Dementia Action Week, taking place from 13-19 May 2024, encourages people across the UK to help support and enhance the lives of those affected by dementia. Highlighting the inadequacies of the social care system, especially during the pandemic, the Alzheimer's Society calls for government action to rebuild a fair, accessible, and affordable social care system. With dementia affecting millions, including 34.5 million people who know someone with the condition, the need for quality, easily accessible, and free care is crucial. The Alzheimer's Society emphasises the importance of a robust social care system to support dementia patients who rely on it.  

Dementia Action Week also presents the perfect opportunity to highlight the importance of creating supportive environments for individuals living with cognitive impairments, especially within healthcare settings across the therapy sector. With the increasing number of people with dementia accessing various healthcare services, including chiropractic care, it is crucial to design these environments to enhance their well-being and independence. A key development in this area is an environmental assessment tool commissioned by The Royal College of Chiropractors and developed by the University of Worcester. 

How can I ensure my clinic is dementia-friendly? 

The environmental assessment tool, inspired by The King’s Fund’s Enhancing the Healing Environment (EHE) tools, aims to help health and care organisations create more dementia-friendly spaces. Since 2015, The Association for Dementia Studies at the University of Worcester has taken this initiative forward, focusing on improving the physical environments within chiropractic clinics. The tool is designed to be practical and easy to use, addressing aspects of the environment that impact individuals with dementia. 

As more individuals with cognitive problems and dementia are now seeking chiropractic care, it is essential to design clinic environments that cater to their needs. A dementia-friendly clinic can significantly improve the experience for these individuals by reducing agitation and enhancing their independence and engagement in care. Such design considerations also benefit all clinic users by making navigation and understanding of the space easier. 

The term ‘clinic’ covers a wide range of buildings, from those used by sole practitioners to larger multidisciplinary clinics. The assessment tool focuses on areas accessible to patients and visitors, ensuring that it is relevant to various clinic types. For comprehensive guidance on dementia care, users are encouraged to refer to the accompanying Introduction to Dementia Friendly Design guidance. 

How to use the Environmental Assessment Tool 

The assessment tool is divided into seven sections, each containing questions that prompt discussion about the clinic environment. While it can be used by a single individual, involving others—such as practice managers, receptionists, people with dementia, and their carers - can provide valuable insights and diverse perspectives. 

Before completing the tool, it is important to walk through all patient-accessible areas of the clinic. The tool asks users to indicate if each question has been ‘Fully met’ or if there is ‘Room for improvement.’ Irrelevant questions can be marked as N/A. For instance, clinics in office blocks may not have outside spaces, and only large clinics may use electronic check-in systems. Any areas where adaptations are not possible should be noted in the free text section provided. 

A summary sheet at the end of the tool helps pinpoint areas for initial improvement and possible staff training needs. The King’s Fund’s overarching design principles for dementia-friendly design, which underpin the tool, are also included for reference. 

The design principles aim to promote well-being and independence rather than provide detailed room-by-room guidance. Developed through the EHE program, these principles incorporate best practices from various care environments. While it may not be feasible to address all elements simultaneously, especially without a new build or major refurbishment, many principles can be introduced with minimal financial outlay. These small changes can create a more supportive physical environment for people with dementia and those who care for them. 

How was the tool developed? 

The King’s Fund tools, developed in collaboration with NHS organisations, are informed by research evidence, best practices, and feedback from over 300 survey responses. The Royal College of Chiropractors adapted these tools specifically for chiropractic settings, testing them in various clinics to ensure their relevance and effectiveness. Each section of the tool draws on research evidence in dementia-friendly design, addressing the visual and spatial problems often associated with dementia. 

Click here to access the tool: https://rcc-uk.org/wp-content/uploads/2018/06/Assessment-Tool-Final-21-6-18.pdf