Ok, so I can't upload my own pdf of my presentation. I'll work on that tomorrow.
Suffice it to say for the moment that I have narrowed my focus to using design-research methods to evaluate comfort for residents in various stages of dementia.
I am intentionally staying away from the label of Alzheimers because it is only one in a long line of conditions which can cause symptoms of dementia. But I clearly understand it is the leading cause of dementia in older adults and will most likely be the population most served by this research. But I do not wish to dismiss those others who have related diseases or conditions and can also benefit from what happens here.
That being said, I think I need to clarify a few other things as well.
First, I need to define and narrow this issue of comfort. For the purposes of my research, I am concerned with the nature of emotional comfort. Not physical comfort (although they are frequently connected) because I am not researching pain management. That is a medical issue of which I am not qualified to explore. I am also not dealing in financial or other aspects of comfort. I am looking only to delve into emotional comfort and ways to identify what that means to a person suffering from dementia. From there I can look at how to translate that information into relevant and useful information for the nursing home industry and the design community.
Plenty of research has been done related to comfort in the dementia population using a scientific method for psychological, psychiatric, and medical information. This is the root of the evidence-based design movement. But I want to go back to the "fuzzy front end" of research and use different methods to evaluate this concept to see if we get any new results. I want to come at this topic from a different angle to make sure we are addressing all the needs of the population.
I don't know yet if this will involve make-tools in the way we have used them in class. It's possible, but I foresee huge obstacles, such as IRB approval in working with a clearly vulnerable population, and the issue of getting information from someone who has difficulty communicating. Not sure how that will work out. We may need to get creative in our methods.
One avenue I need to pursue immediately is this issue of the Snoezelen rooms. Snoezelen is a combination of 2 Dutch words meaning "to seek out" and "to relax". So in its basic form, Snoezelen is a method of seeking relaxation. The original pioneers of the movement noticed that stimulating the 5 senses in various ways helped some residents in various stages of dementia (and some Autistic children) to become calmer and more focused on the stimulus, therefore reducing anxiety and acting out behaviors.
This is an intrigueing concept which I stumbled across last quarter while doing research on sensory stimulation related to emotion. Then while at the Environments for Aging Conference in March, I was able to talk to a designer and phd student who had done quite a bit of research and work related to Snoezelen. The most common form of this therapeutic method is to build a "Snoezelen room" within a facility where residents and staff can go to interact with the various stimuli in order to produce a calming effect. An alternative method is to create, basically, Snoezelen on Wheels, so that the stimuli can go to the resident. This is a less costly approach and gets the benefits into the hands (so to speak) of non-ambulatory residents.
But as Addie Johnson and I were talking, she related that she wished there was a way to build this concept of the Snoezelen room into the entire environment of a facility. Why should these effects be limited to just one room? If the entire environment was designed to promote these same calming effects, wouldn't the benefit on the entire population be greater?
So this is where I am headed with this different approach. I want to build on my social-work and sociology background to connect in an empathetic way with the dementia population. And I want to be able to uncover information that we would not have otherwise had access to through the tradional scientific (EBD) methods that are being so fervently embraced in the industry. We might very well be missing something here.
Another important connection is that under the auspices of Culture Change, we in the senior care industry are supposed to be putting the needs and wants of the residents first, and de-institutionalizing and de-hospitalizing practice. But EBD is definitely an institutionally based model for conducting research. Don't get me wrong here, this is not a slam on EBD. It has a serious and effective place in healthcare research. But in the arena of senior care, when we are trying to move away from the clipboard and the stopwatch, I think a more intuitive approach to the research question at hand will fall more in line with the Culture Change principles.
So there is my rationale. If you read all the way through that, then more power to you. Now comes the hard part...figuring out how to make this happen.
