The UK’s growing social care crisis is perhaps the biggest factor behind the current headlines about the pressures facing the NHS. Lack of investment in the adult social care system has meant elderly and frail patients “blocking beds” because there isn’t the capacity to allow them to return home or be found places into residential care.
Clearly, the crisis wasn’t created yesterday but is the outcome of longer-term trends: an ageing population, people living longer, cuts in local government funding, and so on. This means there aren’t any simple, single solutions, but planning and planners do have something to contribute.
Most people with dementia would prefer to stay in their own home for as long as possible, however they are going into residential care homes earlier, because their own homes are not designed to enable them to live independently and can be difficult to adapt to meet their needs. Staying in familiar surroundings with the right support can help people living with dementia continue to lead an active and independent life for longer. Therefore the local environment can have a significant impact on someone’s ability to do this. This in turn reduces the costs for health and social care.
Photo credit: The Orders of St John Care Trust.
Our new practice advice note on Dementia and Town Planning demonstrates how good planning can create better environments for people living with dementia.
What can town planning contribute?
First there is commitment: The RTPI award winning Plymouth Plan 2011-2031 includes the ambition to become a dementia friendly city by 2031, starting with an audit of whether Plymouth’s communities have access to the services they require. It is one of the few councils that has adopted a plan that explicitly mentions dementia. If more councils can so the same it would be a good start.
Then there is the detail: Worcestershire County Council have worked with planners from the three South Worcestershire Councils to develop a draft Planning for Health Supplementary Planning Document which contains sections dedicated to ‘age friendly environments and dementia’. They give urban design advice to create areas that meet the needs of people living with dementia.
Using available tools: As part of Belfast’s successful application to become a World Health Organization age-friendly city, it developed an assessment tool to gauge how accessible the built environment is for older people. It carried out walks with people with dementia living in supported housing to gain their opinions and use their experience of the walking environment in their area.
Asking people with dementia what they need: In Bradford, the Face it Together group is wholly led by people with dementia. They have provided feedback on signage and accessibility, advised on a hospital refurbishment and planning a Westfield Shopping Centre.
A little bit of lateral thinking (something planners are good at): As part of a scheme to improve the Conservation Area of the small town of Kirriemuir, Angus Council have worked with the Dementia Friendly Kirriemuir Project. The Council gave planning permission for the change of use for a piece of derelict land to become a dementia-friendly garden with a rent of £1 per year. The garden will be a safe, friendly, outdoor space that people living with dementia and the local community can enjoy.
Aiming for the best: Hogeweyk Village, in Weesp in The Netherlands, is recognised as a world leader in the design of the facilities and care for its 152 residents living with dementia. They live in groups in 23 specially designed houses. The village has streets, squares, gardens, a park and a range of shops and restaurants where the residents move around independently and safely. These facilities can be used by both Hogeweyk residents and people from the surrounding area.
Our advice suggests that if you get an area right for people living with dementia, you get it right for older people, for young disabled people, for families with small children – and ultimately for everyone. But there is still little experience amongst town planners in planning specifically for people living with dementia, despite a willingness to learn.
If you have experience or good practice you would like to share please let me know. Contact me at firstname.lastname@example.org.
Sarah Lewis MRTPI, Planning Practice Officer, Royal Town Planning Institute