Dementia‑Friendly Transport and Universal Design

This report investigates travel experiences and barriers faced by people living with dementia in Norway, focusing on how universal‑design principles can be extended to improve cognitive accessibility in public transport. While traditional universal design emphasizes physical disabilities, the study highlights the unique challenges posed by cognitive impairments—particularly dementia—on independent travel and social participation. Qualitative interviews and follow‑along studies with people with dementia and their relatives reveal barriers across physical, sensory, informational, social, organisational and digital domains. Digital interfaces (ticketing apps, machines) emerge as a major obstacle, often preventing solo travel. Caregivers play a crucial role in enabling mobility. The report proposes a comprehensive set of measures: improved signage, accessible ticketing, better physical infrastructure (seating, toilets), increased staff presence, and assistive technologies. International best practices (e.g., Singapore’s “Go‑to‑point” centres, colour‑coded floor signage) are discussed as models. The authors conclude that dementia‑friendly transport requires a holistic approach integrating physical, digital, social and organisational adaptations, and call for further research on solitary‑living persons with dementia and inclusive digital solutions.

Supporting evidence

• Qualitative data: Six in‑depth interviews and two follow‑along studies with people with dementia and their relatives, recruited via the Norwegian National Association for Public Health.
• Theoretical framework: Expanded version of Sen’s capability approach guides thematic analysis, ensuring findings are grounded in both empirical data and established theory.
• Key observations:
  • Recurrent difficulties with digital ticketing systems, requiring caregiver assistance.
  • Signage, information screens and ticket‑machine challenges observed during follow‑along studies.
  • Testimonials stressing the importance of real‑time information, accessible toilets and comfortable seating.
  • Caregivers identified as essential for travel planning and execution; many participants cannot travel independently.
• International benchmarks: Singapore’s dementia‑friendly transport initiatives provide corroborating evidence for proposed measures.
• Alignment with prior research: Findings echo earlier studies that highlight barriers for cognitively impaired travellers and the need for user‑centred design and staff support.

Key findings

1. Digital barriers: Complex ticketing apps and machines deter travel; simplifying interfaces and offering alternative ticketing options are essential.
2. Physical & informational barriers: Poor signage, lack of real‑time information, insufficient seating and toilets impede mobility; multi‑level, symbol‑rich signage and accessible information displays are recommended.
3. Caregiver role: Families are pivotal in travel planning; policies must consider caregiver support, respite and clear information about services.
4. Organisational & social factors: Infrequent services, complicated transfers and limited staff presence increase stress; increasing service frequency, reducing transfers and ensuring staff at key hubs improve accessibility.
5. Assistive technology & best practice: GPS‑enabled smartwatches, digital communication with drivers, and Singapore’s “Go‑to‑point” centres, colour‑coded floor signage, and “caring commuter” programmes illustrate effective solutions.
6. Policy recommendations: Implement real‑time information screens at all stops, improve signage and orientation aids, provide accessible toilets and seating, simplify ticketing/payment, increase staff presence and training, and develop support mechanisms for caregivers.