The Impact of Architecture on Spatial Cognition: Designing for Neurodegenerative Diseases

the impact of architecture on spatial cognition designing for neurodegenerative diseases.

Theories of Architecture Illustrated Essay UBLMYV-15-3 2022/23 Danielle Payne 20003049 Word Count: 2162

Contents Introduction

3

Theoretical Analysis

4

Precedent study

11

Critical Summary

12

Appendices

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Introduction

Our lives are often categorised into three stages: infant,

My scheme, Willow Walk Village is a dementia care

adult and elderly. Contrasting to this linear progression

home located in Paintworks. The village aims to

of aging, our needs and level of care required work

encourage residents to have autonomy over their day

in a cyclical way. While the level of care is similar, the

to day lives, spend more time socialising, and engaging

way that this should be delivered differs. We must be

with animals and nature (Noone et al., 2015).

conscious of retaining dignity for the older generation,

This theoretical analysis, highlights ways that the

by allowing them to have control of their daily

concepts have influenced and developed my project

experiences in a safe and secure environment (Enes,

over time. It is clear how the analysis of this research

2003).

materialises into form and function within my scheme It is estimated that 700,000 people in the UK are

suffering from dementia. This is projected to reach one

and creates a comfortable and engaging environment for those with neurodegenerative diseases.

million by 2025 (Habell, 2012). My driving concept for design, focused on the connection between memory and architecture. Specifically, designing for improved spatial cognition. How can we design mindfully for neurodegenerative diseases, to allow the aging population to retain their independence for as long as possible?

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Theoretical analysis Our minds use our senses to understand our environment and get bearings of our surroundings.

Collectively, these senses help us to gain spatial awareness. Although we use all of our senses to do so, there is one sense which dominates: sight. Our cognition prioritises vision over other senses, as it can provide us with the largest amount of detail of our surroundings (Sussman and Hollander, 2015).

The dependency we have on our vision creates immediate boundaries for those who develop neurodegenerative diseases as visual impairment is one of the primary indicators (Possin, 2010). It is for this reason that we must design with these diseases in mind and create spaces and opportunities for those with neurodegenerative diseases to retain as much independence, for as long as possible.

My scheme aims to design a care home for sufferers of dementia, using the analysis of spatial cognition.

The village promotes freedom, through providing an open, boundless environment which is also secure and

Figure 1. Diagram showing the progression of encouraging socialisation

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comforting. Designing for those with dementia means it

Willow Walk Village aims to create a new version of

is impossible and unrealistic to attempt to view the world

home, where everyone can have the opportunity to

through the same lens. Therefore, it is our responsibility

engage in activities throughout the day, whilst also living

as designers to instead, ask questions and intently listen

on their own terms. The design has been formed directly

to the experiences of those who live with the illness, to

through the analysis of spatial cognition and research

gain the best understanding possible (Bellamy, 2022).

into designing for neurodegenerative diseases.

How do we define memory within place? (Lyndon,

Our brain goes through multiple processes to

2009). Understanding that memories are embedded

gain spatial awareness. This can include using objects

within the architecture we create is pivotal for designers.

as landmarks of spatial importance and permanence.

We must design with the intention of memories and

This technique can then be translated into finding and

experiences being created in the spaces we fashion.

memorising routes using the landmarks as beacons

When buildings hold memories, they become significant

(Sussman and Hollander, 2015). A research paper

to the users and can permeate their minds. Creating

conducted in 2007 observed several elderly people,

positive experiences within spaces can impact those

some with dementia and some without. The aimed

with neurodegenerative diseases. These associated

to determine the difference in their ability to navigate

memories make it more likely that they will continue to

themselves around their local area. All but two of the

view the village as a positive environment. Care homes

members who had dementia were able to navigate the

can be distressing for some as mostly, residents move

route. Upon a follow-up interview, it was found that this

there involuntarily. This can cause confusion and upset

was due to identifying landmarks and following them

when the individual becomes disoriented and misses

along a path (Mitchell, Burton and Raman, 2004). As

their previous home (Jones, Rice and Meraz, 2019).

this navigation technique proved successful, my scheme 5

uses several wayfinding strategies which aim to provide the residents with cues, enabling them to recall their surroundings and put them at ease.

Each unit on the site has a front door and porch entrance to allow residents to inhabit the space as they wish. This can be done by hanging pictures or decorating the outdoor area. The units have different coloured doors, each a bright colour so that the difference is clear for those with visual impairments. For those whose vision does not allow them to see colour, each unit is named after a flower – the respective flower is then planted outside on the porch. The units will be signposted, and a map will be available around the garden for residents to easily navigate themselves. Each of the units are clad in brick, fashioning its own unique façade using varying brick tones and glazes (Mitchell et al., 2003). Figure 2 shows an example of these methods implemented on the unit

Figure 2. Unit elevation showing materiality and ownership of space.

elevation.

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The building form creates a site boundary with a communal garden in the centre and is designed with one secure access point, the main entrance. The only other access points are the fire escapes and emergency access bay. This is because the scheme should be free of boundaries and closed doors to encourage the residents to explore and gain bearings while being in a secure space. Figure 3 displays the various spaces, their level of privacy and how they are arranged on site.

Communal Spaces

Residential Units

Commercial Spaces

Restricted access

Figure 3. Ground floor and first floor plans showing arrangement of spaces within scheme.

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When discussing spatial cognition on a domestic level, we must identify how the hierarchy of spaces stand within the home. Eckhard Fedderson (2014) discusses the theories of Otto Friedrich Bollnow, who envisions the home as the centre of everything. A place of safety; specifically, within the home, the table and the bed are the most important spaces for feeling comfort and security (Eckhard Feddersen and Insa Lüdtke, 2014). This is especially relevant for those with dementia as the presence of a bed can relax the resident and prevent confusion (Wong et al., 2014). It is for this reason that in the units designed for those who need a higher

Figure 4. Diagram showing design considerations for neurodegenerative conditions.

level of care, the bed is in direct eye line of the entrance. This way, residents can enter the property and instantly feel as though they are in a place of comfort. Figure 4 shows the arrangement of these high care units.

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Spatial knowledge is often distorted; this is

become tired or more energised. Exposure to daylight

mainly due to boundaries or barriers imposing on vision

is beneficial for those with dementia, as it can help

(Waller, Nadel and McNamara, 2013). This occurs

individuals situate the time of day. This enables them to

regularly for those with neurodegenerative diseases

make decisions for their own well-being such as eating

due to their visual impairments. Distortion in view paths

and sleeping (Channon, 2018). My design enables

can create invisible boundaries. This can occur when

sufficient daylight to enter units. However, also gives

there is a sudden change of materiality in flooring such

individuals a direct view into the internal gardens which

as a threshold or a rug. Those with dementia and other

encompass a large portion of the centre of the site. This

diseases can mistake this change of texture for a step

viewpoint into the gardens will not only allow residents

or hole in flooring. This can cause accidents if they

to view the nature in the outdoor spaces but will also

attempt to step over or avoid these surface changes.

encourage socialisation of the village as they will be

To combat this within my design, Flooring will remain

able to see their neighbours, carers and authorised

consistent. Limiting flooring change as much as possible

guests interacting with one another in a safe space

will allow individuals to move between spaces safely

(Habell, 2012).

without worrying or becoming unsteady (Mitchell et al., 2003).

Though the primary objective and driving concept for my scheme is based on the experiences of those

Another aspect imperative to design is daylight.

who have neurodegenerative diseases, it is also equally

Although this is a crucial factor in all design, it can

important to consider others who will use the space

be especially necessary to consider when designing

every day. In care homes or medical environments, it

for dementia. This is because daylight can affect our

is important to provide staff members with sufficient

circadian rhythm, involuntarily affecting when our bodies

rest space. A place where they can be separate from

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the residents and recharge, to ensure that they are

2019). This became a driving force for my project, to

providing the best care. Often in similar healthcare

understand the disparity between carer and resident.

facilities these spaces are overlooked, and staff are left

How to cater for both users while not isolating them from

feeling under appreciated (Bellamy, 2022).

one another. Carers are a crucial part in the calmness

Living with dementia can cause frustration and confusion over not recognising any of the people around you. For this reason, it is imperative that the

and composure of residents and can ease confusion and improve their ability to understand their surroundings.

To ensure staff members have the tools to remain

relationships between staff and resident are led by

patient and calm throughout their work, my scheme

consistency and patience. Currently, in care homes, the

incorporates many staff facilities where they can separate

divide between residents and carers can be obvious,

themselves from the rest of the scheme to recuperate

where carers are overworked and constantly moving

before returning to work.

from job to job with little time to build relationships with

The staff spaces include staff rests, offices, and

the residents. Contrastingly, the residents are often left

communal areas to promote a healthy work environment.

with less engaging activities such as television which

These spaces are shown, inhabited in figure 5.

do not encourage any movement or mental stimulation (Jones, Rice and Meraz, 2019).

The project “For a walk with…” by Anton Kats (2019) aims to make the connection between resident and carer by using walking together to begin a collaborative approach to tackling housing, dementia, and redevelopment issues (Jones, Rice and Meraz, Figure 5. Third floor plan showing consideration of staff spaces.

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Precedent Study Care farms: Netherlands Alongside the study of spatial cognition, an essential framework for my scheme was taken from care farms in the Netherlands. These care farms enable those who suffer from dementia to partake in meaningful activities during the day. They encourage residents to spend time outdoors and complete tasks which are a part of a bigger programme. These schemes have become more prevalent for multiple reasons such as the deinstitutionalisation of care homes, catering to fit the needs of individuals and cognition-oriented care (de Bruin et al., 2010). This form of cognitionoriented care has guided the spaces, which have materialised in my scheme. This method aims for a collaborative approach between the individual and the carer, to ensure the patient has a voice in the direction of their care. Understanding this method has guided me to introduce spaces which host activities that can be enjoyed by resident and carer together – these include salons, florists, gardens and animal care facilities where the residents will have monitored responsibility to complete tasks contributing to the function of these spaces. Engaging in these activities will encourage a more active lifestyle, additional time in nature and increased socialisation.

All of which can improve mental well-being and strengthen connection of memory to place (Noone et al., 2015). Figure 6 is an example of how communal areas are the heart of the scheme with residents engaging in social activities and nature simultaneously.

Figure 6. Showing residents partaking in meaningful activities in their communal space.

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Critical Summary

Throughout the course of my project, I have been studying spatial cognition and how to use this theory to design for those with neurodegenerative diseases.

Exploring this topic has enabled me to create a framework for care homes whereby residents can be comfortable and retain their independence for as long as possible.

Understanding memory as a place holder for buildings to exist and develop influenced my design form, function, and aesthetic to work to the advantage of the consumers. Exploring the link between spatial cognition and dementia gave grounding to my design and led the process from the beginning. Without this framework, the scheme would not work in favour of the inhabitants and would not create experiences and opportunities as I intended. By encouraging independence and socialisation in the aging population I hope to shift the attitude of care homes in the UK toward designing more mindfully for neurodegenerative diseases and implementing methods which can help the aging population live well with dignity as they grow older.

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Appendices

Appendix 1 and 2 These diagrams show early progression of thinking into how the form could evolve to cater for security, public access and privacy. It was critical to consult theory during this early phase to understand how best to design for dementia.

Appendix 3 This image is a manifesto created early in my conceptual process. The collage shows combination of engagement with nature, people and their surroundings.

Appendix 1

Private Public Semi-private

Appendix 2

Appendix 3

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Appendix 4 This series of diagrams guided my form as they helped me to understand how my forms connect and where my views could be placed based on the purpose of the form.

I also discovered the need for connection, this later materialised as a rooftop greenhouse.

The third diagram shows how the form encourages residents to socialise and connect with one another as they view the social spaces from their units.

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Appendix 5 Carpe Diem is a precedent which heavily drove my design work.

The care home brands itself as a dementia village which allows residents to walk freely around the scheme. This was something I was keen to implement in my own design and so used their work as a direct influence to my own

Appendix 6 This small series of diagrams is a quick condensed story board of how the residents in my scheme may go about their day.. These were influenced by the care farm framework.

Discussing the day ahead and making autonomous decisions.

(Ramstad and Grini, 2020)

Completing gardening tasks.

Looking after animals..

Carpe Diem landscape sketch

Willow walk Village sketch

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Appendix 7 These sketches aim to solidify my landscaping scheme using the work of Piet Oudolf as a precedent for my design, the aim is to encourage residents to spend more time outdoors.

Appendix 8 These basic visuals give a general feel to the form of the communal areas of the site. They are designed to feel comforting and familiar so that the residents feel encouraged to use them.

Communal hub

Restaurant 16

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List of Figures

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Figure 1. Diagram showing the progression of encouraging socialisation, Author’s own.

Ramstad, K. and Grini, I.M. (2020) Carpe Diem Dementia Village

Figure 2. Unit elevation showing materiality and ownership of space.

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com/955466/carpe-diem-dementia-village-nordic-office-of-architecture

Figure 3. Ground floor and first floor plans showing arrangement of

[Accessed 16 April 2023].

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Figure 4. Diagram showing design considerations for

Sussman, A. and Hollander, J.B. (2015) Cognitive architecture:

neurodegenerative conditions. Author’s own.

designing for how we respond to the built environment. New York:

Figure 5. Third floor plan showing consideration of staff spaces.

Routledge.

Author’s own.

Figure 6. Showing residents partaking in meaningful activities in their

Waller, D.A., Nadel, L. and McNamara, T.P. (2013) Handbook of spatial

communal space. Author’s own.

cognition. Washington: American Psychological Association, Cop.

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