Academic journal article Perspectives in Public Health

The Dementia Care Building Crisis

Academic journal article Perspectives in Public Health

The Dementia Care Building Crisis

Article excerpt

Martin Habell is an architect specializing in dementia environments. He argues that even with good caring staff, current care homes are often unfit for purpose and the UK has to embark on a massive building programme to meet a tidal wave of need

The UK faces a severe care building crisis as the numbers of elderly suffering from dementia increases. In the UK, 700,000 people suffer from dementia and this is estimated to rise to one million by 2025.1 If the current proportion of diagnosed dementia cases in care homes is maintained, there will be a need for one million beds by 2045,2 a leap of 632,000 beds (or 300 new care homes) across the country every year over a generation. In terms of cost, this equates to building an Olympic Park every year for a generation.

Telecare will not meet everyone's needs, and figures already reflect the maximum reduction in bed demand this might achieve.1 While caring for people with mild dementia in the community costs £16,689 per person a year, for moderate dementia it rises to £25,877 and for severe dementia to £37,473. However, care at home is often only suitable for early-stage dementia. Caring for an individual with dementia in a care home costs approximately £31,296 a year.3

Even in these fiscally difficult times there is still bank lending available for expansion of existing viable care homes but most are on too small a site or are constrained by planning policy. There are few opportunities for successful competitive purchase of new sites against commercial competition for land. Meanwhile we are, in fact, losing beds. This has been calculated as 219 care home closures or 5,368 beds in 2008.4

Much of the care stock we have is unsuited to dementia. Only 57% of 142,000 care home residents with dementia as a known cause of admission are in accommodation dedicated to the condition4 and of those residents in non-specialist homes, 75% have dementia.2

Much skilled and well-meaning care is delivered in spite of the physical and mental conditions that exacerbate the condition: anxiety, depression, communicative difficulties and frailty. These demand dedicated spaces and special planning, therapy rooms, unobtrusive security, higher staff ratios and different bed multiples. An emphasis on design for light, noise and behaviour difficulties is vital.

By contrast, existing homes are often converted houses; their old fabric is grossly inefficient in energy consumption and very expensive to maintain. …

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