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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This fun map allows you to see what a nuclear detonation would do to any city on Earth

A 1971 nuclear test at Mururoa atoll. Image: Getty.

In 1984, the BBC broadcast Threads, a documentary-style drama in which a young Sheffield couple rush to get married because of an unplanned pregnancy, but never quite get round to it because half way through the film the Soviets drop a nuclear bomb on Sheffield. Jimmy, we assume, is killed in the blast (he just disappears, never to be seen again); Ruth survives, but dies of old age 10 years later, while still in her early 30s, leaving her daughter to find for herself in a post-apocalyptic wasteland.

It’s horrifying. It’s so horrifying I’ve never seen the whole thing, even though it’s an incredibly good film which is freely available online, because I once watched the 10 minutes from the middle of the film which show the bomb actually going off and it genuinely gave me nightmares for a month.

In my mind, I suppose, I’d always imagined that being nuked would be a reasonably clean way to go – a bright light, a rushing noise and then whatever happened next wasn’t your problem. Threads taught me that maybe I had a rose-tinted view of nuclear holocaust.

Anyway. In the event you’d like to check what a nuke would do to the real Sheffield, the helpful NukeMap website has the answer.

It shows that dropping a bomb of the same size as the one the US used on Hiroshima in 1945 – a relatively diddly 15kt – would probably kill around 76,500 people:

Those within the central yellow and red circles would be likely to die instantly, due to fireball or air pressure. In the green circle, the radiation would kill at least half the population over a period of hours, days or weeks. In the grey, the thing most likely to kill you would be the collapse of your house, thanks to the air blast, while those in the outer, orange circle would most likely to get away with third degree burns.

Other than that, it’d be quite a nice day.

“Little boy”, the bomb dropped on Hiroshima, was tiny, by the standards of the bombs out there in the world today, of course – but don’t worry, because NukeMap lets you try bigger bombs on for size, too.

The largest bomb in the US arsenal at present is the B-83 which, weighing in at 1.2Mt, is about 80 times the size of Little Boy. Detonate that, and the map has to zoom out, quite a lot.

That’s an estimated 303,000 dead, around a quarter of the population of South Yorkshire. Another 400,000 are injured.

The biggest bomb of all in this fictional arsenal is the USSRS’s 100Mt Tsar Bomba, which was designed but never tested. (The smaller 50MT variety was tested in 1951.) Here’s what that would do:

Around 1.5m dead; 4.7m injured. Bloody hell.

We don’t have to stick to Sheffield, of course. Here’s what the same bomb would do to London:

(Near universal fatalities in zones 1 & 2. Widespread death as far as St Albans and Sevenoaks. Third degree burns in Brighton and Milton Keynes. Over 5.9m dead; another 6m injured.)

Everyone in this orange circle is definitely dead.

Or New York:

(More than 8m dead; another 6.7m injured. Fatalities effectively universal in Lower Manhattan, Downtown Brooklyn, Williamsburg, and Hoboken.)

Or, since it’s the biggest city in the world, Tokyo:

(Nearly 14m dead. Another 14.5m injured. By way of comparison, the estimated death toll of the Hiroshima bombing was somewhere between 90,000 and 146,000.)

I’m going to stop there. But if you’re feeling morbid, you can drop a bomb of any size on any area of earth, just to see what happens.


And whatever you do though: do not watch Threads. Just trust me on this.

Jonn Elledge is the editor of CityMetric. He is on Twitter as @jonnelledge and also has a Facebook page now for some reason. 

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