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Francoangeli Open Access ( 10319.8_319.1-7000.319 16/02/21 16:13 Pagina 1 1 This book investigates the role of interior design in the enhancement of the ef - 0 3 fectiveness of Non-Pharmacological therapies for Alzheimer’s disease care. 1 9 The environment plays a main role inside the framework of Non-Pharmacolo - . 8 INTERIOR DESIGN AS A TOOL gical care interventions, as it can reduce behavioural disturbances, and act as a sort of “prosthesis” in the compensation of losses and cognitive deficits, especially S . FOR DEMENTIA CARE in the last stages of Alzheimer’s disease, when the severe symptoms occurring to M . the person require the hospitalization. In fact, when people with dementia expe - G rience a transition from their home to a care facility, interiors play a very important R role, as their sense of belonging towards the living environment is mined, causing A Experiences and guidelines for the Therapeutic Habitat Model anxiety and stress, decreased well-being and poor quality of life. M E Aim of this book is to present the conceptual model for an environmental system G called “Therapeutic Habitat”, meant as a system of environmental interventions, N based on tangible and intangible aspects, products and furniture, objects and A Silvia Maria Gramegna services – close to the logic of Design Discipline – that can enhance the well-being I N of people with dementia and stimulate recognition and interaction with the sur - T E rounding environment. R I This model is articulated through a set of guidelines for designers, defining spe - O R cific environmental intervention and strategies aimed at increasing inclusion, in - D E dependence, interaction and self-confidence in people with dementia. S I G Silvia Maria Gramegna , Designer and PhD, member of Lab.I.R.Int. - Laboratory N A of Innovation and Research on Interiors, is a PostDoc Researcher and an Adjunct S Professor at the Design School and Department of Politecnico di Milano. Her rese - A T arch work addresses issues that explore the strong anthropological value of Design. O In particular, her covered research topics encompass the development of therapeutic O L environments for elderly with dementia, within the context of GRACE_Lab, an ex - F perimental interdisciplinary laboratory aimed at developing spatial solutions and O R devices to enhance the effectiveness of Non-Pharmacological Therapies for Alzhei - D mer’s Disease. Furthermore, her research explores the enhancement of sensoriality E M and perceived quality of places (interiors and urban areas), through an inclusive E approach, which focuses on the evolution of the concept of Inclusive Design, into N T I Design for Diversities – experienced in the field of ageing society. This field of re - A search, which recognizes the different types of fragilities (physical, sensory, com - C A municative and cognitive) and marginalization, has developed different R action-research activities. E Franc oAngeli ISBN 978-88-351-1640-0 La passione per le conoscenze FRANCO ANGELI € 13,00 (edizione fuori commercio ) D.I. DESIGN INTERNATIONAL DESIGN INTERNATIONAL SERIES Direction: Silvia Piardi Scientific Board: Alessandro Biamonti, Alba Cappellieri, Mauro Ceconello, Claudio Germak, Ezio Manzini, Carlo Martino, Francesca Tosi, Mario Piazza, Promil Pande, Angelica Ponzio, Zang Yingchun The Design International series is born in 2017 as a cultural place for the sharing of ideas and experiences coming from the different fields of design research, becoming a place in which to discovering the wealth and variety of design, where different hypotheses and different answers have been presented, drawing up a fresh map of research in international design, with a specific focus on Italian design. Different areas have been investigated through the books edited in these years, and other will be explored in the new proposals. The Scientific Board, composed by experts in fashion, interior, graphic, communication, product and industrial, service and social innovation design, interaction and emotional design, guarantee the high level of the accepted books. After the first selection by the Scientific Board, the proposals are submitted to a double review by other international experts. Copyright © 2021 by FrancoAngeli s.r.l., Milano, Italy. ISBN 9788835115700 Il presente volume è pubblicato in open access, ossia il file dell’intero lavoro è liberamente scaricabile dalla piattaforma FrancoAngeli Open Access (http://bit.ly/francoangeli-oa). FrancoAngeli Open Access è la piattaforma per pubblicare articoli e mono- grafie, rispettando gli standard etici e qualitativi e la messa a disposizione dei contenuti ad accesso aperto. Oltre a garantire il deposito nei maggiori archivi e repository internazionali OA, la sua integrazione con tutto il ricco catalogo di riviste e collane FrancoAngeli massimizza la visibilità, favorisce facilità di ricerca per l’utente e possibilità di impatto per l’autore. Per saperne di più: http://www.francoangeli.it/come_pubblicare/pubblicare_19.asp I lettori che desiderano informarsi sui libri e le riviste da noi pubblicati possono consultare il nostro sito Internet: www.francoangeli.it e iscriversi nella home page al servizio “Informatemi” per ricevere via e-mail le segnalazioni delle novità. Copyright © 2021 by FrancoAngeli s.r.l., Milano, Italy. ISBN 9788835115700 10319.8_319.1-7000.319 16/02/21 16:13 Pagina 2 INTERIOR DESIGN AS A TOOL FOR DEMENTIA CARE Experiences and guidelines for the Therapeutic Habitat Model Silvia Maria Gramegna FRANCOANGELI D.I. DESIGN INTERNATIONAL Copyright © 2021 by FrancoAngeli s.r.l., Milano, Italy. ISBN 9788835115700 To Mariagrazia Sergio Ruggero Ilaria ISBN e-book Open Access: 9788835115700 Copyright © 2021 by FrancoAngeli s.r.l., Milano, Italy. This work, and each part thereof, is protected by copyright law and is published in this digital version under the license Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) By downloading this work, the User accepts all the conditions of the license agreement for the work as stated and set out on the website https://creativecommons.org/licenses/by-nc-nd/4.0 Copyright © 2021 by FrancoAngeli s.r.l., Milano, Italy. ISBN 9788835115700 Contents 1. Dementia & Alzheimer’s Disease pag. 9 1.1. Global ageing and age-related changes » 9 1.2. Understanding Alzheimer’s Disease » 12 1.2.1. A global epidemic » 14 1.2.2. Ageing and Alzheimer’s Disease » 17 1.2.3. Self-consciousness threshold » 23 1.2.4. Loss of the sense of belonging » 24 1.3. Non-Pharmacological therapies » 26 1.3.1. Standard and alternative therapies » 27 1.4. Non-Pharmacological approaches » 30 1.4.1. Gentle Care » 30 1.4.2. Eden Alternative » 35 1.4.3. I’m Still Here » 37 1.5. Living with Dementia: facing the stigma » 39 1.5.1. Stigma on Alzheimer’s Disease » 40 1.5.2. Self-stigma, public stigma and courtesy stigma » 43 1.5.3. Approaches to reduce stigma » 46 2. Design: a disciplinary reflection. Interior design as an anthropological question » 49 2.1. Perception of space and place » 51 2.1.1. The experience and sense of places » 52 2.2. Environment of “Care” » 54 2.2.1. Person-Environment Fit » 56 2.2.2. Environmental-Behaviour Model » 58 5 Copyright © 2021 by FrancoAngeli s.r.l., Milano, Italy. ISBN 9788835115700 2.3. An anthropological approach pag. 63 2.3.1. The role of empathy » 63 2.3.2. From “cure” to “take care” » 65 3. Towards a therapeutic environment » 67 3.1. Environment as Non-Pharmacological intervention » 67 3.1.1. Environmental adaptation » 73 3.1.2. Favourable surrounding » 78 3.2. Dementia-friendly environment » 79 3.2.1. Physical, social and cultural factors » 83 3.2.2. People needs » 86 3.2.3. Living experiences » 93 3.2.4. Reminiscence and nostalgia » 96 3.2.5. Archetypes » 99 4. New scenarios. A collection of case studies » 103 4.1. Nursing home » 104 4.2. Special-care unit » 105 4.3. Small scale living group » 106 4.3.1. Group Living, Sweden » 109 4.3.2. Small Living, Netherlands » 110 4.3.3. Green Care Farms, Netherlands » 111 4.3.4. CADE Units, Australia » 113 4.3.5. Green Houses, USA » 115 4.3.6. Group Homes, Japan » 118 4.3.7. Hearthstone Residences, USA » 119 4.4. Village » 121 5. Therapeutic Habitat Model. Interior design as an environmental system » 123 5.1. From “Building” to “Habitat” » 126 5.2. Therapeutic Habitat Model » 131 5.3. Therapeutic Habitat – General recommendations » 137 5.3.1. Quality of life as the main goal » 137 5.3.2. Dignity, over all » 140 5.3.3. Meaningful daily living activities » 141 6 Copyright © 2021 by FrancoAngeli s.r.l., Milano, Italy. ISBN 9788835115700 5.3.4. Support the creation of a community pag. 142 5.4. Therapeutic Habitat projects » 144 5.4.1. Grace Living Room » 145 Conclusions » 149 Bibliography » 153 7 Copyright © 2021 by FrancoAngeli s.r.l., Milano, Italy. ISBN 9788835115700 Copyright © 2021 by FrancoAngeli s.r.l., Milano, Italy. ISBN 9788835115700 1. Dementia & Alzheimer’s Disease 1.1. Global ageing and age-related changes Who is old? There are a number of existing synonyms for the word “Old”. This variety of words depicts a group of people whose ages cover a range of 40 or more years, with different peculiarities and needs. As Kinsella (2005) reports: Some gerontologists object to the terms “elderly” and “senior citizen” as inadequate generalizations that connote negative stereotypes, including social isolation, frailty, and physical and financial dependence. At the same time, a general term is useful for cross national comparisons. Population ageing is usually defined as the percentage of a given population age 65 or older (and sometimes the percentage ages 60 and older). The number of individuals aged 65 or older was estimated to be 461 million in 2012. Projections suggest that this estimation will continue to grow exceeding 10 million during the next decade; that means more than 850,000 each month (WHO, 2015).
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