Connection to Nature at the Building Edge: Towards a Therapeutic Architecture for Dementia Care Environments

Residential dementia care environments were investigated to discover a potential therapeutic role for architecture by facilitating a connection to nature for residents. A study of ‘place as process’ included over two years of observational data highlighting multiple factors of the built and social environment that challenged or enabled sensory stimulation and nature-related activities. ‘Nature’ was defined and SLANT was developed to quantitatively assess fourteen facilities for their potential to provide a ‘connection’ to nature. The Edge Space Study facilitated sensory stimulation and social interaction and assisted the ability of people with dementia to express themselves creatively, including using nature symbolically, for ethical reasoning, introspection and personification. Because edge spaces supported social interaction while affording natural stimuli, these informal dialogues enabled manifestations of selfhood which contributed to well-being. People with dementia used nature as a tool to communicate. A discourse analysis method based on relationships was developed and demonstrated which contributes to research on selfhood in dementia. The Prosentia Hypothesis was proposed to test the key mechanisms of beneficial human-environment interactions involving people and nature within the context of relationship. Contributions also include the ‘triangle conversation’ interview method and the concept of ‘time frame identity.’ The edge space typology showed therapeutic potential by affording a person the tools and opportunity to explore emotional and spiritual issues. Such benefits are possible if care practice is routinely involved. Design guidance is proposed for edge spaces and for connection to nature in residential care homes, illustrated with examples from existing facilities. This thesis argues for an integration of architecture, landscape and care practice, a re-conceptualisation of the building edge as permeable and inclusive, advancing a new paradigm of integration and creativity over exclusion, separation and learned disability