Booklet by barakatyz

ROOTED Yara Barakat IDES 401 Senior Studio

Contents

Concept Statement

Conceptual Framework

Abstract

Acoustic Considerations

Rationale

Indoor Air Quality

Approach

Ergonomics

Literature Review

Building System Considerations

Precedent Studies

Building Codes

Site Analysis

Design

Interviews

Construction Documents

Bubble Diagram and Adjacency Matrix

106

Endnotes and Image Credits

Concept Statement “A space that creates a community for dementia diagnosed elderly which caters to behavioral, psychological, and clinical needs while still making them feel at home.”

“Everyday, 24/7, you have to fight through it, it never goes away.”

Abstract

“Age is one of the greatest risk factors for developing dementia and as life expectancy is rising, the likelihood of people living longer and developing this condition is increasing.”1 Through understanding the problems that encompass old age, this proposal aims to respond to the needed professional care, beyond clinical care, that Alzheimer’s disorder (AD)/ Dementia patients require in Qatar. In Qatar, 4400 elderly, out of the 2+ percent elderly population (aged 60 years and up)2, have been diagnosed with AD/ Dementia.3 AD is a brain disease that causes disorientation, memory loss, and behavior changes. Often, AD leads to Dementia, a general term used to describe a decline in the ability to perform daily life actions.4 Some of the effects that Alzheimer’s has on the diagnosed elderly is major behavioral changes, therefore resulting in them losing their identity.5“Behavioral and psychological symptoms of dementia (BPSD) are common and varied in the elderly.” “The most common symptoms of BPSD are apathy (36%), symptoms of depression (32%) and agitation/ aggression.”6 Some more specific symptoms of BPSD include hyperactivity, psychosis, and mood disturbances which display a range of aggression, irritability, hallucinations, anxiety and depression. An Alzheimer’s patient describes, “Everyday, 24/7, you have to fight through it, it never goes away. When you get up in the morning, it’s like someone has taken your brain, it’s an old file cabinet and spread all the files over the floor, and you have to put things back together.”7

Caregivers have found themselves having less time to perform any recreational activities, and in some cases, they’ve had to give up their jobs. As the caregivers give up their life to offer their best care, it is difficult for them to maintain patience toward the AD diagnosed patient. One caregiver mentions, “He gets on my nerves. I holler at him and I shouldn’t.” This conflicts with the ideology that the caregivers are trying to provide the best possible care while still not being able to meet a high standard of professional care.8 With understanding the effect of AD on both the patients and the caregivers, it is clear that the use of traditional home care does not provide the required care for the patients. The main objective of this proposal is to provide a space that serves as an elderly home to the AD diagnosed patient, as well as a clinical help center. As this space’s objective caters specifically to the AD diagnosed elderly, it also provides a service for the caregivers: a peace of mind. The interior space plays a big role on the patient and their AD related improvement. Some attributes that provide this improvement are belonging, meaningfulness, safety/security, and autonomy. Scholars put emphasis on the adaptation of physical and social environments, where the identity of the AD diagnosed elderly can be preserved and enhanced through the interior space.

1. Qatar National Dementia Plan. (n.d.). Retrieved from https://www.moph.gov.qa/Style%20Library/MOPH/Files/strategies/dementia/DEMENTIA%20SUMMARY%20E.pdf

As AD has its own issues on the patient, it also provides challenges for the caregivers. The biggest problem that caregivers come across is a sense of pre-grief. This type of loss being described as loss of relationship, loss of closure, and loss of future with the diagnosed elderly. As the disorder affects the patient, it provides limitation to the caregivers’ lives and affects their personal and social life.

2. HMC to survey prevalence of dementia in Qatar. (n.d.). Retrieved September 14, 2020, from https://thepeninsulaqatar.com/article/24/09/2017/HMC-to-survey-prevalence-of-dementia-in-Qatar 3. Ministry of Public Health. (n.d.). Retrieved September 07, 2020, from https://www.moph.gov.qa/english/strategies/Supporting-Strategies-and-Frameworks/QatarNationalDementiaPlan/Pages/default. aspx 4. Dementia vs. Alzheimer’s Disease: What is the Difference? (n.d.). Retrieved September 07, 2020, from https://www.alz.org/alzheimers-dementia/difference-between-dementia-and-alzheimer-s 5. 10 Early Signs and Symptoms of Alzheimer’s. (n.d.). Retrieved September 07, 2020, from https://www.alz.org/alzheimers-dementia/10_signs 6. Agnes Lindbo et al. “Dysphoric symptoms in relation to other behavioral and psychological symptoms of dementia, among elderly in nursing homes.” BMC geriatrics vol. 17,1 206. 7 Sep. 2017, doi:10.1186/s12877-017-0603-4 7. Large, S., & Slinger, R. (2013). Grief in caregivers of persons with Alzheimer’s disease and related dementia: A qualitative synthesis. Dementia, 14(2), 164-183. doi:10.1177/1471301213494511 8. Linn Hege Førsund et al. “The experience of lived space in persons with dementia: a systematic meta-synthesis.” BMC geriatrics vol. 18,1 33. 1 Feb. 2018, doi:10.1186/s12877-018-0728-0

“The social stigma around Dementia causes complications for the economy. ”

Rationale

The Qatar National Dementia Plan (QNDP) aims to provide clinical help and care for people with Alzheimer’s Disease (AD). As this plan provides important clinical coverage, it does not provide access to help through elderly homes, where the AD diagnosed elderly is provided with spatial connection.9 A factor that plays a role in the lack of use of professional care in the form of elderly homes for AD patients is the stigma that emphasizes the duties and responsibilities of the family members towards the AD diagnosed elderly. This social stigma provides restrictions and complications for the AD diagnosed elderly, the caregivers, and the society/economy.10 About 80% of AD diagnosed patients live with their family, where the primary source of care is through them. Through the progression of AD, the responsibilities of caregivers increase, up until formal help is required. However, with caregivers providing constant care towards the AD diagnosed elderly, an increase in mental health problems is resulted. It has been reported that prevalence of depression goes as high as 30% in caregivers, which increases the level of anxiety and burden towards the level of care provided.11 The QNDP provides proof of the psychological and social impact on the caretakers. As the plan’s aim is “to outline the future vision framework of services provided for caregivers,” it lightly mentions the need for psychological support towards the caregivers.12 The psychological effect of the AD diagnosed eldelyy reflects on the economy. As informal care increases, the more likely it is to find an increase in the progression of AD. Within this negative psychological effect that AD causes to the AD diagnosed patient and their caregivers, arises an economic challenge.13 The individuals that provide care to the AD diagnosed elderly have shown great lack in their work life. 57 percent of caregivers reported early leave from place of employment, in comparison to 46 percent of nondementia caregivers.

18 percent of caregivers have needed to reduce work hours to provide care towards the AD diagnosed elderly, compared to the 13 percent of employees who do not have an AD elderly. Nine percent of caregivers have had to completely give up their work. 14 As caregivers feel burdened by their role towards the AD diagnosed patient, their decisions to leave their jobs can affect the economy, increasing the unemployment rates.15 With the inter-relation of the caregivers and the AD patients, a clear connection of the effects that both subjects have upon the society and upon each other is evident. As this research provides a starting point for understanding the caregiver grief in correlation to the AD diagnosed elderly, a research gap was found where the researchers did not find potential links and reciprocal relationships between the grief of caregivers and the grief of the AD diagnosed elderly. The QNDP identified the same challenge as a lack of coordination between health and social sectors, where there is an emphasis on the imbalance in family relations.16 As it does highlight the research question, it only provides the effect AD has on caregivers and not how the caregivers’ mental strain directly progresses the disease. To strengthen the objective of the proposal, a more comprehensive understanding of the research gap will be achieved. To acquire the needed research to fill the research gap, a survey/interview will be conducted of the caregiver’s and AD diagnosed elderly’s experience with the disease. A thorough analysis of a day in the life of the caregivers will be studied to provide the psychological link of the caregivers and the AD diagnosed elderly. A more specific academic journal research will be significant to provide the link between AD/dementia experts and psychologist experts. 1. Ministry of Public Health. (n.d.). Retrieved September 07, 2020, from https://www.moph.gov.qa/english/strategies/Supporting-Strategies-and-Frameworks/QatarNationalDementiaPlan/Pages/default. aspx 2. Large, S., & Slinger, R. (2013). Grief in caregivers of persons with Alzheimer’s disease and related dementia: A qualitative synthesis. Dementia, 14(2), 164-183. doi:10.1177/1471301213494511 3. Castro, D. M., Dillon, C., Machnicki, G., & Allegri, R. F. (2010). The economic cost of Alzheimer’s disease: Family or public health burden?. Dementia & neuropsychologia, 4(4), 262–267. https://doi. org/10.1590/S1980-57642010DN40400003 4. Ministry of Public Health. (n.d.). Retrieved September 07, 2020, from https://www.moph.gov.qa/english/strategies/Supporting-Strategies-and-Frameworks/QatarNationalDementiaPlan/Pages/default. aspx 5. Castro, D. M., Dillon, C., Machnicki, G., & Allegri, R. F. (2010). The economic cost of Alzheimer’s disease: Family or public health burden?. Dementia & neuropsychologia, 4(4), 262–267. https://doi. org/10.1590/S1980-57642010DN40400003 6. “Alzheimer’s Disease Facts and Figures,” 2018. https://www.alz.org/media/documents/facts-and-figures-2018-r.pdf. 7. Large, Samantha, and Richard Slinger. “Grief in Caregivers of Persons with Alzheimer’s Disease and Related Dementia: A Qualitative Synthesis.” Dementia 14, no. 2 (March 2015): 164–83. https:// doi.org/10.1177/1471301213494511. 8. Ministry of Public Health. (n.d.). Retrieved September 07, 2020, from https://www.moph.gov.qa/english/strategies/Supporting-Strategies-and-Frameworks/QatarNationalDementiaPlan/Pages/default. aspx

“Dementia causes behavioral and psychological problems.”

Approach

The proposal aims to address the social stigma in that AD diagnosed patients face when seeking for elderly home, rather than just clinical care. As it focuses on the social stigma, it also highlights the interrelationship between caregiver grief and that of the AD diagnosed patient. The use of qualitative data will be of extreme essence to the nature of this research, as it provides for support the proposal at question. This research will demonstrate the validity of the research gap, which provides a comprehensive understanding of the interrelation between caregivers and the AD diagnosed elderly. A more professional approach to the interviews will be conducted to provide solid clinical information that addresses the research gap. Interviewing someone like Dr. Hanadi Khamis Al Hamad will be extremely important to resolve the research gap, since Dr Hanadi is mentioned as the “focal point for WHO Global Dementia Observatory project in Qatar” in the Qatar National Dementia Plan. Within the research process, an interview with a psychology expert will be conducted to provide solid evidence of the connection between

Despite interviews being an essential source of information for this research, they will not be the only source used to address the research question. Analyzing case studies such as the “Dementia Village” in Amsterdam, will provide significance to the conducted research. Through “Dementia Village”, the relationship of space and reduction of behavioral problems will be studied. This proposal will also explore literature studies such as news, articles and books to gain a better understanding of psychological patterns that both caregivers and AD diagnosed elderly face. Through this research, an attempt at understanding the research gap will be provided, as well as the ability to provide a holistic analysis of the AD diagnosed elderly experience.

the grief overlap of caregiver and AD diagnosed elderly.

“Dementia symptoms overlap with those of depression.”

Literature Review

Introduction The phenomenon of Dementia/ Alzheimer’s Disease (AD) among elderly is very prevalent in Qatar, where a need for professional and psychological help is needed, not just clinical help. The aim of this review is to explore the behavioral and psychological patterns that AD patients face through the progression of the disease. Within these patterns arises an overlap of the behavioral actions of AD patients and caregivers. A comprehensive understanding of how behavioral patterns of caregivers and AD patients intercorrelate will be achieved within this review. Dementia patients face psychological issues that are encompassed within the AD scope. Within this observed pattern, an overall trend has been established within the researched academic articles. The trends follow the theme of emotional and behavioral problems that affect the AD diagnosed elderly. A prevalent theme that emphasizes on these problems is how behavioral problems occur to both AD patients and caregivers, where each is impacted by the other. The point of view that is highlighted within the conducted research is to provide a breakdown analysis of the behavioral attributes that encompass what it is like being an AD diagnosed elderly. The criteria followed for analyzing the literary articles will follow an understanding of the symptoms of the AD diagnosed elderly, a breakdown of similar symptoms that caregiver’s have, and an established overlap between both. The research solely focuses on factors that affect the behavioral and emotional patterns of the AD diagnosed elderly not clinical challenges as it fits the research gap and the main purpose of the proposal.

Alzheimer’s Patient Behavioral Symptoms

To understand the behavioral and emotional symptoms that occur in AD diagnosed patients, the article “Changes in Emotional and Behavioral Symptoms of Alzheimer’s Disease” by Michelle M. Lee, Milton E. Strauss, and Deborah V. Dawson discusses the behavioral and disruptive actions that are resulted because of AD. Their research focuses on the emotional distress, such as depression and anxiety, and the disruptive behaviors, such as agitation, aggression, and wandering, that AD patients face. The aim of their research is to report results of their investigation of the progression of emotional and disruptive behavioral symptoms over the course of three years. Through this conducted case study, an assessment of the emotional distress and disruptive behaviors of 26 AD diagnosed people has been registered once at the time and again three years later, to observe the progression of these behavioral changes. The results of the assessment showed that patients had a 22% increase in the disruptive behaviors. However, patients also showed a 46% decrease in the emotional symptoms. As their research was in a cluster format, a big decline in the results of emotional distress was found. Nonetheless, they have found that in terms of individual patients, the results showed stability, where if one patient had high levels of emotional distress, there is not much of a change 3 years later.17 However, a study by Juan Lasprilla, Alexander Moreno, Heather Rogers, and Kathryn Francis in the article “The Effect of Dementia Patient’s Physical, Cognitive, and Emotional/ Behavioral Problems on Caregiver Well-Being” shows different results in the behavioral and emotional problems that AD patients face. Through their case study, 90% of the studied AD patients showed signs of depression, 83% showed extreme dependency on caregivers, and 82% showed lack of interest.18

Another article that provides supporting research of the emotional and behavioral patterns, “Alzheimer’s Disease and Depression,” is an academic journal written by Linda Teri and Amy Wagner that highlights the phenomenon of depression, as an emotional distress symptom among AD patients. Through their findings, it’s been established that dementia can result to depression. They’ve reviewed the prevalence of both in terms of physiological and psychological theories, where depression could result from damages that occur because of dementia, or depression could result from the loss of skills and abilities of dementia. They argue that it is unlikely that both, depression and dementia, are unlinked. Teri and Wagner observed and highlighted a gap where they’ve stated that making the correlation can be problematic since if the AD diagnosed elderly makes the observation that they’re showing symptoms of depression, their observation could be unreliable. The reason behind that is because with the dementia comes symptoms that overlap with depression. Loss of interest, for example, could be due to cognitive recession of dementia but it could also be apathy of depression. The research establishes a way to analyze these symptoms and classify them under either one of the categories. Professional clinicians and researchers often take the word of the caregivers as the biggest tell on what the AD patient’s symptoms entail. Since they’ve established a sense of reliability of depression with AD patients, they’ve observed depressive symptoms such as social withdrawal, loss of interest, feeling constant guilt and worthlessness, and suicidal thoughts. Through that, an informed observation has been made that patients with both dementia and depression experience heavier demented symptoms, such as behavioral disturbances and delusions.

Caregivers Behavioral Symptoms

Overlap of Behavioral/Emotional Symptoms of AD Patients and Caregivers

As AD directly causes complications for the AD patients, it also affects the caregivers in a similar way. “The Effect of Dementia Patient’s Physical, Cognitive, and Emotional/ Behavioral Problems on Caregiver Well-Being,” an article written by Juan Lasprilla et al highlights the negative impact that the AD patients have on the caregiver’s social and emotional well-being. Lasprilla, Moreno, Rogers, and Francis recruited 73 caregivers for AD patients where they’ve been studied for behavioral and emotional problems that they face as a caregiver. Established negative features that the selected caregivers include are depression, anxiety, guilt, anger, burden, and worry. The results of the conducted case study show that 31% of the caregivers reported no burden, 32% mild burden, 27% moderate burden, and 10% severe burden. In terms of depression, 60.3% of the caregivers reported no signs of depression, 23.3% mild depression, 13.7% moderate depression, 2.8% severe depression. The research then starts to develop the overlap between the behavioral/emotional problems of caregivers and AD diagnosed elderly. 19

Lasprilla, Moreno, Rogers, and Francis’s research began to question the correlation of behavioral problems that caregivers and AD patients face. As their research mentions that some studies establish this association, while others do not, they’ve concluded that the overlap between the behavioral problems of AD patients and emotional burden of caregivers might only be applicable when the problems are ordinary and not drastic. Within their study, they found that caregiver burden influences the behavioral problems of the patients in the conducted sample. The study also establishes that the cognitive and emotional/behavioral problems of AD patients predicted the depression and burden of the caregivers. The study indicated that with the high levels of depression with the caregiver, the AD patient’s emotional problems increase.20 “The Effects of Incident and Persistent Behavioral Problems on Change in Caregiver Burden and Nursing Home Admission of Persons with Dementia,” written by Joseph E. Gaugler et al, also highlights the behavioral patterns that AD patients face and how caregiver’s emotional distress can add onto the behavioral imbalances of AD patients. Through their research, they’ve concluded that with the increase of the behavioral disturbances that the AD patient goes through, the caregiver burden and depression follow that of the patient. The research establishes that with the increase of caregiver burden, the more frequent the AD patient behavioral problems occur. Therefore, this establishes a solid link between the emotional distress of the caregivers and the behavioral problems of the AD patient.21 Another article, “A prospective study of the effects of behavioral symptoms on the institutionalization of patients with dementia,” offers the same insight as the previously mentioned study. However, this study establishes that with this overlap in caregiver emotional distress and patient behavioral problems, a sooner institutionalization of the AD patients is resulted, where the AD patients are sent to nursing homes.22

Conclusion In summary, the research sources establish an understanding of what the AD patient behavioral and emotional problems encompass, such as: depression, anxiety, loss of interest etc. An established understanding of the symptom’s caregivers encounter is reviewed through the research sources. With the information provided about both subjects, other sources elaborate on the interrelation of the symptoms both face and how they affect one another. The bodies of literature reviewed provide a strong understanding of the intended research topic. However, as the sources do provide valid information, there is a gap in the resolution aspect. The research sources provide the factual information but do not provide possible solutions and treatments of the behavioral and emotional problems of AD patients. As the conducted research has provided a thorough analysis of the AD patient problems, the overall research helps develop ideas of a space for the AD diagnosed elderly where the highlighted aspects are targeted and tackled through design. As stated, AD patients face many emotional and behavioral issues. With that acknowledged, the proposed Alzheimer’s elderly home will provide spaces targeted for tackling this issue, and ways to decrease negative impacts on the AD diagnosed elderly.

1. Michelle M. Lee, Milton E. Strauss, and Deborah V. Dawson, “Changes in Emotional and Behavioral Symptoms of Alzheimer’s Disease,” American Journal of Alzheimer’s Disease 15, no. 3 (2000): pp. 176-179, https://doi.org/10.1177/153331750001500305. 2. Juan Carlos Arango Lasprilla et al., “The Effect of Dementia Patient’s Physical, Cognitive, and Emotional/ Behavioral Problems on Caregiver Well-Being: Findings From a Spanish-Speaking Sample From Colombia, South America,” American Journal of Alzheimer’s Disease & Other Dementiasr 24, no. 5 (2009): pp. 384-395, https://doi.org/10.1177/1533317509341465. 3. Linda Teri, and Amy Wagner. “Alzheimer’s Disease and Depression.” Journal of Consulting and Clinical Psychology, The Emotional Concomitants of Brain Damage, 60, no. 3 (June 1992): 379–91. doi:10.1037/0022-006X.60.3.379. 4. Juan Carlos Arango Lasprilla et al., “The Effect of Dementia Patient’s Physical, Cognitive, and Emotional/ Behavioral Problems on Caregiver Well-Being: Findings From a Spanish-Speaking Sample From Colombia, South America,” American Journal of Alzheimer’s Disease & Other Dementiasr 24, no. 5 (2009): pp. 384-395, https://doi.org/10.1177/1533317509341465. 5. Juan Carlos Arango Lasprilla et al., “The Effect of Dementia Patient’s Physical, Cognitive, and Emotional/ Behavioral Problems on Caregiver Well-Being: Findings From a Spanish-Speaking Sample From Colombia, South America,” American Journal of Alzheimer’s Disease & Other Dementiasr 24, no. 5 (2009): pp. 384-395, https://doi.org/10.1177/1533317509341465. 6. Joseph E. Gaugler, Melanie M. Wall, Robert L. Kane, Jeremiah S. Menk, Khaled Sarsour, Joseph A. Johnston, Don Beusching, and Robert Newcomer. “The Effects of Incident and Persistent Behavioral Problems on Change in Caregiver Burden and Nursing Home Admission of Persons With Dementia.” Medical Care 48, no. 10 (2010): 875-83. http://www.jstor.org/stable/25750573. 7. Marjolein E. De Vugt et al., “A Prospective Study of the Effects of Behavioral Symptoms on the Institutionalization of Patients with Dementia,” International Psychogeriatrics 17, no. 4 (2005): pp. 577589, https://doi.org/10.1017/s1041610205002292.

Precedent Studies

Precedent Study 1: Dementia Village ‘De Hogeweyk’ Architect: Molenaar&Bol&VanDillen Location: Heemraadweg 1, 1382 GV Weesp, Netherlands Area: 12,000 m2 Project year: 2009

Figure 1- Dementia Village

Project Description:

Relevance to Proposed Project:

Located on the outskirts of Weesp, the Netherlands, Dementia Village is a village style neighborhood for elderly people with dementia. The village offers the eldelry to lead a normal lifestyle with maximum mobility and normality. The village holds around 152 residents with Dementia. As each resident has a different lifestyle, Dementia village’s concept highlights the need for a space that is inclusive to different lifestyles.

Dementia Village tackles the way Dementia elderly live their lives, by creating a nursing home that acts as a piece of the outside world. As Dementia Village provides a successful framework for the proposed project, it embodies a good balance between a clinical institution that provides housing for elderly with Dementia, as well as a “village” where the elderly can feel as any other member of society. This project is a good precedent as it provides the proposed project with a better understanding of the facilities provided that help tackle the symptoms of Dementia.

The main concept of the Dementia Village is to provide familiar building blocks that support different lifestyles of the residents. The space was tailored to provide the elderly residents with conditions that challenge their incentives in order to lead and remain an active life. Residents are divided into groups, where they reside with people that share the same interest and backgrounds. The design of the homes are made to be tailored to the chosen lifestyle.

An analysis of the interior and exterior elements will be carried out to have a more comprehensive understanding of the function of the spaces and their relevence to dementia symptoms.

Floor plan layout:

Artisan Christian Cultural Upper class Home Indian Urban Facilities

Dementia Village is composed of 23 homes that follow a different lifestyle category. The 7 lifestyles are artisan, christian, cultural, upper class, home, Indian, and urban (fig. 2). The buildings are laid out to provide a common courtyard between every other building (fig. 3). The spaces used for housing are considered to be the private areas, while the open courtyard area is a pulic area as it holds everyone. The buildings enclose the courtyard but provides access points to other courtyards. This provides the elderly with Dementia with the freedom to roam around while still controlling their movements and providing them with a sense of security. This helps simplify the circulation of the elderly.

Primary Circulation Secondary Circulation Figure 2- Floor plan showing space division of private spaces and circulation

Circulation: Within each courtyard, there are multiple entry points from the buildings that surround it. The elderly is also ale to roam around other courtyards as there are access points to them. That was important within the design aim of Dementia Village, as they did not want the users of the space to feel jailed. The circulation is mainly possible in the outdoor spaces. Indoor spaces were mainly utilized for housing. Indoor circulation is exclusive to the function aspect of space, where the user can only use the indoor spaces for housing purposes, such as sleeping, using the toilet, and seating areas. The primary circulation paths is the circulation in the courtyards. The secondary circulation paths are the paths used for the residents to go back to the building facility (fig. 2).

Figure 3- Floor plan showing public courtyard

Elements that cater to the symptoms of Dementia Interior spaces: Furniture: Keywords: Color, unity, balance

Shared spaces: Keywords: Multi-purpose, Semi-public

“When residents move in, it leaves a void, and familiar surroundings need to fill it”.

The shared spaces within the buildings incorporate many aspects that help the elderly increase their concentration and focus. The interior shared spaces incorporate muli-purposed elements that help increase concentration and focus. Within these spaces, there is a TV area with seating, bookcases with books of famous authors, fairy tales and children’s books. There’s also board games and play materials. These elements trigger brain activity for the elderly with dementia (fig. 5).

The use of furniture helps with the dissociation dementia symptom. The different buildings have different themes of furniture. Some of the buildings have the residents bring their own furniture. This helps the dementia elderly adjust to a newer environment. As the buildings are divided based on the lifestyle of their choice. Based on these lifestyle choices, the furniture is adjusted to the theme of these buildings. For example, in the traditional buildings, the interior furniture reflects a homely and cozy feel. This tackles dissociation by helping the elderly connect to the space on a personal level through connection to furniture that brings memories. Through the use of color, the furniture connects the elderly to their feelings and thoughts. The color within the furniture provides a pop of color within the space which provides the elderly with a better connection to the surrounding environment (fig. 4).

Figure 4- Furniture

Figure 5- Shared Spaces

High windows: Keywords; Open, lighting The high windows provide the elderly with a view that helps regulate their mood. The high windows provide maximum access to sunlight which provides the elderly with a peace of mind. The windows also provide a view which helps them feel like there’s something going on, to distract them from their constant mood changes (fig. 6).

Figure 6- High windows

Figure 7- Courtyard

Elements that cater to the symptoms of Dementia Exterior spaces: Open courtyards: Dementia elderly are often encouraged to stay physically active in order to keep their minds and bodies engaged. The different courtyards in Dementia Village provide the Dementia elderly with a space to be able to move around and have areas for communication and social exchange (fig 7,8). This helps the dementia elderly maintain their physical activity. As dementia elderly often feel disoriented, the open courtyards provide the elderly with a space to be able to have access to outdoors and not have to worry about finding their way back home.

Figure 8- Greenery

Seating: As physical activity helps the dementia elderly improve mentally, the outdoor space also provides the elderly with benches and seating (fig 9). Dementia Village focuses on improving the mood of the elderly through outdoor spaces, where even sitting on a bench outside can help improve their overall well-being.

Figure 9- Seating

Criticism received about Dementia Village: A criticism received about Dementia Village is that it is deceptive,fake-believe,” presenting a “fake normality,” “feigned reality,” or “manufactured utopia.” Dementia village employers commented on that saying that they are not duping their residents. “We have a real society here,” she says. “I don’t think people feel fooled. They feel fooled if we just tell them a story that’s not true and they know it. We’re not telling stories.” 24

Conclusion: Dementia village provides an intensive way of problem-solving through the interior and exterior elements to tackle the symptoms of dementia. Overall, Dementia Village proposes successful methods to provide the dementia elderly with a way of living that is inclusive to normal living but exclusive to those who need the special care.

Precedent Study 2: Rehabilitation Centre Groot Klimmendaal Architect: Koen van Velsen, Hilversum Client/ owner: Foundation Arnhems Revalidatiecentrum, Groot Klimmendaal, Arnhem Location: Heijenoordseweg 5 Arnhem, Netherlands Area: 14,000 m2 Project year: 2011

Figure 10- Groot Klimmendaal

Project Description:

Relevance to Proposed Project:

Groot Klimmendaal is a rehabilitation center that provides clinical care and outpatient rehabilitation for children, youth, and adults. The building is located in the middle of the forest in the Netherlands. The rehabilitation center focuses on the rehabilitation therapies that help patients suffering from respiratory problems. Groot Klimmendaal provides the idea of rehabilitation through the use of an unconventional approach. The main concept of the project is to break the stereotype behind rehabilitation centers by making it a welcoming, pleasant, and comforting experience to the user.

Groot Klimmendaal provides an unconventional way of rehabilitation, which the proposed project also aims to do. It also successfully applies facilities and interior/exterior elements that help improve the user’s mental health, as well as their general well-being. It focuses on how interior elements greatly impact the recovery process, without necessarily having direct contact to the exterior element.

The building blends in with the surrounding environment, the reason behind that is to create a building that doesn’t look like a typical rehabilitation center but rather to create a building that is a part of its surroundings and the community. The design highlights the healing capabilities of nature by giving the user a constant view of nature. The design also highlights the healing capabilities of through the interior aspect of the space. The building hosts leisure and recreation facilities that help the user focus on their recover, as well as using the interior elements to reduce anxiety and depression.

As the proposed project aims to break the conventional care concept, it also aims to help tackle the well-being of the dementia patient. As this precedent study isn’t designed for dementia patients, it still provides elements and facilities that can be implemented to tackle the behavioral aspect of dementia patients.

Space layout

RMD House

Impatient accommodation Treatment

Entrance

Special Functions Management

Management

Figure 11- Space layout diagram Vertical circulation

Groot Klimmendaal has 6 floors, including the basement level. Every level serves a particular purpose. The basement level is for management purposes where it consists of offices. The ground and first floor serve as the main spaces for recreation facilities, that encompasses spaces such as: sports hall, a swimming pool, a theater and the restaurant. The ground floor has a double height ceiling, where the first floor has a smaller surface area than the ground floor. The second floor is for treatment spaces, and the third floor is for inpatient accommodation, which is where patients reside in. The fourth floor is called the Ronald Mcdonald (RMD) house, which is where patient’s families can stay in for the night when they’re visiting (fig. 11, 12). The layout of the building floors provides the user with an easy access to facilities and an easy familiarity of the space. The addition of the RMD house is a really efficient and good addition to the space, as it provides the patients to have their parents visit which can help them feel supported.

Figure 13- Floor plan showing circulation path

Primary horizontal circulation Secondary horizontal circulation

Circulation: The verticality of the space allows for vertical and horizontal circulation. The use of vertical circulation allows the user to access the other floors of the building. The horizontal circulation is mirrored in almost all the floors, where there are long hallways as the primary circulation path. These primary circulation paths then branch out to secondary paths that lead the user to specific rooms and spaces they are tying to access (fig. 13). Koen van Velsen’s aim through the play of horizontal and vertical circulation was to create a suggestion of overlaid trajectories which creates an invitation for people to take part in the play.

6 5 4 3 2 1 25

Figure 12- Section showing space layout

1 Management 2 Recreation facilities 3 Recreation facilities 4 Treatment 5 Impatient accommodation 6 RMD House

Figure 14- Corridor color use

Figure 15- Swimming pool room exterior

Figure 16- Corridor

Figure 17- Gym room exterior

Elements that help rehabilitation process Interior spaces: Color: Keywords: Color, form, contrast

Form: Keywords: Geometric forms, color, way-finding, corridors, circulation

Koen van Velsen used colors, such as dark blue, light green, yellow, orange against light beige backgrounds within the interior spaces (fig. 14, 15, 16, 17). This emphasizes on the architecture of the space and how there is an interplay of planes and lines that intersect to form the geometrical forms, that are prominently used within the interior.

The use of different forms is very prominent within the space. The use of form and color are closely related. The use of geometric forms are mostly used within the corridor spaces (fig. 14, 16). Color is used to extenuate the use of forms used. The geometric forms are implemented within the wall, floor, and ceiling elements.

In terms of the patients, the use of color within the space helps create a lively and light atmosphere that invokes a feeling of self-confidence and livelihood for the user. The use of color is subtly implemented within the space. This helps lighten and improve the patient’s mood in a subconscious way.

In terms of the patients, the use of these forms within the corridors triggers the physical activity of the patient. This helps increase morality and helps spread up their rehabilitation process. It also helps the users with way-finding as the forms are easy to spot and helps simplify navigation within the circulation through the space.

Figure 19- Gym

Recreation facilities: Keywords: Multi-purpose, physical activity The implementation of recreation facilities helps the user’s morale by inducing physical activity. Through swimming and exercising, the patient is able to transfer their negative energy through physical activity (fig. 19, 20). The theater room provides the users with a place for entertainment where they can watch a play and unwind and relax. These simple aspects were very important in the design intention, as they provide a big leap in the healing path.

Figure 20- Swimming pool

Figure 22- Light entry diagram

High windows: Keywords: Open, lighting, light and shadow, nature Through the use of high length windows, the user is able to connect with the outside which helps the patients reach a deeper connection amongst themselves and nature (fig. 21). Through the use of high windows, the space has a higher level of transparency, continuity and a play with light and shadow (fig. 22). This creates a stimulating environment for the user which helps them with their healing process.

Conclusion: Groot Klimmendaal provides many strategies that control and enhance the wellbeing of the user. It supplies the user with successful methods to lead a healthier life that leads to rehabilitation.

Figure 21- High windows

Site Analysis

About the Country Qatar Location: Qatar is a sovereign state in the middle east. It occupies a peninsula that juts into the Arabian Gulf. After it completed its independence from Britain in 1971, Qatar emerged as one of the most important producers of oil and gas in the World. Geography: Qatar is peninsula located amid the western coast of the Arabian Gulf. The peninsula is about 100km across and it extends 200km into the Gulf. Qatar has several islands, the largest ones are Halul, Shraouh and Al-Asshat. The Qatar border is shared with Saudi Arabia and a maritime border with Bahrain, the United Arab Emirates and Iran. Topography: The land mainly consists of a flat rocky plain, covered with a range of low limestone. Area: Qatar occupies an area of 11,521 square kilometers. Capital: Doha. Population: Qatar has a population of approximately 2,5 million. Religion: Islam. Official Language: Arabic is the official language, but English is commonly spoken. Currency: Qatari Riyal. Why Doha? As the capital of Qatar, most of Qatar’s population are resided in Doha. Qatar is the political and economic center of Qatar. The project’s site is proposed to be in Doha, as it has the most residential areas. The site selected is perfect as it is not completely on the outskirts if Qatar, but it also is placed in the most populous city which helps the users by not abandoning them.

Figure 23- Qatar map

About Msheireb Downtown Doha: Msheireb Downtown Doha is located in the heart of Doha, where it is only minutes away from the Hamad International Airport and serves as a midway between two key routes in Doha. Msheireb is defined as a city in transformation. The northwest of Msheireb is the Corniche which provides the iconic skyline views of West Bay’s commercial towers. Across Msheireb is the traditional market and tourist attraction, Souk Waqif. Msheireb Downtown Doha recreates the Qatari’s cultural way of living. This is reflected in the architecture and interiors through the use of materials, form, and colors. Msheireb, the world’s first sustainable downtown regeneration project, revives the old commercial district with a modern use of architecture that is still inspired by the Qatari traditional heritage and architecture. Msheireb reflects the use of Qatari culture and modern architecture through proportion, simplicity, space, light, layering, ornament and response to climate. As Msheireb follows the use of sustainable technologies, it follows high standards in green buildings, that support a sustainable approach within the entirety of the space.

The Msheireb project aims to reverse the pattern of development that is followed in Doha, such as the reliance on car trsnaportation and structures that are have a high energy consumption. Msheireb is the new social and civic hub, located in the city centre, where it is utilized as a space that is enjoyable to live in as well as for work, shopping, and quality time with loved ones. Msheireb regenerated the use of traditional commercial buildings by bringing a new vitality to Doha’s landscape.

Msheireb Downtown Doha Key Figures: Project Cost: Approximately QAR20 billion (US$5.5 billion) Land Area: 31-hectares (310,000 square metres) Project Name: Msheireb means ‘a place to drink water’ in Arabic Project Timetable: Construction commenced in 2010, construction completion scheduled in phases Parking Spaces: 10,000+ Total Buildings: 100+ Building Height Range: 3 to 30 storeys LEED Rating: Entire development is targeting LEED Gold minimum, with several buildings targeting LEED Platinum

Figure 24- Doha map highlighing Msheireb

Climate: Qatar’s climate is a desert. It has mild winters and hot sunny summers. As it is a small and flat country, the climate is uniform throughout the country as a whole. Qatar has two main seasons: a cool season from December to February, and a hot season from April to October, where May through mid-October is a distinguished very hot period. March and November are transitional months, where the weather is neither too hot nor too cold.

Figure 25- Temperature graph

Temperature: In Doha, the capital, the lowest temperature (in January) goes as low as 12.8°C. The highest temperature goes as high as 41.5°C in July. The coolest time of the year is in January, during the beginning of the year, while the hottest time of the year is in July, during the middle of the year.(fig. 3) Humidity: Doha is generally very humid. The lowest humidity percentage is 41% humidity in June, and the highest percentage is 71% humidity in December and January. Humidity is inversely proportional to temperature, where as the temperature increases, humidity decreases. (fig. 4)

Figure 26- Humidity graph

Rainfall: Doha doesn’t have a lot of rainy days, it’s mostly dry. The driest months, with no rain, are June till September. The most rain is usually in February, with a total of 2.1 full rainy days. (fig. 5) Daylight hours: Daylight hours and sunshine hours are directly proportional. Daylight hours are more than sunshine hours. June has the most daylight and sunshine hours, 13.7 daylight hours and 11.4 sunshine hours. December has the least, with 10.6 daylight hours and 7.8 sunshine hours. (fig. 6)

Figure 27- Rainfall

Figure 28- Daylight graph

Figure 29- Msheireb plan witth space functions

Residential Residential & Retail Retail Hotels Commercial & Retail Mosque

About Heritage Quarter: Heritage Quarter, the highlighted area, focuses on the Qatari heritage through architecture while providing a contemporary and modern twist. Heritage Quarter consists of 4 traditional houses, Radwani House, Company House, Mohammed Bin Jassim House and Bin Jelmood House. They are located in the oldest part of the capital, opposite to Souk Waqif. Preserving and reinterpreting Qatari heritage was central to the restoration works carried out. (fig. 7)

Civic

Site Analysis:

Taxi stop

Metro Station Wind Direction

Tram stop

Bus stop Tram route Sun Path

Figure 30- Msheireb plan with analysis

Mohammad bin Jassim House: Mohammad bin Jassim House (MBJ House) demonstrates a strong example of Msheireb’s traditional values, in terms of future development of Doha. This house introduces the transformation of Msheireb by bringing back memories of the past, presenting the presend, and providing a vision of the plans for the future. This house takes the user back in time where an appreciation of Doha’s history ans the architectural heritage is acquired. The MBJ House is built by Sheikh Mohammed Bin Jassim Al-Thani, son of the founder of modern Qatar. This house addresses the past, present, and future and also tackles the sustainable aspect that Msheireb Downtown Doha is based on. The MBJ House demonstrates Msheireb’s traditional values and a framework for the future development of Doha. Courtyard: The MBJ House focuses on the exterior aspect of the space, where there is a clear importance to the courtyard area as it reflects the old Qatari home styles. The renovated courtyard reflects the past heritage while also reflecting a contemporary and modern approach in terms of architectural elements. The courtyard is 400 m2 where it fits up to 200 people.

Figure 31- Quote in the MBJ House

Translation: Msheireb Doha is a source of inspiration for architects and individuals and societies to find models capable of answering this question: What is our modern identity as Gulf societies and Qatari society? -Her Highness Sheikha Moza bint Nasser

Figure 32- MBJ House exterior view

Original use of building:

Figure 33- MBJ House illustration showing heritage

Exterior of MBJ House:

Figure 34- Courtyard

Figure 36- Courtyard

Figure 35- Exterior rooms that are accessed through courtyard

Figure 37- Tram track/ stop right across the MBJ

Interior of the MBJ House:

Figure 38- Corridor

Figure 40- Exhibition space

Figure 39- Exhibition

Figure 41- Exhibition

Figure 43- MBJ House plan with space functions Exhibition space Interperative space in historic building Front of house Staff facilities Cafe/Restraunt and kitchen Education/Research Circulation/Services and WC’s Back of house

Figure 42- Site plan

Figure 44- Ground floor plan

Figure 45- West elevation showing the entrance

Figure 46- Cross-section through the building

Interviews

Interview 1: Claire Solu-Burd Occupation: Psychotherapist, social worker Location: New Jersey, United States of America Interview type: doxy.me (video call) Interview date: 28th of October 2020 Interview Duration: 40 minutes

Biography: Claire Solu-Burd has an undergraduate degree in Psychology. She also has a degree in Political Science. She has a master’s degree in Public administration and in Social Work. During her master’s degree she specialized in ageing. During her university path, she worked at a nursing home that dealt with Alzheimer’s and Dementia patients for 5 years. She has a social work and clinical license. She curently works in a private practice where she works with dementia/ alzheimer’s elderly, as well as their families and/or caregivers.

What are some of the most common mental problems that people with Alzheimer’s/Dementia face? It’s hard to discern when mental health issues come up for, the dementia/ Alzheimer’s elderly, but what I saw when I worked at the nursing home are symptoms of depression and anxiety. Sometimes, almost 1 out of 10 patients would present delusion, where they could have a period of delirium or hallucinations. They hear, see, smell things that are not in the room. What are some of the methods you provide them with to help cope with the issues they are facing? We use a technique called validation therapy. It’s such a compassionate way to manage someone in a moment of extreme stress or sadness. It’s basically whatever they say and whatever they do is validated. If, for example, a dementia patient complains that someone is bothering them and there is no one in the room, what I would say for example is, “yeah why does she always bother us like that?” So, instead of escalating the stress what we do is contain the stress. The minute you challenge a patient with dementia or Alzheimer’s they become even more dysregulated. We also use recreational therapy, which is a whole set of staff members that provide services for dementia patients. They might do music therapy, a very healing method of therapy for dementia/alzheimer’s patients. It calms their nervous system to where they feel more alive. There’s also massage therapy and aromatherapy. Recreation staff would sometimes do hand massages. As for aromatherapy, they would use diffusers that would release different scents that would calm the nervous system of the dementia/ Alzheimer’s patient. We’ve also done pet therapy, where people bring in animals. Just because you have Alzheimer’s doesn’t mean you don’t want to connect with the things that you love. There’s also art therapy. Art therapy is not about being a good artist, it’s about connecting with paint, materials, glue, and glitter. They tend to tailor the art therapy around the time of the year and the holidays. Often dementia and Alzheimer’s patient don’t remember what time of the year it is, so stirring up their emotions by reminiscing, using reminiscence therapy helps them piece together pleasurable memories from the past. There is also at least one exercise a day that the dementia/ Alzheimer’s patients too such as chair exercises.

Do you feel like exposure to the outdoors helps the person with Alzheimer’s/ Dementia improve their mental health?

There’s a couple of things that I’ve seen that really work one is a bird feeder. Connection to nature is very important. It could just be through the window. The whole mood of the person when the sun hits their face for the first time is transformational, we really value outdoors with our patients. It’s about sitting somewhere and noticing the little things and being more mindful of your surroundings. Bringing attention to the current moment is really helpful for the dementia and Alzheimer’s elderly. It evokes it works peace within the elderly.

What are some ways caregivers can help the people with Alzheimer’s/Dementia, in terms of improving their mental state, or helping the person with Alzheimer’s/ Dementia cope with the cognitive problems, or other issues they might face? When you provide socialization for people with dementia and Alzheimer’s, it reopens their capacities for connection. Socialization is incredibly important but certain features of dementia or Alzheimer’s isolate people. It’s extraordinarily isolating so these adult day centers are specifically for people with challenges. It’s important for caregivers to find a community of people for the person with dementia or Alzheimer’s who have similar challenges so that your loved one can go and have socialization and not feel judged. For caregivers, connecting with other people who are going through similar challenges is just as important. This helps normalize the experience instead of having a feeling of shame or embarrassment.

Would you recommend for the person with Dementia/ Alzheimer’s to stay at home with their caregivers or stay in a nursing home? It depends on the capacity of the caregiver. Caregivers are always hypervigilant, where they’re always scanning the dementia elderly to check on their well-being. This increase of stress translates to the relationship dynamic. Considering the progressive nature of the disease, the caregiver would have to evaluate the level of care needed for the dementia elderly. There’s research that shows that the caregivers sometimes get even more sick than the person they’re caring for because they don’t prioritize themselves. It’s mostly on a case-by-case basis since every case is different. What are some ways can Alzheimer’s/Dementia elderly do to familiarize themselves in their place of residence? I worked in a facility that called itself a bed and breakfast. It was well decorated, but with safe furniture that wouldn’t topple over. There were lamps, instead of the industrial overhead lights. Every single month, there was a change of decorations and it was easily seen what they were trying to communicate through this change. Every month there would be a clue on what’s going on in the world outside. There was also safe access to the outdoors. There was a water feature and lots of plants. There would be gardening activities with the residents because we didn’t want them to lose their interest. We want them to heal like they are at home. They would use facility furniture, something safe but they’d also make it provide the feeling of home. There’s a lot of ways to humanize what feels clinical. When it comes to people with Alzheimer’s or dementia that stay at home, I would say always keep a photo album. A photo album that shows the image, and for example would mention (daughter) or (granddaughter). When we think about presenting the day and the time, there are huge alarm clocks the narrate the day, the date, and the weather. Making things more accessible in a safe space is very important.

If so, how can they enjoy the outdoors without exposing themselves to danger or harm? Some facilities create a courtyard in the middle over the facilities where there’s only a certain number of entrances this can be accessed. These spaces usually have a lot of windows looking in on that space to make sure that the patients are being monitored. The facility I worked up would have sensors on the doors so we would know if someone was attempting to leave. It feels more like a punishment to lock the doors but it’s a safety measure that we have to take, just to make sure that their accompanied when they are going out. Access to outdoors has to be careful and we have to think of all the what ifs.

Do you recommend the person with Alzheimer’s/Dementia to be in the same environment as other persons with Alzheimer’s/Dementia? If yes, why? If no, why not? I think it makes better sense to help people who are struggling with the same cognitive issues to be cared for it together. It would be hard to meet their needs if they weren’t going through the same cognitive issues. Even with dementia, it’s hard to navigate it because you don’t want someone to feel embarrassed or ashamed that they don’t know what day it is, for example. It’s sort of like if you have a school with a first grader in 9th grade and you’re trying to teach them the same thing. You would do it very differently. In an institution, it’s easier to feel comfortable when dealing with the same types of gaps because there’s stuff that are trained to deal with it. In some ways, that makes it more tolerable to have a place that caters for similar issues.

Do you think that they should be isolated to avoid harm to themselves, or more active in the society where they go out and see people? If you think about it in stages, when you put someone in a nursing home, where they just got a dementia diagnosis, is not a good idea. Dementia or Alzheimer’s, in the first stages, isn’t as difficult. They can live by themselves and not someone to check on them. It’s hard to make generalizations since there are different stages. If they have demonstrated that they could be a danger at home, then it makes sense to have a 24-hour nature to their care. That could be through aids, nursing assistants that stay at home with them or staying in facility. Some people don’t need as much socialization but most of us benefits so greatly from other people so there would be a big benefit of being in a facility with others dealing with the same issues. 46

Interview 2: Dr. Mohamed Lafta Mozan

As a neurologist, what is it that you do for Dementia and Alzheimer’s patients?

Occupation: Senior Consultant Neurologist

Our duty in neurology clinics is to differentiate treatable causes of dementia from untreatable causes. The main treatable dementias are those associated with metabolic disorder and endocrine disorder, mainly hypothyroidism and exclude surgical cases like brain tumors and subdural hematoma and NPH. In neurology clinics, we depend on diagnosis of lab tests and MRI brain tests. Some patients are also sent as far for SPECT or PET scan. Our main tool for detection of memory brain disorder is the use of MMSE test scores. Alzheimer’s disease is a complex neurodegenerative disease considered as the most common cause of dementia. 75% of all dementia is due to Alzheimer’s disease. It is the 5th leading cause of death and effects 1/3 of people above 85 years old. Every year, 5 million new cases are added to the pool of the disease. There are now 25 million cases all over the world.

Location: Doha, Qatar Interview type: in-person Interview date: 31st of October 2020 Interview Duration: 15 minutes

Biography: Dr. Mohamed Lafta Mozan has a bbachelor’s degree in Kufa College of Medicine in Iraq in 1999. He was part of the Neurology Board in Baghdad in 1998. He worked in BBaghdad Teaching Hospitals from 1990-1998. Then, from 1998-2007, he worked in Saddam General Hospital in Baghdad, Iraq. He’s had training courses in Neurophysiology in the USA. He’s had 18 years in practice within the neurology field. He’s in the American board in Aniaging Medicine. He has awards and recognition for UCL Exam in neurology and Felowship of American Academy in regenerative medicine. He currently works in Al-Emadi hospital in Qatar where he treats neurological cases for outpatient clinic and inpatient in relation with central and peripheral nervous system.

What are the biggest problems people with dementia/ Alzheimer’s face? What are the symptoms? It depends according to the stage that the dementia elderly is at of the disease. the three stages start from mild, moderate to severe. It can go from memory to loss of insight to psychotic episodes, dehydration, loss of eating and loss of control of feces. What are some medications that you prescribe or recommend for the diagnosed elderly? In medical terms, we use Donepezil, Rivastigmine, Galantamine. These medicines decrease the acetylcholine levels. We also use NMDA inhibitors such as Memanine lomytab that increase the glutamate levels. There isn’t a single just one dementia test memory decline and impact on daily life function leads to the decline and inability to judge and think and plan in one’s daily life this leads to emotional liability and social life coarsening such as depression and anxiety.

Do these medications provide different side effects?

These medications do provide side effects some of the side effects are problems with urination. if the patient has a cardiac disease then some medicines are to be reconsidered since it could negatively affect them. the medicines also cause agitation where the patient has a difficulty to fall asleep.

What advice do you usually give the caregivers when you meet with them, on how to take care of the elderly? It usually depends on the stage. It’s encouraged for the patient to do mathematical exercises, read novels and/or religious books. It’s also encouraged for them to be socially active and to meet with people, to ensure a sense of socialization. In more advanced stages, it’s recommended for them to follow a routine within their life, where they stay in the same place, follow the same activities, and see the same people. What can be a trigger for the dementia patients, something might worsen their symptoms? Usually, when they have other illnesses, such as just infections or previously done surgeries. This could trigger the dementia/Alzheimer’s symptoms. A big change of scenery could also negatively impact the patient, such as travel or a big change in the routine. What are your recommendations for the people with Alzheimer’s or dementia, in terms of what can help lessen the progression of the disease? Keeping a certain routine for the patient is very effective. Access to the outdoors is very helpful, a deeper connection with nature. Accessing these outdoor environments would obviously be only with a familiar person. Having kids around them increases their morale. Allowing them to do some simple manual work, like drawing or painting or gardening helps with the behavioral problems they might face.

In Qatar, what type of care do the families of dementia patients choose for the year diagnosed elderly? Usually, the ones that take care of the patients are the family members. in Western countries they usually hire a carer that could be paid by the government, or the patient could be referred to a rehabilitation institution or nursing home where their retirement money is sent to the center. What other diseases can result from dementia and Alzheimer’s? Dementia could cause brain failure. Dementia could also result to a chest infection which could cause death. Falling is a big issue that could result to fractured bones. Dementia patients also get bed sores and septicemia. A lot of dementia patients in severe cases face difficulty in swallowing, They could also have cases of dehydration.

Dr. Mohamed Lafta Mozan provided the Mini-Mental State Exam (MMSE) that they use in Al-Emadi hospital, where they test the patient’s orientation, attention, memory, language and visual-spatial skills to determine the severity of tthe cognitive issues.

Design Considerations

Bubble Diagram and Adjacency Matrix

Reception Exhibition

Theater Common area

Cafeteria In-patient residential bedrooms Staff residential bedrooms Doctor consultation room Prayer room ADA bathrooms Staff bathrooms

Courtyard Massage therapy

LEGEND Primary adjacency

Art therapy room Recreation room

Secondary adjacency No adjacency Public zone

Staff common area Storage

Semi-public zone Private zone Recreational zone Work zone

ADJACENCY MATRIX

Figure 47- Bubble diagram

Figure 48- Adjacency Matrix

Conceptual Framework

The phenomenon of Dementia Disease is very prevalent in Qatar as care is not provided beyond clinical care. This project proposes a semi-residential care center that tackles the complications that Dementia elderly face, such as the psychological and behavioral problems. The project aims to provide the elderly with a space that mitigates these complications while still providing the elderly with a home-like environment. To ensure that, a theory in environmental psychology must be implemented within the care center. The Elements of Legibility theory by Kevin Lynch will be implemented to enhance spatial legibility for the elderly occupying the space. This theory highlights space not just as a physical arrangement but as a direct experience of human elements. The theory establishes five elements that analyze spatial legibility: paths, edges, districts, nodes, and landmarks. The relevancy of each element differs depending on its function.

Edges is an organizing feature where clear boundaries are established within different spaces. Through developing a boundary between each space, an emphasis on each space is established. This helps the elderly with distinguishing one “edge” from the other.46 These distinctive spaces support Dementia diagnosed elderly with orientation, as well as a better understanding of space and time. Legibility is expressed through distinguishing the level of public/ privacy the space has, which allows the elderly to distinguish the space from the others. 47 Districts describe internal harmony through different spaces. Through providing a district, the elderly feels included to a larger community. This understanding establishes a legible framework for the elderly to help understand the context they are in. 48 Developing this district provides a safe parameter for the Dementia diagnosed elderly; safe of wandering and access to controlled exterior spaces. 46

Paths are channels used to move from one area to another. These paths usually connect the whole space together as it narrates the physical experience of the user. To ensure a successful experience, it is important to maintain visual access within the paths within the space. Through establishing legibility within these paths, disorientation is controlled with the Dementia diagnosed elderly, levels of independence increase, and personal orientation becomes clearer. Through the use of obvious and easy-to-follow routes, a higher level of self-esteem and confidence is achieved. 47 Nodes define the overlap and intersectionality of the spaces. Nodes define the space’s connection points. The nodes produce common areas that reduce social withdrawal and depression. 47 The nodes generate a legibility in assisting orientation of the elderly which assists means of wayfinding throughout the space. 49 Landmarks are points of reference that define certain elements within the space. Landmarks serve as guiding elements that serve as a return point for the Dementia diagnosed elderly. These reference points provide visual cues for Dementia elderly which helps with individual orientation, as well as a remembrance and an understanding of the environment. Some induced behaviors stimulated by this visual cue are social interaction, connection with the space, and reduced pacing. 47 Through the use of the five elements of legibility, the space starts representing a collective function which provides harmony throughout the space by articulating the different functions of each element. This theory can be applied to the proposed project through the interior design elements, wayfinding, and zoning/ space planning. Some design considerations that would be how building codes collide with the theory, how the selection of materials affect the theory, and how color relates to elements that implement the theory.

Elderly feels included to a larger community

Emphasis on each space Helps elderly with orientation, better understanding of space and time, and distinguishing one “edge” from the other Clear boundaries are established

Provides a safe parameter for the Dementia diagnosed elderly; safe of wandering and access to controlled exterior spaces Helps elderly understand the context they’re in

DISTRICTS

Define the space’s connection points

Generate a legibility in assisting orientation N O D E S of the elderly which assists means of wayfinding throughout the space

EDGE

ELEMENTS OF LEGIBILITY

LANDMARK

Overlap and intersectionality of the spaces Guiding elements that serve as a return point

Maintain visual access within the paths within the space

P A T H S Increase in

orientation becomes clearer & levels of independence & less disorientation for the elderly

Paths usually connect the whole space together

Social interaction, connection with the space

Provide visual cues for elderlyhelps with individual orientation & well as a remembering and understanding the environment Figure 49- Conceptual Framework

CONCEPTUAL FRAMEWORK

Acoustic Considerations

With designing a Dementia semi-residential care center, acoustics are an essential design aspect to provide with considerations for. Through acoustic manipulation, the space can trigger certain vital emotions that tackle behavioral and psychological complications. The complications that Dementia diagnosed elderly face can affect wayfinding, disorientation, spatial legibility, and user’s personal orientation. As the environment has a significant impact on the elderly’s mood and emotional instabilities, the use of acoustic sound control can be used as a tool to trigger specific emotional, physical, and psychological responses through the control of levels of loudness and sharpness. 50 Acoustic levels can be controlled depending on the spatial zones and its function for the user. The space is divided into five zones: public, semi-public, private, recreation, and work zones. Public Zone The public zone areas within the space are the exhibition, theater, and the courtyard. Since these spaces are mostly acoustically driven to enhance elderly well-being, acoustic control will be mainly controlled to avoid sound leakage out between these spaces and other spaces with the care center. The site provides these spaces with opportunities to function as public spaces, through the use of high ceiling heights (fig. 50,) but does not offer options to help with decreasing sound leakage. To maximize sound efficiency within the theater, the use of acoustic panels, with sound absorptive qualities, the space maximizes acoustical awareness while still maintaining control over the sound distributed. 51 To minimize sound spreading within the exhibition, the use of semi-hard flooring materials will be implemented with an acoustic underlay (fig. 51) to reduce sound transmission of footfall noise, as that is the most noise produced. An acoustic ceiling (fig. 52) will also be implemented to eliminate unnecessary sound reflection. This reduces high stimulation of sounds but doesn’t reduce all sound produced to avoid under-stimulation where elderly could exhibit bored and problematic behavioral actions. 52

Figure 50- High ceiling height

Figure 51- Acoustic underlay

Figure 52- Acoustic ceiling

The courtyard, contrastingly, is intended to provide a higher level of controlled acoustic stimulation to connect the elderly with nature. Sounds of nature must extenuated to provide the elderly with an identifiable familiar sound stimulus. Placing sound reflecting surfaces such as paving and concrete (fig. 53) increase reflections within the exterior space which enhances sound quality, therefore helping the elderly understand the space surrounding them. Since the courtyard allows external stimuli influences such as, vehicle activities, tram sounds, and people activity, the space must accommodate to a certain acoustic control to decrease that. This can be achieved through using acoustic barriers and absorptive treatments within the courtyard. 52 Semi-Public Zone The semi-public spaces are the common seating area and the cafeteria. As they are both high activity spaces, the treatment for both spaces follows different methods of acoustic control but both avoiding high levels of acoustic travel to nearby in-resident bedrooms to accommodate to site constraints. The cafeteria minimizes sound by installing acoustic absorption (fig. 54) to parts of the ceiling and by using slip-resistant PVC floor instead of tiles. Sounds within the kitchen must still be heard to generate sensory prompts to establish a level of familiarity for the elderly. The common area minimizes sound reverberation by using furniture and curtains to soften the space. The common area will contain a level of 50 STC, as well as discontinuous construction to avoid sound from traveling to the bedrooms in the private area. A sensory element, such as a music, will be used as a positive distraction to create a physical and emotional connectional within the space and the resident, as well as to reduce behavioral and psychological outbursts. 52

Private Zone The private spaces include the in-patient residential bedrooms, staff residential bedrooms, doctor consultation room, bathrooms, and prayer rooms. As the in-patient residential bedrooms are close to the common area and the cafeteria, a level of 50 STC acoustic performance as well as discontinuous construction will be implemented to avoid sound transmission from the semi-public areas to leak to the private areas. Sound masking will be possible by adding a sound stimulator within the rooms, such as a radio or television, as a positive distraction as well as to increase comfort level by heightening the hearing sense for the elderly. Controlling reverberation is possible trough providing an acoustically absorbent ceiling along with soft furnishing. Recreational Zone The recreational spaces include a massage therapy room, a recreation room, as well as an art therapy room. These rooms are within close parameters of the courtyard, a public space. To ensure sound control within these spaces, as they involve machinery that could produce noise, the installation of acoustic absorption to the walls as well as using acoustical ceiling panels. This is important because wandering has to be reduced in the courtyard towards the recreation spaces, as it is not intentional wandering. It also reduces abrupt noises that could disturb the elderly. 52 Conclusion Through the use of acoustic control within the different zones, the spaces control the noise impacts on the elderly. Within the use of these different methods of acoustic control, the space presents itself as acoustically compliant for the elderly with the aim to creating a semi-residential care center that evokes an engaging and calming feel.

Figure 53- Concrete and pavement

Figure 54- Acoustic absorption panels

Indoor Air Quality

Through designing a Dementia semi-residential care center, an understanding of the indoor air quality must be acquired. Through accommodating to indoor air quality, the user’s experience within the space is simplified and with no unnecessary complications that can affect the dementia diagnosed elderly’s quality of life. For Dementia diagnosed elderly, the importance is of indoor air quality is essential as since with their aging there is a decline in their physical health immunity. This makes them prone to more respiratory infections. 53 To ensure a successful and comfortable space for Dementia diagnosed elderly, sources of air pollution must be looked at, as well as how indoor air quality affects the user experience, and strategies to improve IAQ. Since the Mohammad bin Jassim building is located across from a main vehicular road and tram route, the effects of these factors affect the IAQ of the building (fig. 55). The space is exposed to the active nature of vehicles which affects the indoor air quality of the space. This increases pollutants that are of major public health concerns. Some pollutants include PM, nitrogen oxide, sulfur dioxide, and carbon monoxide. PM is the most harmful as it is small, increasing easy penetration to the respiratory tract. This causes a decline in cognitive performance as it triggers health problems for the elderly that trigger behavioral and psychological outbursts. 54 Another source of air pollution is the humidity and hot weather (fig. 56). This triggers a bad state of indoor air temperature. Improper use of cooling/heating systems within the space impact the health and well-being of the dementia elderly, which increases agitation and behavioral outbursts. Improper indoor air temperature increases risks of illnesses such as hypothermia and hyperthermia. Factors of the building envelope, such as wall, windows, floor, and ceiling/roof, affect the conditions of poor indoor air temperature.

Figure 55- Sources of Air Pollution

Figure 56- Humidity and hot weather in Qatar

Strategies that prevent poor IAQ include source control, improved ventilation, and air cleaners. Source control works on eliminating individual sources of pollution or to reduce their emissions. This works on small scale causes of IAQ and is often a cost-efficient approach. Sources that contain asbestos can be found in materials in the wall, ceiling, flooring. A way to control that is be sealing them by using proper finishes that do not release the toxins. Other sources could be gas stoves, machinery used in gyms, and equipment used in the massage therapy room. They can be made adjustable to decrease the amount of emissions. 55 Improved ventilation can be accessed through allowing more outdoor air to improve the indoor air quality. This can be through maximizing methods of natural ventilation (fig. 58). Through providing more openings such as windows and doors, the interior space starts to open up to the exterior space, maximizing levels of air quality. Another method could be through mechanical means such as outdoor air intake through heating, ventilation, and HVAC systems (fig. 57).

To reduce PM intake for the elderly, air infiltration sources can be added to reduce the PM consumption. Air infiltration is a process which outdoor air flows into the interior space through openings of the interior elements, such as the walls, ceiling, and floors. Air infiltration methods include adding air purifiers throughout the space, such as in bedrooms. Adding plants throughout the space also purifies the air. In conclusion, indoor air quality is an essential element to consider in Dementia elderly homes. Indoor air quality improves behavioral and psychological factors for elderly. Through using IAQ improvement methods, environmental factors are controlled improve agitation and behavioral outbursts for elderly.

Figure 57- Air infiltration

Figure 58- Natural ventilation

Ergonomics

Accommodating for ergonomics for elderly with Dementia is an essential element to consider as it impacts the user’s well-being and comfort level within the space. With considering ergonomics for Dementia elderly, the space lends itself as a Dementia compliant space that considers behavioral and psychological factors that Dementia elderly face that often go unaccommodated for. As Dementia elderly are heavily impacted by the environment they reside in, the physical and cognitive ergonomics focuses on the physical and mental stresses that Dementia elderly face. 56 During the course of the elderly’s disease, they are more likely to develop behavioral and psychological complications. Some of these complications could be signs of disturbed behavior such as agitation, mood swings, irritability, etc. 57 As the semi-residential Dementia center proposes methods that are not entirely clinically dependent, ergonomics carries a big importance in helping the elderly deal with non-clinical needs. The importance of ergonomics is to monitor and positively impact behaviors that are resulted with the progression of Dementia. These behaviors include restlessness, wandering, combativeness, and other behavioral challenges. As Dementia diagnosed elderly have deficiencies in cognitive and physical abilities, ergonomics functions as a filler to satisfy their needs for these deficiencies. Cognitive ergonomics is used to provide memorabilia for the elderly. This is provided through space planning. A method that will be implemented within the space is the “Memory Trail.” (fig. 59) The memory trail focuses on sensory stimulus, the stimulation theory, as well as the legible spaces, through the elements of legibility theory. The memory trail follows the sequence of sensory stimulus to a threshold space that evokes movement. All this activity would be revolved around a focused space that implements a landmark feature from Lynch’s Legibility theory. Through following this strategy, cognitive activity is triggered. Through cognitive activity, behavioral and psychological outbursts are controlled. 58

Figure 59- Memory Trail

Figure 60- Space planning

Sensory stimulation helps reduce unnecessary cognitive activity and triggers spatial understanding and connection. Through the use of visual sensory elements in the space, the space lends itself as a relaxing stimulated space. This will be implemented through the lighting throughout the space. Light manipulation will be used to control interaction and activity level. Artificial light will be bright during the daytime. The light, then, gets gradually dimmer as nighttime approaches. Through providing manipulation through the light sensory factor, elderly’s activity levels become more regulated and stabilized. Through the use of light using the Memory Trail the user associates light by memory with the appropriate physical activity. Cognitive ergonomics depends on physical ergonomics to provide a positive result for the elderly. 59

Threshold spaces provide a pathway to memorabilia as it allows for cognitive activity. Controlling cognitive activity is possible through the use of a physical ergonomic factor, such as color. Through the use of color, cognitive activity is appropriately controlled for the elderly, as well as physical legibility throughout transition spaces. In transition spaces, the elderly are in need of a visual cue for enhanced perception. This can be possible through the use of a contrast in saturated colors to provide a visual cue for a differentiation in certain elements (fig. 61). This defines spaces for the elderly which enhances wayfinding through memory. 60

The focus point will be the exterior element in the project, which is the courtyard. The Memory Trail focuses on an exterior feature that is often considered the landmark feature of the space. Within the courtyard, the maximization of views and light encourages the elderly to socialize and helps reduction of agitation. Exposure to natural elements within this feature space provokes a memory stimulus as it triggers positive cognitive memory for the elderly (fig. 62). 61 Through understanding how ergonomics impacts the elderly’s activity, the space effectively functions as a positive effect on the users. Behavioral and psychological outburst are controlled when following the Memory Trail as it provides a structured cognitive process that helps control the elderly’s outbursts.

Figure 61- Contrast in colors

Figure 62- Central courtyard WARM

NEUTRAL

COOL

Figure 63- Light manipulation

Building System Considerations

In order to create a space that lends itself as legible and safe for the dementia diagnosed elderly, two building systems will be implemented. These building systems gravitate towards creating a space that is safe for the elderly, where minimal harm is resulted. This also contributes to the Lynch’s Elements of Legibility theory, where a legible and easy-to-follow space is created for the elderly. The first system is the lighting system. The lighting system aims to establish a play between artificial and natural lighting that helps associate the elderly with the timing as well as ease of lighting for the aged eye. The other system is a monitoring system that ensures a safe experience for the elderly by monitoring them and using specific methods to ensure the elderly’s safety. The lighting system works to reassociate the elderly with specific functions of the room, as well as helps the elderly associate interior lighting in accordance with the time of the day. 62 This regulates the human circadian system through a 24-hour light-to-dark pattern. To create this, a timed light system will reflect light within the space by mirroring the daylight patterns. During the day, light follows a cool light color temperature (1000 lux) as it improves cognitive functions and promotes more physical opportunities for the elderly. The nature of the light would reflect a dispersed light function as it doesn’t disturb the elderly’s flow within the space and helps elderly with vision impairment difficulties. 62 Later during the day, as the sun sets, the light temperature becomes warmer. This helps relax the elderly by having a dimmer and more calming light pattern. Through that, physical activity and cognitive functions adjust to sleep patterns. An additional consideration would be adding dimmers for further light adjustments, as well as light motion sensors to pave the elderly’s path during nighttime. 62

Monitoring systems work towards assisting and improving the elderly’s quality of life by minimizing risk of injury and exposure to dangerous situations (fig. 64). To provide a secure and safe space, the use of infrared sensors and cameras will be the main ways of tracking the elderly’s movements and activity. Infrared sensors will be positioned in the elderly’s bedroom’s as well as the hallway that leads to the courtyard. These sensors will be located at main points of activity: the bed, the bathroom, the bedroom door, and the hallway (fig. 66). If there is activity, the sensors link to a computer that informs the staff where activity is occurring. This surveillance method also uses this data to track their overall movements to indicate disease progression based on behavioral changes. Extra locks will be reinforced on doors leading to the courtyard. In case an elderly tries to use the doors, an alert will be sent to the staff for further assistance towards the elderly. 63 For the other interior spaces, supervision is achieved through a camera system. Cameras will be covered in the main interior hallway, as well as the rest of public interior rooms. High activity regions will be covered by multiple points to capture the space from multiple vantage points, to ensure a safer and full coverage of activity levels (fig. 65). 64 Through the use of the lighting and monitoring system, the space serves itself as a safe space that encompasses the elderly without imprisoning them. These systems aim to effortlessly function without disturbing the elderly’s activity throughout the space. Through them, the space becomes easy-tofollow and legible for the elderly to roam through with maximum safety and comfort.

Camera system Infared sensors Reinforced door locks

Figure 64- Location of monitoring systems

Figure 65- Camera placement in common area

Figure 66- Sensor placement in bedroom area

Building Codes

In order to design a space that hosts elderly by providing maximum safety measures and general protection considerations, building codes must be considered for the elderly semi-residential center. It’s important to look at codes that are relevant to elderly users that may have specific considerations that need to be catered to, such as wheelchair users, elderly with vision impairments etc. The building type falls under Institutional Group One (I-2 and I-4), as the use of the building structure in which care or supervision is provided to people who are incapable of self-preservation without physical assistance. The space’s occupancy load fits up to 200 people within the space. 65 The two building codes that will be implemented are the International Building Code and the American Disabilities Act. The IBC implementation within the space focuses on creating barrier-free space for the elderly to allow access to other spaces with ease. In order to provide a path of egress that allow for the elderly’s exit access path to be clear. The ceiling height must be at least 2286 mm high. This helps the user move throughout the space easily. For main circulation paths, any protruding objects from the ceiling must allow 2286 mm headroom vertical clearance. As for horizontal projections, objects must not protrude more than 102 mm horizontally into the circulation paths. The only exception is handrail protrusions, which are permitted to extend up to 114 mm from the wall. In terms of floor surfaces, the means of egress walking surfaces must be slipresistant to ensure safe circulation throughout the path. 66 Because of the occupant load, the exit access must lead to two exits. (fig. 67) 65

ADA codes are extremely important for elderly users as the space caters to problems of dementia but also to handicapped and users that have slower mobility. To follow with ADA codes, accessibility for the elderly is an essential design element to consider. Doors must have a minimum of 800 mm, although it is preferable for the opening to be 914 mm which helps give better clearance access to frail elderly. In areas of transition, a turning circle with a minimum of 1676 mm is required for wheelchair users to maneuver around. Corridors must have a width clearance space that can fit two passing wheelchairs (fig. 68). Doors must have door handles that do not require tight grasping or twisting of the wrist. Push-pull mechanisms, such as sliding doors or light doors that can be pushed open, for doors help decrease excess physical efforts (fig. 69). 67 In order for signage to be ADA-complaint, there must be a high level of contrast between the background and words (fig. 46). This helps the sign’s legibility for elderly users with vision problems. Signs must also not create any glare as the reflections as this causes disruptions for the elderly. By following IBC and ADA, a safe environment is created to ensure maximum comfort and a safe experience for the elderly. Through these building codes, a better understanding of how the elderly interacts with the space is achieved, therefore creating a space that allows the dementia diagnosed elderly to reside in a place of comfort.

Figure 67- Number of exit according to occupancy

Figure 68- Corridor fitting two wheelchairs

Figure 69- ADA compliant font types

Figure 70- Push-pull door mechanisms

ROOTED YARA BARAKAT

“A space that creates a community for dementia diagnosed elderly which caters to behavioral, psychological, and clinical needs while still making them feel at home.”

Withered roots

Full grown roots

FAMILIARITY

harmony- socialization-

STABILITY

community

hierarchy-

accessibiltygrounded

CONNECTIVITY memorabiliasoothing

Outdoor parking

Cooling plant

V e h ic u la r p a th

Underground parking

Wind direction

Bin Jalmood House

Mosque Company House

MOHAMMAD BIN JASSIM HOUSE Tram route

Radwani House

Vahicular path Tram route

Constructtion documents

W01

STAFF BEDROOMS

STAFF BEDROOM S D01

D01

W01

D01

W01

D02

D01

W01

D01

W01

D03

D01

W01

D03

D01

W01

GAMING ROOM

W01

D04

W01

D01

W01

D02

BEDROOMS

D01

W01

EXHIBITION D01

D01

D03

W01

LIVING ROOM

MASSAGE ROOMS

W01

3 W01

D02

ART ROOM

LIBRARY

CAFETERIA D01

D01

D04

CENTRAL SEATING ARE A

W01

W01 D02 D01 D01

AUDITORIUM

KITCHEN

W01

D01

RECREATION ROO M SEATING ARE A D01

D01

W01

GARDENING AREA

STAFF AREAS W01

D01

W01

D01

STAFF AREAS W01

W01

2 3 5

DOOR AND WINDOW SCHEDULE CODE

TYPE

QUANTITY

MANUFACTURER

FINISH

D01

Single swinged door

Garafolli

Wood

D02

Single swinged door

Garafolli

Wood

D03

Double swinged door

Origin doors and windows

Wood

MMI door

Bolando

D04 W01

Double swinged door Qatari style window

D01

D02

D03

Wood

D04

W01

B01

TO3 B01 CHO4

TO3 CHO4

TO3 B01 CHO4

B01

TO3

T01

CHO4

CH01

T02

CH07 T03 CH02 B01

B01

T03 CH07 T03

B01

CH02

B01

CH06

CH03

TO3

T04

B01

CH08

CH03 T04

CH05 TO4

CH05

CH07

CH05

T03 CH07

CH04

T03

CH04

FURNITURE PLAN

2 3 5

FURNITURE SCHEDULE QUANTITY

MANUFACTURER

FINISH

Casual sofa

Garnet furniture

Wood

CH02

Simpliciter

B&b Italia

Wood

CH03

Acanto

B&b Italia

Fabric

CH04

Charolette

B&b Italia

CH05

Cosmos

B&b Italia

CH06

Jens

B&b Italia

Wood

Edoward

B&b Italia

Fabric

Wood pedestal

B&b Italia

Fabric

Walnut table

B&b Italia

Wood

Docksta

Ikea

Adjustable bed

Aidacare

CODE CH01

CH07 T01

TO2 TO3

B01

TYPE

White finish

CH02 CH05

TO2

T01 CH03 CH06

CH04

CH07

B01

TO3

B 01

C 02

T 01

V 01

W 01

M 01

B 02

PT 01

M 01

W 01

B 02

FINISH SCHEDULE FINISH CODE

MATERIAL l NAME

COLOR

FINISH

MANUFACTURER

B 01

Red and Yellow Brick

Red & Yellow

In-situ

Mohawk

C 01

Red Carpeting

Red

Matte

Forbo

T 01

Beige Tiles

Beige

Matte

Marjan Tiles

V 01

Yellow Vinyl Flooring

Yellow

Polished

Mohawk

W 01

Linoleum Wood

Brown

Honed

Arta Clic

M 01

Deep Beige Marble

Beige

Honed

Mohawk

Flooring Finish

Wall Finish B 02

White Limestone Brick

White

Polished

Estoneworks

PT 01

Deep Red Solid Paint

Deep red

Matte

Jotun

PT 02

Blue Solid Paint

Blue

Matte

Jotun

PT 03

Orange Solid Paint

Orange

Matte

Jotun

PT 04

Beige Solid Paint

Biege

Matte

Jotun

F 01

Gypsum Board

Grey

Semi-glossy

Homesmiths

F 02

Semi-transparent porcelain fabric

Off-white

Fabric

Glass Supply

Ceiling Finish

PT01

C01

B02

C01

PT04

W01

B02

PT01

B02

V01 T01 PT03

PT04

B02

T01

M01

PT03 PT03

F01

F02

PT04

F01

PT03

B02

B01

B02

B02 B02

B02

PT04

F01

W01

B02

T01

V01

F01

V01

M01

F01

T01

B02

FINISH PLAN

F01

F01 B02

V01

M01

PT04

B02

F01

V01 F01

V01

B02

V01

PT02

V01

PT04

B02

C01

T01

B02

PT01 B02

B02

PT02

PT04

C01

T01

PT01

PT02

PT02 B02

PT02

PT01 B02

T01

PT04

C01

PT02

T01

PT01

T01

B02

T01

B02

C01

PT01

F01

PT04

V01

F01

PT02

T01

PT02

PT04

PT04 B02

PT02

T01

C01

PT03

T01

C01

PT03

C01

T01

PT04

C01

2 3 5

DOOR AND WINDOW SCHEDULE

SYMBOL

TYPE

QUANTITY

MANUFACTURER

WATTAGE

Ceiling mounted light

Greenice

65 W

Flourescent Light

Dmlights

50 W

Spotlight

Astro Lighting

60 W

Wall mounted light

Santa & Cole

50 W

REFLECTED CEILING PLAN

2 3 5

Deep red painted wall

E L E VAT I O N

White limestone brick

SECTION

Rendered Perspectives

POINTED ARCH Use of arch that has been used in old Qatari homes

MAJLIS SEATING Use of traditional furniture

RED BACKDROP WALL Implimentation of a pigmented color as a visual cue

PICTURE FRAMES Use of picture frames and photo albums to induce memorabilia

WHITE LIMESTONE Use of original building material that enhances memorabilia

100

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Endnotes 1 Qatar National Dementia Plan. (n.d.). Retrieved from https://www.moph.gov.qa/Style%20Library/ MOPH/Files/strategies/dementia/DEMENTIA%20SUMMARY%20E.pdf 2 HMC to survey prevalence of dementia in Qatar. (n.d.). Retrieved September 14, 2020, from https://thepeninsulaqatar.com/article/24/09/2017/HMC-to-survey-prevalence-of-dementia-in-Qatar 3 Ministry of Public Health. (n.d.). Retrieved September 07, 2020, from https://www.moph.gov.qa/ english/strategies/Supporting-Strategies-and-Frameworks/QatarNationalDementiaPlan/Pages/default. aspx 4 Dementia vs. Alzheimer’s Disease: What is the Difference? (n.d.). Retrieved September 07, 2020, from https://www.alz.org/alzheimers-dementia/difference-between-dementia-and-alzheimer-s 5 10 Early Signs and Symptoms of Alzheimer’s. (n.d.). Retrieved September 07, 2020, from https:// www.alz.org/alzheimers-dementia/10_signs 6 Agnes Lindbo et al. “Dysphoric symptoms in relation to other behavioral and psychological symptoms of dementia, among elderly in nursing homes.” BMC geriatrics vol. 17,1 206. 7 Sep. 2017, doi:10.1186/s12877-017-0603-4 7 Large, S., & Slinger, R. (2013). Grief in caregivers of persons with Alzheimer’s disease and related dementia: A qualitative synthesis. Dementia, 14(2), 164-183. doi:10.1177/1471301213494511 8 Linn Hege Førsund et al. “The experience of lived space in persons with dementia: a systematic meta-synthesis.” BMC geriatrics vol. 18,1 33. 1 Feb. 2018, doi:10.1186/s12877-018-0728-0 9 Ministry of Public Health. (n.d.). Retrieved September 07, 2020, from https://www.moph.gov.qa/ english/strategies/Supporting-Strategies-and-Frameworks/QatarNationalDementiaPlan/Pages/default. aspx 10 Large, S., & Slinger, R. (2013). Grief in caregivers of persons with Alzheimer’s disease and related dementia: A qualitative synthesis. Dementia, 14(2), 164-183. doi:10.1177/1471301213494511 11 Castro, D. M., Dillon, C., Machnicki, G., & Allegri, R. F. (2010). The economic cost of Alzheimer’s disease: Family or public health burden?. Dementia & neuropsychologia, 4(4), 262–267. https://doi. org/10.1590/S1980-57642010DN40400003 12 Ministry of Public Health. (n.d.). Retrieved September 07, 2020, from https://www.moph.gov.qa/ english/strategies/Supporting-Strategies-and-Frameworks/QatarNationalDementiaPlan/Pages/default. aspx 13 Castro, D. M., Dillon, C., Machnicki, G., & Allegri, R. F. (2010). The economic cost of Alzheimer’s disease: Family or public health burden?. Dementia & neuropsychologia, 4(4), 262–267. https://doi. org/10.1590/S1980-57642010DN40400003

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Booklet

Articles inside

Endnotes and Image Credits

Building System Considerations

Building Codes

Ergonomics

Indoor Air Quality

Acoustic Considerations

Precedent Studies

Literature Review

Interviews

Conceptual Framework

Rationale

Approach

Concept Statement

Abstract