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Architecture and Ageing: On the Interaction between Frail Older People and the Built Environment
KTH, School of Architecture and the Built Environment (ABE), Architecture, Architectural Design. (ArcPlan forskargrupp)
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This doctoral thesis deals with the type of architecture that materializes when age-related problems become a long-term condition (LTC) and gradually restrain the individual’s ability to perform activities in daily life (ADL). Their life situation necessitates a support from relatives or municipal eldercare staff in order for them to continue to participate in everyday living. In addition, the architectural space requires a close adjustment to the personal panorama of cognitive or functional impairments. The habitat can be a flat appropriated many years previously or in a residential care home for dependent and frail seniors. Architecture for ageing with dependency demonstrates how space can be used either to affirm or oppress the older person’s attempts to maintain an independent life style. By use of design theory, case study methodology and a heterogeneous research strategy, this study uses a threefold approach—a retrospective, a contemporaneous, and a future-oriented approach—to explore frail older people’s interaction with the architectural space of residential care homes. This has resulted in seven papers that focus on aspects of these human interactions with the built environment. Based on twelve exemplary models, the research paper I concludes that national guidelines result in a homelike, a hotel-like or a hospital-like environment. Research paper II is a retrospective study that examines the use of architecture competitions as a socio-political instrument to define architectural guidelines. Research paper III focuses on dependent seniors’ spatial appropriation of the communally shared space of a ward in a residential care home. Research paper IV employs two environmental assessment methods from the architecture profession and gerontological research (TESS-NH) in order to evaluate the use of interior colouring when refurbishing two residential care homes while the residents remained in place. Research paper V displays a municipal organizer’s considerations to opt for an architecture competition as a means of renewing architecture for the ageing population. Research paper VI examines competition documentation of three municipal architecture competitions organized during the period of 2006 to 2009. Research paper VII, the final study, explores notions concerning the appropriate space for ageing found among a group of municipal representatives, and people from organizations defending older people’s right. It supplies a model for understanding the appropriate space for ageing. This study illustrates the absence of older people with frailties in the public discussion about appropriate architecture for ageing. During the 20th century, the multi-dimensional idea of an architectural space with a homelike appearance has been used to contrast the negatively charged opposite—the complete and austere institution. The overarching conclusion of this study is that architecture for dependent and frail seniors constitutes a particular type of built space that requires an extended dialogue involving dependent seniors, architects, building contractors and care planners in order to conceive appropriate architecture for the ageing society.

Place, publisher, year, edition, pages
Stockholm: E-print AB , 2011. , viii, 186 p.
Series
Trita-ARK. Akademisk avhandling, ISSN 1402-7461 ; 2011:3
Keyword [en]
residential care home architecture, architecture competition, user values and planning considerations, appropriate space for ageing, homelikeness, societal building
National Category
Architecture
Identifiers
URN: urn:nbn:se:kth:diva-40483OAI: oai:DiVA.org:kth-40483DiVA: diva2:441455
Public defence
2011-10-12, F3, Lindstedtsväg 26, Stockholm, 13:00 (English)
Opponent
Supervisors
Note
QC 20110921Available from: 2011-09-21 Created: 2011-09-16 Last updated: 2011-09-21Bibliographically approved
List of papers
1. Home, hotel or hospital?: On Swedish architecture used in twelve residential homes for frail older people between 1983 and 2003
Open this publication in new window or tab >>Home, hotel or hospital?: On Swedish architecture used in twelve residential homes for frail older people between 1983 and 2003
(English)Manuscript (preprint) (Other academic)
Abstract [fr]

En 2006 le gouvernement suédois a alloué des ressources aux nouveaux établissements d’hébergement de personnes âgées et dépendantes (EHPAD), étant donné que le nombre d’appartements avait baissé de quinze pour cent. L’architecture suédoise d’EHPAD est soumise à des lignes directrices de conception promouvant l’idée d’un habitat accueillant : l’appartement est à considérer comme un domicile dans le logement ordinaire mais une partie de la superficie pour cuisiner et agir socialement est transférée à un espace commun. A propos de l’EHPAD, la Direction nationale de la santé et des affaires sociales (DNSAS) a découvert un manque de statistiques. De plus, l’effet des lignes directrices sur l’architecture d’EHPAD n’est pas évalué. Basée sur un échantillon de douze modèles de logements EHPAD, cette étude analyse leur effet sur l’espace architectural. On peut identifier trois scénarios conceptuels, montrant que les lignes directrices engendrent des environnements caractérisés comme habitat privé, hôtel ou hôpital.

Abstract [en]

In 2006 the Swedish government allocated funding for the construction of new residential homes for frail elderly seniors. The number of flats available had dropped by fifteen per cent. Swedish architecture for residential homes is instructed by conceptual guidelines that foreground the ideal of home-likeness: The flats in residential homes are like flats in ordinary housing complexes but with the distinction that a partition of space for preparing meals and socializing is transferred to a communal space. The National Board of Health and Welfare (NBHW) have detected a lack of statistics concerning residential homes. Moreover, the influence of the guidelines on the realized architecture has never been evaluated. Based on a sample of twelve exemplary residential homes this study analyses the impact of the guidelines on architectural space. Three design scenarios have been identified that suggest that the guidelines create an environment that could be described as home-like, hotel-like or hospital-like.

Keyword
Architecture, residential home, home-like space, hotel-like space, hospitallike space, architecture, EHPAD, habitat privé, hôtel, hôpital
National Category
Architecture
Identifiers
urn:nbn:se:kth:diva-40804 (URN)
Note
QC 20110920 Även titel i franska "Habitat privé, hôtel ou hôpital ?: L’architecture relativeà l’hébergement de personnes âgées et dependantes,(EHPAD) en Suède"Available from: 2011-09-20 Created: 2011-09-20 Last updated: 2011-11-08Bibliographically approved
2. Architecture for dependent seniors: the architecturecompetition as a socio-political instrument todefine space for Ageing in the Twentieth Century Sweden
Open this publication in new window or tab >>Architecture for dependent seniors: the architecturecompetition as a socio-political instrument todefine space for Ageing in the Twentieth Century Sweden
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Since mid 19th century, approximately seventy-two architecture competitions have been organized in Sweden with a focus on space for dependent senior persons. On three occasions, in 1907, 1948 and in 1979, these competitions were used to promote new architectural thinking and to prepare for a reform of existing social legislation. Starting with two research questions—firstly, what kind of architectural space did the competition documents of these competitions (competition briefs, jury assessment reports and submitted competition entries) define as appropriate for eldercare; and, secondly, did the use of the architecture competition renew thinking about appropriate space for frail older people—this study explores the architectonic realization and the political vision for social work. The study argues the presence of a link between the competition documentations and the ruling welfare typology at the time of the competition. The architecture competition defined guidelines consistent with these paradigms concerning the appropriate space and social work for ageing with chronic conditions. These guidelines designated small-scaled architecture with homelike connotations as the appropriate one for ageing with frailties. The study lends support to an overarching conclusion that the architecture competition influences cultural beliefs about social work and space for dependent ageing since the competition brief encapsulates a political vision that the participating architects interpret spatially. This has led to the progressive realization during the 20th century of the individualized space for dependent seniors.

National Category
Architecture
Identifiers
urn:nbn:se:kth:diva-40808 (URN)
Note
QC 20110920Available from: 2011-09-20 Created: 2011-09-20 Last updated: 2011-11-08Bibliographically approved
3. Appropriating space in an assisted living residence: On architecture and elderly frail people's spatial use
Open this publication in new window or tab >>Appropriating space in an assisted living residence: On architecture and elderly frail people's spatial use
2011 (English)In: Considering Research: Proceedings of the ARCC spring research conference 2011 / [ed] Architectural Research Centers Consortium, Southfield, MI: Lawrence Technological University , 2011, 1-19 p.Conference paper, Published paper (Refereed)
Abstract [en]

An assisted living residence with identical layout for two non-special care units (NSCU) and twospecial care units (SCU), designated as an exemplary model, was used as a test bed for this study on elderlypeople’s spatial appropriation of communal space. Using qualitative research methods (interviews,participatory observations, TESS-NH), eighteen residents’ spatial usages were mapped. Thereafter, tenresidents with dominantly somatic diseases were interviewed as to their appreciation and use of thecommunal space. Using the same qualitative interviewing guide, three staff members were interviewed inrelation to eight persons with dementia. The collected data was analyzed by use of the Lynchean imageabilitypentad. Depending on the residents’ age-related problem and the specific conditions in situ, the elderlypersons’ spatial usages of the individual unit could be described graphically in a mental map. A place-makingprocess was the motivating force behind this spatial appropriation, conditioned by age-related problems. Atthe NSCUs, the elderly spurred this process themselves by developing a pattern consisting of movementstowards places open for activities, contact and social interaction. On the other hand, at the SCUs, thedementia diagnosis affected this pattern. At these units, the movements and the places depended upon theelderly person’s dependency on the staff for self-affirmation and calm. The overarching conclusion of thisstudy is that an appropriate architectural space for an assisted living residence reinforces the place-makingprocess, either the one of the elderly frail people, or the one staged by the staff. Besides generalrequirements of accessibility, functionality, and usability, this type of architecture needs to employ spatialelements that constitute a communal space that fosters an appropriative process based on the sensuousstimulation exploitable at a particular place. Thus, architecture acquires a supportive quality that nourishesthe perceived homeliness by the elderly people themselves, or as staged by the staff.

Place, publisher, year, edition, pages
Southfield, MI: Lawrence Technological University, 2011
Keyword
assisted living architecture, architectural design, age-related problems, appropriation, mental maps
National Category
Architectural Engineering
Identifiers
urn:nbn:se:kth:diva-33444 (URN)9781257321896 (ISBN)
Conference
ARCC 2011 Detroit, USA
Note
QC 20110930Available from: 2011-05-06 Created: 2011-05-06 Last updated: 2011-10-17Bibliographically approved
4. "Touching up" Communal Space of a Residential home set-ting.: A Comparative Study of Tools for Assessing Changes in the Interior Architectural Space
Open this publication in new window or tab >>"Touching up" Communal Space of a Residential home set-ting.: A Comparative Study of Tools for Assessing Changes in the Interior Architectural Space
2011 (English)In: Journal of Housing for the Elderly, ISSN 0276-3893, E-ISSN 1540-353X, Vol. 25, no 2, 175-216 p.Article in journal (Refereed) Published
Abstract [en]

This study focuses on the interior remodeling of two Swedish residential homes for dependent seniors. A regular maintenance operation was turned into a color intervention project, and the residents stayed during the process. The aim of the study was to assess the changes in terms of supportiveness for elderly individuals with cognitive or functional impairments. The settings were evaluated prior to and after remodeling. Architecture profession method and the Therapeutic Environment Screening Survey of Nursing Homes instrument were used. The conclusion is that a supportive architecture was not achieved, due to a restraining focus on color instead of the relation between aging, color, and homeliness. On the other hand, the architecture profession method and the Therapeutic Environment  Screening Survey of Nursing Homes instrument proved to be useful complementary tools for assessing interior changes in architectural space.

Place, publisher, year, edition, pages
London: Routledge, 2011
Keyword
interior remodeling, maintenance, residential home, architecture, TESS-NH
National Category
Architecture
Identifiers
urn:nbn:se:kth:diva-40482 (URN)10.1080/02763893.2011.571085 (DOI)2-s2.0-79957861528 (Scopus ID)
Note
QC 20110920Available from: 2011-09-16 Created: 2011-09-16 Last updated: 2017-12-08Bibliographically approved
5. Creating empathetic architecture for the frail elderly: Socio-political goals as criteria in an architectural competition
Open this publication in new window or tab >>Creating empathetic architecture for the frail elderly: Socio-political goals as criteria in an architectural competition
2011 (English)In: Architectural Competitions: Research inquiries and experiences / [ed] Magnus Rönn, Reza Kazemian, Jonas E Andersson, Stockholm: Axl Books , 2011, 1, 260-301 p.Chapter in book (Refereed)
Abstract [en]

In 2006, the Swedish municipality of Jaerfaella arranged an open architecturalcompetition focusing on future-oriented architectonic visions forelderly citizens. The location would be in a new residential area that wouldbe developed at a former airbase. The jury assessment report praised thetown plan in the winning Danish entry, but concluded that the majority ofthe thirty-three entries, including the winner, had designed rather conventionalhousing for elderly citizens who would have need of daily assistanceand care. This paper is based upon findings in a single case study, andfocuses on the municipal organizer’s decision-making process in arrangingan open municipal architectural competition. The research material consistedof interviews, offcial records, drawings and other relevant documentationof the process. The collected research material implied that the organizationof an architectural competition in a Swedish municipality is a vivavoce process, where spoken arguments are summarized in writing. Havingdelimited the case study, structured and thematic questions were designedfor use in interviews with a sample of thirty interviewees. The thematicsection of questions was inspired by the French Photolanguage method,and was used to discuss an important Swedish principle for creating a senseof homeliness for the frail elderly. Twelve interviewees were then identifiedas key informants and their statements were correlated with offcialrecords, drawings and other documentation. The analysis of the researchmaterial called for a guiding theory of discourses integrated into architectureas a field of practice. Based upon the guiding theory, six theoreticalconclusions were formulated: 1) The municipal organizer used divergentdiscourses to assess the feasibility of an open architectural competition; 2)The discourses were shaped by personal experiences with built environmentsfiltered through an individual profession-based framework; 3) Therewere five different discourses: a planning-based, a visionary, an ethical, anda conceptual discourse, all of which interacted with a human-spatial bounddiscourse on ageing and architecture; 4) A concept of integration open forinterpretation unified the five discourses and furthered the possibility ofan architectural competition. The concept was understood differently inthe five discourses; 5) The motives for a competition were connected tothe possibility to market the municipality. 6) The main principle of theSwedish concept of homeliness needs further defining to generate strongerguidelines for architecture.

Place, publisher, year, edition, pages
Stockholm: Axl Books, 2011 Edition: 1
Keyword
architectural competition, municipal organizer, discursive model, frail elderly, design process. Introduction Within the study of architecture lies the ambition of realizing a built environment without resemblance to anything built before, something completely nouveau – a dream of the ideal city. One example of such an ideal city would be Vällingby, an ABC-city 1 some 15 kilometres northwest of Stockholm. The town planning and the architecture in this city embody social ambitions spanning from improved housing standards and human working conditions to realizing public welfare goals of democracy and public health (Sax, 1998). The Royal Saltworks at Arc-et-Senans in Franche-Comté, which reflects the ideal city from the Age of Enlightenment, would be another example. A third example would be the small Italian town of Sabbioneta in Lombardy, which is an unfinished realization of the ideal Renaissance city (Marten, 1995). Sabbioneta reflects the Machiavellian vision of the princely autocracy, whereas the Royal Saltworks at Arc-et-Senans embodies the enlightened thinking about human existence and the societal responsibilities of an absolute monarchy. The suburb of Vällingby exemplifies the Swedish model of organizing dwelling and work for the modern welfare society.
National Category
Architecture
Identifiers
urn:nbn:se:kth:diva-33445 (URN)
Note
QC 20110920Available from: 2011-05-06 Created: 2011-05-06 Last updated: 2011-09-21Bibliographically approved
6. Public competitions and competition briefs: Implementing welfare goals for dependent seniors in the architecture competition context
Open this publication in new window or tab >>Public competitions and competition briefs: Implementing welfare goals for dependent seniors in the architecture competition context
(English)Manuscript (preprint) (Other academic)
Abstract [en]

In western society, the homelike architecture is acknowledged as the ideal space for a dependent and older person. The realization of this space can be achieved by use of guidelines. These can be precise requirements to realize generally or conceptual criteria to reinvent individually. The open guideline creates a dilemma when an architecture competition is organized: The writing of a competition brief forces the organizer to define a preliminary set of goals for the participating architects to contemplate, but it equips this actor with preconceived views on what to be accomplished. In the competition situation, the main objective of the brief is to generate design solutions that go beyond the organizer’s expectation. Sweden uses open guidelines for space intended for dependent and frail people.

This paper has three purposes: I) to investigate how three public stakeholders prepare and structure their competition briefs for use in competitions focusing on the habitat for the older frail people and housing for senior citizens; II) to explore the participating architects’use of the competition brief; and III) to study the link between the brief and the jury assessment report. During the period 2000 to 2009, three public stakeholders organized architecture competitions that focused either on housing for dependent older frail people or on residential architecture for senior citizens with few frailties. These competitions constitute three case studies.

This paper draws seven preliminary conclusions: The successful competition brief conveys the organizer’s intentions; supplies ideas necessary for creative thinking, and fuels the subsequent assessment process. In addition, the competition brief is the key element for the execution of the architecture competition. It defines the design task and its parameters, the jury and assessment criteria, and the need of secondary referential consultation. This is a shared responsibility between the organizer and the national association of architects.

Keyword
competition brief, public organizer, assessment process, competition jury, appropriate housing for senior citizens
National Category
Architecture
Identifiers
urn:nbn:se:kth:diva-40809 (URN)
Note

QC 20110920

Available from: 2011-09-20 Created: 2011-09-20 Last updated: 2016-05-23Bibliographically approved
7. Architecture for the silver generation: Exploring the meaning of appropriate space for ageing in a Swedish municipality
Open this publication in new window or tab >>Architecture for the silver generation: Exploring the meaning of appropriate space for ageing in a Swedish municipality
2011 (English)In: Health and Place, ISSN 1353-8292, E-ISSN 1873-2054, Vol. 17, no 2, 572-587 p.Article in journal (Refereed) Published
Abstract [en]

This paper focuses on an architecture competition for the silver generation, namely those aged 65 years and older. Twenty-seven Swedish informants were interviewed using an interviewing guide that included a photographic survey. The informants emphasised aesthetic dimensions in architecture for the prolongation of ageing in place and independent living in a residential home. This study highlights the individual adjustment of space, and the integrated location in existing urban settings near nature. Based on the findings, a habitational model for exploring the appropriate space for ageing is formulated. It suggests that architecture through location and spatial features needs to generate positive associations with the users.

Keyword
architecture, place making, ageing in place, residential homes, user values
National Category
Architecture
Identifiers
urn:nbn:se:kth:diva-33442 (URN)10.1016/j.healthplace.2010.12.015 (DOI)000289339000020 ()21317019 (PubMedID)2-s2.0-79952534505 (Scopus ID)
Note
QC 20110516Available from: 2011-05-06 Created: 2011-05-06 Last updated: 2017-12-11Bibliographically approved

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Citation style
  • apa
  • harvard1
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  • modern-language-association-8th-edition
  • vancouver
  • Other style
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  • en-GB
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  • nn-NO
  • nn-NB
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  • Other locale
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