. 

You can find full guidance on specifying lifts for care homes and retirement homes in our blog Specifying lifts for care homes.

The Design Audit Tool for Care Homes, Day Centres and Medical Centres

The University of Stirling Dementia Design Audit Tool provides a framework for making decisions about the design and spaces for people with dementia in buildings, new buildings and refurbishment projects in care homes, day centres and medical centres. 

Under the audit, three different certification levels can be obtained:

  • Bronze (60-74%) means a building is an adequate example of design for people with dementia,
  • Silver (75-89%), means it is a good example of design for people with dementia,
  • and Gold (90% or above) means a building displays an excellent example of design for those with dementia.

Overall scoring is from a mix of essential and recommended category points. The final score is weighted according to category. Lifts are covered within section 1 of the 11 sections of the audit tool and account for eight recommended points out of 42 (3.4% of the total overall score). A platform or passenger lift can be used to get the recommended points.

The guidance notes for the audit tool do not make recommendations for the most suitable type of lift specification, but they recommend seeking further advice from BS8300, relevant building regulations and the Equality Act.

Dementia Design Checklist

Whichever lift type is the most suitable to suit the building and user requirements, some items can be added to the lift specification for health and social care. Here are some of our top tips for lift specification regarding dementia-friendly lift design…

Lift specification and finishes

  • The lift interior should be pastel-coloured, not reflective or shiny. The use of strong or swirly patterns should be avoided as they can appear to move.

  • Flooring should match the landings avoiding variations that can lead to hesitancy, slips, trips or falls. A sparkly or swirly finish and the colours black and blue should be avoided (as they can be mistakenly interpreted as a hole or body of water). The landing door sills should also be the same colour as the floor.

  • Lift skirting should contrast with both the floor and walls.

  • Lighting should be bright and uniform and most standard lifts have a diffusing ceiling to minimise shadows which can be misinterpreted as holes or objects.

  • The use of mirrors or reflecting surfaces should be avoided as reflections can be interpreted as a stranger. If a mirror is required for wheelchair users, it should be angled at height. As this conflicts with guidance in Part M building regulations and elsewhere, it will require dispensation from Building Regulations.

  • Lift controls must be easy and intuitive to use. If you are specifying a platform lift, you may want to consider a cabin platform lift's automatic (one-touch) button. These will be more suitable than the constant pressure buttons used in traditional platform lifts.

  • The lift has an announcement system, which advises passengers of their location, door movements and arrival at their destination.

  • Consider an additional emergency communication device close to the lift floor in case of falls (optional)

 Lift landings and location

  • Use clear and attractive signage towards the lift in a bold face with good contrast between the text and the background.

  • Landing doors must be easy to distinguish. This can be achieved by using a different colour or tone to set these apart or by painting around the architrave.

    • The glass doors on platform lifts should be marked, as people with dementia may not see the glass. Additionally, the door handrail should contrast with the colour of the door.

    • On automatic doors, ensure the door dwell time can be adjusted to avoid the doors' abrupt closure, which could frighten users. These can also be adjusted to give more time to enter the lift.

    • Landing sills should match the car and landing floor, this can be achieved by painting in the respective RAL colour.
  • Landing button controls must be large, clear and in contrast with the surrounding area.

  • Finally, lift shafts/enclosures should be positioned away from bedroom walls as unexpected noise from the lift whilst in use can create distress or confusion.

Running through this checklist should help to create a lift that gets full points in the Design audit tool and a lift that is designed to be as dementia-friendly as possible.

How Stannah can help

With the number of people with dementia predicted to reach a staggering two million by 2051, designing dementia-friendly retirement homes or other buildings suitable for dementia sufferers is an essential consideration that shouldn’t be ignored. 

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