The Architectural Needs and Preferences of Autistic People Versus Gerontological Residential Care Facility Design Practices

Background: Older autistic people in the United Kingdom are facing a social care crisis. Autistic people are more likely to need social care as they age, but little is known about the architectural needs of autistic people, meaning current residential care facility design makes this form of social care inaccessible to them. Older autistic people often have to rely on fragile informal care or are placed in unsuitable social care situations such as long-stay hospital wards. In contrast, there are established gerontological best practices for designing residential care for older people. This article discusses how the residential architectural needs of autistic people and gerontological residential care design best practices may conflict. Methods: One hundred and five autistic people answered an online questionnaire asking about their architectural needs and preferences. Qualitative results were analyzed using reflective thematic analysis with an inductive approach, and quantitative results were described and tested for statistical significance where appropriate. Results: The research identified three themes where there may be conflict between the architectural needs of autistic people and gerontological residential care design practices: sensory challenges, interactions with others, and day-to-day life. Elements within these themes could make buildings inaccessible to autistic people, cause sensory overload, cause distress, or negatively impact their executive function and ability to complete daily tasks. Conclusions: Certain aspects of residential care design that may positively influence older people’s well-being and quality of life may cause autistic people distress and discomfort and inhibit their ability to undertake daily tasks. Some of the elements that may cause this dichotomy are the building location and connectivity, building and spatial size, navigation and wayfinding, open plan flexible spaces or distinct separate spaces, spatial interconnectivity, the extent of the private domain, and social space design. Further research is needed on how to overcome these conflicts.