Holistic care and environmental design: the future for dementia care

Purpose - This paper aims to outline the development of a new approach, using environmental design and non-drug-based interventions to support individuals with dementia to live independently and safely in their own homes. Although in its infancy, this approach is beginning to show how it can help to improve the mood, socialisation, and short-term memory of people with dementia and reduce the need for residential care or hospital admission. Design/methodology/approach - As a case study, this paper is based upon the development teams' observations, complemented by those of other key stakeholders. It first reviews the policy context and evidence for the scale of the problem and some psychological approaches such as reminiscence work, which can alleviate the symptoms. It then outlines the potential in home improvement work in "dementia-proofing'' and "retro-fitting'', to enhance reminiscence-based "life experience'' work. Finally, the approach is illustrated via an individual example. Findings - The results so far - though not formally evaluated - suggest that design-based approaches may add significantly to the effectiveness of psychological management of dementia via reminiscence work; early results suggest a reduction in the "chemical cosh'' of medication. Practical implications - This paper describes early developments in a new approach with great potential. In the long-term, it is hoped that this dementia care model can be rolled out for replication in any home improvement agency or social care setting. Originality/value - The impact of dementia is of increasing concern both for individuals and for public budgets. The potential in dementia-friendly environmental design to complement other psychological approaches is an example of the search for more holistic approaches that respect and work with the strengths of the individual, in contrast to purely medical approaches relying on medication and/or institutional care.