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Lost in Time: Designing Spaces for Dementia When Perception is Lost

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Bloomfield, Sibyl
Pedersen Zari, Maibritt

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Thesis

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Master of Architecture (Professional)

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Auckland University of Technology

Abstract

Dementia has been framed as a global health priority, affecting 55 million people worldwide, with a new case being diagnosed every three seconds. In New Zealand there are currently 70,000 individuals living with dementia, but numbers are expected to triple by 2050. This increase in numbers creates an increasing demand for architecture to design supportive care homes that enhance cognitive functionality and emotional wellness. The term “dementia” is derived from the Latin word “demens”, meaning “out of one’s mind”. This condition is progressive and is characterised by a collection of symptoms that significantly impact cognitive health and function. Persons with Dementia (PwD) often experience a range of behavioural, psychiatric, and cognitive symptoms such as memory loss, delusions, wandering, and a decline in social abilities. Despite extensive research, the exact cause of dementia remains unknown and there is currently no existing cure. This lack of knowledge historically contributed to the establishment of the ‘medical care model’, which prioritised the condition itself, rather than the needs of the person affected. As noted by Kitwood (1997), this model fostered a dangerous ‘no cure - no hope’ mindset, which disregarded the psychological, social, and emotional dimensions of dementia. Consequently, the traditional dementia care environments seen today often resemble hospital settings, with sterile and hostile atmospheres. Research indicates that the structure and layout of those environments do not adequately support autonomy, privacy, wayfinding, and stimulation. While contemporary frameworks such as person-centred care have been established to contrast these environments, the current narrative still emphasises the loss associated with a dementia diagnosis, rather than viewing it as an opportunity for growth and autonomy. Implementing person-centred care is important, not only in philosophy but also in architecture, to design supportive and prosthetic care homes. The built environment is recognised as having the ability to shape human behaviour, influencing not only how people interact with their surroundings, but also their wellbeing. This is especially significant for individuals with cognitive impairment, since they require much more support from their surroundings, meaning that minimal changes in their environments can affect their mood and behaviour. This thesis builds on literature research and precedent analysis to propose a planning philosophy and a new transformative architectural solution that answers the research question: How can architectural initiatives be leveraged to reshape traditional nursing homes and generate strategies that enhance Cognitive Functionality and Emotional Wellness? To engage with this question, this thesis has generated twelve fundamental strategies that aim to improve the living conditions and the quality of life for PwD. These strategies aim to enhance autonomy, wellbeing, personhood, and a sense of community through architectural interventions.

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