Thoughts on toilets for older people and people with dementia


Thoughts on toilets for older people and people with dementia

Whenever I have to use a public toilet, I am fascinated to see how they are designed. Many years ago, there was a publication called ‘The good loo guide’ (first published, 1965) where loos in London were awarded stars for excellence. My fascination for loos in public places stems from then.

Too often, going to a public toilet is stressful  – hard to find, not clean, too small, no paper or paper that’s hard to get, no soap – the list goes on. We’ve all had such experiences.

A couple of recent examples:

  • At a conference held in an architectural ‘Centre of Excellence’, a gentleman was overheard coming out of the toilet, saying (I hope in jest!) that “the urinals were awfully high up…” – these were, in fact, trendy round metal basins in a row along the wall
  • In an airport ‘Ladies’ room, a desperate lady with soap all over her hands was heard asking “how do you turn on the water?” – there was a black button to operate the water located under the shelf at the back of the sink, which was completely invisible.

For people with dementia, even getting to a toilet can be a real achievement – as signage is often very poor. Needing the ‘loo’ and not being able to find one is very stressful – and stress is disabling for us all and particularly so for someone with dementia.

Many people in the UK have poor sight - by 2050, it is predicted that the number of people with sight loss in the UK will double to nearly four million. Currently, 1 in 5 people aged 75 and 1 in 2 people aged 90 and over are living with sight loss; 63% of people with sight loss are female, 37% are male (Access Economics, 2009).

So you’ve managed to find the toilet – and help! – everything inside is white, the toilet, seat, walls, grab rails, paper…This is likely to be really hard to see for someone with sight impairment, as it will blur into a white fuzzy mass. People with dementia just won’t understand it.

So what do we need?

  • A toilet that’s easy to find, with a cubicle large enough for someone to use with ease
  • Good colour definition so we can see what is what – and good lighting too
  • A paper dispenser that is easy to use and understand (not the type that you have to put your hand up inside to scrabble desperately for paper!)
  • Grab rails to help you if you need them
  • Locks that are easy to use
  • Basins that are understandable – not little round sinks or great big troughs
  • Taps that work easily – and if a hot and cold tap, ones that you can tell easily which is which
  • And the if the kind of tap that is a single lever from cold to hot, it must be pressure controlled or else you are drowned by the time you get hot water!

Then, drying your hands…paper towels are the most effective to use and understand.

The latest mechanical dryers are very noisy, which can be frightening for many people, both young and old. Noise levels can vary from approximately 58 dB taking 45 seconds to dry up to 90dB taking only 12 seconds to dry. ( 90dB is equivalent to a hand drill and the level at which sustained exposure may result in hearing loss.

Visiting the toilet should be a pleasant experience – where the basics such as paper, soap, water and ways of drying one’s hands are easy to find and use, in a peaceful environment. And particularly so when we are older and if we have dementia.

So let’s get back to sensible and thoughtful design – and make going to the loo a pleasant experience for all, young, older, old and those with dementia.


Annie Pollock

Associate Consultant, Architect and Landscape Architect
HammondCare Dementia Centre



Annie Pollock



Annie Pollock is an experienced architect and landscape architect. She set up her Edinburgh-based landscape practice, Arterre, in 1987. Until October 2015, she was Director of Landscape Design at the Dementia Services Development Centre, University of Stirling and now has moved on to be an Associate Consultant for the Dementia Centre, HammondCare.
Annie has specialised in designing outdoor spaces for older people and those with dementia. She has won several awards for her work including:
•    Royal Horticultural Show silver medal for the ‘Forget me not Garden’ for Alzheimer Scotland and Action on Dementia, (Strathclyde Country Park 1999)
•    BALI award (British Association of Landscape Industries) for the courtyard garden at the Iris Murdoch Building (University of Stirling 2003) 
•    BURA commended award (British Urban Regeneration Association) for Dumbiedykes Estate regeneration (Edinburgh 2008). 
Annie spoke at a HammondCare conference in Sydney, Australia in 2011 and has lectured widely on internal and external design for people with dementia. She has also provided consultancy and training services extensively throughout the UK and Europe for various bodies including private clients, local authorities, NHS trusts and housing associations.
Annie has authored, contributed to and edited various articles and design guides, including ‘Designing Gardens for People with Dementia’, ‘Air Quality and Health for People with Dementia’ and the ‘Design for People with Dementia Audit Tool’ (published by the University of Stirling in 2001, 2008 and 2015 respectively). She was editor and contributor of ‘Designing Outdoor Spaces for People with Dementia’, published in 2012, jointly by the University of Stirling and HammondCare and is currently writing a new book on the design of ‘The Outdoor Room’ for HammondCare, to be published later this year.