Dementia-friendly places benefit us all – so we should start planning for them

David Cameron (remember him?) speaking about dementia in 2013. Image: Getty.

Dementia is an issue that touches everyone. With an estimated 850,000 people living with dementia in the UK today, we all have family and friends who have been affected by this most serious and debilitating illness, with its wide ranging and often misunderstood symptoms.

During his premiership, David Cameron launched the “Dementia Challenge”, which aimed to find a treatment or cure by 2025. We certainly hope that his presidency of Alzheimer’s Research UK, announced last week, will help the medical world meet this immense challenge.

But while we wait for the cure, life goes on for many people living with the disease. And there is a more immediate and more achievable outcome we can do something about: improving the environment to help people live well and independently longer. 

Public interest in wanting to contribute to support and improve the lives of people living with dementia is shown by the fact 215 local communities have already signed up to become Dementia Friendly Communities. This initiative, established by Alzheimer’s Society, galvanises local efforts and support.

While still in the early stages attention is now turning to how the local built environment can impact on the quality of people living with dementia and help them to maintain their independence for longer.

Dementia and Town Planning, new practice advice published this week by the Royal Town Planning Institute (RTPI) and endorsed by Alzheimer’s Society, demonstrates how good planning can create better environments for people living with dementia. It argues that, if you get an area right for people living with dementia, you also get it right for all older people, for young disabled people, for families with small children – and ultimately for everyone.


So what can town planning contribute? Rather a lot.

Commitment: The RTPI award-winning Plymouth Plan 2011-2031 includes the ambition to become a dementia friendly city by 2031, starting with an audit whether the city’s communities have access to the services they require. It is one of the few councils that has adopted plans that explicitly mention dementia. If more can do the same it would be a good start. 

Detail: Worcestershire County Council have worked with planners from the three South Worcestershire Councils to develop a draft Planning for Health Supplementary Planning Document which contains sections dedicated to “age friendly environments and dementia”. They give urban design advice to create areas that meet the needs of people living with dementia.

Using available tools: As part of Belfast’s successful application to become a World Health Organization age-friendly city it developed an assessment tool to gauge how accessible the built environment is for older people. It carried out walks with people with dementia living in supported housing to gain their opinions and use their experience of the walking environment in their area.  

Asking people with dementia what they need: In Bradford, the Face it Together group is wholly led by people with dementia. They have provided feedback on signage and accessibility, and advised on both a hospital refurbishment and the planning of a Westfield Shopping Centre.

A little bit of lateral thinking: That’s is something planners are good at. As part of a scheme to improve the Conservation Area of the small town of Kirriemuir, Angus council have worked with the Dementia Friendly Kirriemuir Project. The council gave planning permission for the change of use for a piece of derelict land to become a dementia friendly garden with a rent of £1.00 per year. The garden will be is a safe, friendly, outdoor space that people living with dementia and the local community can enjoy.

Aiming for the best: Hogeweyk Village, Netherlands is recognised as a world leader in the design of the facilities and care for its 152 residents living with dementia. They live in groups in 23 specially designed houses. The village has streets, squares, gardens, a park and a range of shops and restaurants where the residents move around independently and safely. These facilities can be used by both Hogeweyk residents and people from the surrounding area.

I have to confess to having rather a vested interest in all of this. I have had ME, an invisible and often misunderstood illness for most of my adult life, and like dementia it affects both my physical health and my cognitive functioning. I have decided to make my home in London, a wonderful city in many ways but quite unforgiving on those who find it more difficult to move around. Try negotiating the multiple escalators and steps of Canary Wharf with a pushchair and an inquisitive toddler. Exhausting doesn’t cover it.

So my point is; if we create places that are suitable to meet the needs of people living with dementia, they will be that little bit kinder for all of us to use.

Sarah Lewis is planning practice officer at the Royal Town Planning Institute.

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Was the decline in Liverpool’s historic population really that unusual?

A view of Liverpool from Birkenhead. Image: Getty.

It is often reported that Liverpool’s population halved after the 1930s. But is this true? Or is it a myth?

Often, it’s simply assumed that it’s true. The end. Indeed, proud Londoner Lord Adonis – a leading proponent of the Liverpool-bypassing High Speed 2 railway, current chair of the National Infrastructure Commission, and generally a very influential person – stood on the stairs in Liverpool Town Hall in 2011 and said:

“The population of Liverpool has nearly halved in the last 50 years.”

This raises two questions. Firstly, did the population of the City of Liverpool really nearly halve in the 50 year period to 2011? That’s easy to check using this University of Portsmouth website – so I did just that (even though I knew he was wrong anyway). In 2011, the population of the City of Liverpool was 466,415. Fifty years earlier, in 1961, it was 737,637, which equates to a 37 per cent drop. Oops!

In fact, the City of Liverpool’s peak population was recorded in the 1931 Census as 846,302. Its lowest subsequent figure was recorded in the 2001 Census as 439,428 – which represents a 48 per cent decline from the peak population, over a 70 year period.

Compare this to the population figures for the similarly sized City of Manchester. Its peak population also recorded in the 1931 Census as 748,729, and its lowest subsequent figure was also recorded in the 2001 Census, as 392,830. This also represents a 48 per cent decline from the peak population, over the same 70 year period.

So, as can be seen here, Liverpool is not a special case at all. Which makes me wonder why it is often singled out or portrayed as exceptional in this regard, in the media and, indeed, by some badly briefed politicians. Even London has a similar story to tell, and it is told rather well in this recent article by a Londoner, for the Museum of London. (Editor’s note: It’s one of mine.)

This leads me onto the second question: where have all those people gone: London? The Moon? Mars?

Well, it turns out that the answer is bit boring and obvious actually: after World War 2, lots of people moved to the suburbs. You know: cars, commuter trains, slum clearance, the Blitz, all that stuff. In other words, Liverpool is just like many other places: after the war, this country experienced a depopulation bonanza.


So what form did this movement to the suburbs take, as far as Liverpool was concerned? Well, people moved and were moved to the suburbs of Greater Liverpool, in what are now the outer boroughs of the city region: Halton, Knowsley, St Helens, Sefton, Wirral. Others moved further, to Cheshire West & Chester, West Lancashire, Warrington, even nearby North Wales, as previously discussed here.

In common with many cities, indeed, Liverpool City Council actually built and owned large several ‘New Town’ council estates, to which they moved tens of thousands of people to from Liverpool’s inner districts: Winsford in Cheshire West (where comedian John Bishop grew up), Runcorn in Halton (where comedian John Bishop also grew up), Skelmersdale in West Lancashire, Kirkby in Knowsley. There is nothing unique or sinister here about Liverpool (apart from comedian John Bishop). This was common practice across the country – Indeed, it was central government policy – and resulted in about 160,000 people being ‘removed’ from the Liverpool local authority area.

Many other people also moved to the nearby suburbs of Greater Liverpool to private housing – another trend reflected across the country. It’s worth acknowledging, however, that cities across the world are subject to a level of ‘churn’ in population, whereby many people move out and many people move in, over time, too.

So how did those prominent images of derelict streets in the inner-city part of the City of Liverpool local authority area come about? For that, you have to blame the last Labour government’s over-zealous ‘Housing Market Renewal Initiative’ (HMRI) disaster – and the over enthusiastic participation of the then-Lib Dem controlled city council. On the promise of ‘free’ money from central government, the latter removed hundreds of people from their homes with a view to demolishing the Victorian terraces, and building new replacements. Many of these houses, in truth, were already fully modernised, owner-occupied houses within viable and longstanding communities, as can be seen here in Voelas Street, one of the famous Welsh Streets of Liverpool:

Voelas Street before HMRI implementation. Image: WelshStreets.co.uk.

The same picture after HMRI implementation Image: WelshStreets.co.uk. 

Nonetheless: the council bought the houses and ‘tinned them up’ ready for demolition. Then the coalition Conservative/Lib Dem government, elected in 2010, pulled the plug on the scheme. 

Fast forward to 2017 and many of the condemned houses have been renovated, in a process which is still ongoing. These are over-subscribed when they come to market, suggesting that the idea was never appropriate for Liverpool on that scale. 

At any rate, it turns out that the Liverpool metropolitan population is pretty much the same as it was at its peak in 1931 (depending where the local borough boundaries are arbitrarily drawn). It just begs the question: why are well educated and supposedly clever people misrepresenting the Liverpool metropolis, in particular, in this way so often? Surely they aren’t stupid are they?


And why are some people so determined to always isolate the City of Liverpool from its hinterland, while London is always described in terms of its whole urban area? It just confuses and undermines what would otherwise often be worthwhile comparisons and discussions. Or, to put it another way: “never, ever, compare apples with larger urban zones”.

In a recent Channel 4 documentary, for example, the well-known and respected journalist Michael Burke directly compared the forecast population growths, by 2039, of the City of Liverpool single local authority area against that of the combined 33 local authority areas of Greater London: 42,722 versus 2.187,708. I mean, what bizarre point is such an inappropriate comparison even trying to make? It is like comparing the projected growth of a normal sized-person’s head with the projected growth of the whole of an obese person, over a protracted period.

Having said all that, there is an important sensible conversation to be had as to why the populations of the Greater Liverpool metropolis and others haven’t grown as fast as maybe should have been the case, whilst, in recent times, the Greater London population has been burgeoning. But constantly pitching it as some sort of rare local apocalypse helps no one.

Dave Mail has declared himself CityMetric’s Liverpool City Region correspondent. He will be updating us on the brave new world of Liverpool City Region, mostly monthly, in ‘E-mail from Liverpool City Region’ and he is on twitter @davemail2017.