The Dementia Podcast

Talking Design: Understanding Accessibility

Professor Colm Cunningham

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Colm sits down with return guests Annie and Ricky Pollock to talk design. Design is one of the major pillars at HammondCare’s Dementia Centre and this episode is a revealing look as to why that might be.  

Annie and Ricky were last on the show for the episode Talking Design: Air Quality, Acoustics and Dementia. 

In the episode Ricky and Annie talk about their road to architecture and what made accessible design their passion and focus. Annie expounds on her many years of experience in designing smart and immersive outside spaces – more from Annie can be found in her free book, A Breath of Fresh Air. In addition, Ricky speaks about the relationship between the outside and inside space and the legibility of the building and more.  

They also speak to the practicalities of the push and pull in conversations of design, of minimum standards and about what to keep in mind when designing accessible spaces. 

If you’d like more on accessible design we’d love for you to check out one of our previous episodes, Talking Design: Why it can ‘provoke’ behaviour with Liz Fuggle and Meredith Gresham. In addition, you can also purchase the book, Designing Outdoor Spaces for People with Dementia edited by Mary Marshall and Annie Pollock.

Colm Cunningham:

Hello to you and thanks for joining us on today's episode of The Dementia Podcast where we're talking design. Over time, we plan to build up a significant knowledge bank on these important issues and the research behind them. With over a quarter of a century of HammondCare's Dementia Center being involved in the design, build and research globally around design, you'd expect us to be passionate about this issue. In our December 15 2021 episode, we had guests Ricky and Annie Pollock, as we celebrated the launch of two important books on air quality and on acoustics. We only scraped the surface in those episodes on some of the important issues, both practical and technical. But the good news is that these books are available as free downloads. So you just need to follow the links in the show notes to be able to get access to these fantastic materials. I could not miss out on the opportunity to continue the conversation with Annie and Ricky about their journey into architecture, why design for dementia became so important. And as they specialized in the design of the built environment, and the gardens and access to outside, that's so important, what they learnt, their tips, and indeed their challenges from those early days in the 1990s to now. So join me again in the living room of Ricky and Annie's home in Edinburgh, Scotland. Thanks so much for having the podcast audience again, as your guests. Hello.

Ricky Pollock:

Hi there. Colm

Colm Cunningham:

Now, please. I know we asked you a little bit about this in the last podcast, but it would be fantastic to know a little bit about what led you into architecture. So I don't know who started first or whether you were on the same course. So who wants to tell us start then the story of then?

Ricky Pollock:

Well, uh, my reasoning was that there were very few jobs that I knew about as a child growing up in a small town. You had doctors, dentist, lawyer, banker, teachers, shopkeepers, all the usual things. But I wanted something a little bit different. And my uncle was an architect. And he looked terribly important. And I thought then that, huh, what skills do you need to become an architect? And he said, Well, not alot really. You need to be good, quite good at a lot of things. But you don't have to be very good. At any particular thing.

Colm Cunningham:

I think we might get some feedback on that.

Ricky Pollock:

So I thought that suits me. Made for me,

Colm Cunningham:

So you went into architecture training where Ricky?

Ricky Pollock:

I did that in Edinburgh. And I had a choice of two colleges, the Regional Art College, University of Edinburgh, and I looked up the requirements, and the art college said you had to have a portfolio and I had no idea what a portfolio was. So I applied to the University of Edinburgh.

Colm Cunningham:

Oh, my God, you're being very honest here in this. Annie. What's your story? Did you go to the University of Edinburgh?

Annie Pollock:

I did. I had a Scottish godmother. And she she was a very strong force in my youth. And she's why I eventually came to Edinburgh. My father had been on ships with her husband during the war, the big links. And that's, of course, where I met this man. We were in the same year. But we did ignore each other for sort of four of the five years. When we finally got engaged, it was Oh, really who they got engaged to.

Colm Cunningham:

But so who spotted her? Yeah, I've never actually asked you that. I'm sorry. I'm doing that live on air.

Annie Pollock:

We had a Mini he had a Mini and I was always the one wanting a lift. I think that was probably the reasoning.

Colm Cunningham:

And you also spent some of your life in Singapore. Do you think that that influenced your passion for the outside environment?

Annie Pollock:

Oh absolutely. I mean, the vegetation and the plants in Singapore were just amazing. And having been back twice, I look at them and I just think ah, this is fabulous. I think it very much did.

Colm Cunningham:

Now I don't want to skip over too much to your considerable careers as architects, but what Ricky, led you into design for people with dementia?

Ricky Pollock:

In many ways. It was slightly sideways and accidental that the early work I did mostly housing was for public funded social, affordable accommodation. And we didn't work for the private sector. And that was the area that was looking at how to provide housing that was more suitable for more people, including wheelchair specific provision. And I got rather interested in that, in that I couldn't see why isn't all housing this way, we should be making it all accessible and inclusive. So we did lots of projects. And there was one project in particular, in St. Leonard's in Edinburgh for Edinburgh Housing Association, which was our first really big, big project and on the committee was Professor Mary Marshall. Spoiler alert. And we were as an office doing presentation of our early designs to the committee. And then, to my horror, Mary Marshall asked a simple question, is there anything in the design of this housing that is supportive of people with dementia, or would be suitable for people with dementia to be able to live independently, and I went white, I had no idea what dementia was. And I had prided myself on being an architect who was very good at getting wheelchair access, visibility issues, all the rest of what I thought were providing for disability, but I hadn't thought about dementia. So we went away and tried to find what is there about this? Nothing, there was virtually nothing. What year was that? That would be 1992 1993. Right? When all this was at very early stages, so we virtually had to do our own research. And we came up with some very basic principles of waymarking and things in our scheme. And we've taken this forward really ever since. And we look at all buildings in the same way libraries, health care buildings, public buildings, offices, they all should cope with a design that suits people with dementia.

Colm Cunningham:

Annie, was your journey the same? Was it the fact that record bumped into this Mary Marshall, what led you into this space?

Annie Pollock:

Yes, it probably was actually, because on this same scheme that he's talking about. I was a landscape architect, right. And so I took on some of these principles. Unfortunately, the landscape contractor who wasn't willing to sort of entertain me afterwards said, I don't understand what you mean here. Can you can you help out a bit more, which I wasn't unfortunately, able to do because of the way the contract was sorted. But it started off that train of thinking about landscapes for people with dementia. And then in 1999, Scotland had a year of dementia, or was it just Glasgow, Ricki it was Glasgow, Glasgow, city of Art and Design. That's right city of Art and Design 1999 with dementia as a theme, and I was asked to do a garden for the Royal Horticultural Show designs such as they have at Chelsea. It was in in Scotland at that point, to do a design by Alzheimers Scotland and Action on Dementia, it was called the Forget Me Not garden, for which we won a silver medal, which was great. And Mary asked me to write my first garden design book on the back of that experience. And then from there on, doing work for Sterling. I was put on a course in Chicago on therapeutic garden design, which was absolutely wonderful. And then it's obviously from Sterling to HammondCare. And we're now both members of the Edinburgh access panel, which deals with designing for people with disabilities. So we're learning more all the time in terms of how to be inclusive.

Colm Cunningham:

So from the 90s, to where we are now, you must have quite a list of things that you've probably fallen out with people on telling them that they really must do the list of musts have probably increased over the years. I certainly think I remember of your 1999 garden design, the importance of people feeling that there are spaces within spaces in the gardens is the way I would describe me you probably have a better way describe it But what would be some of your list of things from an outside environment point of view, Annie,

Annie Pollock:

I think clarity of where you've come out from and how to get back to where into the building from the place that you left so that people don't get lost. But along that route, you can have different events and also depending on your ability cognitively, these might get further afield, if that's appropriate. But it can be planting. It can be games, mini golf, things like that. It can be just places to sit and be quiet and rest. It can be places where there are particular types of plants of plants of memory. It can be sheds, where you might find tools for gardening. All of these things that people have done throughout their life in a garden, are really important to contain within a garden design. So that there are things of memory, I remember, as a little girl loving the garden that we lived in this was before I went to Singapore, and looking at the bees on the lavender and having a pyracantha bush with red berries. And to this day, I like those plants, I have them in the garden, and we watch the bees. Wow. So all of these things, you know, can be from when you were very small, if you've liked the outside space. And it's important to look at who you're designing for, what their culture is, and what they might want. So if it's multicultural, you might have somewhere where people can go and maybe indulge in religious thought, and meditation as well.

Colm Cunningham:

And I know last year, Ricky, when you were talking about the importance of acoustic management, one of the things that you might want to be doing is being able to get out into an open space Annie had to get away from some of the sound. And I've seen you just to talk, you were talking about meditation, or you've even put a gate within a garden so that people feel that they've moved to another space, which I would never thought of before, but just giving people a sense that they have some control over these spaces.

Annie Pollock:

Yes, absolutely. Having something that you can go through at will you have to be careful therefore, about how it works. And to some extent, maybe a gate that has a slow swinging mechanism might be one way of dealing with it. But to be able to go through from one space to another, be allowed to and to enjoy it. And still to be able to find your way back maybe with signposting or marker plants and guidance is all very important. But to be sure too that you keep the color of the path the tone of any path, the same all the way around. And very similar to the entrance that you go into through into the buildings so that there's no visual barriers or changes of term.

Colm Cunningham:

And I certainly think that that's one of the challenges is I've seen that we have to be very mindful to keep an eye on the build that that doesn't change. Because you're absolutely right. You don't want people feeling like they can't step out onto the space. Ricky you we're going to.

Ricky Pollock:

Yes, it's as well as the outdoors being inviting to explore the indoors has to be inviting back in again. It hasn't to be a hostile, dark environment. So we need plenty of light within the building, that people can transition from the brightness of outside to inside without feeling they're going into a cave.

Colm Cunningham:

So what were some of the things now that you see as fundamental in the inside spaces. I know you've designed outside spaces that well, Ricky, but what are some of the things that over the years you have seen as fundamental

Ricky Pollock:

Eh the legibility of a building generally, that spaces are logically where people expect them that there is really good visibility, while somebody with dementia can see something, it's never forgotten. There's no reliance on remembering. So if a dining room separated from a corridor as a glazed partition, it's obvious what the function of the room is. From the corridor, you don't need to remember which door serves the dining room. It's visible to people at all times

Colm Cunningham:

And I imagine it's the same on the outside as well.

Annie Pollock:

It is one thing I was going to add is I'm somebody who has no sense of direction, right, which has probably helped me in my thinking about design for dementia, something Ricky taught me is when you go somewhere, always look behind you so that when you want to come back, you know what you're aiming for. And the number of times one will go somewhere like for example into a public toilet. And when you come out again, you're faced with about three doors, it's probably the door to the cupboard where they store things the door out to where you want to go to maybe the door to a disabled toilet, but they all look the same. And there isn't guidance, you can be completely nonplussed. So remembering to put the way back as clearly as the way out

Colm Cunningham:

and I think I've experienced that in our conference with people with dementia where you're absolutely right. It was all lovely glazed, beautiful, but the obvious place, they were drawn to was the cleaning cupboard. So everybody with or without dementia was going to that door to leave. So you can imagine how foolish people were all feeling.

Ricky Pollock:

Yes, staff doors are a menace unless they are beautifully concealed by blending them into the wall.

Colm Cunningham:

And I imagine there's a few things over the years, you say, I wish I hadn't designed that way I dead end paths. So imagine something and racetracks were of their time. So the importance of what you're saying Annie about, making sure that if you do have a loop that actually there, it's not just a blank canvas, it's something with reasons to stop and do things.

Annie Pollock:

I think that's true. There are cases where I've maybe put in some different kind of paving to emphasize something and then realize that was a bad idea. And unfortunately, right now, certainly in the UK, there's a tremendous fashion for having paving, which is multicolored granite, laid randomly. So I look at it, and think that just looks like a whole lot of holes in the pavement, a whole lot of repairs. And yet, some people find that really attractive, it's become a fashion. So there's a lot of education needed to say to somebody, take off your glasses, if you're short sighted, look at that, and see what it really makes you think of.

Colm Cunningham:

And that's something I know that you called out in, designing outdoor spaces for people with older people and people with dementia, the importance of that consistency. And I imagine it's the same on the inside. And it isn't just about the carpet, and that that's another area that's a passion for you, Ricky is light.

Ricky Pollock:

Yes, without good levels of light, we struggle to function, the older we get. And light is best, if it's natural, because it's free. If we have big windows, plenty of daylight, we have free good lighting, but that needs to be supplemented by quality interior lighting, to the levels that enable people to do the tasks that they're trying to do.

Colm Cunningham:

What are the things in the insides basis do you see as key core core design features?

Ricky Pollock:

An easy ability to find a toilet, the stress that people can feel from not knowing where the toilet is, I'm sure everybody has been in a situation where no idea where a toilet is that is when you're going to need to visit. So they should be as many as possible, as visible as possible, particularly in places like dining where they're bound to be needed.

Colm Cunningham:

And you know, it's one of the things I remember when we used to do audits together that you could walk a room and say this is such and such a length and I just go How does he do that? I can now by talking about the toilets, that because we all know what they're sign needs to be 1.2 meters from the base of the floor so that the person who actually needs to read it, not the person who's fitted it can actually read it they the person who's a resident of that space, I can spot that now but I think that's just having worked with you for a long time. But you're absolutely right, the barrier to toilet. And all of the interventions and intrusion personally to somebody of not getting that right is so significant.

Annie Pollock:

And signs which makes sense. I have a lovely story where I went to a local arty workshop place with my granddaughter to look in the shop and we looked around the building. And she said to me, as we looked at the toilet door, she said, Why is there somebody in a bath and a flying baby? Now that somebody in a bath was an arty interpretation of somebody in a wheelchair, but it looked exactly like it was a bathtub with a head on top. And the flying baby was to indicate that you could have baby change nappies, but it was at a sort of 45 degree angle quite substantially above the bath or the wheelchair. And so clarity of signage is important for absolutely everybody but all the more so for people with dementia.

Colm Cunningham:

So we're not trying to be down on innovation. But as you say, clarity has to trump every time

Annie Pollock:

Absolutely sensible design that understands it's got to look like what you're trying to tell the story you're trying to tell. And unfortunately, this comes back to you know, a lot of clever designs, designers can be sheep that follow fashion, but often to the detriment of people with disabilities. So it's making sure that it's clear and sensible. And on top of that, if you want to make it a good design, but not designed such that it really is incomprehensible which is happening too often.

Colm Cunningham:

And of course small domestic familiar, the research, much of which as you say wasn't around when you started this process has only come to validate what you're saying to us now

Ricky Pollock:

Yes. And a big issue. I think with architects, as designers, we have regulations. And there are a massive number that relate to hospital care, home, housing, all types of building. And architects will design to minimum standards. Now, I'm always lecturing about do you realize a regulatory standard is the worst that is legally acceptable? It's not good. So why the architects I love are the ones that tear up the regulations and design properly. So you don't say a doorway must be 750 millimeters clear for a wheelchair, and then make them smaller to fit that if you've got room make it wider. Yeah. And then it accommodates more wheelchairs, a bigger range. It's friendlier, easier for access, but yet people use regulations is what's the smallest I can make this?

Colm Cunningham:

And is there any favorite gardens that you've seen? In your travels?

Annie Pollock:

We went to a lovely garden just last year, what was that one called the Japanese garden, Cowden Cowden in near Kinross. It was beautifully laid out, it was well interpreted. There were areas that you wouldn't walk over if you were an older person, like stepping stones across a water feature. But it was a joy to be in. And it had paths that could take you around different levels. And it was beautifully designed and beautifully maintained. And that was an absolute pleasure to go to.

Colm Cunningham:

Can I ask you. So you've worked together? Or do you work separately in terms of because, you know, I've always seen Ricky and Annie Pollock we say it in one breath. But what's it been like to be in this space together?

Ricky Pollock:

It's really taken a lot of pressure off me when I started into designing for disabilities and then dementia, I did the whole inside outside. And Annie saw he is enjoying this. And he's tramping on my territory. So we had a negotiation that we would divide our responsibilities at the door thresholds. But we wouldn't forget, we still had to get either side of the threshold to match.

Colm Cunningham:

Can I throw a spanner in there, which is that Annie might have got the more challenging side of things, because my experience has been that often people focus their budgets on the building and not on the outside space. Is that fair comment Annie?

Annie Pollock:

That is very fair comment Colm. And one of the last projects I worked on, was in an area of Scotland where the climate was challenging. And in that case, I had put in lots of shelter, protect the gardens, places to sit with shelter, they all got cut out. I said, Well, you won't have any plants if you do that. But it was cut out, possibly for cost, but also possibly for management reasons, to enable people to have a view all the way down rather than be outside. And so there are all sorts of compromises that can hit you. Which, to my way of thinking are bad. Uh huh. It can be marketing, it can be money. And obviously landscaping the tail end of the process is the one that's most likely to get problems because other considerations come in late on in a stage which didn't exist at the beginning.

Colm Cunningham:

So Ricky, you must therefore have ended up being in terms of this double act having to be the advocate for the importance of the budget balancing to allow for the importance of what we all know, which is access to outside is key. But people will often clip that one or if the budget's challenging and you probably have been in situations where you've had to go hang about

Ricky Pollock:

Absolutely. The dealing with what we call Value Engineering is a tough project in itself. That what we have often to deal with is beautifully generous corridors, ample space for storage, which is and then the value engineers come along, how wide does that corridor really need to be? And I would argue it needs to be the way I've drawn. And they pick up the regulations again, but you know, we could get away with 1.8. So we're always having to chip away at what we think is quality to get just good enough.

Colm Cunningham:

And of course that's short term economics because the cost of the impact on care and care staff hours and staffing flows and all medication because somebody's agitated but all of these things so there's no But arguably a false economy on the way they're looking at the immediate cost, not long term.

Ricky Pollock:

Yes, it's possibly the biggest fault in in construction industry is everything is based on first cost. Because first cost is borne by one part of an organization, the follow up costs are borne by something completely different. So when a hospital is built, the capital team produced the building, then they're off, and they are handed over to the staff that have now got to manage it. And though they don't meet, and it's this terrible, save on day one, and stack up extra costs further down the line,

Colm Cunningham:

Any final words of wisdom for us? I know I'm asking a lot over the decades. But for people listening in terms of priorities, you've clearly talked about the importance of the internal and outside spaces working together. You've talked about being able to see and sense the importance of light, noise, the importance of different spaces, both internally and externally. But something you want to call out Annie can I pick on your first is really say, please, please consider this,

Annie Pollock:

I would ask the people who are in control of the budgets, to try and take off their outside coat and their shoes and put themselves into the shoes of a person with a disability. And just to imagine, what it might be like, how it might be, if you can't find something, if you can't get outside, would they feel happy? Make sure there's plenty of fresh air, make sure that people have that they are treating those that they're looking after, by trying to understand what they're going through, and not cutting costs. From their own point of view,

Ricky Pollock:

I would just reinforce that's exactly what I was going to get a message across, we have to think ourselves in to the shoes of all those individuals who have a massive range of disabilities, abilities, dementia, we're a wide broad church. And we've got to think what it's like for every single one of us to get the best out of the buildings, we're designing for them

Colm Cunningham:

On behalf of everybody who I know, in the job that I have been influenced by your work over decades and knowledge you've shared and as I've said, a lot of the work that you've written and we'll share in the links in the show notes. Your books, again, have influenced their thinking. I want to thank you on behalf of all of them. Thanks so much for joining us on the Dementia Podcast.

Ricky Pollock:

Thank you very much.

Annie Pollock:

Thank you. It's been a pleasure. It's been a lifetime of wonderful work.

Colm Cunningham:

Thanks to Annie and Ricky for joining me in this episode, you can find out more about what we discussed in our show notes, including those free downloads to their latest books, and previous publications. If you're new to the dementia podcast you're most welcome. We have other excellent podcasts on design just like this one, waiting for you in our back catalogue. If you've any questions, comments or feedback, we'd love to hear from you via our email hello@dementiacentre.com. Bye for now