A design project for a Dementia Respite Center: Inspired by poetry, driven by empathy and designed by architect Chiara Ponrouch

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Today 850,000 people are living with dementia in the UK, a number doubling every five years and projected to reach 1.6 million by 2040 (WHO, 2017). Of those, 60% are currently supported and taken care of by a relative in their home, and the rest are placed in residential care homes or care facilities (ibid., 2017).

The topic inspired Architecture graduate, Chiara Ponrouch, to conduct a research-based study aiming to design a Dementia Respite Centre for people with dementia and their carers. Here are the elements of her study, rooted in poetry and driven by the author’s technical skills and empathy.

The studio project

A comprehensive study of Alzheimer’s indicated that although primarily characterized by memory impairment and loss of cognitive skills, other key symptoms of this progressive brain disease include alteration of sensory stimuli and spatial disorientation (Marquardt & Schmieg, 2009). Sensory therapy is common in dementia care homes as it triggers memory recollection and allows patients to reconnect with a part of their self-identity that has been lost (ibid., 2009). Hence, I have studied ways in which the physical environment can enhance or trigger autobiographical memories through olfactory sensory stimulus as means of aiding the demented to recapture past memories.

From the beginning, a key driver has been to create a shift in the current homogeneous care facilities that are institutionalized, devoid of culture and seemingly without architectural symbolism (Jencks, 2010), towards a scheme that creates a building experience based on memory recollection through sensory stimuli and domestic spatial configuration.

My studio project was informed by the theory of memory recollection. It is grounded on the intricate relationship between domestic space and memory, and the navigation through space based on memory.

Two 19th century French writers and philosophers, Gaston Bachelard and Marcel Proust, were concerned with one’s ability to unintentionally recall past memories through sense inducement and spatial setting. Urban theorist Kevin Lynch also provides insightful observations on one’s primitive spatial navigation in relation to our past experiences. Although my project is rooted in poetry and literature, design decisions were supported by scientific research.

“Here space is everything, for time ceases to quicken memory. Memory – what a strange thing it is! […] We are unable to relive duration that has been destroyed.”

(Bachelard, 1964, p.31)

Gaston Bachelard, in his 1964 book The Poetics of Space, explores the poetics of a space in his own introspective reveries. His writings are pertinent for several reasons. First, he adopts a different take on phenomenology that is far removed from Husserl’s concept of phenomenology that focuses on one’s conscious interpretive thought through body experiences (Seamon, 2000), whereas Bachelard’s is “materialistic is nature” (Dekkers, 2011, p.295). Whilst most later phenomenologists focused primarily on the human body, Bachelard’s main interest was in its direct surrounding, the space that conceives images: a house, a room or a wardrobe (Bachelard, 1964). Second, Bachelard’s main concern in the Poetics of Space is to unveil the convoluted link between domestic space and memory. He argues that because a house is a man’s earliest memory, domestic space holds one’s dreams and memories and therefore various dwelling-places “retain the treasures of former days” (Bachelard, 1964, p.6). Third, Bachelard’s study on memory complements that of another French philosopher, Marcel Proust, who also contributes to the theory of memory recollection. In his writings, Proust converses how odours spontaneously elicit involuntary autobiographical memories, and famously illustrates the relation between flavour and smell and the reminiscence of childhood memories.

Various sources mould the theory of memory recollection that substantiates my studio project. For my scheme to cater to the needs of demented people who experience short term memory impairment and loss of cognitive skills, the physical environment aims to enhance memory recollection through sensory stimulus and domestic spatial configuration.

THEORETICAL ANALYSIS

I. FROM SMELL TO MEMORY

The olfactory system is most closely associated with our ability to remember past events as smell triggers a brain response in the form of autobiographical memories (Leret, 2017). In French literature, Marcel Proust coined the term “involuntary memory” elicited by flavour and smell with his famous “taste of the crumb of madeleine soaked in [a] decoction of lime-flowered,” prompting memories of his childhood weekends spent at his aunt’s (ibid., 2017, p.66). In his literature, Proust uses the associative power of smell to describe strong sentimental recollections through odours. Indeed, researchers confirm that odours have the ability to evoke involuntary autobiographical memories, hence sensory gardens in dementia nursing homes are a common feature (Chu and Downes, 2010).

According to Proust’s literature, “taste and smell alone […] remain poised a long time […] and bear unflinchingly […] the vast recollection of time” (Proust, 1928, p. 51). This theory of smell and taste evoking memories informed my design as I placed the kitchen at the hearth of the scheme. Regular daily cooking classes, informal luncheons and afternoon tea gatherings aim to stimulate the users’ olfactory senses to evoke memories from their past – an unregulated reminiscence therapy. Instead of a sensory garden that appeals to all five senses, I focused on the link between olfactory and memory as olfactory cues which are more effective in triggering autobiographical memories (de Bruijn & Bender, 2018).

A COUPLE AROUND THE CHESTNUT DINING TABLE FOR AN AFTERNOON TEA AND WARM SCONES

II. DOMESTIC SPACE AS MEMORABLE FEATURE

Demented individuals experience spatial disorientation and therefore become dependent on a compensating environment. It is crucial to intuitively guide them to enable them to locate themselves (Marquardt & Schmieg, 2009). In The image of the city, Kevin Lynch studies how primitive animals navigate through space at a city scale, using reference points (or landmarks), nodes, and paths. He also argues that there is a link between the “immediate sensation and [the] memory of the past experience” as guidance (Lynch, 2000, p.3). Lynch stresses that cues such as “the visual sensations of colour, shape, motion and polarization of light, as well as other senses such as smell, sound, touch , kinesthesis” aid in the process of way-finding (Lynch, 2000, p.3). Hence, in my project, I have accentuated definite sensory cues in the direct physical environment to help users navigate in autonomy. The kitchen, a key reference point, is characterized by the synthesis of visual and tactile cues of materials, textures and colours, with the olfactive stimulation of cooking. As illustrated in figure 4, the oriental rug sits on the concrete floor to demarcate a pocket reading corner. A resident is quietly sat down in a yellow velvet sofa chair, immersed in an old book that has retained its vanillin smell whilst people are congregated around the adjacent heavy chestnut dinner table to chat over a cup of tea and warm scones.

AMALGAMATION OF SENSORY CUES IN POCKET SPACE

Additionally, Lynch’s work was read along with researchers’ findings on environments that facilitate way-finding in dementia nursing homes. Memorable and unique features, such as a live-in kitchen, function as anchor points for navigation as illustrated in figure 5 (Marquardt & Schmieg, 2009). This informed my design in that the kitchen space acts a reference point, a sensory stimulation and allows the facility to feel more domestic, informal and less institutional. The latter is achieved through the use of a domestic kitchen layout, with a large dining table welcoming everyone, some decorative elements such as a collection of Russian dolls, or oil paintings on the wall give a homey feeling. Also, the space is visible from the entrance, and the open plan layout allows people to be drawn to it. Architectural historian and co-founder of Maggie Centres, Charles Jencks, would agree as he claims that, when possible, medical facilities should feel “Informal, like a home – meant to be welcoming, domestic, warm, skittish, personal, small-scaled and centred around the kitchen” (Jencks, 2010, p.13).

The centrality of the kitchen gives the space a domestic and familiar feel. The space not only stimulates the senses with visual, tactile and olfactory cues but also acts as a polarizing core, a memorable reference point that supports the users’ allocentric orientation strategy (Marquardt & Schmieg, 2009).

THE KITCHEN AS POLARIZING CORE

III. THE ATTIC ROOMS: A PLACE TO DAYDREAM

In The Poetics of Space, French philosopher Gaston Bachelard explores the relationship human beings have with their direct physical environment and a domestic environment in particular. According to his concept of phenom- enology, illustrated by his philosophy of imagination, daydream and memory, we are made by material images (as visual, verbal, auditory and tactile imaginings) that we remake in our way (Bachelard, 1964, p. xix). Bachelard describes that a dwelling-like place permits one to “recall flashes of daydreams that illuminate the synthesis of immemorial and recollected.” Therefore I aimed to recreate a domestic environment in my scheme that would not only provide a pleasant, non-institutional climate, but also evoke memories of the users’ life (Bachelard, 1964, p.27). Along with the kitchen as hearth, I have also designed individual rooms with their respective conservatories to allow users to temporarily escape into solitude and daydream, which, according to Bachelard, enhances memory recollection: “every corner in a house, every angle in a room, every inch of secluded space in which we like to hide, or withdraw into ourselves, is a symbol of solitude for the imagination….” (ibid., p.155). A secluded place is associated with intimacy, safety, protection and comfort. Elements such as a coloured door, a clock, a textured rug, a crackling wood floor, a cartridge paper pad, or an oil painting hanging on the wall are all carefully placed in the room to elicit memory recollection.

SECTION THROUGH BUILDING SHOWING INDIVIDUAL ROOMS

These distinctive “attic rooms” are unique in their interior design and domestic spatial arrangement. The sensory cues previously discussed stimulate the user’s senses, along with added physical clues to trigger memory recollection. For instance, as illustrated in Attic Room figure below, a wooden dresser with unlocked drawers, a swaying retro leather chair, a loud ticking analogue clock as reminder of time passing and a growing succulent plant aim to trigger memories of the past. This attention to detail and the study of micro-climate in the scheme is supported by Bachelard’s examination, “memories are housed in a house and if the house is bit elaborate […], our memories have refuges that are all the more delineated” (Bachelard, 1964, p.30). The attic rooms are therefore an opportunity to withdraw in solitude to daydream in a domestic space filled with agents and triggers of the past.

ATTIC ROOM + CONSERVATORY = A PLACE TO DAYDREAM

CRITICAL CONCLUSION

Ultimately, one’s response to sensory stimulus, especially with reduced cognitive skills, is highly personal. The difficulty with relying on phenomenological theory is that space is interpreted and felt individually (Seamon, 2000). Bachelard himself wrote his texts in his own retrospective reveries. That said, the scheme provides the necessary stimuli for one to unconsciously embark on an intimate venture in the aim to recapture past memories.

This paper analysed the ways in which my project is grounded on the theory of memory recollection through sensory stimulus and domestic spatial configuration. The aim is to create a building that caters to the needs of demented people, that is to stimulate their senses and help intuitively navigate the space. Memory recollection is crucial as it allows them to reconnect with their past and their identity. Further studies may look into the link between memory and nostalgia to gain a better design insight for people affected with dementia as the difficulty with designing based on sensory therapy is its unpredictability: one cannot foresee which specific smell, texture, colour will trigger which memory (Leret, 2017). In its efforts to understand dementia and the needs of its people affected directly and indirectly, this project strives for a balance between medical facility and a domestic, welcoming and familiar climate.

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