Field observations into the environmental soul: spatial configuration and social life for people experiencing dementia.

Abstract

This article focuses on the important, facilitating role architectural design plays in social interaction within long-term care facilities (LTCFs) serving people with dementia. Here, we apply space syntax, a set of theories and techniques for the analysis of spatial configurations, as an objective measure of environmental characteristics. Almost 150 rounds of behavioral observations were collected in the social spaces of 3 LTCFs. Using the visibility and proximity metrics of space syntax, the locations of occurrence of various social activities in relation to the furniture and spatial layout on architectural floor plans have been identified. The results did not confirm the space syntax hypothesis that spaces with greater visibility and proximity promote more social interaction. Further analysis revealed that when in settings with better visibility and accessibility, the residents were more likely to engage in low levels of interaction. High-level social interactions actually were more likely to occur in settings providing greater privacy (eg, less visibility and accessibility). The findings suggest an important nuance that architectural configuration factors impact not only the likelihood but also the type of conversations likely to occur in certain locations. This would have implications for both design and staff training on how best to utilize social spaces for therapeutic effect, particularly within the context of person-centered care.