What can people with dementia teach us about the liveability of our places?

 

That’s not about creating a one-size-fits-all dementia handbook: “All older adults are different, and so are people with dementia,” Biglieri asserts. “If you’ve met one person with dementia, you’ve met one person with dementia.”

 

The nature of the illness means that usually a person with dementia will feel most comfortable in a familiar environment, whether that’s a city or the suburbs. This suggests demolishing a familiar landmark or pop-up roadworks can have large unintended impacts. Clutter can also be overwhelming, from pavements crowded with outdoor seating to the noise and changing lights of intersections.

 

Things like public transport and walkability remain universally important: “If you lose your driving license, that’s not going to have as much of an impact if you can still walk [or take public transport].” It’s also important to have something to walk to – both for social interaction and community connection – be that a local shop on the corner or a library.

 

With a rapidly ageing population – 1 in 4 people in the UK will be over 65 by 2050 – the white paper published by the Built Environment Committee of the House of Lords has called for new homes to accommodate the rise in older people living alone, where the ability to remain independent and healthy for longer will be critical given pressures on social care.

 

As for public consultation and community engagement, Biglieri says simple changes in format and style would make it easier for people with dementia to participate fully and share their feedback.

 

“If you’ve met one person with dementia, you’ve met one person with dementia”

 

“There are small things we could do tomorrow that don’t really cost much money,” Biglieri says. One is the physical set up of the room. Biglieri accompanied her research participants with dementia to a series of public consultation meetings and the setting made a big difference to their capacity to engage:

 

“They get overwhelmed by sound and noise and activity and light very easily… We went to an open house that was in a church, in a small carpeted room, and people talked about how much they loved that location because they could concentrate.”

 

Using physical presentation boards is another quick win: “The great thing about boards is that you can take as long as you like – you can go at your own pace. [The presentation boards] give time and space to think, and if they’re in a semi-circle, there’s a visual indicator about what to do next.”

 

In conversation, “Giving people space and time to respond, and pausing, makes a huge difference,” says Biglieri.

 

The impact of a well-run meeting was profound on her research cohort. “They would tell me, ‘I don’t necessary remember what happened, but I remember that the planner made me feel like I was important,’” Biglieri says.

 

“It made them feel belonging and inclusion,” Biglieri says. “I mean, this was just a humble statutorily mandated open house. Imagine if we were doing more targeted outreach, what could be achieved.”