Architecture and dementia Care: an ethnographic study of the everyday life of a secure dementia care environment

Abstract

The irreversible nature of dementia eventually affects the individual’s ability to perform daily living activities, strongly predicting the person living with dementia will move to a specialized dementia care environment. The architectural production of these environments often disregards their and other users’ input. With limited empathic understanding of dementia, and of how the body experiences the environment through embodied knowledge, there is a disconnect between design intent and environmental experience. Acknowledging the impact of the physical environment on individuals, this thesis advances knowledge of how the production of architecture and the conceptualization of space affect the user experience in a dementia care environment. Adopting an ethnographic approach to inquiry and using multiple data collection tools, this qualitative study researched the user experience from different perspectives of those involved in the dementia care experience: residents, staff, and family members. Fieldwork relied on participant observation, interviews, walk-along chats, and social encounters which provided rich personal narratives illustrating how individuals adapt, adopt, or resist the care home. This study reaffirmed the importance of space in enabling or limiting the individual’s ability to feel in place. It also highlighted the different tensions stemming from the care home’s hybrid typology: home, workplace, and healthcare. It critically discussed the gaps in the design process which arguably result in essentializing the individuals living with dementia. Persons living with dementia were presented as individuals with embodied biographies, capable of communicating and asserting their identity. The social aspect of space was found to be critical in understanding the potentiality of the physical environment in bridging past and present biographies, effectively acknowledging the body’s tacit potential of expression and recollection. These findings prompted a construct of place – a milieu - as unfinished space; concrete yet abstract; social, with plural relations; performative, and always in the process of becoming.