Monday, June 9, 2008

Word on Health Care Facility

Here is a bit of waffle that i will tighten up over the next few weeks

The design proposal is for a facility to treat, manage and observe those suffering from various stages of dementia.
The site currently exhibits evidence of its history, the building up and layering of materials and textures, and the wearing and erosion around the exhaust stack. A balance is achieved between the degradation of the site and its renewal through maintenance and produces a visible trace of time and layering. This balance presents the passerby with instances where the site can be understood as having a memory or being a record of activity.
This record of activity, the alternating erosion and build up of materials has given the site its own vernacular that can be extended to influence the development of the health care facility. The role of memory to the dementia sufferer is a critical consideration in the health facility’s design and there is an important link between the mind, the body and architecture. Memory is made stronger by strong experiences. The spatial experience of architecture is a major contributor, from the ability of landmarks to improve path finding to the decorum of a building serving to reference ideas or activities that take place within.
Dementia sufferers generally experience the gradual loss of memory, among other functions, that starts by affecting the short term memory. Long term memories remain largely intact for a longer period and may provide a base to build on to help offset the loss of basic skills. Path finding is on such basic skill that seems to suffer enormously. The ability of the dementia sufferer to move from one place to another is affected by several factors. The lack of short term memory means it is likely that during the journey the destination will be forgotten. Similarly, the typical situation of admitting a dementia sufferer to a facility when the disease has taken hold, makes it difficult to have much recall of the building layout. This is made more difficult by the design of such facilities to be as simple and uncluttered as possible, resulting in them being consistent and repetitive and difficult to distinguish one room from another as a result.
The approach of the proposed design is to encourage independent decisions among sufferers and to help facilitate this independence and the sense of achievement and satisfaction that dementia sufferers should feel. Factors and experiences that encourage various activities will be explored to provide a system of structuring space to aid in intuitive path finding and to give support as required.
The almost derogatory idea of ‘keeping your mind active’ to offset the effects of conditions such as dementia, has usually been done with activities such as scrabble and crosswords. Perhaps a more useful approach is to keep the mind active by subjecting it to a system that tests everyday skills that are more beneficial to the sufferers quality of life. Much like any learned habit, the habit of doing a crossword is just that. The challenge eventually becomes an activity of repetition and of going through the motions.

2 comments:

Kimberley said...

Sounds like a great start, there's definitely a lot to build upon and I'm sure there's a massive amount of research on the topic. What strikes me is the potential of exploring short term vs long term memory - in my grandmothers case, her long term memory started showing signs of deterioration long before her short term memory did - she could recount her childhood in Africa in exquisite detail, but timelines and locations were skewed, and eventually the 'memories' she described were not actually her own. Over the next 10 or so years, her short term memory deteriorated notably to the extent that she felt lonely because she couldn't recall any of her (many) visitors throughout the week. Despite this, weekly events like ten pin bowling (oldschool, not on a Wii!) undertaken at her care facility stood out to her because it was a shared experience with those she spoke to at each mealtime every day. I'm not sure if she specifically remembered daily conversations on the topic, but she could remember a great deal of information about the events (even remembering her scores on occasion).

I'm not sure if this is typical or not, but in her case at least it suggests to me that the combination of the shared experience and the continuous contact with those who shared the experience has the potential to have an incredibly positive impact on those in the later stages of dementia.

Jules said...

Thanks Kimberley, i hadn't really considered the idea of shared experiences. Instead i was focusing on improving the ability to function individually with the idea that this would enable a sense of achievement when activities are completed.
I will have to incorporate the group activities as its an important aspect that i had overlooked. Cheers