Designing for cognitive well-being in long-term care

By Monica Fleck

Imagine you’re a third-year college student in an interior design program and you’ve just completed six weeks of observing how long-term care residents with dementia interact with their living space. Now you find yourself presenting your recommendations to the architect who actually designed the facility and the CEO who oversaw the build.

That was exactly the experience this fall for 25 students in the Interior Design Program at Fanshawe College who were given this unique learning opportunity through the collaboration of Professor Natalie Rowe of Fanshawe’s Faculty of Art, Media and Design; Richard Hammond, architect at Cornerstone Architecture; and Steven Crawford, CEO of McCormick Care Group, the governing organization of McCormick Home, a long-term care facility in London, Ontario.

“It was really interesting and a bit nerve-wracking,” says Fanshawe student Christine Belanger of the presentation experience.  But as it was the first time she was able to interact with the people living in the study space, she found that the positive experiences outweighed any apprehensions. “The project helped me to understand that we are designing for real people and not for hypothetical clients.  It was heartwarming to put a face to the work.”

“It’s definitely not just about physical design – this project gave us the opportunity to look at the space from a human-centric point of view,” she adds.

The students were asked to observe the daily living activities of people with dementia and how they interact with their surroundings in five particular areas – dining rooms, recreation spaces, bathing areas, nursing stations and wayfinding.  The students were asked to identify improvements that could be made at McCormick Home’s current building, which opened in 2006, as well as provide recommendations that could be used in the construction of new facilities.

Students from Fanshawe College’s Interior Design program researched the physical facilities at McCormick Home to better understand how to create an optimum physical environment for people living with dementia in long-term care.

“This project really opened my eyes to how design can genuinely support peoples’ health and well-being. I enjoyed the freedom to learn by experience,” says student Lauren Hylands.

One team summed up the research philosophy in this way: “The psychological framework of a human is so complex and delicate, our direct surroundings heavily impact not only our physical comfort, but also our mental well-being.” This approach helped to guide the sensitivity involved in seeing the living environment from the perspective of someone who is facing cognitive challenges.

“Being able to interact with people in real life and not just research online was a great learning experience,” says student Breymann Welch-Clark.

While some groups focused on more major renovations such as adding or removing walls, others focused on finer design details such as lighting, finishing materials and colour.  For example, enhancing privacy and introducing vanities and storage spaces more reminiscent of home would help improve the bathing experience for the residents and the staff providing their care. Replacing traditional serveries with open kitchens and breakfast bars would enhance the olfactory, visual, auditory and tactile experience. Another group eliminated nursing stations in favour of using mobile technology to repurpose the space for residents and families.

This design demonstrate an open-concept kitchen with defined social spaces to enhance social connection and stimulate the sensory experience.

Common themes emerged from all teams, including creating an environment that is more home-like and nature-oriented, and one that is designed to stimulate the human senses and optimize the residents’ experience of interacting with their surroundings.

“The students’ design ideas were very innovative. I liked the range of recommendations, which varied from broad to specific,” says Hammond.

Other layout and design suggestions include:

  • Maximizing the amount of window space to connect with the outdoors
  • Using Smart Screens to project images that trigger pleasant memories, promote visual stimulation and provide recreational opportunities
  • Projecting sounds of waterfalls or waves on a shore to create a relaxing atmosphere
  • Displaying nature scenes in photos and artwork
  • Building recessed benches along the hallways where people can stop and rest
  • Using matte finishes and warm colours for lounge areas and stronger colours to assist in area recognition and wayfinding
  • Building rounded corners on fixtures and counters to improve the visual flow of the space and enhance safety
  • Creating more defined social spaces for resident and family visits

The recommendations across all five areas demonstrated a thoughtful and compassionate approach to enhancing quality of life and making the most out of a resident’s abilities, according to Rowe. “The time students spent at McCormick Home resulted in an attachment not only to the building, but to the staff and residents. There were spontaneous activities and experiences that cultivated a level of curiosity and empathy for the journey the residents were on. As a result, the design solutions came from a place of passion and desire to make the world of long-term care a better place for everyone.”

“The creativity and professionalism demonstrated by the students far exceeded my expectations,” says Crawford. “When we talk about intergenerational programming within long-term care, we often think of younger school-aged children. These college students offered us a new level of engagement with our residents, bringing their particular expertise and perspectives to help the needs of a different generation.”

For more information, please contact Steven Crawford at

Monica Fleck works in communication at McCormick Care Group.