Signage – compensating for design or disability!


Design principles for better signage

Good building design should depend as little as possible on the use of signage and instead should be based on such features as open-planning, use of landmarks, reduced lengths of corridors and glazed partitioning to enable wayfinding (O’Malley et al., 2015). Where signs are needed, they should be designed in accordance with the following principles (Barker & Fraser, 2000):

  • Use signage only where necessary
  • Omit, conceal or make less prominent signs that are not needed by building users
  • Locate signage as part of the building design process; it is good practice to develop a whole of building signage strategy
  • Keep messages short, simple and easy to follow, avoid long-winded, superfluous   text
  • Keep the design of the signage consistent with established palette of colours and contrasts

Research has also identified key issues in presenting information to older adults generally (Farage et al., 2012). The following issues, which are a variation on these five principles, are of even greater significance for people with dementia:

  • ‘Simplicity
  • Intuitive logic
  • Moderate pace
  • Minimum of non-relevant information’

Good example of a clear directional sign

Good example of a clear directional sign


Types of signage

There are three basic categories of signage types:

  • Directional
  • Locational
  • Statutory/regulatory/safety

Directional signs need to have an arrow or forefinger pointing indicator of the route that must be followed in order to reach a destination. It is essential that these are provided at every change of direction and at every decision point, otherwise people with dementia will be at risk of becoming disorientated and distressed at being ‘lost’.

Locational signs are used to indicate the use or function of a room or space and should be placed on the doors, not beside them unless the doors are held permanently open, in which case the signs should be placed to the latch side of the doors.

Good example of locational sign with photo of actual toilet behind the door

Good example of locational sign with photo of actual toilet behind the door


Regulatory signs and signs that are only for staff such as those that indicate infection control issues, fire safety and other risks should be placed as inconspicuously as possible so that they do not attract the attention of people with dementia. 

Staff information sign well ‘hidden’ at top corner of door

Staff information sign well ‘hidden’ at top corner of door


All signs for older people (with the exception of those for staff only) require to be mounted at a height of around 1.2m above floor level, which is generally within the range of vision of older people with stooped postures. Signs mounted at high level, such as those that are hung from the ceiling, are much more difficult for them to see.

Sign content

Signs for people with dementia should consist of text together with symbols or a graphic. A lot of the evidence for this is based on research carried out by Miles Tinker, an American whose work on legible typography was carried out in the first half of the last century. His papers and publications are far too numerous to list in this short article.

The research carried out by the UK Department of Transport for the design of signage for the planned new motorways in the 1950’s also provides useful guidance on the implementation of type styles, which can be summarised as follows:

  • Start with a capital letter followed by lower case, since the presence of ascenders and descenders enables a person with sight impairments to recognise the patterns of words more clearly than all capitals.
  • Use ‘Sans serif’ fonts, which are generally clearer to read
  • Avoid italics, very bold letters and cramped narrow fonts
  • Use more generous letter (kerning), word and line spacing
  • Avoid too many typefaces
  • Braille is unlikely to be helpful to people with dementia

Symbols and graphics can also be more useful than text for some people with dementia and these should have the following characteristics:

  • Clear 3-D symbols and graphics generally more legible than 2-D
  • A good toilet (WC) image is much easier to recognise that the standard ‘stick person’ symbol (Richards, 2016)
  • Realistic images rather than over-symbolic or abstract
  • Icons need to be at least 100mm in height
  • Any photographs should be recognisable and relevant

Unintelligible BSI standard ‘stick man’ symbol

Unintelligible BSI standard ‘stick man’ symbol


Reliance on colour is not as helpful as might appear, but contrast is absolutely crucial (Bright et al., 2004). The lettering and symbols must contrast with the sign background and this in turn must contrast with the wall or door it is mounted on.

The materials used in manufacture should be matte finish to avoid glare and reflections. Signs can also only be seen where there is a good level of light. Light toned letters on a dark background are more visible than dark on a light background.



British Standard for Graphical Symbols and Signs – Safety Signs, including fire safety signs (BS 5499: Part 1: 2002), BSI

Design of buildings and their approaches to meet the needs of disabled people –
Code of practice (BS 8300 2009), BSI

Wayfinding: Effective Wayfinding and Signage Systems guidance for healthcare facilities, Health Facilities Scotland, October 2007

Bright K, Cook G, Harris J, Colour, Contrast & Perception – Design Guidance for Internal Built Environments (Project Rainbow), University of Reading, 2004

Cruikshank L, Creating a safe environment for people with sight loss and a learning disability, RNIB Scotland, 2015

Tinker M, Various journals, University of Minnesota

Farage M A, Miller K W, Ajayi F and Hutchins D, Design principles to accommodate older adults, Global Journal of Health Science, 2012

Barker P & Fraser J, Sign Design Guide – a guide to inclusive signage, JMU Access Partnership, 2000

O’Malley M, Innes A, Wiener J M, Decreasing spatial disorientation in care-home settings: How psychology can guide the development of dementia friendly design guidelines, Bournemouth University, 2015

Richards L, Inclusive Symbols for People Living with Dementia - Feasibility Research, 2016


Ricky Pollock, Associate Consultant Architect with the Dementia Centre, HammondCare*. This article is based on his extensive experience of working in field of designing the built environment better for people with dementia. For the purposes of this short article, a great deal of more detailed advice on signage has had to be omitted.




Richard (Ricky) Pollock formed the architectural and planning consultancy Burnett Pollock Associates with partner David Burnett in 1974. Since then, the Edinburgh-based practice has established both design and research expertise in sustainable development, specialised care accommodation, assistive technology for disabilities and dementia friendly design. Richard is currently a consultant to the newly formed practice, BPA Architecture. He was also the Director of Architecture at the Dementia Services Development Centre (DSDC) at the University of Stirling from 2008 up until last year.

Richard first demonstrated principles of design for people with dementia in the ‘St Leonard’s Initiative’ social housing project in Edinburgh for Places for People Housing Association in 1992 following a period of research into barrier free design started in 1987.  This was followed by Richard’s involvement in several projects for Glasgow City Council to convert existing care homes with low environmental standards to be more ‘dementia friendly’ as part of the Social Work Department’s contribution towards Glasgow being designated ‘City of Architecture and Design’ in 1999. Since then, Richard has been the project architect responsible for three of the ‘Opening Doors for Older People’ projects undertaken by West Lothian Council in partnership with Bield Housing Association. His practice designed the model Iris Murdoch Building for the Dementia Services Development Centre at the University of Stirling, which was completed in 2002.

Richard has spoken at a HammondCare conference in Sydney in 2011. He has lectured widely on accessibility issues and authored several research papers and design guides including writing ‘Designing Interiors for People with Dementia’ and contributing to ‘Designing Lighting for People with Dementia’ and the ‘Design for People with Dementia Audit Tool’, published by the University of Stirling in 2003, 2007 and 2008 respectively. Richard has also provided consultancy and training services to local authorities and NHS trusts extensively throughout the UK and abroad.


Contact details:

+44 (0) 7787 168 168

*HammondCare provides a bespoke product evaluation service to encourage manufacturers to make their products more suitable for people with dementia.