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 is a civic pride for the digital age”: why we should why we should willingly let City Hall have our data

He was the future once: David Cameron discusses smart cities with Angela Merkel and a German technology executive. Image: Getty.

Victorian England. From the shadows of wealth grew poverty. Slums slumped against symbols of civic pride, cowering next to towering town halls funded through rich merchant princes, whose elitist rule was insufficient to deal with too many people in too few houses with too little infrastructure.

Enter municipality. With darkness came electric light; with disease came tunnels to disperse their cause; with time came reform, regulation and the rise of town planning.

It’s over a century since those places which first industrialised became those first urbanised; yet even the wealthiest cities in the world continue to struggle with the complexities of urbanisation. In London, ten thousand die each year from pollution; in New York, six times this amount reside in homeless shelters.On the rush-hour roads of Sydney, cars stand still, and in the ‘burbs or banlieues of Paris slums still stand.

An umbrella bought during a downpour costs more than one bough under blue sky – and the truth is that, for too, long city halls have failed to forecast and so incurred greater costs. It’s a reactive culture summed up by words first head in Jimmy Carter’s budget office: if it ain’t broke, don’t fix it. Disease before sewer, gridlock before investment, collapse before rebuild – visible fix over unseen prevention

But with the world’s urban population growing by 65m every year, this has to change: there is not enough resource to manage cities reactively. Enter technology and the move to smart cities.

From Barcelona to New YorkOxford to Amsterdam, Singapore to Seoul: billions of low-cost devices are being installed into everyday objects to send and receive data: street lights recording pollution, and bridges reporting performance; traffic lights that count, and whose analysis will be counted upon, to ease traffic congestion; health wristbands understanding our heart’s needs, shop ceilings noting our heart’s desires. A web of information woven into the very fabric of cities which, when added to data from sources like mobile phones, is providing a living-breathing picture of how we and our cities operate.

This data is no longer retrospective or historic but live and dynamic. It is of such quantity, and can be analysed at such granular detail, that it can provide certainty where once there was only supposition. It is build-up before the gridlock, illness before epidemic; the crack of an ageing bridge, the first signs of smog. It is diagnostic to preventative. Umbrella under blue sky.

Those promoting the “internet of things”, estimated to be worth $11.1trn a year by 2025, will declare it a panacea – but it is not, at least not entirely. Sure, challenges regarding data quality, privacy, standardisation, and security will be overcome; 4G will become 5G will become 6G. Devices will communicate intelligently with each other – autonomous vehicle to autonomous vehicle, autonomous vehicle to bridge, drone to home. Data will become as fundamental to cities as infrastructure, and will be referred to as such.

Yet city halls in democracies, whilst infinitely better informed, will continue to make their decisions which are restricted by commercialism, framed by political ideology, and driven by short-term electoral or media pressures.


People first

From the mid-sixties to the start of this century a UK television programme called Tomorrow’s World showcased future living. For every correct prediction (mobile phones) came countless incorrect ones: the floating-bicycle, say, or paper underwear. My point is that only a small part of understanding the future of cities is about understanding technology. The majority is about understanding people and society, the people from whom the very word “city” is derived: civitas, the collective of citizens.

Gutenberg did not change the world by inventing the printing press in the 13th century – but he did enable the world to change. The technology was the printing press, the outputs were books filled with knowledge, the outcomes were the actions of the many who used that knowledge. Technology is a tool, a process towards an outcome. 

In much the same way, the Internet of Things will not change the world – but it will enable the world to change. Sensors are the technology, data the outputs, the analysis of this data and subsequent decisions, the outcome.

It is crucial to avoid the Tomorrow’s World approach. That is, racing to implement technology first without consideration of identified social, economic or environmental needs; introducing more complexity when most citizens seek simplicity. As the writer and urbanist Jane Jacobs once said:“First comes the image of what we want, then the machinery is adapted to turn out that image.”

Start with people. Form the image. Think of technology through the Greek origins of the word, techne and logos – a discourse about the way things are gained – and capitalise on collective intelligence to move towards that image.

Since cities first started to appear some millennia ago, they’ve provided incontrovertible evidence that the wisdom of crowds is far greater than the individual; that collective intelligence gained from that trinity of city institutions – citizen, government, industry – surpasses what can be achieved by any one in isolation. Where would Apple, Uber, or Google be without the government-backed inventions like the world-wide-web, touchscreen technology, WiFi or global positioning systems?

A new civic pride

Of course, an app on a smart phone that can ask a thousand questions is meaningless if nobody feels motivated to answer. Increasing urbanisation brings increasing interdependency: lives intrinsically linked, services shared. The challenge for city halls is to turn the increase in what people have in common, into an increase in common purpose, through understanding the three benefits that motivate and lead to action.

Extrinsic benefits, of status and reward, caused merchant princes to fund city halls in Victorian England: such benefits today see the ambitious putting in extra hours. Intrinsic benefits, like competitiveness or fun, that once caused business tycoons to compete to build the tallest skyscrapers, now explain why “hackathons” and “city challenges” are such a success. Then there are the pro-social benefits of altruism or benevolence, that cause millions to volunteer their time to give back and feel part of something bigger than themselves.

These motivations are of greater significance, because there are no longer people with clipboards standing on street corners asking permission to collate our views on services: it is happening automatically through the Internet of Things. Our choices online, movements offline; the travel we take, the pollution we make; our actions and interactions. We are data.

City halls can take a click-box-small-print approach to this, like so many apps. But there is opportunity to do the opposite. They can promote the fact that citizens can knowingly provide their data towards making lives better; visualise and enable citizens to see and understand their input, alongside data provided by others.

They can incentivise interaction with data, so that entrepreneurs can work back from outcomes, solve challenges, and re-localise where appropriate (we should not need a multinational to get a taxi). They can be proudly open, enabling citizens, industry and government to receive pro-social benefit by contributing to something bigger than themselves: their life and the lives of others.

This is a civic pride for the digital age. Not just localism or patriotism based on geography but the strength of connection between people and their ability to direct and determine change through data. Not just pride in the buildings and infrastructure that form our physical world, but in the quality of data that will shape our future world and move us from a diagnostic to preventative society – umbrellas under blue sky.

We should take pride in technology, yes; but that should come second to the pride in those who, enabled by that technology, drive progress. Who, through the wisdom of crowds, form an image of the future and strengthen democracy by motivating society to move towards it. Who embrace openness and help overcome the challenges of urbanisation.

Kevin Keith is a writer, researcher, urbanist, and director of the southern hemisphere’s largest open data competition, GovHack. He tweets as@KevKeith.

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