Professors Niall McLaughlin and Yeoryia Manolopoulou on designing for dementia
Professors Niall McLaughlin and Yeoryia Manolopoulou (The Bartlett Faculty of the Built Environment) discuss their work on designing buildings for people with dementia.
What attracted you to investigate the field of architecture and dementia and why is it important?
Niall McLaughlin: I worked for ten years on the design of a prototype Alzheimer’s respite centre for the Alzheimer’s Society of Ireland between 1999-2009. I spent a lot of time in care centres speaking to people with dementia and trying to understand their experiences. It struck me that the capacities that they were losing were ones which we all take entirely for granted. We do not realise the extraordinary intricate process by which we locate ourselves in time and space.
Yeoryia Manolopoulou: It all started when Niall invited me to collaborate on a response to Ireland’s call for the making of its National Pavilion for the 15th International Architecture Exhibition. The theme of the 2016 Venice Biennale asked architects to reflect on pressing contemporary challenges of which dementia is an obvious one. I had done some work on spatial perception and architectural representation which was relevant to this theme but, at the time, I knew little about dementia. Our work then became, for me in particular, a project of learning.
A more scientifically informed and nuanced understanding of how the brain comprehends space should prove invaluable to all aspects of architectural design, so that we can create delighting and healthy environments not only for people living with a decline in brain functioning but for everyone.
Can you tell us about the project ‘Losing Myself’ and how it came about?
Niall McLaughlin: I was asked to submit a proposal for Ireland’s pavilion for the Venice Architecture Biennale. I wanted to reflect on the thinking I had been doing over the previous decade. I had previously done some writing on the subject for a UCL multidisciplinary seminar called Spatial Thinking, and I had enjoyed my dialogue with other researchers in the University. It was also interesting to compare my earlier research and speculation to the lived reality of the building as built. I thought that Yeoryia would be a good partner because she has a complimentary skill set to me. I knew her already through teaching and so I asked her if she would collaborate on the Biennale submission.
Yeoryia Manolopoulou: Becoming lost and having no sense of place is common in Alzheimer’s disease. ‘Losing Myself’ examines such experiences and associated design challenges and opportunities. It asks how the human mind acquires spatial knowledge and the implications of this for architecture.
We revisited the Orchard Alzheimer’s Centre in Dublin to study how it had changed since its completion and how it was being used seven years after it was built. In response, we created a collective new way of drawing this building that integrated lessons from its social reality. Our design and research were guided by what we were learning in parallel from our interdisciplinary dialogues with a range of experts.
View the project 'Losing Myself: Architecture and Dementia' here.
What findings from disciplines like neuroscience, art, anthropology, healthcare and policy can help architects design for people living with dementia?
Niall McLaughlin: There are so many. The fundamental thing we learnt was to understand the deep processes that allow us to place ourselves in the world and the fragility of these processes. It was also important for us to realise, as architects, that the buildings we design may be experienced very differently by the people who inhabit them, especially when they have challenges with orientation and memory.
Yeoryia Manolopoulou: Experience is not picture-like. The brain makes self-to-object connections but also complex and relational object-to-object correlations. Our understanding is that this latter more complex allocentric frame of perception is particularly and progressively degraded in people living with dementia. This transformation, along with many other changes in the brain, is a huge challenge for a person’s sense of situatedness and their navigation and orientation abilities.
As architects, we need to take into account this challenge and design spaces that have clarity and coherence, recognisable landmarks for navigation, good signage and accessibility, an abundance of daylight, a reduction of physical barriers as well as minimal noise and air pollution. These are some of the qualities that we need to achieve, if we want to create thriving dementia-friendly buildings and inclusive cities from the outset.
Can you explain what is meant by empathetic designs for dementia and ageing?
Niall McLaughlin: Empathy in architecture refers to the way in which we are required to make judgements about the experiences of others and to make environments based on these insights. It is particularly challenging working for people with dementia because there is a limit to their ability to report back from the world that they experience.
Yeoryia Manolopoulou: In dementia-care settings, tensions frequently emerge between health policies and the management of hygiene and safety intended to protect the users of the setting and the building’s own affordances and different degrees of user freedom and personalisation. A continuous and empathetic relationship between architect and client at all stages of the building, before and during occupation, is essential to help ease many of these difficulties.
Attention must also be given to culture change and the need for stronger public awareness of the impacts of ageing and dementia. We need, as a whole society, to create better infrastructures for living that will cultivate a sense of belonging and compassionate and informed communities.
How is the way we construct and compose an understanding of space different to the way architects configure space?
Niall McLaughlin: I’m not sure who ‘we’ are in this instance. Architects use forms of relatively abstract representation to allow themselves to simultaneously consider many spaces all at once and to make high level judgements about their connections and associations. Everyone does this, but at a less conscious level. More often, people turn their conscious thought to episodic and linear forms of spatial apprehension. It is the difference between reading a map and walking along a familiar route. Non architects begin to think like architects when they get lost.
Yeoryia Manolopoulou: A common limitation of the architectural plan is that it represents the building as a static and whole object, usually neutrally drawn from the singular all-seeing position of the architect. The human experience of a building, however, is much more complex and partial, influenced by circumstance and subjectivity. For this reason, and with the aim to study the building as a lived reality rather than a fixed object, we gathered a group of 16 architects to experiment with fluid, fragmented and social forms of architectural drawing which we developed into a dynamic multimedia installation.
What are some of the challenges of designing for dementia?
Niall McLaughlin: The main one is not knowing what not is like to have dementia.
Yeoryia Manolopoulou: A main challenge is the things that we do not know about cognition and the human mind. The brain is hidden and the presentation of dementia in each individual is different and constantly changing. Architects and built environment professionals need to support independence for as long as possible and question reductive universal dementia design guidelines that may limit personhood.
What are your plans for future work in this area?
Niall McLaughlin: I hope to continue to collaborate with thinkers outside the discipline of architecture to deepen my knowledge of how we create representations of our place in space and time. In 2016 we concentrated on neuroscientists, psychologists, and health experts. Since then, I have been looking at disciplines like anthropology and archaeology to understand how our representations of our situation have emerged and developed.
Unfortunately, it is difficult for architects like me to get further building projects in this sector. Despite many attempts, we have not designed another building for people with dementia. There is a disconnect between the way in which healthcare is procured and those who are thinking in interesting ways about the subject. Despite years of lecturing and writing, I have never bridged that.
Yeoryia Manolopoulou: I am hoping to support UCL’s initiatives on neuroarchitecture and to continue to collaborate with colleagues on the integration of neuropsychology and cognitive science in problems and methods of design. As an architect, I want to remain active in drawing and the design of spaces that centres on the inhabitants’ mood, cognition and health.
