Home' Australian Ageing Agenda : AAA Jan-Feb 2018 Contents Australian Ageing Agenda’s regular dementia section is guest edited by Colm
Cunningham, director of The Dementia Centre, HammondCare. For further
information, email: firstname.lastname@example.org
enny Fletcher, who has dementia, can no
longer attend meetings because she cannot
find the toilet in the station and she cannot
use those on the train. This is a limitation
of her human rights.
The UN Convention on the Rights of
Persons with Disabilities includes Article 19:
Living independently and being included in
the community, and Article 29: Participation in
political and public life.
People with dementia are often unable to use
public spaces, buildings and transport because
they cannot find or use the toilet.
They can experience a complex combination
of impairments, as those of old age interact
with those of dementia. The complexity is
compounded by individual differences in the
way dementia is progressing, physical and
psychological health, emotions and circumstances.
The impairments of old age may include
diminished muscles, such as those of the arms,
hands, lungs, neck and pelvic floor often being
neglected by designers, impaired vision and
hearing, and impaired proprioception.
As far as design is concerned, the key
impairments of dementia can include impaired
memor y, learning and reasoning.
Many people with dementia also have sensor y
challenges in relation to interpreting what they
are seeing, hearing, smelling and tasting.
Perceptual problems are the most crucial
in design. This is a complex combination of
impairments but we do know how to design to
compensate for them.
The main issue in finding a toilet is signage:
it can be too high, hidden on boards with a lot
of other information, insufficiently contrasting,
incomprehensible or too small.
Having located a toilet, working out which
door to enter can be a challenge as toilet signs
become increasingly zany. Many people with
sight impairment cannot see the difference
between stick-figure signs and many people
with dementia do not understand them. They
are often too small, too high on the door, too
reflective as well as incomprehensible.
Once in the toilet, the next challenge is
working out which cubicle is vacant; indicators
are usually too small and unclear.
Within the cubicle, the toilet may be invisible
because of inadequate contrast, the paper may
be in an incomprehensible container or the flush
impossible to understand.
Washing and drying hands can be problematic:
taps can be completely unfamiliar and often not
at all intuitive; the soap does not look like soap
and there may be no guidance on how to get it
We need to talk
There are many design features that are limiting access to toilets for people
with dementia, but some mostly cost-neutral measures can improve the
situation, writes PROFESSOR MARY MARSHALL.
out. The hand dryers are baffling as, increasingly,
are the paper towel dispensers.
Finally, finding the exit may be difficult with a
multiplicity of doors, or doors that are invisible
because they do not contrast with the wall.
Greater awareness of the issue is the first
priority. This is a matter that affects a wider
community than those with dementia, including
people with learning disabilities, frail older
people and people on certain medications.
We have to get past the hilarity that greets any
discussion, and make it clear that people’s lives are
being profoundly affected. Along with awareness,
there is a need for greater knowledge and
understanding of issues such as visual impairment,
cognitive impairment, sensor y challenges and the
simple, mainly cost-neutral, changes needed.
We also need to understand why the design
of modern toilets is becoming less and less
functional and comprehensible. This is an issue
needing speedy attention if we are to work with
product and interior designers.
The human rights implications provide a
strong starting point.
See the free resource Toilet Talk: Accessible
design for people with dementia available at
Professor Mary Marshall is a senior
consultant with The Dementia Centre,
specialising in design, an Honorary Professor
at the University of Edinburgh and Professor
Emeritus at Stirling University.
australianageingagenda.com.au | 53
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