Category: Research papers for built environment

Academic papers and publications

Designing hospitals with dementia in mind

A long wide corridor with lots of confusing lines in a hospital. Need to design with dementia in mind.Most of us feel vulnerable in hospital environments. Usually it’s because of their size, lots of people, corridors and signs. For people with dementia and other cognitive conditions, this can be extra scary. A team of researchers in Ireland gathered the research on designing hospitals with dementia in mind and similar cognitive conditions. They’ve come up with key design themes which are expanded upon in their article:

    • Support engagement and participation
    • Provide a people-centred environment
    • Support patient safety, wellbeing, and health
    • Balance sensory stimulation
    • Support legibility, orientation and navigation’
    • Adequate space to support the particular needs of a person with a cognitive conditions. 
    • Space and supports for accompanying persons and staff

The title of the Cochrane Review article is, Hospital design for older people with cognitive impairment including dementia and delirium: supporting inpatients and accompanying persons. It’s by Grey, Fleming, Goodenough, XIdous, Mohler, and O’Neill.

From the abstract

The aim of the study was to assess the effects of planning and design of hospitals, and to find out which approaches and features affect the health and wellbeing of older inpatients with cognitive condition such as dementia and delirium.

The study also assessed the effects of built environment interventions on accompanying persons. The focus was on any design feature that supports any person accompanying the patient in the hospital. The study also assessed the effects of built environment interventions on staff who are providing care to older patients with cognitive conditions. 

Universal design and dementia friendly hospitals

Front cover of the documentAcademic research and consumer input underpins this comprehensive guide to designing dementia-friendly hospitals from a universal design approach. The guide was developed in Ireland where they estimate almost one third of patients have dementia. Of course, dementia friendly design using a universal design approach is good and inclusive for everyone. The guidelines are available to read online using Issuu software. 

The short video below provides an overview of the design factors to consider in creating a dementia friendly hospital.

Dementia friendly hospitals: An in-depth study

A hosptial room with three empty beds. It looks very clinical and not dementia friendly. The design of the hospital environment can have an effect on people with dementia. That’s the finding of some new research carried out in hospitals where they interviewed patients and family members. 

The title of the article is, Dementia Friendly Hospital Design: Key Issues for Patients and Accompanying Persons in an Irish Acute Care Public Hospital  You will need institutional access for a free read. Or you can go to ResearchGate and ask for the full text. 

From the abstract

The findings are based on a stakeholder engagement process. The research team spent approximately 150 hours observing within the hospital, administered 95 questionnaires to patients and/or accompanying persons. Two structured interviews were carried out with patients and accompanying persons. 

This research confirms the negative impact of the acute hospital setting on older people with cognitive impairments including dementia and delirium. The research points to the value of understanding the lived experience of the person with dementia and accompanying persons. The voices of patients, particularly persons with dementia, are a crucial element in helping hospitals to fulfill their role as caregiving and healing facilities. 

Placemaking or Making Place?

A blue picture with swirling shapes as if under water.It’s time to move away from the word “placemaking” to “making place” and “making space”. This concept is discussed from an Indigenous Australian context in a book chapter titled, There’s No Place Like (Without) Country. Making place and making space allows for a view of spatial histories, claiming and reclaiming sites, and to uncover stories that are often overlooked in urban design practice. This is an academic text in,  Placemaking Fundamentals for the Built Environment, and you will need institutional access for a free read. It includes an example of the authors’ experience at the Sydney Olympic Park site. Sydney Olympic Park has documented some of the local Indigenous history.

Introduction: “In this chapter, we critique traditional placemaking approaches to site, through the Indigenous Australian concept of Country. We contest that a move away from the word ‘placemaking’ is overdue. We instead propose a practice of ‘making place’, and further ‘making space’ (i) that allows overlooked spatial (hi)stories to reclaim sites that they have always occupied, and (ii) for the very occupants and stories that are ordinarily overlooked in urban and spatial design practice. To do so is to accept that we must look to those marginal occupants, practices and writings that challenge the gendered, heteronormative, white, neuro-typical and colonising discourses that dominate architecture. Placemaking practices employ community consultation, privileging local stories and quotidian ways-of-being in response. It is our position, that even these ‘community-engaged’ processes perpetuate erasure and marginalisation precisely through their conceptualisations of ‘Site’ and what constitutes community. We present a model for an Indigenous/non-Indigenous collaboration that offers methods of spatially encountering site within a colonial context. We share our experiences of a project that we collaboratively produced in the Badu Mangroves at Sydney Olympic Park, to share the overlooked spatial histories and cultures of countless millennia. We have woven together Indigenous epistemologies, ontologies and axiologies, and design-as-research methodology.

See also Introduction: making Indigenous place in the Australian city from Post Colonial Studies journal.

Designing for dementia using personas

An older woman sits at a table in a room with a tv behind her.Asking users directly is the best way to find out which designs work best.  But when that is not feasible, perhaps personas can help. That’s the claim by a group of researchers who want to help architects and designers to create meaningful public places and spaces inclusive of people with dementia. The process of developing personas proved to be complex and difficult. This is not surprising because dementia affects different people in different ways. The full chapter is via Springer and requires institutional access for a free read. However, it’s possible to get a copy via the ResearchGate route.

The title of the paper is, Developing Dementia Personas for User Centered Architectural Design Considerations in Non-specialized Contexts. 

Abstract: This paper is concerned with dementia persona development as a research and design tool to help architects and designers to uncover important information towards design processes and decisions in practice. Architects design spaces for specific functions, but do they truly consider integrating these objectives with a focus on creating meaningful spaces for people with dementia while designing and if so, on what grounds. The reason for using dementia personas and not directly approaching people with dementia is due to the fact that it can be very hard to understand the needs of dementia care as people with dementia are dependent on caregivers and family members, in addition to this many designers and architects do not have ethical clearance to work with people living with dementia; as a consequence of their designation. A literature analysis and participatory workshops were used to develop the dementia personas discussed in this paper. The process of developing dementia personas posed many challenges; iterative revisions had to be made to make the personas relatable and concrete enough to be used as a successful design tool. The complex context of the case requires more personas to represent the diversity of persons with dementia in the service provision on different levels and this is the start of the persona development process. The findings are reported herein.

Learning through experience

A scene of the station showing people near the ticket barrier gates. Claremont College students from different disciplines joined the EnviroLab Asia 2019 Clinic Trip to Japan. A short video shows them checking out accessibility at Umeda train station and Ogimachi Park. The trip included time with Osaka Institute of Technology’s Robotics Department working on a project. They explored robotic technologies and universal design and created a model high tech recreational space for older people. The students conclude that barrier free places are not just for people with disability – it’s about including everyone. 

Abstract:  Studying Accessibility in Japan shows the research project led by Professor Angelina Chin (history, Pomona) with students who studied universal design and accessibility in Japan during the EnviroLab Asia 2019 Clinic Trip. The group also worked with the Osaka Institute of Technology’s Robotics Department.

Editor’s note: This is a video only publication – I couldn’t find any written material other than the abstract. The download button takes you to a high definition of the video, not a document. It is a very large file.

Toilets, taboos, and design principles

Directional sign to toilets in an outdoor area. Toilets, taboos and design principles.Public toilets are a key factor in getting out and about. But are they useable by everyone? Ever thought about how they contribute to our economic and social growth? A myriad of issues are brought together for a thoughtful discussion in Katherine Webber’s Churchill Fellowship report. The report is based on her international study tour. It has several recommendations for design, maintenance and social planning. The title of the report is, “Exploring Accessibility and Inclusion in Public Toilets“. There is a one page checklist on public toilet design principles. See below.

The report has a great quote from Lezlie Lowe that indicates the importance of public toilets in everyday life, “Have we ever granted toilets – and especially public toilets – their due? Have we given them credit for how they’ve helped grow our world? As gross or goofy or quotidian as they may seem, public toilets represent higher notions and beliefs. Fundamentally: who is in and who is out. Whom we see as part of the city. Whom we see as human.” From, No Place to Go: How Public Toilets Fail Our Private Needs. A list of public toilet design principles.

Building Code: Rights and Research

picture of a modern building Norway Opera House.Building regulation is a highly contested space, especially in relation to disability access. So the Norwegian Building Authority decided that standards and codes should be based on evidence rather than the views, compromises and experience of interest groups. The Norwegian Research Laboratory for Universal Design was set up to focus on access solutions using established research methods. But this brings about a dilemma.

People with disability have fought for many years to have equal access to the built environment. “Some of the criteria have been based on compromises and “old truths”. These criteria are now put under scrutiny. This examination and possible reversal of minimum requirements may feel like a slap in the face of those who have fought for these rights. But what is the possible downside?” 

Their research results are based on the 90th percentile. But what happens to those who are outside the 90%?  Who pays for the compensatory adaptations or assistance? This is where it becomes political. Nevertheless, research by the Laboratory suggests that “those who cannot manage the minimum levels cannot manage any level”.

The paper provides some interesting research results on doorway approaches and ramp gradients. A relatively short paper with some good food for thought.

The title of the paper is, Deregulation of the Building Code and the
Norwegian Approach to Regulation of Accessibility in the Built Environment. 

Abstract: Deregulation is on the political agenda in the European countries. The Norwegian building code related to universal design and accessibility is challenged. To meet this, the Norwegian Building Authority have chosen to examine established truths and are basing their revised code on scientific research and field tests. But will this knowledge-based deregulation comply within the framework of the anti-discrimination act and, and if not: who suffers and to what extent?  

This project is part of the quest for Norway Universally Designed by 2025 and the updated Action Plan. 

Housing Design for All?

Front cover of the dissertation.Environments that include older people include everyone else too. So it’s good to ask older people what works for them. The findings from a Helsinki study indicate that neighbourhood design, public transport and green environments influence mobility and social integration. Mainstream housing design is a key factor in supporting older people to stay within their communities.

The title of the dissertation by Ira Verma is, Housing Design for All? The challenges of ageing in urban planning and housing design – The case of Helsinki. The abstract summarises the findings well. 

From the abstract: The results indicate that the neighbourhood design, public transport network and proximity of green environments influence mobility and the sense of integration within a community. Moreover, the length of residency was related to the familiarity of the living environment, which gave residents a sense of security, and supported their activities of daily life. Furthermore, the results show that older residents preferred the local services that were the most accessible ones.

Comprehensive design and a versatile environment with various activities may promote Ageing in Place policies and enhance cross-generational social encounters. Moreover, many obstacles caused by reduced physical and sensory functioning capacities can be lessened by applying Universal Design of the built environment. Architects and urban planners have a major role in designing the city and ensuring that it does not exclude any resident groups. Mainstream housing developments with attention to a variety of resident groups will enhance living at home at old age. Moreover, frail people with high care needs should experience being part of community life. Collaboration with local service providers, schools, cafés and restaurants may enable to providing a variety of activities to the residents in sheltered housing.

Healthy Placemaking: Practitioner perspectives

Why do built environment practitioners create places that contribute to preventable disease and early death, despite evidence on healthy placemaking? That was the question the Design Council wanted to answer. And you could ask the same thing about access and inclusion. According to their survey of over 600 practitioners, many said they often have to convince clients and other professionals to invest in healthy placemaking. They also found that more emphasis was given to outdoor places than indoor places. Physical activity was given priority over buildings that could support job creation and boost employment rates. Homes were given the lowest priority. Not using available information to inform designs was a major concern. The 10 key insights capture the overall picture that emerges from the report.

There is much to take in with this report as it covers systemic issues, and competing priorities and individual attitudes. There is a web page with the introduction where you can download the report document in PDF.

There’s a related post on this topic: Healthy view of placemaking.

Editor’s note: The same issues are found within the industry in terms of access and inclusion. Many issues are systemic and that means individuals who support healthy inclusive environments cannot make a significant difference if the rest of the system does not support the ideas. And evidence is not the game-changer.

 

Designing for empathy

A distant view of a circular seating arrangement in a huge room for the parliamentary members.Human centred design and inclusive design processes focus taking an empathic approach to the users. But what if you turn that around and design for empathy itself? To shift from being the empathiser to become an empathy generator? That was the question a team of designers in Finland wanted to know the answer to. Using socio-cultural design tools rather than physical empathy design tools, they created a co-creative process with the Finnish parliament. 

The title of the paper is, Design for Empathy: A co-design case study with the Finnish Parliament. 

Abstract: Globalisation and the mixing of people, cultures, religions and languages fuels pressing healthcare, educational, political and other complex socio-cultural issues. Many of these issues are driven by society’s struggle to find ways to facilitate deeper and more emotionally meaningful ways to help people connect and overcome the empathy gap which keeps various groups of people apart. This paper presents a process to design for empathy – as an outcome of design. This extends prior work which typically looks at empathy for design – as a part of the design process, as is common in inclusive design and human centered design process. We reflect on empathy in design and challenge the often internalised role of the designer to be more externalised, to shift from an empathiser to become an empathy generator. We develop and demonstrate the process to design for empathy through a co-creation case study aiming to bring empathy into politics. The ongoing project is set in the Parliament of Finland, and involves co-creation with six Members of the Parliament from five political parties. Outcomes of the process and case study are discussed, including design considerations for future research.

 

Older people value outdoor spaces

Stockholm from the water showing classic Scandinavian heritage buildings.What makes a city or community age-friendly? The World Health Organization has researched this and produced a comprehensive guide. But sometimes it pays to drill down to the detail at a more local level. Older adults’ perceptions of public spaces could be different to younger people. A research paper from Stockholm looked at green spaces, transport infrastructure and urban development and growth. The methods included visual methods and focus groups. The title of the paper is Promoting ‘Age-Friendly’ Cities: Assessing Elderly Perceptions of Public Spaces.  

The report concludes that respondents gave a high degree of importance to green spaces, features that promote continuity and connection to local histories. Spaces that encourage social interaction were also important. Loss of identity or character of buildings, as well as being inaccessible and poorly lit, added to feelings of discomfort.

Editor’s comment: The speed of, and need for, urban growth must include population ageing in its plans. Dismissing the feelings of older people as being “out of touch” or “not liking change” can have unintended consequences.

Picture by Maria Michelle.

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