Dreaming of Home: Long-Term Residential Care and (In)Equities By Design

De-Medicalizing Architecture: Humanizing Design and Intervention for Elderly Care

“…It is thus important to take into consideration the implication of design on those providing care and working within the setting itself: "work organization was congruent with spatial design." 71 In my thesis research I pointed to the concept of home as a central 'feeling' that can be designed for in a de-medical care centre that is proposed at a residential and intimate scale. What was perhaps not emphasized enough, is the relationship of the people living in the care centre -the family that lives in the 'home' -and how this can promote healing.…”

“…Braedley and Martel remark from site visits in Ontario: "One aide pointed out that because most residents have kept house much of their lives, these chores gave them an involvement that was 'like home ' " 72 , which is similar to the role they would have played in their family or domestic life. Furthermore, "the care work included developing a relationship with residents, so that the residents' needs and wishes are understood and respected" 73 and requires a set of skills that are drawn from domestic tasks such as cooking and cleaning. 74 In creating integrated care spaces -spaces for interaction not only between the elderly, but also those working closely with them and maintaining the space they are inhabiting (whether permanently or for short durations of time) -the elderly can find a place to partake in their own care, directly express their wishes and concerns and find a sense of independence and comfort all in one.…”

“…The obverse scenario, as described by Braedley and Martel further demonstrates the direct link between architecture and its affect on a building's inhabitants: "Workers are isolated from one another and constrained from co-operating because of the physical design." 75 Creating a common space that is free of barriers, for tasks such as preparing meals and drinks, providing access to safe cleaning supplies, and enabling the elderly to partake in chores that they feel they can accomplish, is of the utmost importance.…”

“…"65 In this scenario, residents are encouraged to "bring in their own belongings, to respect residents' personal routines, to have pets and plants, and to encourage family visiting. "66 Additionally, it is described that the elderly are able to choose, to some extent, their personal schedules including when they bathe, go to sleep and eat their meals 67. FUNDING: Another aspect that was not fully considered in my thesis research, but that Braedley and Martel raise in their article is funding, and its impact on care.…”

“…However, whether the owner or operator be non-profit, for-profit or public, it is ultimately the province's public funding that allows these care centres to function.Braedley and Martel highlight in their article Dreaming of Home: Long-Term Residential Care and (In)Equities by Design that "more than two thirds of all new and renovated beds have been in forprofit facilities-dominated by chain, for-profit ownership-despite their poor record on quality of care. "68 This points to funding as a central issue that can have a profound effect on reinforcing "class divisions, allowing privacy only to those who can afford it. "69 In this model care is commodified, and design is thrown to the wayside.…”