[P1–623]: WHY STANDARD CARE ENVIRONMENT ARCHITECTURE FAILS: CAUSING EXCESSIVE CHALLENGE TO QUALITY CARE, INCREASING BPSDS AND ACTIVELY OPPOSING WELLBEING—CAN EVIDENCE BASED, YET FUNDAMENTALLY NEW, APPROACHES TO CARE ENVIRONMENT DESIGN MAKE EVERYONE'S LIVES BETTER?

Care homes continue closing at worrying rates and only 1% of adult social care remains rated as outstanding (CQC, The State of Health Care and Adult Social Care in England 2015/16). Is the fundamental architecture of dementia care environments playing a negative role in the delivery of outstanding care? If so, how? Can the underlying architecture, instead, play a wider positive role in making care giving easier, all round wellbeing better and the buildings more affordable to construct? Analysing the history of care environment design. Time spent giving art sessions in dementia care environments, and as a carer in general care environments for challenging behaviours. Study of research documents on enhancing wellbeing - dementia specific documents as well as general. Discussion with experts in dementia & neuroscience. Discussion with carers and people living with dementia. International Travelling Fellowship with the Winston Churchill Memorial Trust, to view acclaimed projects that support individuals living with a dementia and meeting experts across Australia, Canada & the Netherlands. Studying Cognitive Bias research, such as Hyperbolic Discounting, Functional Fixedness and Pseudo Certainty Effect. Looking at elements of relevant research from other fields of specialist care. Fundamental design models for elder & dementia care have not changed for decades. Rooted in a design family tree that stretches either from prison to asylum to hotel architecture, or from community to monastic to expensive ‘family style’ mini care homes. These standard models for dementia architecture do not take into account the fullness of modern research into wellbeing, instead focusing too narrowly on solving ‘symptoms of dementia’. Also the unique burden on staff delivering person centred care is not taken sufficiently into account. Excellent working examples of care can be found in part, but not in full. By bringing the various qualities together and combining them with up to date research on wellbeing in general as well as dementia specific, we believe it is possible to demonstrate new radical approaches to design for care. These architectural changes can make the giving of outstanding person centred care much more straight forward, enhancing wellbeing and reducing BPSDs.

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