Description

The majority of patients treated in hospitals are over 65 years of age and dementia is in many cases a secondary diagnosis alongside the primary clinical condition. The design of the patient rooms of the geriatric unit at the St Joseph-Stift in Dresden shows how one can address the challenges of dementia and impaired mobility with the help of a coherent overall concept.

The new, three-storey west wing of the St Joseph-Stift comprises a 1200 m² large acute geriatric care unit with capacity for about 400 patients annually as well as a central outpatient clinic on the ground floor that brings together all the outpatient consultation facilities in one place. Its 720 m² accommodate 18 treatment rooms and extensive waiting areas. From the outside, the brick and render façade with its striking grouped window strips is more reminiscent of a residential building than a clinic.

Inside, the floor plans have been kept very clear. Patients of an advanced age and especially those with dementia often find admission to hospital a highly confusing experience. To help them find their bearings in unfamiliar surroundings, the design deliberately conveys a calm, non-challenging atmosphere. The simple floor plan arrangement assists in providing effective orientation, with straight corridors leading in clear directions and direct visual relationships between patients and staff. It allows patients to move freely around the ward while simultaneously preventing them from “walking off”. The system of double corridors with a central transparent nurses’ station is well-suited to this purpose.

Alongside providing acute therapy, acute geriatric treatment aims to enable patients to maintain or regain the ability to care for themselves independently. As such, the patient rooms are not just a place for the patients to stay but also a therapy room. Due to the greater need for assistive aids, the rooms are 20 % larger than the usual hospital rooms so that there is ample room for patients using walking frames, rollators or wheelchairs. The patient bathrooms are also designed to be accessible to people with handicaps and are twice as large as those normally found in normal patient rooms. They include wall-hung washbasins for easy wheelchair access, sufficient turning space for wheelchair users, hooks and controls that are easy to reach while seated, and low-mounted mirrors.

As many patients are predominantly sedentary, the sill height of the windows is lower to afford a better view and the sills often double as a bench seat. Curtains provide greater privacy – a common preference among older people – while also allowing daylight into the room along with a glimpse of the sky.

A helpful detail brought over from the hotel sector is the use of orientation lighting close to the floor that helps patients find their way to the toilet at night without being dazzled by the bright light of the room or disturbing another patient in the room. A large mirror with additional handrails near the entrance to the room is useful for postural training after a stroke.

Another key element is the so-called “Memoboard” with a therapy calendar, television and a large, clearly legible wall clock. Staff can attach personal treatment reminders and use it for memory training with the patients. There are also “empty” picture frames for patients to insert personal mementos and family photos.

In the patient rooms and accompanying bathrooms, blue and orange colour accents have been used to assist patients with dementia and those with poor sight to locate and recognise key parts of their environment. The colour code is used for distinguishing the respective patient’s cupboards, shelves in the bathrooms and also the towels. Special attention was also given to the choice of colours and materials to ensure sufficient light/dark contrast between different surfaces. Clear differentiation between the bed and the floor, the chair and the floor, the wall and the floor, and the handrail and the wall help reduce the risk of accidents and falls.

A continuous, non-reflective and pattern-free floor covering was chosen to avoid the risk of floor markings being mistaken for steps or gaps, causing unintentional stumbling or missteps. Only where such visual barriers are useful – for example in front of the ward exits to discourage patients from wandering out of the ward – has this principle been used very specifically.

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Originally published in: Wolfgang Sunder, Julia Moellmann, Oliver Zeise, Lukas Adrian Jurk, The Patient Room, Birkhäuser, 2020.