Best Designs for Comfortable Eating
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This year, I have been working with BUPA (British Healthcare) to improve the quality of eating for elder people with dementia in care.
Although dementia is not limited to older people, the chances of getting a form of dementia increase with age. Recent figures suggest that as much as one in three people over the age of 65 will be affected in their lifetime.
There are currently an estimated 700,00 people in the United Kingdom with dementia, over a third of which live in care homes.
In a recent interview with the Alzheimer's Society, Barbara Pointon said that the brain controls absolutely everything that we do, think and say. When that master computer goes wrong, it cannot be mended. The whole body starts to disintegrate.
In care homes across the country, you will find some of the most extraordinary people who daily have to overcome high levels of mental disability, physical disability and dependency.
This year, with the help of BUPA, we have humbly entered the world of care to understand it more deeply and see what role design can play.
I adopted an immersive research method which included background reading, interviews with residents, interviews with carers, and observation. I also attended carer training.
A resident remarked to me last week, "I may be an invalid, but I do not want to be treated as one."
It has been our aspiration to improve the lives of older people with dementia in care, and use design even in the smallest way to help them live at the highest level of their ability.
The focus this year has been on eating in particular, that is, assistive technologies. Today, I am going to briefly talk about some of the prototypes completed and that you will be able to see on this website.
There are plenty of assistive technologies on the market, but few have been specifically designed for the care environment.
This means they have some basic failings. They don't stack, they age badly, or they make the food look un-appetizing.
As a result, they don't fit in a commercial kitchen, people don't buy them, or if they do, they get frustrated and throw them out because they are not doing their job.
The negative side of this is that residents are not getting the tools they need to retain their eating skills for longer.
So I have adapted some of the tried-and-tested features already on the market and looked at how they could be used to improve existing tableware.
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Esthetics matter because people can't help but judge the identity of a person through the objects they surround themselves with.
By creating a coherent table service, we can reduce the stigma attached to using assistive products.
In order to design a range that will help the widest amount of residents possible, I looked at disabilities which are common to aging, such as arthritis and visual acuity.
This area includes cataract, the yellowing of the lens with age, or the loss of depth-of-perception, which is common to Alzheimer's.
We then combined these findings with the degenerative nature of dementia to create three distinct groups that we felt could benefit from assistive tableware.
LOW ASSIST is for people who can eat competently but may have sight problems.
MEDIUM ASSIST is for people beginning to lose their skills.
HIGH ASSIST is for those who can no longer feed themselves.
The LOW ASSIST objects are all about color-contrasts. In this comparison image, the left plate is a color which contrasts the food. People need to be able to locate the food in order to pick it up.
This logic follows through to the cup, allowing people to easily locate handle and rim.
The MEDIUM ASSIST pieces address dexterity. It can become quite difficult to pick food up.
This plate offers an overhang to help push the food onto the spoon.
This cup challenges the need to provide two handles, avoiding it resembling a baby-cup, as shown earlier. The easiest grip to offer is that of putting your hand around the entire cup. The grip is thus insulated with neoprene to facilitate the drinking of hot liquids.
The HIGH ASSIST range is aimed at creating a set of tools for assisting residents who can no longer feed themselves.
They are designed to be light and easy for carers to hold, which encourages them to bring the food into the sensory range of the residents, so they can see and smell what they are eating.
Another area that we have been looking at is the table. When used in a common area, it should be set 30 minutes in advance of mealtimes to encourage anticipation and appetite.
Use objects and patterns which are synonymous with dining to reinforce what activity is about to take place.
We have also made the underside flat, for wheelchair access. Existing tables like this one, which have support structures underneath, make it difficult for residents to get close to the food.
This means they have to lift the food over their laps, leading to spillages. This, in turn, could lead to having to wear rather stigmatizing bibs.
Finally, we have been looking at hanging additional lighting directly over tables, some older people needing three-times as much light as that of a younger person.
The light toggles through three light-levels by passing one's hand closely underneath, the idea being that a carer can tune each table-light to the residents' need, without having to run around to locate dimmer switches.
I have talked about eating, but we are only half-way through what we are planning. Next year, I will be joined by another designer, Nick Reisenbury and together we will be looking at activities and bedrooms. The results will join our findings in eating and culminate in design-guidelines this time next year.
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Source:
Eating, Design & Dementia Symposium Presentation 2009, by Gregor Timlin
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