healing spaces for elderly - nus - national university of … · · 2009-04-28healing spaces for...

Healing Spaces for Elderly

Dr RUZICA BOZOVIC-STAMENOVICAssistant Professor

Department of Architecture, National University of [email protected]

NUS Visa Meeting 2009


There is more to support than supporting hand

on platform, new elderly, healing spaces, design, paradigm, semiotics, research…

- “Health in older age is the accumulated effect of illnesses and health behaviour throughout the life course” Dr Mary Ann Tsao

- Health as important strategic asset – healthy population - Health as resource:

- personal- social – statistics in SG and ageing society and economy

public health

Health as a selling product Health and brand

- healthy lifestyle- healthy food- healthy products- products for healthy lifestyle


HEALTH

Most prominent thing associated with retirement is poor health (29%-source HSBC future of retirement, insights for Singapore 2006)

PLATFORM

new paradigm for health supportive spaces based on

shift from

disease management to risk managementfrom

illness prevention to health creation

Salutogenic approach as opposite to pathogenic

leads to a new paradigm and a reorganization of healthcare, housing and public spaces

Antonovski, Dilani


as defined by WHO - World Health Organization

HEALTH – more than just physiological health & physical mobility


Escaping from (life) problemsstressHospital

Dealing with life (problems)sanitation“Death houses” in Sago street

Are spaces designed to sustain this change?

China town - SingaporeNUS Visa Meeting 2009


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PHYSICAL ENVIRONMENT• the world is ageing and urbanizing – more people live in cities


PUBLIC SPACES and BUILDINGS• barrier free and enabling interior and exterior spaces • accessible transportation

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Speculations about the future :

Man - Aging populationNew Elderly, Prevention, healthy life-style, aging in place, E-health

Medicine and Technology - New discoveriesGenetic engineering, human genome; electronic monitoring systems (as part of environment too)

Architecture – Healing Spaces New non-hospitals Decline in hospital occupancy ratios; empowered patients; universal rooms; blurring lines between departments; elusive boundaries between public and hospital facility domain, continuous risk assessment …..

New sustainability modelBeyond energy savings only; promotes environment as healing tool

not harming is not enough, boosting wellbeing is the main goal!


Medicine and Technology

There has been more new knowledge in the last 40 years than in the last 5,000, and now our knowledge is doubling every 2.5 years

TIME LINE - as predicted in 2000By 2005 - virtual medical network will take shape

By 2010 - computer-aided imaging, robotic surgery, telesurgery

By 2020 - transplantations, genetic engineering,human genome

By 2025 - breakthroughs in molecular biology

By 2050- people rely more on electronic monitoring systems

NEXT …the future

Technology has already reached the level of development predicted for 2010

Design and space

Transition from healthy to healing spaces



NEW elderly – our new user group with new needs

BeforeElderly over 65

Now new categories:New Elderly

65-75 still physically and mentally fit, independent and active, require new spaces and functions but need space characteristics to be adjusted to their declining abilities and chronic deceases

75-82majority live independently but need help and support, relay on primary care institutions outpatient facilities

82+majority relay on nursing homes, hospices, hospitals

Mainstream:New programs, new image, new spaces, new attitudes to ageing no stigma


Report on inter-ministerial committee on the ageing population (Nov 1999):

• establish “ageing in place” – home and/or community• not about accessibility only• health prevention and promotion• elderly friendly homes and environments

• elderly of the future will be more educated, more independent and have different needs and aspirations, but still will have health issues

group of 65-74 with sec education form 11% in 1995 to 62% in 2030

- Healing Spaces – beyond healthy space concept

- Space as a healing tool – PNI Psycho – neuro - immunology

From Healthy to Healing space why, what is interesting about itNUS Visa Meeting 2009

Healthy space concept / limiting– IAQ, healthy materials, levels of light, noise, etc.

Guidelines established to prevent damage

Healing spaces and places / encompassing

– Total Healing Environment vision for the futureGuidelines established to promote wellbeing

Human being is on physical and psychological level a holistic, interdynamic entity:

Negative emotions – rage, depression, hate, fear, frustration ….manifest as physical disease

Positive emotions – may have positive impact on health

Total Healing Environment Model


Transitionhealthy spaces to healing spaces


Senses

are the psychophysical tools engaged in methods of perception

Perception

is the process of acquiring, interpreting, selecting, and organizing sensory information

PNIpsycho-neuro-imunology

Wellbeing = Health

PNI is research proven mechanismNUS Visa Meeting 2009

PNI refers to the relationship between: the mindthe brain, nervous system,endocrine and immune system

PNI on micro or cellular level: brain - neurotransmitter cells, receptor cells initiate immune system reaction In reverseimmune system –neurotransmitters that reach the receptors in brain = pharmacopoeia “drug store”

PNI on macro or behavioral level: the psyche, the emotions, thoughts, beliefs, values…have impact on happenings on biochemical level

Psychological state of happiness better predictor of coronary risks than other clinical variable – research proven


Relevant theories and potential areas of research

• PNI (psycho–neuro-immunology) & visual stimuli• Aesclepion - restoration of patients’ everyday context • WHO definition reflecting dual character of health• Santigen vs prevailing pathogen approach to health• Eustress -positive stress as a significant contributor to healing• Stress support model and pro-environmental behavior theory• Views; positive distraction (R. Ulrich)• Theory of senses & their irrevocable interdependence (J. Pallasmaa)• Higher senses & memory (Pelletier)• Biophilia Hypothesis (E. Wilson); theory of basic psyche (C. Jung)• Theory of color ( A.Torrice; M. Gappell; J. Itten) • Theory of neural networks & micro events as trigger for decision making• Discourse on home as ideal space (K. Dovey; J. Pallasmaa; J. Hill)• Identification with space (M. Heidegger)• Phenomenology of space (P. Zumthor; W. Benjamin)• Theory of pattern recognition (Smith)• Theories of art; interpretation and techniques• Theory of healing places; impact of local context on recovery (M.Oppermann)


SENSORY STIMULATION DESIGN

Beyond the physical, measurable aspects of space there are issues of :

Cognitionspatial organization and distribution of programs, wayfinding,

Feelings, spatial arrangements to boost hope, optimism, activity,

Sensesspace as calculated stimuli for all senses, not just essential ones

As a method for achieving healing spaces for the elderly



Brain‘s environment system - orientation and wayfinding, perception and cognition, cognitive mapping memory, learning…

• Environment / behavior / neuroscience • The way our minds manage environmental input and knowledge • Emerging neuroscience research connects environment related activities

with our brain

• Awareness of “place” is critical to the definition of a memory. • Physical environment is essential to memory reconstitution

• Cognitive maps • The mind creates, holds and reconstructs cognitive maps of the physical environment

• cognitive maps are stored in the hippocampus (“place cells”)

External physical environment actively influences recall processes

• Rudolf Steiner (in the 1920’s) proposed twelve senses….

tactile (touch)gustatory (taste),

olfactory (smell),visual (sight or vision )

auditory senses (hearing)

+• 'higher senses' that depended upon the healthy development of the foundational

senses of balance, movement, pain/wellness and touch.• the sense of phoneme or language,• the sense of thought• the sense of ego

Senses


Identification with the spaceMemory (ego)

The sense of ego

Dr Oon Chiew Seng; Apex Harmony lodge- nursing home for dementia patients


SMRT =DEATH

DEATH

DEATH DEATH

The sense of phoneme / language

Mass Rapid Transit


Common bias MORE….sensorial stimuli is BETTER ?


NEXT …the future of Total Healing Environment model

Who is to be responsible for the new paradigm?

ALL• The society – enforcing education and planning,

• The business - responding promptly to changing needs

• The architects - adapting the design process to new demands of ageing society and initiating further advances in healing design


MET

AL

COLD SHARP

STERILE SCIENCE FICTION DEAD

Replies from survey respondents

Forgiveness factor Research proves that if respondents like the design they are willing to rate the space higher even if not satisfied with function, efficiency or other attributes


According to processing fluency theory (Reber, Schwarz & Winkielman , 2004)

“Aesthetic experience is a function of the perceiver’s Processing Dynamics;

• the more fluently the perceiver can process the visual image, the more positive the aesthetic response is.

• Nature and organic forms due to inherent familiarity are better perceived, especially in high-stress environments

NUS Visa Meeting 2009 Why are images of nature more appealing?

“Please, choose ONE of two provided pictures/photographs:

Research on poster design for HOSPITALS:

CULTURE & CONTEXT SPECIFIC


Posters in hospital environment

• Boost coziness in living spaces

Combination of motives, colors & scenes to: • Enhance relaxation in rooms

INTRODUCINGcultureand context specific themesin institutional hospitalenvironment

Blurring the boundariesbetween hospital and public & private domain

• enhance wayfinding, care & efficiency, recovery…


“S Line”

Handrail that brings the spirit of natureinto the hospital environments. The curved handrail is created to have aesthetic and therapeutic value

S Line benefits both the mind and the body


“S Line”The curved line is calculated and adjusted to respond to differences in height and different length of footsteps

Changeable section of the curved handrail is molded on human palm

The core - Sanitizer dispenser- Light

S Line has properties of the therapeutic device –massage, exercise…

ErgonomicSensorialHygienic / sanitizerFun


NUS Visa Meeting 2009 Ergonomics and elderly

Design details to fit mental and physical abilities of elderly users

Play park for elderly Manchester UK

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Bathroom urinals in the Amsterdam airport

Problem:Hygiene,

Solution:behavioral approachatavistic behavior –man as hunter

The resultSpillage declined 80 percent


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REVERSIBLE DESTINY LOFTS – MITAKA

“….this architecture invites optimistic and constructive action. What could be more optimistic and constructive than a living space that in every way both prods and coaxes its residents to continue living for an indefinitely long period of time?! That is what the term reversible destiny signals loudly and clearly. Each reversible destiny loft has structured into it the capacity tohelp residents live long and ample lives”

Housing for?

elderly



“Design isn’t just an aesthetic luxury, it’s a core health related area..”Roger Ulrich, Texas A&M University

Research into the impact of design on healing is yielding results in:

economic and clinical indicatorsmarket sharesatisfaction numbers

results that carry weight with decision makers !


SingaporeExperience with hybrid healthcare tourism and leisure industry Leader in sustainable future citiesLeader in public policies

Singapore as first Total Healing Environment City


“Age is an issue of mind over matter. If you don't mind, it doesn't matter" Mark Twain

THANK YOU

healing spaces for elderly - nus - national university of … · · 2009-04-28healing spaces for...

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