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Places of care Interviews

A healthcare space has to be an open space

The "therapeutic" value of the characteristics of the space as a support to the difficulties linked to cognitive deficits

Interview with Gianluca Darvo

Architect, University of Florence

By May 2020July 17th, 2020No Comments

Can environmental and spatial characteristics contribute to improve the quality of life of people with dementia?

Several scientific data demonstrate that certain characteristics of the space can sometimes acquire a “therapeutic” value and help face the difficulties connected to cognitive deficits. On the other hand, whenever spaces are not designed adequately, they can also contribute to emphasise the disability of the person and can hinder the efforts of the health workers. In this respect, aside from representing a benefit for the guests, architecture can become a support or an impediment to the correct implementation of rehabilitation and bio-psychosocial therapies. For the space to be considered “therapeutic” it has to be designed in such a way to offer the individual the chance to re-establish an interaction with the place, through communication channels suitable for their remaining abilities. The features of the space can stimulate the memory, create a supportive environment, reduce the sense of frustration and contain the fear, thanks to the feelings of safety and wellness that the person experiences. All of this can happen in a state of reduced awareness and it’s for this reason that among the design criteria the perceptual-sensory aspects prevail over the functional ones.

Can initiatives like the Hogewey “Dementia Village” in Holland – the first village for Alzheimer’s patients – make a difference?

Internationally the Dutch experience remains, even ten years later, the most innovative intervention in the landscape of architecture and dementia support services – built as a real urban community, although protected and controlled. Nonetheless, the element that clashes the most with the continuity of the care management and the need (social and economic) to reduce institutionalisation is the nature of the village, which was designed for a few people and for the initial phases of the condition. Although on one hand this can represent an answer to the defined, and at times reduced, phase of the illness, it actually does not change significantly the care management during the most critical phases, risking to push towards institutionalisation people that could otherwise continue to stay home leading a normal life (instead of an artificial normal life).

In this regard the question that Professor Marco Trabucchi asks around Alzheimer’s villages in his book I volti dell’invecchiare (The Faces of Aging) is rather significant: “An easier life or a village for the mad where, under an apparent respect, lies a condition of segregation for the ill-fated?” Instead, the projects linked to the concept of “Dementia Friendly Communities” have a completely different vision, aiming to include those suffering with dementia in the activities of the community and the urban context, without creating protected and exclusive facilities that might risk becoming lonely places.