Older age is consistently associated with an increased risk of disabilities and diseases, especially dementia. Dementia is a syndrome due to the disease of the brain, which is characterized by a progressive, global deterioration in the intellect including memory, learning, orientation, language, comprehension, and judgment. Because of their cognitive and age-related bodily impairments people with dementia are in need of assistance with numerous daily tasks. Over the last decades, dementia-friendly care concepts have been well established in many different nursing care settings. In this context, a large body of research supports the relationship between the design of the built environment and well-being, functionality and behavior among people with dementia. However, dementia- friendly care concepts were hardly introduced to acute care hospitals. Acute care hospitals face big challenges, caused by the increasing number of dementia patients. Dementia is rarely the reason for admission to general acute care hospitals, but it is present in a significant number of elderly patients. They are at risk of losing more independence and cognitive status during their hospital stay. Problematic behavior and disorientation among these patients are challenging for hospital staff and other patients. The aim of this paper is to present current state of work and future tasks from a doctoral thesis dealing with the question how to design dementia-friendly acute care hospitals.

An extensive literature review on ´building design for people with dementia´ forms the basis of the thesis. The review aimed at gaining an overview of the current state of research on this topic. Several design factors were identified, which influence people with dementias` outcomes. However most of these findings are related to the nursing home setting. A next crucial step will be the translation of these findings to the hospital setting. A combination of different methods will be used. A qualitative analysis will be implemented to find out in what ways the hospital environment differs from long-term care facilities, to define patient`s and staffs ‘characteristics and to identify physical features in the hospital environment, which hinder and support patient`s with dementia during their hospital stay. Data will be collected through observations and interviews in an acute care hospital in Dresden, Germany. However, there is a need to define this methodology more precisely and to determine which outcomes to use. Results from the literature review and qualitative analysis will be discussed in focus groups to develop evidence-based design recommendations for dementia-friendly acute care hospitals. Though, there is a need to find ways to generalize the results. Furthermore, research gaps will be exposed in the working process. Therefore, further steps could be the testing of different design interventions to fill the identified research gaps.

The findings will be summarized in a guideline to design dementia-friendly hospitals. This guideline will provide information for architects and health-care professionals on how to develop dementia-friendly floor plans as well as patient and common rooms. Furthermore, suggestions on what can be done to communicate information through the hospital environment to support spatial, timely and situational orientation in patients with dementia will be given.