The social health and well-being of people with memory problems and dementia

This thesis explores how mobility research can contribute to the development of the concept of social health for dementia. Specifically, the focus is on the mobility of people with memory problems and dementia and how interactions with the social and built environment support social health and well-being. This thesis begins with an overview of dementia, social health and how understanding the mobility of people with memory problems and dementia can support social health and well-being. Additionally, the introduction describes the context of this thesis in both a description of the Dutch setting and how the study is embedded in the COORDINATEs project, a larger international, interdisciplinary research project

The Reorganization of a Psychiatric Unit During COVID-19:A Reflection for Psychiatric Hospital Design

OBJECTIVE: The COVID-19 pandemic has impacted healthcare systems worldwide. Although this disease has primarily impacted general medicine intensive care units, other areas of healthcare including psychiatry were modified in response to corona measures to decrease the transmission of the disease. Reflecting on the modifications to the environment provides an opportunity to design psychiatric environments for future pandemics or other demands for healthcare. BACKGROUND: The therapeutic environment of psychiatric wards was modified in Friesland, the Netherlands, in response to COVID-19. During this time, an interdisciplinary team met consistently to contribute to the preliminary design of a new psychiatric hospital. METHODS: During the first 18 months of the pandemic, clinical reflections were made to describe the impact of COVID-19 on the psychiatric care environment. Architects have created a preliminary design of a new psychiatric hospital based on these reflections, monthly collaborative design discussions based on virtual mock-ups and evidence-based design based on theoretical concepts and research. RESULTS AND CONCLUSIONS: This theoretical and reflective study describes how an inpatient psychiatric environment was restructured to manage infection during COVID-19. The therapeutic environment of the psychiatric ward and patient care changed drastically during COVID-19. The number of patients accessing care decreased, patient autonomy was restricted, and the function of designated behavioral support spaces changed to manage the risk of infection. However, these challenging times have provided an opportunity to reflect on theories and consider the design of new hospital environments that can be adapted in response to future pandemics or be restructured for different care functions

Healing Architecture in Healthcare:A Scoping Review

OBJECTIVES: The purpose of this scoping review is to identify evidence on how characteristics of healing architecture in clinical contexts impact clinical practice and patient experiences. Based on these insights, we advance a more practice-based approach to the study of how healing architectures work. BACKGROUND: The notion of "healing architecture" has recently emerged in discussions of the spatial organization of healthcare settings, particularly in the Nordic countries. This scoping review summarizes findings from seven articles which specifically describe how patients and staff experience characteristics of healing architecture. METHODS: This scoping review was conducted using the framework developed by Arksey and O'Malley. We referred to the decision tool developed by Pollock et al. to confirm that this approach was the most appropriate evidence synthesis type to identify characteristics related to healing architecture and practice. To ensure the rigor of this review, we referred to the methodological guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. RESULTS: There are two main findings of the review. First, there is no common or operative definition of healing architecture used in the selected articles. Secondly, there is limited knowledge of how healing architecture shapes clinical and patient outcomes. CONCLUSIONS: We conclude that further research is needed into how healing architectures make a difference in everyday clinical practices, both to better inform the development of evidence-based designs in the future and to further elaborate criteria to guide postoccupancy evaluations of purpose-built sites

“If you just sit at home and look out of the window, then there is no life.” An ethnographic study of how home-dwelling people with dementia use the cityscape’s life in practice

In the near future, more people with dementia will be living at home within an urban context due to a combination of an increased number of people living with dementia and this past decade’s urbanization. A common perception is that home-dwelling people with dementia experience a shrinking world, but emerging research from the UK, Sweden, and the Netherlands has broadened this notion by foregrounding how people with dementia experience neighborhoods as a resource in self-care practices. With this article, we contribute to this emerging body of literature and aim to explore how people with dementia experience the cityscape in relation to the onset and progression of their dementia. This study outlines findings from a 7-month ethnographic study involving 12 home-dwelling people with dementia. Using semi-structured interviews, walking interviews, and photovoice, the study explores how the cityscape of Copenhagen, Denmark, affects the everyday life of home-dwelling people living with dementia. Through thematic analysis, three key themes are identified: interaction with the city’s life and space as self-care practices, getting out and about as a way to practice a sense of “being in the world” and the loss of orientation abilities and the changing boundaries of the cityscape. The findings from this study contribute to current discussions concerning how people with dementia experience and perceive city and neighborhood environments

Using the concept of activity space to understand the social health of older adults living with memory problems and dementia at home

Globally as the population ages, the prevalence of dementia will increase. Simultaneously, there is a trend toward people ageing at home. Therefore, more people will be ageing at home with dementia, as opposed to institutional environments. In this context, there has been a recent shift in research exploring ways that people can live well with the consequences of the disease. As a part of this emerging research, the social and spatial aspects of the lives of people living with memory problems are becoming increasingly of interest. The aim of this article is to use the concept of activity space to examine the social health of older adults with memory problems and dementia who live at home. Activity space data were collected from seven older adults experiencing memory problems and living at home in the Netherlands. Using a mixed-methods approach, insight into their activity spaces were gained through walking interviews, 14 days of global positioning system (GPS) movement data, travel diary entries and in-depth interviews. The GPS data, travel diary data and interview transcripts were analyzed using a grounded visualization approach. Our findings show that participants interact independently in routine activity spaces but depend on others to participate in occasional activity spaces. Interactions within both these spaces contribute to the social health of older adults with memory problems and dementia who live at home. Additionally, participants used coping strategies and decision-making to maintain autonomy in daily life. The findings can inform dementia-friendly initiatives and social health care planning