The 2009 Australian Bureau of Statistics (ABS) Survey of Disability, Ageing and Carers (SDAC) found that approximately 110,000 Australians have dementia or Alzheimer’s Disease. Dementia is of course closely related to aging with less than 1% of people surveyed having dementia or Alzheimer’s in the age bracket of 65-69 year olds, and increasing progressively to 28% of centenarians.

It is also well established that our society is an aging one. Projections suggest that by 2056 the proportion of people aged 65years and over will represent approximately 24% of the population. The corresponding figure in 2007 was 13%. In the absence of significant medical breakthroughs, the correlation between aging and dementia would suggest a strong prevalence of the condition in the years to come.

Further to this, of those identified as having the condition, 62% were living in a health establishment such as a nursing home, an aged care hostel, or the cared component of a retirement village. This is significant as older adults with dementia encounter significant challenges in negotiating unfamiliar environments. The design of facilities for older residents is therefore crucial in supporting the ongoing function and independence of people with dementia.

The Dementia Centre founded by Hammond Care provide a number of resources inclusive of publications, guidelines, audit tools and design courses to assist in the creation of suitable environments for people living with dementia (www.dementiacare.com.au). Many of their resources and other previous research indicates that incorporating familiarity into environmental design can help augment deficits noted in dementia, this being reasoned to long-term memories remaining more intact than short term memories.

Of course with aging other co-morbidities also arise. These may include arthritis, limited mobility and fatigue due to stroke or heart condition, affected hearing and vision, amongst others. Balancing design to address ‘ease of use’ while maintaining familiarity is therefore important in achieving appropriate outcomes.

Some important considerations are summarized below:

• Increase lighting levels to assist with deteriorating vision. Maximizing natural light is especially useful as it not only assists with vision but supports people’s orientation to time. Take care not to produce sources of glare in increasing the lighting available. Locate switches consistently and provide contrasting colours to surrounding walls to assist users in finding them.
• Noise can have a detrimental effect on a person with dementia’s concentration and cognitive processing. Reducing and eliminating background noise is therefore an important consideration. Soft furnishing and finishes can assist in dampening noise. Due consideration of the age group should be applied in selecting these in order to make them as familiar as possible. The location of services within a building can impact on persistent low level noise, and of course acoustic separation via design as well as via materials used in partitioning, doors, etc. should be closely deliberated.
• Select materials and fixtures which are familiar to the age group. An example may be a capstan tap in lieu of a mixer tap lever even though levers are generally physically easier to use. Unfamiliar items and new methods to perform everyday tasks can be confusing and stressful for a person with dementia.
• Provide flooring finishes which are continuous and do not have bold patterns on them. Changes in floor finishes and patterns can be perceived as a change in level or an item forgotten in their path, sometimes becoming the precursor to a fall.
• Providing contrasting wall and floor finishes to assist in defining the shape and size of the room. This can also assist with orientation and navigation.
• Select furnishings, fixtures and fittings so that there finishes contrast against the background they will be viewed against. This is especially important in bathrooms where fittings are often white viewed against white wall tiles.
• Investigate appropriate assistive technologies which could be incorporated such as tracking devices, chair / bed occupancy sensors, enuresis alarms, motion detectors for lighting during night time toileting, etc.
• Consider suitable safety devices and strategies such as additional smoke, heat and gas alarms, tempering valves for taps, providing locked cabinets for storage of hazardous substances, monitoring devices, cooking appliances which switch themselves off, etc.
• Consider open shelving as opposed to cupboards, or cupboards with Perspex or safety glass fronts to assist with locating items.

 

George Xinos
Functional Access Solutions

This year’s release of the Building Code of Australia (BCA) 2014 and its application in May, as with every year, brings a number of changes. An ongoing ambiguity for many years was the requirements for stairway treads, landings and ramps to have slip-resistant, non-skid or non-slip properties. A very sensible inclusion given that in Australia a staggering 144,000 hospital day beds annually are attributed to admissions due to falls.

The problem arising with these inclusions however, was that the terms were not clearly defined, that an objective level of slip resistance for each application was not provided, and that a method for measuring slip resistance was not outlined or identified.

To address this issue, the relevant Australian Standard regarding the measurement and classification of slip resistance, AS 4586: 2013 Slip resistance classification of new pedestrian surface materials, was revised accordingly and is now referenced to the BCA 2014. This standard sets out suitable testing methods as well as the resulting classifications for each of the test methods.

Test methods included in the standard allow for both wet and dry conditions and the limitations of some of the test methods are also raised. The BCA however only references classifications achieved via a Wet Pendulum Test or Oil-Wet Inclining Platform Test; these are generally classification values preceded by P or R.

The Australian Building Codes Board (ABCB) had raised their intention to reference the revised standard in early 2013, soon after the release of the standard. The intent being to allow manufacturers of flooring materials to undertake the necessary testing in time for the incoming changes to the BCA. Given this, many manufacturers and suppliers should be now well placed to provide the information necessary to architects and designers when specifying flooring.

It should be noted however that the inclusions to the BCA are targeted at only two building elements identified as presenting a higher risk of slips and falls. These are stairs and ramps with some differentiation also identified based on the gradient of a ramp. Step ramps, that is, pedestrian ramps with a gradient of 1:10 will require a higher level of slip resistance to longer 1:14 ramps. Designers and specifiers are also allowed flexibility with designing floor finishes on stair treads by either providing a suitably slip resistant surface to the entire tread or to just the nosing of each tread as well as the landing edge.

Also significant is that these requirements have been included in both Volumes of the BCA, effectively making them a requirement across all building classifications. Volume 2 however does not include reference to ramps given that access to people with a disability is not a BCA requirement to private individual residential dwellings.

Following on from this however, all other building classifications must be accessible to people with disabilities under the BCA with the referenced Australian Standard outlining requirements for access being AS 1428.1: 2009 Design for access and mobility – General requirements for access – New building work. AS 1428.1 subsequently states that continuous accessible paths of travel and circulation spaces defined in the standard must have a slip resistant surface; as with the BCA previously, no further information is however provided with regard to testing and classification. To better address this omission, designers are best advised to consider HB 197: 1999 - An introductory guide to the slip resistance of pedestrian surface materials in their selection of floor finishes to the remainder of the buildings they design. This guide is also raised as a suitable guideline within the revised AS 4586: 2013.

Factors arising at occupation and use must also not be forgotten in the consideration of floor finishes. Frequency and type of usage, cleaning systems, coatings and patterns of wear can all have a significant impact on the characteristics of the floor affecting slip resistance. The limitations of the new requirements and their application to only new materials should also be acknowledged. Installed flooring materials should be tested in accordance with AS 4663: 2013 Slip resistance measurement of existing pedestrian surfaces.

George Xinos
Functional Access Solutions