REPORT FROM THE FRONTLINES OF KNOWLEDGE
Workshop: Neuroscience of Facilities for the Aging and People with Alzheimer’s

by Leslie G. Moldow, AIA
AIA Design for Aging Knowledge Committee Advisory Group

Ed. Note: With this issue, AIArchitect launches a new, occasional series we call “Report from the Frontlines of Knowledge,” in which we will share the highlights of a conference, workshop, podcast or other learning event, as seen through the eyes of an architect participant. Starting off on this new project, it seems fitting that we kick off the series with a report that appeared in the inaugural issue of the AIA Design for Aging Review.

Summary: Late last year, we witnessed an extraordinary and unprecedented event: Neuroscientists, cognitive psychologists, senior living operators, and architects together discussed how the aging mind perceives its surroundings and how to apply this knowledge to improve environments for our elders. The workshop focused on identifying research topics for the scientific community that would enrich and inform the architectural design process. Held at the Dana Foundation in Washington, D.C., on November 30 and December 1, 2006, the Academy of Neuroscience for Architecture (ANFA) served as the link among the various disciplines involved in this challenging mission. The workshop location was meaningful: the Dana Foundation, founded in 1950, is a private philanthropic organization with interests in brain science, immunology, and arts education.

We participants experienced a mixture of excitement and nervousness about our groundbreaking discussions, which crossed disciplines and ran the risk of losing information in translation. However, welcoming comments and introductory presentations set a collaborative basis for the work to follow. I was privileged to deliver the opening comments and tried to create common ground for the participants by noting that everyone was seeking answers to the question: “What if?” Scientists might frame the question as a hypothesis, while architects structure space, but both strive to generate environments that best support the needs of our elders—therapeutically, socially, and spiritually.

Sharing knowledge
The workshop progressed with four presentations that helped clarify multiple perspectives and continued to develop a common language for cross-disciplinary discussion:

• John Zeisel, PhD, board member of ANFA and president of Hearthstone Alzheimer Care, introduced the background and purpose of the conference and shared powerful information on connections between the brain and the environment. He said, “If you want to know how people use and interact with their environment, use environment-behavior approaches. If you want to know why people behave the way they do in environments, add neurosciences to the mix. And if you want to affect person-environment interactions deeply, make the linkages explicit and study them.”
• Stefani Danes, AIA, Perkins Eastman, then explained the role of design for aging, recognizing the fact that brains rewire in response to environments. She clarified the design process and the relationship between the environment and perception.
• Russell Epstein, PhD, assistant professor at the University of Pennsylvania, revealed his groundbreaking neuroscience research that explores how people orient themselves to where they live.
• Cameron Camp, PhD, director and senior research scientist at Myers Research Institute, discussed his success in teaching people with Alzheimer’s new things that they then remember.

Multidisciplinary thinking
With a better understanding about how each discipline approaches work, a crash course in how others see the world, and a new vocabulary, participants broke into multidisciplinary working groups of a mix of operators, scientists, and architects. The groups had less than a day to explore a given topic with the goal to define significant research that could give designers a new basis for appropriate evidenced-based design. Topics included:

• Memory: How the environment might provide better cueing of meaningful events, memory enhancement, and self-direction
• Physiological and physical ability: How to create architecture that becomes prosthetic as seniors begin to lose balance, strength, and clarity
• Sensory perception: How architects can manipulate lighting, acoustics, materials, temperature, and fragrance in ways that stimulate perception and enrich seniors’ lives
• Cognitive mapping: How to create a match between seniors’ perception and the design of an environment that is easy to perceive
• Environmental press: How the environments can add meaning rather than confusion to seniors’ lives.

Collaborative process and an “aha!” moment
To achieve consistent results, all groups were asked first to state a hypothesis, for example:

“Orienting activities (helping a person to understand who and where he or she is) that enhance memory for relative time of day and sense of place within the environment will facilitate the individual’s engagement in daily activities.”

The groups then extrapolated their hypotheses into potential research, expanding domains of study, and measuring techniques across the disciplines of environment, neuroscience, physiology, behavior, and performance. The groups then re-assembled to get feedback from others on their initial concepts. By the end of the second day, they delivered compelling PowerPoint™ presentations of their shared ideas. Architects talked about declarative and semantic memory, (albeit tentatively!) and neuroscientists had sketched some ideas.

There were some “aha!” moments. The architects explained the intention to design open, country-style kitchens in Alzheimer’s residences to stimulate the sense of smell and cueing for meals. Incredulous scientists remarked that this design strategy might be inappropriate, because the sense of smell is one of the first to go in people with Alzheimer’s disease. But all agreed that the concept deserved further study.

Far-reaching effects
The workshops were personally enriching, but, more importantly, the scientists felt that they had gained information worthy of taking back to their labs to generate grant proposals and interest from doctoral candidates. Participants agreed to continue disseminating information to as many scientists, owners, and architects as possible through conferences, articles, and Web sites. We also determined to establish a chat room to continue their cross-disciplinary explorations and dialogues, as well as to keep in touch via e-mail.

The visionary behind the conference, John Eberhard, FAIA, architect and founding president of ANFA, brought the abstract hypotheses back into the context of the people we all serve—the seniors. Eberhard has recently moved into a retirement community and described how profoundly and positively friendships, a sense of community, and the setting have affected him personally. All participants were reminded of the powerful impact that their work makes on people’s lives.

My lessons learned
As a design professional, I came away with some additional insights from this workshop:

• As architects we can always design our work better and smarter.
• We need to take responsibility and ask hard questions rather than adopt solutions that may not have been adequately tested.
• Results are always better when we look outside our professional boundaries for inspiration and understanding.
• Collaborating with others from different disciplines with different insights, processes, and world views energizes our work with new ideas.