How a dementia-friendly net-zero home will help older people stay put
Cameron Jewell | 5 September 2017
In 2013 a group of students from University of Wollongong and TAFE NSW made headlines after winning the global Solar Decathlon net-zero house competition in China. Now they’re in the running again, with a dementia-friendly design that promises to help keep people living comfortably in their own homes.
Dementia is the single biggest cause of disability in Australians aged over 65, and with an ageing population we can expect more than 500,000 people to be living with the condition by 2025.
The pressure on our health and aged-care sector will be immense but a group of students from the University of Wollongong may hold the key to keeping people living in their own homes and communities for as long as possible.
“Desert Rose” is Team UOW’s submission to the Solar Decathlon Middle East, a global competition to create a net-zero solar-powered house, due to be held in Dubai in 2018. Aside from being designed to weather the harsh climate of the Middle East (and unique cultural considerations), the home is also being designed to better accommodate older people, and those living with early-stage dementia.
The decision to tackle ageing in place and living with dementia goes back to the team’s winning entry in the 2013 Solar Decathlon China – the Illawarra Flame House, a net-zero retrofit of a traditional 1950s fibro home.
Because the Illawarra Flame House, as a retrofit project, meant the architecture limited what the team could achieve, there were particular challenges around designing for “living in place”, Professor Tim McCarthy, faculty advisor for Team UOW Australia-Dubai, told The Fifth Estate.
“With a clean slate we can actually address the architectural footprint from scratch,” McCarthy says.
“It has allowed us to address some issues that were problematic with the retrofit and provided us the opportunity to develop a house that lives up to as many of the principles [of designing for dementia] that have been discovered.”
This focus is helped greatly by the renowned Dementia Training & Study Centre being located onsite at the University of Wollongong, headed up by Professor Richard Fleming, an international expert in dementia-friendly architecture.
He says both economic and moral pressures are converging, forcing a rethink of how we tackle dementia and aged care, because to maintain the current level of residential care for people with dementia, 400 new beds would be needed each month for the next 40 years.
“There isn’t a society on earth that can afford that,” he told UOW’s The Stand magazine. “We can’t keep putting people with dementia in residential care. We have to make the local communities more supportive.”
Designing for dementia
According to McCarthy, Desert Rose strives to do just that by helping older Australians stay in their homes for as long as possible. This has involved designing to tackle the three major triggers for people being taken out of their homes and placed into aged care – cognitive impairment, incontinence and falling.
One of the most important considerations regarding designing for dementia, McCarthy says, is line of sight, or visual access.
“The main thing that makes a house or living unit dementia-friendly is the visual cues a person has. If someone can see their destination, they’re more likely to go there. When things are out of sight … it’s like they say, ‘Out of sight, out of mind.’
“With Desert Rose, line of sight helps people with their daily activities, especially going to the toilet.”
In fact, someone with advanced dementia will be five to eight times more likely to use a toilet if they can see it.
In Desert Rose there will not only be a direct line of sight from bed to toilet, but also a novel technique to assist people getting there.
The technique, called “ushering”, works by guiding inhabitants around the house using cues, that may be through light, voice prompts and even smells.
For the toilet, a sensor in the bed will detect when someone gets up, and light will guide them to the toilet, to the basin and then back to the bed.
The line of sight strategy also extends to things like eating, and may include having glass doors on refrigerators and pantries.
“With dementia, short-term memory is impaired, so people will forget things are there.”
Other innovations could include smart locks to allow access to the house for residents and carers, and taps that can automatically turn off and limit temperature.
It’s simple techniques like this that can help “stave off those crisis points that cause people to move into care”.
Ahead of the market on ways to get to net zero
McCarthy won’t be drawn on most of the technology that will bring the home to net zero, as he doesn’t want to tip off competitors, but as the Illawarra Flame House incorporated products that were ahead of the market, so too will Desert Rose.
“Many of the things might be available in the commercial space but not yet in the domestic space.”
What he can say is that there’ll be desiccant cooling, and ways to store cold effectively, such as phase change materials.
“I think the big challenge is keeping the house cool,” McCarthy says, particularly as the house must be designed for Middle East, and there is a solar PV limit of 8kW.
Indoor comfort key
Having a stable indoor temperature, though, is key to creating a comfortable environment for those living with dementia.
The university’s Dr Federico Tartarini, who recently completed a PhD on indoor environment quality and its effects on those living with dementia, found that people with dementia have a narrower range of temperatures in which they are comfortable. Going out of these ranges can cause agitation.
“This actually leads to the carers applying more sedation, and that in turn can lead to further problems of disorientation,” McCarthy says.
One of the findings of Tartarini’s research, he says, is that people with dementia generally preferred temperatures slightly higher than carers (around 24°C versus 22°C).
“If the clients were comfortable, less medication was required and the carer’s job was made easier.”
A home for everyone
McCarthy stresses that the home is not only for those living with dementia.
“It’s actually a house for people that are quite healthy,” he says.
This feeds into another important factor for those living with dementia: familiarity.
“With our house, you could downsize into it while you’re still healthy.”
Supporting and facilitating people living with dementia, McCarthy says, is an “added feature”.
“The features promote wellbeing so it’s a good place to move into. It’s a comfortable house that supports an active lifestyle, and it adapts as people age in place.”
Flourishing in the desert
McCarthy says choosing the name of the project was a challenge, though the students finally decided on naming it after the Sturt Desert Rose, a plant that grows throughout the centre of Australia.
“We’re going to build this house in the desert in Dubai,” he says. “The Desert Rose is a flower that can live in harsh climates, and blossoms and flourishes. The idea is that our house will flourish in the desert.”
The University of Wollongong’s Sustainable Buildings Research Centre will provide an augmented reality tour of Desert Rose on Sustainable House Day on Sunday 17 September, where the Illawarra Flame House will also be on display.