The Multi Sensory Environment (MSE) in dementia care: the role of design

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The proposal builds on previous research carried out by Kingston University's Designed Environment Research Group with its successful track record for investigating the environmental needs of people with dementia, and prior research undertaken by the Co-I exploring engagement strategies for the latter and the effect of MSEs on functional performance. This new project will conduct a focused investigation into the concept and design of MSEs and their current and future demanding role within homes caring for residents with dementia. The timely relevance of this research rests on a broader consideration of the rapid growth of an ageing population, the rising number of people affected by dementia, and the over-prescribed use of antipsychotic medication in dementia treatment. Cost-effective interventions supporting dementia care are urgently needed. Carers, therapists and designers are therefore keen to investigate the MSE in this context.The observed benefits of MSEs within dementia care are improved function and alleviated psychological and behavioural symptoms e.g. challenging behaviour, depression, increased appropriate communication, improved staff morale (Collier et al 2010). MSEs, incorporating sensory equipment which targets the primary senses, are now widely used and specified but evidence suggests that they often fail to succeed because of inadequate/poor design and haphazard arrangements (Dalke et al 2010). Conversely, there has been a lack of research into design innovations regarding the future development of MSEs for those living with dementia. The project will investigate to what extent the above criticisms can be substantiated via a study involving 15 care homes in Greater London with some type of MSE facility. The facilities will be examined and staff observed/interviewed (using a specifically designed questionnaire). The intention is to evaluate service and usage in relation to MSEs' joint function as both a resource for meaningful leisure activity and a therapeutic intervention for users with dementia. This study aims to establish whether the improved overall design of MSEs could add value to the experience on offer maximising the benefit for these particular users and their carers. More importantly, because little documented design guidance for MSEs for older people with dementia exists, the overall purpose of the proposed research is to establish new knowledge from which coherent, user-centred design solutions can be developed. The proposed study has the potential to inform the development of design ideas and recommendations for a MSE template tailored towards people with dementia, their physical and emotional needs. In order to improve the MSE experience the design development would not be confined to solutions that place additional technology in a room. It would involve designing the space as a whole to achieve aesthetically inspiring, stimulating environments which are sufficiently flexible and adaptable to the specific individual needs of users. Embracing an inclusive design approach, such spaces should generate a sense of wellbeing and engagement not only for people with dementia but also for staff and relatives sharing the experience of the service users. The research findings and results will be written up in a Design Sourcebook, and assist occupational therapists, activity co-ordinators, managers and designers of care homes by informing their practice and strategic planning, particularly when making improvements to existing MSE facilities or setting up new ones. Another main output will be an exhibition-related event at the end of the project where the research results will be presented to a wider audience of professionals in the field, policy makers and the general public. Societal and economic impacts would increase during the course of a follow-on research project linked to performing trials with focus groups and subsequently providing proof-of-concept and implementation strategies.