Somewhere to call home – authored by Jackie Barker 

“But this isn’t a home” complained my mother, who had just lost her husband. They had both been living in the same upmarket care home, both with dementia.

“What makes a home a home?” I asked. “Children” she replied.

For many, a home is a place where you feel comfortable. It is a place of choice and control, where you make your own decisions in the moment. You belong to the space and the space belongs to you. You can invite people in or shut people out. You can choose when to step out and feel the air.

Hotel-style care homes

In my opinion, most care homes are ‘hotel-style’ design.

Hotels require you to choose between your room and group spaces and care homes can be very similar. Group spaces are often accessed via a corridor; approaching a group space one never quite knows who you will find there. There is often no middle ground between isolation and sitting right up close and personal to someone, often a stranger. Seating, positioned at good vantage points on route to the group spaces, is often occupied. A person with dementia may forget the group spaces exist because they can’t see them. Some people may enjoy forming special friendships, but inviting a friend to a bedroom may not feel right.

There is a reason ‘a care home’ is singular. It is one shared home, not a set of homes. I believe that is why my Mum said, “it’s not a home.”

Street-based designs

I propose a change from hotel-style to a street-based design where everyone has a “home”, a shareable base.

In a street-based design, ‘homes’ (which are simple ensuite rooms) have windows that look directly onto ‘the street’. The street is bathed in natural light, planting, street furniture. Your home has its own front ‘veranda’ with two seats, one for you and one for a friend, which of course you can personalise, and from where you can watch the world and receive hellos from passers-by, whilst remaining near your own toilet. The building is designed around maximising and equalising the likelihood of people passing by each home. There is shared seating in the street, and points of interest and activity. Life is within sight, and you get to choose, in the moment, just how much to engage with it. You can form relationships, invite a friend back, sit in your own space to watch the world, or retreat indoors. The door to the genuine outdoors is always open.

For my Mum, this would have been perfect. Mum mostly chose to sit on the chair in the corridor outside her room, capturing those rare ‘hello’ moments. She never remembered what was along the corridor, down the lift, and generally did not like being asked to sit in a group with others.

My Dad liked to wander further, feel the sense of freedom and control and purpose, and say ‘hellos’, without the demands of longer interactions. He liked to explore and watch activity but not necessarily take part.

Accommodating changing needs

My parents’ care home had an assisted living wing and a dementia wing. The idea was you started on one side and later moved to the other. Unfortunately, this placed the need to adapt on the person with dementia instead of on the care provider. The street model is designed to better accommodate differing and changing needs. The aim is that people, with and without dementia, or at different stages of their condition, live alongside each other. Perhaps, if my parents had lived on a street they could have been happy together longer.

Come over to my place

The street-based model focuses on feelings of home. It pays attention to the sense of ownership, sharing one’s own space, and genuine, nuanced choices about the degree to which you connect with others. I believe it should also include unhindered access to the real outdoors.

It is a street of homes. A place you might see children playing.

If street- based designs already exist, I’d love to know. I’d also love to share the designs I have created with anyone who enjoys imagining.

Do you agree with Jackie? Why not submit a blog on this topic expressing your views by emailing: voices@dementiapublishing.community   

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