Author:

Keywords:

architecture, dementia, experience, orientation, activities of daily living, qualitative research

Abstract:

Due to memory loss, most people with dementia are increasingly disorientated in space, time, and identity, which causes profound feelings of insecurity, anxiety and homelessness. The built environment is expected to hold great potential for offering support in coping with the challenges resulting from disorientation. However, adequate architectural design knowledge is still lacking. Exploratory meetings with professional architects suggest that most research findings do not match their approach to designing architecture for people with dementia. The aim of this PhD research is offering architects insights into the experiences of people with dementia to broaden knowledge on architectural design for them. The central research question is: how could architecture support or hinder people with dementia in orientating in space-time-identity? A novel approach is developed to inscribe this PhD research in current emancipatory discourses on housing and caring for people with dementia, and to bring the findings closer to the discipline of architecture. Starting epistemologically from a constructionist approach and theoretically from a phenomenological perspective, being oriented in space-time-identity is considered as having a sense of oneself situated within a spatial, temporal and social framework. The research is built up around three case studies: two private housing settings, and one residential care facility with a focus on three of its residents. In each case study ethnographic techniques are combined with an architectural analysis. The first case study highlights how architecture can support a person with dementia in orientating by accommodating places for privacy and togetherness, as well as places and objects for everyday activities. The everydayness of such places and objects, the case study suggests, can counter the alienating experience of being disoriented. This is important to keep in mind when designing residential care facilities, which only with great difficulty manage to transform their hospital-like character into the everydayness ofnbsp;environments. In the second case, the person with dementia finds support in creating ‘little worlds’, spaces that are narrow enough to provide a sheltering environment and that offer personal places where belongings are ready-to-hand. Also paramount is the importance of order, of creating spaces wide and light enough in which to move, rdquo; and think clearly. Unlike the tendency to associate architecture for people with dementia with traditional and primeval housing types, this suggests that they might as well benefit from architectural qualities often found in contemporary housing. Case study three reveals different ways in which people with dementia use and experience the same built environment. This study also highlights important challenges in designing architecture that supports orientation in the context of a residential carenbsp;articulating boundaries between different spatial entities and domains, articulating facets of residents’ lives, and taking into account the spatial aspect of social interaction. Together, the case studies show that architecture can support people with dementia in coping with the challenges of disorientation by articulating their relation to places, people, and their history, both on a smaller and larger scale. The smaller scale concerns the design of strategic places that allow people to be occupied with a daily life activity in a comfortable, more or less active way, and an architectural context that facilitates support from other people. On the larger scale, and particularly in case of a large and complex program of a residential care facility, it is important to consider to what extent the architecture reflects the presence of an overarching care organization and its logistic requirements, or also other facets of residents’ lives. Other points of attention are the social dynamics of people living together and the design of shared spaces and facilities. In this way, architectural design for people with dementia transcends the specificities of this group and includes a broader architectural program than – to put it bluntly – merely filling out theldquo;details” of projects that have been set in stone already to a great extent. The case studies give voice to people with dementia and provide insights into their experiences in a format that allows architects to develop affinity with their perspective. For care givers, this PhD research shows (part of) the repertoire that architects possess to design architecture for people with dementia. By linking insights into living with dementia with architects’ “core business” of form and spatial organization, this PhD research could enhance dialogues between architects and their clients, and broaden their view on possible roles of architecture in the daily lives of people with dementia.