2.3 THE ARCHITECTURAL PROBLEM

1.3 OUTLINE BRIEF:

This mini-dissertation presents the design of an intergenerational retirement community for the elderly in Mayville, Pretoria. This mini-dissertation explores a possible strategy model for retirement communities for application in various retirement communities throughout the elderly residential landscape of South Africa. The proposed retirement community seeks to create a sense of community and place not only within the boundaries of the site a retirement strategy that bleeds over the edges and creates meaningful connections with the surrounding context. The community will incorporate the elderly that live within the boundaries and extend to the incorporation of individuals (of all ages) who live off the premises.

Furthermore, the proposed retirement community will integrate public space and intergenerational social and learning spaces to create a symbiotic relationship between the elderly and younger generations of South Africa. Hopefully, this symbiotic relationship will benefit the younger generations and allow the elderly to regain a new goal and purpose in retirement that could aid in the ongoing battle against loneliness and social isolation.

This mini-dissertation explores the following design considerations: • Facilitating inclusion and encouraging diversity (in elderly care facilities typically seen as homogenous) to create a socially healthier environment for the elderly. • Creating a healthy living environment with a sense of place incorporating various design principles from The Death and Life of Great American Cities by Jane Jacobs, A Pattern Language by Christopher Alexander, Murray Silverstein, and Sara Ishikawa, and ‘15 principles for designing great civic places’ by Peter Ciemitis. • Introducing social elements and public space into a facility that is traditionally seen as a closed-off medical facility. • Incorporating nature throughout the proposed retirement community to satisfy the people’s innate need to be connected with nature.

*Intergenerational: relating to, involving, or affecting several generations (lEXICO, N.D.).

CHAPTER TWO:

IDENTIFYING THE PROBLEM:

2.1 THE LONELINESS EPIDEMIC

2.2 GRANNY DUMPING

2.3 THE ARCHITECTURAL PROBLEM

2.4 THE SOCIAL PROBLEM

2.5 THE MAIN PROBLEM STATEMENT

2.1 THE LONELINESS EPIDEMIC:

In 2020, and with continued effects in 2021, the unprecedented pandemic due to COVID-19 has brought the world to a standstill. Although loneliness and social isolation has always been an issue, the current global quarantine and stay-at-home lockdown orders (although they have positive intentions) have significantly influenced global mental health. The terms ‘loneliness’ and ‘social isolation’ are often misunderstood as the same concept, but the two are distinctly different. The term ‘loneliness’ is defined as a subjective feeling of being alone that leads to sadness and anxiety, while social isolation refers to an objective state of an individual’s social environment. Social isolation can also be described as a near-complete lack of frequent social interactions between individuals and society (Hwang, et al., 2020).

The older population already experienced loneliness and social isolation before the restrictions were put in place due to functionally dependent relationships with their families and caretakers. However, due to the global initiative for social distancing and isolation, these pressing feelings of abandonment and social isolation are exacerbated by the current COVID-19 pandemic’s rules and restrictions (Hwang, et al., 2020).

Various physical and mental repercussions are associated with social isolation and loneliness, such as elevated blood pressure and an increased risk of coronary-arterydisease-related deaths. Further research also shows that loneliness and social isolation are independent risk factors contributing to a higher all-cause mortality rate. Therefore, reducing the loneliness and social isolation experienced by the older population will decrease the risk of cardiovascular issues (Yu, et al., 2020).

Loneliness also affects mental health by increasing depressive symptomatology and functional impairment rates, leading to the inability to perform self-care activities and maintain mobility and directly impacting independence. Untreated depression is directly linked with an increased inability to use public health care services and a reduced

FIGURE 2.1: Despairing Senior Man. (Bialasiewicz, 2015). ability to self-manage and make self-informed health care decisions regarding physical and mental health. These problems of depression can lead to early mortality (Hansen, et al., 2016).

These depression symptoms ultimately lead to an adverse change in the person’s quality of life (Lee, et al., 2019). Due to the older population typically feeling like a burden, it is easier for them to neglect themselves and their physical and emotional needs. According to Hansen, et al. (2016), most self-neglect cases reported by Adult Protective Services (APS) are older adults who live alone in communities with little support and many mismanaged mental and physical health conditions – the most common being depression.

This problem currently being experienced by the elderly (and to a lesser extent, the rest of the population) raises a question that architecture could possibly solve. How can architects design social living spaces that allow people from all walks of life and social classes to symbiotically live out the flow of life without excluding specific demographics and aid in the ongoing battle against self-neglect and decaying mental health?

*Self-neglect: The physical neglect of an individual’s well-being (Lexico, n.d.).

2.2 GRANNY DUMPING:

Due to the shift in society’s lifestyle choices, significant changes have occurred in the nuclear family structure in recent decades. With the rise of globalisation, the nuclear family’s structure is mainly influenced by the shift in the economy, the nature of the workforce, and the job market expansion beyond international borders, which contributes significantly to the core family’s structure being geographically disconnected (Newman, et al., 2008). This geographical disconnect contributes to the phenomenon known as ‘granny dumping’.

‘Granny dumping’ is the term used by professionals in the medical and social work fields and is defined as the active act of abandoning elderly people in public places (Lexico, n.d.), such as hospitals and nursing homes due to the caretakers (usually relatives) who are unwilling and too stressed to care for the elderly. (Lexico, n.d.). Granny dumping is not a new phenomenon and is similar to the centuries-old Japanese ubasute practice. This practice involves familial caretakers of the poorer economic class who take their senile elders to mountaintops to be abandoned and left to die because the caretakers cannot care for them anymore (Weller, 2017). Albeit more extreme than the current-day granny dumping, I feel that the current retirement home archetype can be seen as the modern-day equivalent of ubasute. Instead of leaving the elderly on mountaintops, families leave the elderly in lifeless beige squares where they will live out the rest of their final days in loneliness and social disconnect.

FIGURE 2.2: Sad Mature Indian Woman (Nigam, n.d.).

2.3 THE ARCHITECTURAL PROBLEM:

Traditional retirement homes are treated as independent and isolated communities that only cater to one specific age demographic. These communities are seen as monotonous entities due to the lack of age diversity among the residents.

Although many variations of retirement homes and communities are being developed worldwide, they still serve the same purpose. The basic requirement for a retirement community is for professional caretakers to provide 24-hour assistance for the elderly residents’ daily activities. This essential requirement technically then defines a retirement home as a medical institution with a secondary function as a place for the elderly to reside. According to Dr Steven Foldes (1990), retirement homes serve a dual purpose as institutions and homes. This means that traditional retirement homes were designed as institutions rather than homes because the model for the traditional retirement home was based on the medicalsomatic model of care. This medical model dictated that traditional retirement homes should be designed to emphasise illnesses and the treatments of underlying pathology. Due to the institutional nature of traditional retirement homes, they are seen as spaces that have to be fortified and protected. With retirement homes designed with these points in mind, the homes resemble hospitals rather than homes due to the lack of autonomy, set rules and routines, and few options for personalisation (Foldes, 1990).

*Medical-somatic model: A model created to focus only on physical symptoms that results in major distress and dysfunction, such as pain and weakness

*Pathology: A branch of medicine that focuses on laboratory examinations of body tissue for diagnostic or forensic purposes.

Figure 2.3 shows the current state of my grandmother’s room in her retirement home. One of the biggest problems with her current retirement home is the lack of seating and social spaces. Due to her inability to walk, it is hard for the family to collect her and take her out for the day. Therefore, most of the family gatherings are held in her tiny room that has inadequate seating. She has a mild case of dementia and lives in a care facility with five other people who have dementia and Alzheimer’s disease. There is not much social interaction between the residents, and I can see that my grandmother is socially isolated in her current facility.

(Update: As of October 2021, we are in the process of moving my grandmother to a better care facility due to her dementia worsening.)

FIGURE 2.3: My Grandmother’s Room.

01 INTRODUCTION02: IDENTIFYING THE PROBLEM