Universal design in public housing : an ethnographic study on enhancing the quality of life of older people with mild cognitive impairment living alone

Abstract

The population of Hong Kong is ageing and is expected to gradually increase, and thus an increase in single older people with mild cognitive impairment is expected. This may progress to dementia overtime. By 2064, a third of Hong Kong’s total population is expected to be aged 65 or above, which will put extreme pressure on long-term health services and increase social care costs. Studies of mild cognitive impairment (MCI) and dementia have mainly been conducted in the west, and evidence-based research addressing the genuine needs of patients with MCI in their daily activities is limited. The home is the central focus of many people’s lives, and the elderly will spend most of time in it. The specific objectives of the study are: (1) to briefly review and explore the common strengths and limitations of public housing in Hong Kong and selected cities; (2) to identify the deficiencies of current public housing in terms of universal design and broaden the scope of this approach; (3) to develop a model of the relationships among coping strategies for enhancing quality of life, unmet needs and the feeling and concerns of people with MCI living alone; and (4) to gain research experience by conducting user research with older people in Asian cities. This ethnographic study is aimed at revealing some of the contemporary concerns about human culture and social interaction. A triangulation study approach is taken, beginning with participatory design workshop followed by participant observations with five residents living alone with MCI, and an in-depth interview with a centre manager who assisted in this study and is a carer for those with dementia. This study suggests that universal design principles are not sufficiently applied in the development of public housing for single elderly people living with MCI. To address this deficit in interior, home furniture and product designs, the concept of a visible reminder has been suggested, which includes multisensory and psychological considerations. Design practitioners should fully utilise this conceptual model when developing universal design furniture for the general public, without stigmatising those with disabilities such as MCI. The coping strategies for improving the quality of life these older people are identified as continued home care and family support, an awareness of universal design principles, social networks and engagement and revisiting public health policies. Governments should take the lead in helping to improve the quality of life of people with MCI through healthcare, social engagement, caring and universal design.