Design for People Living with Dementia

Interactions and Innovations

Emmanuel Tsekleves, John Keady

• Éditeur: Routledge
• Année: 2021
• ISBN:
  9780429808975
• Édition: 1
• Sujet: Medicine
• Sous-sujet: Diseases & Allergies

There were an estimated 50 million people worldwide living with dementia in 2017 and this number will almost double every 20 years, reaching 82 million in 2030. Design has significant potential to contribute to managing this global concern. This book is the first to synthesise the considerable research and projects in dementia and design. Design interactions is a new way of considering how we can improve the relationship between people, products, places and services and of course technology trends, such as the 'internet of things', offer great opportunities in providing new ways to connect people with services and products that can contribute to healthier lifestyles and mechanisms to support people with acute and chronic conditions. In light of this, the book explores the contribution and future potential of design for dementia through the lens of design interactions, such as people, contexts, material and things.

Design for People Living with Dementia is a guide to this innovative and cutting-edge field in healthcare. This book is essential reading for healthcare managers working to provide products, services and care to people with dementia, as well as design researchers and students.

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1Introduction

Book need and motivation

The aim of this monograph is to chart the developments of design research in dementia and provide the reader with a cutting-edge and innovative review on this emerging field.

There were an estimated 50 million people worldwide living with dementia in 2017 and this number will almost double every 20 years, reaching 82 million in 2030.¹ Much of the increase will be in developing countries, leading to a considerable impact for millions of families and carers involved in supporting those living with dementia. Dementia is a wicked problem, since cause and effect are often difficult to identify and model, and there is not always consensus on the root problem and solutions (Mitchell et al., 2016). As demonstrated by Tsekleves and Cooper (2017) in their book Design for Health, design has the propensity to contribute significantly to complex health-related areas. Furthermore, it identified dementia as a key area in health prevention and healthcare that designers can focus their skills and attention on.

Traditionally designers have paid particular attention to acute and chronic care, through new medical products, hospital, clinic and care home design (Jones, 2013; Tosi et al., 2016). More recently, the complex picture of maintaining population well-being, of health (ill-being) prevention has begun to emerge, and thus the role of designers indirectly in supporting the promotion of healthy lifestyle or in their contribution to ill-being (Cooper et al., 2011).

Design research has now broadened its skill base and its application. Service design (Meroni and Sangiorgi, 2011) has introduced a new opportunity to address the improved delivery of products and service both within and outside the healthcare system (Bate and Robert, 2006; Lee, 2011). Behavioural design – grounded in psychology and behaviour change theory – has enabled designer to ‘design out’ barriers found across objects, services, spaces, environments (Niedderer et al., 2014) and to influence and/or shape human behaviour (Michie et al., 2011). The ‘Design in Policy’ field is introducing new approaches to developing policy and aiding innovation in organisational, local, regional and national governance (Bason, 2014).

Design interactions is a new way of considering how we can improve the relationship between people, products, places and services and of course technology trends, such as the ‘internet of things’, offer great opportunities in providing new ways to connect people with services and products that can contribute to healthier lifestyles and mechanisms to support people with acute and chronic conditions. In light of this, the book explores the contribution and future potential of design for dementia through the lens of design interactions, such as people, contexts, material and things.

There is a wide research literature reporting on the psychological and social needs in dementia, from earlier work by Kitwood and Bredin (1992) to more recent reports such as those by Vogt et al. (2012) and McDermott et al. (2019). Much of this literature focuses on designing interventions to support people living with dementia and their caregivers (Span et al., 2013; Rodgers, 2018). For instance, how to facilitate reminiscing to enhance a sense of personhood (Kuwahara et al., 2006; Wallace et al., 2013; Siriaraya and Ang 2014); social interaction and living in the moment (Treadaway and Kenning, 2016; Luján et al., 2017), or to address the safety and autonomy of people living with dementia, to better deal with excessive walking (Lindsay et al., 2012; Holbø et al., 2013); or to support daily living and independence (Mountain, 2006; Ikeda et al., 2011; Ehleringer and Kim 2013; Hoey et al., 2011).

Although there is a considerable amount of design research and projects in dementia, there is no dedicated monograph in this area, which covers the entire spectrum of design and design research that currently exist. Moreover, given the rapid increase of this field, the area of inclusive design does not really cover the nuances of designing for dementia.

In addressing the lacuna of a monograph in this area, the authors have written this book to chart the research projects, methods, challenges and opportunities with the aim of increasing number of researchers engaging in this field.

Book structure and chapter summary

The book is divided into three parts. Part 1 sets the scene by exploring the area of dementia and design research through four lenses employed in design interactions, namely people, contexts, material and things.

More precisely, in Chapter 2, John Keady presents an overview of dementia. Starting with a brief social history of the condition John traces its place and positioning in contemporary society. The chapter then discusses in more detail the different types of dementia and provides information on disease progression and how this affects people living with dementia in their everyday living. The importance of the biopsychosocial model of dementia is highlighted together with the recent addition of a ‘physical’ domain to open up the intersections between the physical environment and design opportunities. The chapter concludes by setting out recent advancements in citizenship and human rights for people living with dementia.

In Chapter 3, Emmanuel Tsekleves presents the challenges for design across the different facets of our society. The chapter addresses challenges related to diagnosis, care, quality of life, research and ethics as well as the different contexts where research in dementia is targeted, such as the home, nursing home, hospital and community. Through analysis of the relevant literature, it provides researchers, especially those who employ design research methods, with a better understanding of the challenges people living with dementia, as well as their family and caregivers face. Opportunities where design research can intervene and support people living with dementia are highlighted and discussed too.

Chapter 4, by John Keady, provides the reader with an understanding about the different design research methods that can actively be used to both support and empower people living with dementia. Adhering to the underpinning vision and values of this book, the chapter outlines participatory approaches to research and the importance of co-design and co-production alongside people living with dementia. It covers patient and public involvement in research and offers a discussion on how people living with dementia might want to be positioned in the research process, from setting the research question to taking part in dissemination activities. It introduces the COINED model that focuses towards a more egalitarian and democratised approach to undertaking and evaluating design research. The chapter concludes with two brief examples of relevant work where design research methods have been used and applied in the dementia studies field.

The last chapter in Part 1, Chapter 5, by Emmanuel Tsekleves, provides an overview of design research work that contributes to the context of dementia through the research, design and development of relevant non-pharmacological interventions. In doing so it maps the landscape of design research in this field, outlining several opportunities for design researchers in this field. Drawing from the literature, the chapter identifies four key research themes where design research effort has recently been focused, namely: (i) reminiscence and personhood, (ii) social interaction and living in the moment, (iii) independent and assisted living and (iv) cognitive and physical stimulation.

Part 2 presents in more detail ten case studies across different research contexts in designing for people living with dementia. The case studies are representative of current work in the area and have been drawn from an international pool of research projects. The case studies are based on synthesising published work and material, such as on outward facing websites, supplemented by either face-to-face or online video interviews with the identified project researchers.

Case study 1 presents a UK-based research project that explored reminiscence and personhood (focusing on regeneration and about how community and neighbourhoods had changed) through a participatory research approach with people living with dementia and their caregivers.

Case study 2 provides an overview of ...