While his practice is developing designs for a new dementia facility, Roger Hawkins of Hawkins Brown is contending with the effects of the disease on his own family.
My 90-year-old mum has dementia. Not the everyday forgetfulness that results in repeatedly asking what time it is. She has lost the ability to recognise people or understand basic hygiene requirements. It’s a vascular dementia that on reflection has caused a slow deterioration in her cognitive function for many years. Perhaps it is ever since she stopped reading books or watching films because she couldn’t follow the plot. People used to think her rude because she would lose the nuance of a conversation and say something out of context. My two Aunts have been similarly afflicted, which may be something to do with the aluminium pans my Grandmother used, or it might be genetic. I forget. She lives in a purpose-built care home with 35 other people who have reached the top of the waiting list for dementia needs. There are three 12 room clusters organised around an inaccessible courtyard. The corridors are connected which allows the most able (including my mum) to walk endlessly around a triangular loop. Except that one of the houses, as we are encouraged to call them, is kept locked to separate the more difficult residents, so that the route is blocked. It isn’t good enough. The place smells of human waste despite the best efforts of wonderful staff. Windows and doors which would otherwise provide some fresh air are kept locked to prevent escape attempts. Ventilation systems are inadequately restricted to internal bathrooms, ceilings are low, lighting is institutional, buzzers and alarms are constantly ringing, televisions are showing repeats of ‘Come Dine with Me’ while care assistants spoon processed food into grateful mouths.
This is one of the best dementia care homes around, yet it could be considerably improved if the building performed better. As architects involved in specialist care facilities, we can identify examples of good practice and promote dementia research. Using a GERT suit (GERT is short for gerontology – the scientific study of aging) helps designers understand the physical challenges and anxiety associated with navigating buildings. There is software which allows architects to design more effectively by seeing the world as though they had dementia. We should all use it.
According to Alzheimer’s Research UK, almost 1 million people are living with dementia in England and Wales and 25% of hospitals beds are occupied by those over 65 with the condition. At nearly £20 billion per annum, the health and social care cost of dementia in the UK is bigger than cancer and heart disease combined. It is the UK’s number one killer, so why do we hear so little about this cruel disease? And what’s being done to find a cure? It is estimated that if there was a disease modifying treatment that delayed the onset of Alzheimer’s by 5 years, by 2035 there would be 425,000 fewer people with dementia in the UK, with accumulated savings of around £100 billion.
No wonder that the Government’s 2020 challenge on dementia is currently investing in a new research centre which is to be located on the former site of the Eastman Dental Hospital on Gray’s Inn Road. Hawkins\Brown has been working with UCL Queen Square Institute of Neurology and the UK Dementia Research Institute to design a new world-class, purpose-built biomedical facility which will support over 500 staff with a 200-seat conference facility and exhibition spaces to host international events in dementia care and research. The building includes a comprehensive out-patient clinic, 6 brand new MRI Scanners (which will enable around 80,000 scans a year). Centralised technologies and highly supported laboratories to encourage collaboration whilst giving scientists more time to carry out research and spend less time managing a lab. The conference space is to be used for international events, lectures, staff training and engagement activities. While a public café and waiting areas provide a range of spaces for people to mingle with researchers, clinicians and other patients. The intention is to provide a supportive environment for carers to feel at ease whilst loved ones seek treatment.
All this is thanks to UCL, the UK Research Partnership Investment Fund, the Medical Research Council and significant philanthropic donation – as well as money raised, through the plastic bag tax, by the UCL Dementia Retail Partnership. Appropriate then, if you forget your shopping bag you can contribute towards ongoing dementia research.
Roger Hawkins (Hawkins Brown)
Hawkins Brown are Supporters of The Architecture Foundation