Finding Home: Urban And Architectural Responses To Young Onset Dementia

The project explores how architecture and urbanism could respond to this urgent gap. Working across scales, the project offers a layered strategy that makes care visible and shared.

The Urban Scale (1:1000)

The project proposes a cognitive urbanism that acts as both an orientation tool and a new threshold.

The Street Scale (1:200)

Architectural landmarks, sensory exchange and public retreat points create a fabric of informal wayfinding and memory anchors.

The Domestic Scale (1:50)

At home, a central spatial core is proposed to organise daylight, anchor daily routines and allow for supportive spatial elements.

“Finding Home” is not a village for dementia. It is a real village reimagined. It does not imagine a future without dementia, it imagines one where people can still find home within it.

A Societal Crisis

Dementia is rapidly becoming one of the most pressing societal challenges of our time, and Young Onset Dementia exposes the biggest gaps in our current care system.

Unlike late-stage dementia, which care homes in Denmark are primarily made up of, YOD affects people in the middle of active, independent lives. They may still be working, parenting, or caring for others. The existing healthcare and spatial systems offer them little support beyond the normative institutional care. This leads to premature disconnection from everyday life which leads to rapid cognitive deterioration, a breakdown of family structures, and economic strain on the next of kin. As numbers grow, the crisis is no longer just clinical, it's architectural, urban, and societal. New, inclusive models are urgently needed to meet this demographic shift with dignity, care, and imagination.

What is Dementia?

Dementia is not just a single disease it is an umbrella term for a collection of symptoms that are caused by abnormal brain changes.

Dementia is a growing problem that is only getting bigger in the next couple of decades. By 2040 we will in a best case scenario have 125.000 people diagnosed in Denmark alone. 
As of 2021 3000 people in Denmark were diagnosed with YOD, which means they were diagnosed below the age of 65, but due to the lack of knowledge and misdiagnosis it is believed that there is an undiagnosed shadow number of the same amount. On top of that there is about 9000 next of kin for people with YOD alone.

The symptoms of dementia trigger a decline in cognitive abilities enough to impact daily life, behaviour and feelings. It affects all parts of the brain and its function. Dementia will affect the memory, first short term then long term memory. The long-term memory is rooted deeper in our brains and takes longer to be affected. It also disturbs our senses. 

The Social Burden Of Dementia

During the project explorations into the current issues that follows after a diagnosis were made.  Dementia does not only affect the people diagnosed, especially not when it comes to YOD. 

What Has Architecture Got To Do With It?

There is no cure for dementia and we will not find it in architecture. but dementia is not just contingent on medical solutions. 

We do consider the social model, where the problems with disabilities are not the individual’s fault but the inaccessible world. Therefore, solutions to alleviate some of the issues that people with a disability, like dementia, feel can be found in the built environment. 

It is also important to consider the built environment in care as feeling out of place in it repetitively can constitute a form of violence that leaves spatial imprints on the body. These spatial imprints will over time change our cognitive capacities and worsen them. Architecture can therefore play a big role in supporting both people with YOD, and dementia in general, and their next of kin.

Currently we have a huge gap in Denmark when it comes to the legal aspect of disability care. The CRPD (Convention on the rights of persons with disabilities) only mentions public buildings and not the urban environment. As recent as last year the UN raised criticism of Denmark due to the fact that the CRPD is not written into Danish law and the standard of care is generally falling.

As it stands today 80 percent of people in care homes have late stage dementia. We have gone from healthcare to sick care and the amount of specialised care needed for late onset dementia overshadows the needs of someone with YOD in institutions. We will also need 15.000 spots in the next 5 years putting extra pressure on the institutions. But maybe most dangerously 25 percent of people with dementia are medicated with antipsychotic medicine in institutions. This has proven to worsen the disease exponentially but that is outweighed by the need of docile patients.

This means there is a growing number of both experts, patients and next of kin that wish to stay out of institutions or reinvent them. Like a son not wanting his dad to leave home, or a nurse questioning why there is no space for the next of kin in existing typologies. All of these difficulties call for a shift in paradigm to address the pressing issues.

No Place Like Home

We believe that to address these issues we must explore a solution that bridges existing building typologies and redefines traditional care roles. A model that positions itself between the private home and the institution, supporting autonomy for longer, through a civic care network. We ask ourselves:

Spatialising Young Onset Dementia

This project takes shape as a pilot project in Odsherred Municipality. A municipality anticipating a 50% rise in dementia cases within 12 years.
We see consider Odsherred as an ideal site of interventions due to several characteristics. 

This is why we consider some of these local communities as an ideal place for interventions cue to their close tie and tradition of already looking out for one another when it comes to care.  

The project situates itself in Havnebyen, a small village in Odsherred in the sjælands odde area. This village, size and opportunities has been discussed with healthcare specialists in dementia design.

We do not consider a future where everyone in Havnebyen will develop dementia, but instead that this will be an offer for dementia families, by care specialists in the healthcare system. 

Havnebyen's industrial identity is fading. Its buildings are being replaced by holiday homes or left vacant, while the municipality proposes a future where only the old smokehouse is converted into a spa retreat favouring the many tourists that drive through the area each summer. This has been met with local resistance.

The site as experienced on our site visit, showed the characteristics of the strong identity in the harbour to the different single family housing areas, and smaller farm buildings in the edge zone.

The Landscape in Havnebyen is a part of Geopark Odsherred and has classic ice age landscape features.

To understand out site, we have been looking into the local features by interacting with the locals, as well as analysing the dementia threats as projected by our findings in research and interviews with experts. 

We have collected several of the local stories, quirks and tales, to understand the characteristics of this local community, with a variegated population, and where everyone knows everyone; from the woman who feeds the deers by hand, to the hoarder’s house, where everyone is welcome for a chat.

When you develop dementia, one’s perception of space changes along with difficulties in sensory responses. 

The village now stands at a crossroad, with the municipalities wish for a spa retreat centre, but can we think of an alternative future. A future that speaks into the locals needs, as well as responding to the healthcare issues we see in our society today. 

For our project we have collected information, and talked with families, to hear their stories.  Two different families with dementia and one local family were picked as case studies to imagine future scenarios of Havnebyen.

A Cognitive Urbanism

We created a toolbox of success criteria that architecture and urban planning could have an effect in addressing when designing for people with dementia. 

Based on these learnings we have developed a catalogue of change that benefits people with dementia but also included the locals that are currently living in a dilapidating village that no one is addressing.

We build our urban strategy up from defining present zones, rethinking circulation, and implementing our catalogue of change so it supports people with dementia to have the same right to roam the village as everyone else.

A Cognitive Community

The following explores solutions in four different spaces within the loop on how architecture can guide and accommodate spaces of conflict for people with dementia while maintaining the local heritage.

Due to the previous industry much of the local, native landscape was asphalted. The only space left untouched is the wild grass plot in Moseengen. According to the locals it is rarely used as it holds no activities and is used mostly for its access across the village. There are rarely any animals in the area.

For people with Young Onset Dementia the many access points are confusing, especially in a monotone environment. The lack of initiatives is not conducive for someone with dementia either. Being in nature is also imperative for someone with dementia and have many health benefits. It is a safe activity many enjoy. Especially the sounds of nature and animals have been found to be comforting.

The exploration in designing a space that can maintain a significant amount of access points while still be usable for someone with Young Onset Dementia proposes an implementation of subconscious guiding elements that can lead you through the landscape and clearly define spaces. These interventions will also act as moments of biodiversity that can rewild itself over time and bring back the diverse wildlife that used to exist.

Jessensvej and the identical non-profit houses is a recognizable part of Havnebyen. The locals are sad to see several of them empty and fear that they will fall into ruin. They have a central placement in the village and is never far from green spaces or spaces of gathering.

For people with Young Onset Dementia the access points to the surrounding village are disguised as another driveway or simply not registered. Access only defined by vision is the most draining cognitively for someone with dementia as well.

The exploration in designing clear access that exchanges one draining sense for a less draining one proposes a threshold that is defined by the smell and touch. Rammed earth pillars frame the view into the green area and all the way to the harbour. The pillars have vegetation growing that allows for smell to guide the way. The pavement activates the body and guides it on its way through a gradient of pavers leading a person with Young Onset Dementia from the street to the green areas and the green areas to the street.

Before, the harbour was not very clearly defined, with a lot of different pavements, and lack of walkable paths leading down to the harbour making it a difficult space for someone with dementia to navigate if the energy is low or too many impressions are to be processed. However, the open space has always been used by the locals for markets, small concerts and other gathering. 
The proposal tries to unite the space with a new pavement and continuing to have an open space suitable for the different social activities. A new walkable connection has been made with a handrail to guide you along the way, as well as markers in the top and bottom to orient towards. We are working with the thresholds and the gradient between social and solitary, through a wall made from existing buildings materials that invites to interaction when one allows it, rather than completely divides into in or out. Furthermore, we use one of the vacant storage buildings as a space to withdraw from parts of the sensory stimulation but maintaining either the visual or auditory stimulation depending on how you situate yourself in the room.

The smokehouse is slowly fading away only left for vacancy and decay. Also a space without clear distinction and direction, as well as no clearly defined walkable connection to this highest point of the village. 
The proposal seeks to give space to the local associations, from the fishermen, to knitting, willow weaving, bow shooting union amongst others. A space to meet around knowledge sharing, indoor and outdoor. To enter the area, we have made a new walkable path, with a rail to guide you all the way, as well as a pavement that directs you to the buildings, and all the way out to a viewing platform, making it possible to get a view towards Kattegat Ocean and looping you back into the village. For each building we are working with the openings and controlled ruin, to clearly define where to go. If one is to be over stimulated by sensory impressions, we have utilized the old smoke chimneys, as a moment of retreat.

A Cognitive Domesticity

The project works across different scales to propose a holistic framework with similarities between them to make the transition between scales as effortless as possible for people with dementia.

Based on interviews and research conducted, a set of success criteria for the domestic scale was established.

The core is divided across the house's two floors. Highlighted in red are the functions of the sun catcher and distributor, down to one of the bedrooms on the first floor, as well as the bedroom on the ground floor.  

The core is reaching out towards the front door, inviting you towards it, with small markers into the living room, and a small temporal stop in the alcove situated in the kitchen before entering the bedroom, in which the light is distributed down the chimney towards the bed.
On the top floor the memory wall holds the personal stories of the family and aids a person with dementia with reminding cues.

In the dining and living room two different situations are clearly defined. The dinner table, with lowered ceiling, and sliding doors to create a temporal confine space. In the living room the concept of a studiolo is introduced. A room of one's own. A concentration space adapting to ones needs. 
On the first floor the two bedrooms are located. One of them gets light directed from the chimney and the other holds the memory display of one’s own little studiolo space. 

To understand how the memory chimney facilitates the small moments of everyday life an explorative scenario of a day in the life of Bruno and his family were conducted.

The Prototype Of Finding Home

This project cannot tackle the enormity of the dementia crisis in waiting in terms of sheer scale, or the multidisciplinary expertise and resources required, the belief is that human scale interventions and neighbourhood solutions can provide valuable knowledge from a prototype project as in Havnebyen. This will act as a first step to bring Denmark towards an inclusive urban and architectural strategy that is universal, sympathetic and within ones chosen own home and community.