Eating, Design and Dementia: Improving dining in care homes

Around 700,000 people in the UK have dementia, over a third of which live in care homes. Eating and drinking within the care home environment becomes an even more critical issue when a resident is affected by dementia. 

The ability to eat and drink with dignity and independence is often taken for granted, yet is a key indicator of quality of life for care home residents. This project set out to improve the experience by designing tools to help maintain eating skills for longer and by creating environments that address the challenges of advanced ageing.

Many products specified in care homes are often appropriated from other sectors, making them ill-suited to the care home setting. To improve design in this environment, it was important to understand it from both a resident and care worker perspective. Immersive research methods were adopted to identify key issues involving residents with dementia.

The designer visited several care homes to interview and observe residents, and attended Bupa care staff training to understand the needs of care workers, whose experiences were thoroughly explored in further interviews. Best practice and emerging theories in dementia care were researched to establish which elements of the environment would have the most importance if redesigned. Existing care products were audited to discover what was accepted or rejected in care homes.

After the initial stages of research, the project focused on two key areas: tableware and the table setting. The design solutions were consolidated into three groups: low, medium and high assistance. A low assistance cup and plate compensate for poor vision, using colour to ensure the food contrasts with the plate, and that the plate edge is visible against the table. Handles have also been designed to accommodate people with osteoarthritis.

The medium assistance, high-lipped plate helps people with limited dexterity to keep food on the plate, and a removable microwavable outer layer keeps food warm for longer. The cup replaces stigmatising double-handled cups by removing the handles altogether and replacing them with a layer of neoprene. The high assistance plate is shaped for care workers to hold close to residents who can no longer feed themselves. This ensures they can see and smell what they are eating, promoting an experience that is about their needs and not the task of feeding. The cup opens and closes easily in the hand, avoiding spillage.

A specially designed table, light and tablecloth work together to promote a better eating experience for residents. The table is designed to accommodate wheelchairs so that all residents can get close enough to their food to eat. The light can be adjusted for different visual acuities, some residents needing three times as much light to see properly. The tablecloth can be placed and removed easily, encouraging carers to reset the table before each meal. This encourages anticipation and appetite for residents with memory difficulties.

By making many small design changes the quality of dining can be improved, affording people with dementia the dignity and respect they deserve. This project will now go into a second year with Bupa's support to extend the research methodology to other aspects  of the care home environment.

Research Associate 2009: Gregor Timlin
Research Partner: Bupa
RCA Department: Design Products