How innovative home design could revolutionise dementia care – and even slow down symptoms

The Alzheimer’s Respite Centre. Image: Nick Kane.

When a clip from Dominic Sivyer’s Grandad, Dementia and Me documentary went viral on Facebook last year, I found it really touched a nerve. Like many who shared the video, I’ve known a dementia sufferer. Like many, I’ve suffered the heartbreak of a blank, unrecognising stare from a family member. 

Today, there are roughly 850,000 people living with dementia in the UK, each surrounded by family and friends also bearing the costs – emotional and otherwise – of the debilitating condition. With an ageing population, that number is expected to reach over a million by 2025, yet cash for research and quality of care is still desperately lacking.

As recently as this year, reports suggested that up to a third of dementia patients in the UK are not receiving full, adequate care. Year on year, more sufferers unnecessarily end up in A&E during the final year of their lives. Frequently, the confusion and distress inherent in these visits proves fatal.

The complacent hope is that we’ll have figured out a cure by the time these numbers reach crisis level. While this is, of course, possible, it’s by no means guaranteed. Without a miracle drug on the horizon, it may be time to get creative. For architects like Niall McLaughlin and Yeoryia Manaloupoulous, this means turning to tailored architecture and home design for a solution.

It sounds deceptively simple, but researchers and architects in this niche area have hit on something that has the potential to revolutionise dementia care. Dementia-friendly design, astoundingly, has the power not only to improve the lives of sufferers and cut costs, but also to decelerate symptoms.

Losing Myself, at the 2016 Venice Biennale. Image: Nick Kane.

Through “Losing Myself”, an interactive piece at the 2016 Venice architecture exhibition Biennale, McLaughlin and Manaloupoulous explored this idea at length. Their exhibit was a reflection upon their dementia-friendly “Alzheimer’s Respite Centre”, built in Dublin back in 2010, and invited gallery-goers to traverse a projection that played scrambled moving images of the building, while speakers blared a cacophony of overlapping voices. The idea was to immerse the audience in the experiential qualities of dementia that make wayfinding, spatial orientation and remembering so difficult.

A poignant experience, yet creating empathy with the sensory world of sufferers was just a starting point for these architects. At the Alzheimer’s Respite Centre, this understanding of a dementia patient’s cognitive and perceptive reality precluded every architectural and design choice in and outside of the building. Swirly patterning can appear in motion to sufferers, so interior design is kept deliberately plain. Dementia patients often get confused about where they are and what time of day it is, which designers hope to combat with large windows throughout the centre to let in natural light.


Were you to visit and walk around the garden, you’d eventually notice that every path loops naturally back to the main building, allowing patients to wander independently without getting lost. Toilets visible from the bed remind patients where they are, so that in the morning – when they’re likely to need it – they can access the bathroom without help.

Such features play a key role in improving sufferers’ quality of life, facilitating independence and avoiding the dreaded “institution” atmosphere. But the really revolutionary aspect of dementia-friendly design, of course, is its potential to actually alleviate common symptoms. Several American studies have backed this theory; recording, amongst other things, less aggressive behaviour and longer sleep duration in patients who are exposed to greater amounts of natural light. One even found that patients living in a facility with long corridors (making wayfinding more difficult) had more advanced psychiatric symptoms after a six-month period than those living in a more easily navigable “L”-shaped space.

McLaughlin and Manaloupoulou aren’t the only ones to see the potential benefits. Just last year, Scottish architect David Burgher developed a virtual reality tool that allows users to experience the visual impairments of a dementia sufferer, hoping that better understanding of the condition will breed better architecture. Liverpool John Moores’ ongoing “design for dementia” research project aims to set new architectural standards for dementia design, speculating that it may eventually become possible to adjust existing homes for sufferers rather than building new ones. With so many patients wishing to remain at home for as long as possible, researching, funding and implementing dementia-friendly design could be a lifeline for thousands as we continue to search for a cure.  

 
 
 
 

Here’s why we’re using a car wash to drill into the world’s highest glacier on Everest

Everest. Image: Getty.

For nearly 100 years, Mount Everest has been a source of fascination for explorers and researchers alike. While the former have been determined to conquer “goddess mother of the world” – as it is known in Tibet – the latter have worked to uncover the secrets that lie beneath its surface.

Our research team is no different. We are the first group trying to develop understanding of the glaciers on the flanks of Everest by drilling deep into their interior.

We are particularly interested in Khumbu Glacier, the highest glacier in the world and one of the largest in the region. Its source is the Western Cwm of Mount Everest, and the glacier flows down the mountain’s southern flanks, from an elevation of around 7,000 metres down to 4,900 metres above sea level at its terminus (the “end”).

Though we know a lot about its surface, at present we know just about nothing about the inside of Khumbu. Nothing is known about the temperature of the ice deeper than around 20 metres beneath the surface, for example, nor about how the ice moves (“deforms”) at depth.

Khumbu is covered with a debris layer (which varies in thickness by up to four metres) that affects how the surface melts, and produces a complex topography hosting large ponds and steep ice cliffs. Satellite observations have helped us to understand the surface of high-elevation debris-covered glaciers like Khumbu, but the difficult terrain makes it very hard to investigate anything below that surface. Yet this is where the processes of glacier movement originate.

Satellite image of Khumbu glacier in September 2013. Image: NASA.

Scientists have done plenty of ice drilling in the past, notably into the Antarctic and Greenland ice sheets. However this is a very different kind of investigation. The glaciers of the Himalayas and Andes are physically distinctive, and supply water to millions of people. It is important to learn from Greenland and Antarctica, – where we are finding out how melting ice sheets will contribute to rising sea levels, for example – but there we are answering different questions that relate to things such as rapid ice motion and the disintegration of floating ice shelves. With the glaciers we are still working on obtaining fairly basic information which has the capacity to make substantial improvements to model accuracy, and our understanding of how these glaciers are being, and will be, affected by climate change.

Under pressure

So how does one break into a glacier? To drill a hole into rock you break it up mechanically. But because ice has a far lower melting point, it is possible to melt boreholes through it. To do this, we use hot, pressurised water.

Conveniently, there is a pre-existing assembly to supply hot water under pressure – in car washes. We’ve been using these for over two decades now to drill into ice, but our latest collaboration with manufacturer Kärcher – which we are now testing at Khumbu – involves a few minor alterations to enable sufficient hot water to be pressurised for drilling higher (up to 6,000 metres above sea level is envisioned) and possibly deeper than before. Indeed, we are very pleased to reveal that our recent fieldwork at Khumbu has resulted in a borehole being drilled to a depth of about 190 metres below the surface.

Drilling into the glacier. Image: author provided.

Even without installing experiments, just drilling the borehole tells us something about the glacier. For example, if the water jet progresses smoothly to its base then we know the ice is uniform and largely debris-free. If drilling is interrupted, then we have hit an obstacle – likely rocks being transported within the ice. In 2017, we hit a layer like this some 12 times at one particular location and eventually had to give up drilling at that site. Yet this spatially-extensive blockage usefully revealed that the site was carrying a thick layer of debris deep within the ice.

Once the hole has been opened up, we take a video image – using an optical televiewer adapted from oil industry use by Robertson Geologging – of its interior to investigate the glacier’s internal structure. We then install various probes that provide data for several months to years. These include ice temperature, internal deformation, water presence measurements, and ice-bed contact pressure.


All of this information is crucial to determine and model how these kinds of glaciers move and melt. Recent studies have found that the melt rate and water contribution of high-elevation glaciers are currently increasing, because atmospheric warming is even stronger in mountain regions. However, a threshold will be reached where there is too little glacial mass remaining, and the glacial contribution to rivers will decrease rapidly – possibly within the next few decades for a large number of glaciers. This is particularly significant in the Himalayas because meltwater from glaciers such as Khumbu contributes to rivers such as the Brahmaputra and the Ganges, which provide water to billions of people in the foothills of the Himalaya.

Once we have all the temperature and tilt data, we will be able to tell how fast, and the processes by which, the glacier is moving. Then we can feed this information into state-of-the-art computer models of glacier behaviour to predict more accurately how these societally critical glaciers will respond as air temperatures continue to rise.

The ConversationThis is a big and difficult issue to address and it will take time. Even once drilled and imaged, our borehole experiments take several months to settle and run. However, we are confident that these data, when available, will change how the world sees its highest glacier.

Katie Miles, PhD Researcher, Aberystwyth University and Bryn Hubbard, Professor of Glaciology, Aberystwyth University.

This article was originally published on The Conversation. Read the original article.