Laura Arpiainen is the first professor in Finland in Health and Wellbeing Architecture, at Aalto University in Helsinki. She has led a research project that has designed new, flexible living solutions for the elderly with mild memory disorders. The acoustic design was one of the focus areas and resulted in the development of an acoustic guide for seniors and assisted living facilities.
Sensory design for seniors with memory disorders
Laura Arpiainen leads the SOTERA research group that focuses on social and healthcare buildings at the School of Architecture. In addition to being an architect, she is also an internationally acknowledged healthcare specialist with a deep interest in how design can contribute to well-being. Sensory design for the elderly is an excellent example.
How did you get interested in healthcare buildings?
What I am really interested in is what buildings do to us. I investigate stuff like urban and environmental health and sensory design. We are used to evaluating architecture based on architectural merit, which is basically about clarity, planning, and aesthetics. I think this must give way to more multifaceted values.
My specialty in teaching design includes all healthcare buildings and the larger topic of how the building environment affects health and well-being in general, including landscape architecture. I like to bring many things under this big umbrella and look at how they work together. And how we should consider all these aspects when we design healthcare buildings.
Do you mean there is not only one answer on how to do things?
Precisely, and I like to shake and challenge things a bit. In 2019, I led a project aimed to design an environment for hospices, for end-of-life care. Healthcare design is very constrained by standards and requirements, where infection prevention is one of the big ones. We all know why it is there since experiencing Covid –19. But I wanted the students to design something that was not so limited. In end-of-life environments, there are no expectations of a cure, and as hospices are homes where people die, the design requirements are more relaxed.
I wanted the students to design something that was not so limited. In end-of-life environments, there are no expectations of a cure
I brought in a sound designer to teach about soundscapes, enabling the students to design a sound world in the hospice. In many cases, the hearing is the last sense to go away. People might already have closed their eyes, not feeling much, but they can still hear. The question to my students was: What is the last sound you want to hear before you leave this world? Many used nature sounds, water fountains, chimes, and so on. That was quite powerful.
Why is it important to include our senses in the design of buildings?
Let’s say you cannot move and are bound to a wheelchair or a bed. Then the windows must be low, so you still can feel the warmth from the sun on your face and sense the changing of the days and the seasons. These things are super important. I am a strong advocate for humanizing care environments and increasing the understanding of what in the building contributes to well-being. But well-being is not so easily defined, it is highly personalized and culturally dependent.
When people enter the health system, they are not so healthy. But I want to argue that even if you are very sick, you can have a high level of well-being. That is the part that I put my efforts in.
You are leading the so-called MonIA project that is focused on persons with memory decline. Please tell us more about it!
We started the MonIA project at the beginning of 2021. The objective was to look at how we could design environments that are conducive to a high level of independence for people with memory decline. In Finland, people with memory decline tend to at some point get institutionalized. By that, I mean being moved to a 24-7 complex residential care facility. This is the least favored option, for many reasons. It is very expensive for society, and it takes away a lot of the resident’s independence. So, there is a high motivation in Finland to try to find alternatives between living on your own and being in a residential care facility.
We looked at ways to have more integrated, communal living solutions for persons with memory decline. These may include that you still live in your own home, made more supportive of your condition, or with day programs and other kinds of lighter supports.
We want to reduce segregation based on your health. Even if you have a worsening health condition, you should be able to still live in your community, where a big part of your emotional and social support is. That was our starting point.
The project consisted of students doing their master’s thesis. What kinds of orientation did these students have?
We formed a thesis group for this project that was mentored by a doctoral student. We had one student that was into new buildings and one that did the interior design. One architect was interested in sensory design and ended up doing a thesis on acoustical design, focusing on the sense of hearing. We also had one student within landscape design who looked at the outdoor spaces, one who studied renovations of old building blocks to be memory friendly, a service designer, and one student who did IT-assisted outdoor walking routes. So, we had an interesting spectrum of theses coming out of this memory design project.
An IT-assisted outdoor walking design?
Yes, this student looked at creating a computer-assisted network with beacons that connect to seniors’ devices, so they can go out on their own without getting lost.
There are a lot of apps and tools to help people manage old age, but I am quite critical about these. A lot of them result in adding to people’s loneliness. They have been developed to reduce the needs of staff. I am only interested in apps that increase the well-being and quality of life of seniors.
You mentioned the thesis on acoustical design, Viivi Salminen’s master thesis Acoustic design in memory-friendly housing. Ecophon has compiled a guide based on her findings. Is there anything you want to add about the acoustical aspects?
Her findings are important to fully understand that it requires skills to design an acoustical environment. Here I can see different levels of understanding.
- The first level is to go beyond what you may think is obvious; that everything must be calm. That is not accurate. We need to have a proper, stimulating, and clear acoustical environment. Intense calmness can make people withdraw.
- The second level is to understand that unsatisfactory things have a very negative effect on well-being. It confuses and can cause harm in the way of injury, misunderstanding, or getting lost. It can also cause social harm. If a person is confused and cannot hear, the immediate reaction is to withdraw and not participate.
- The third level is to understand that if you design the environment well, including the acoustic aspects, you can support well-being. The highest level is to understand that if you design it really well, then you can actually improve people’s health!
Laura Arpiainen has been described as an optimist. Is that so?
Yes! I believe we can create a better world through education and collaboration. Ignorance is an absence of wisdom, and that is an impediment to progress. We need to remove ignorance, and a big part of what we do is educate and spread the word by publishing our findings. We know so much more now about the importance of the environment for our well-being!
Photo: Jaakko Kahilaniemi Aalto University