EM

E. Miedema

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10 records found

The thesis aims to investigate the role of the built environment with the help of design elements, in promoting mental health among young adults. The study will focus on how architectural design choices can contribute to- wards normalization and de-institutionalisation of mental healthcare facilities for the youth. The academic paper aims to explore the impact of the built environment on mental health in an ever changing modern society. The research will examine several literature studies, academic writings, case studies and primary sources through fieldwork, observations and interviews. Social and environmental factors which might influence the youth and how design choices can address these factors will also be analyzed. Overall, the thesis seeks to provide insights on how architects can create spaces that not only prevent mental illnesses but also promote mental wellbeing among young adults. While mental health is a very prominent topic currently, this thesis aims at providing an alternative approach towards the topic through architecture. ...

A study about the feeling of autonomy in psychiatric clinics

Psychiatric clinics where patients live are only used when the patient cannot
live on their own anymore. Stays are kept as short as possible and patients are
stimulated to reintegrate and live on their own again (GGZ Noord-Holland-
Noord, n.d.). For patients with the prospect of moving out again, this now often
fails, because the difference between living in a clinic and living in your own
home is too big. The architecture does not fully support aspects of giving and
taking autonomy, which can result in patients feeling helpless (Evans, 2003).
This research aims to make it easier for patients admitted to psychiatric clinics
to reintegrate into out-patient care and their own home, by finding ways in
which architecture can increase the autonomy that patients in clinics have.
For this research, the subject of feeling at home is taken from J. Habraken
(1961), who says that a place can only feel like a home when you are able to
build, to change it to your preferences. The paper by Golembiewski (2010) is
used as it directly posed architectural guidelines. There is no research yet that
combines elements of architecture and the built environment into guidelines
to increase the feeling of autonomy for patients admitted to psychiatric clinics.
Part of the research is done by a case study analysis, in which 5 psychiatric
clinics in The Netherlands will be ranked points in five different categories,
with a maximum of five points. The categories are: Room for activity within,
Activities in surroundings, Possibility to choose your whereabouts, Possibility
to personalize and Stigmatization. Another part of the research is done by by
interviews and observations in a Field Work. Three interviews were done with
members of staff and there have also been observations directed to finding
out people’s needs, wishes and relationship with the building.
The research resulted in 17 architectural guidelines that architects can use
in order to design psychiatric clinics and increase the amount of autonomy
patients have. Within the guidelines, there is a clash between those that make
sure safety and privacy is provided within the building and thosethat stimulate
social contact and activities. It is both important to comfort patients as well
as prepare them to live on their own.

Key words: Autonomy, personalization, temporary co-living, psychiatric clinics,
inpatient healthcare facilities, patient-centred healthcare. ...
The driving force for this research was the rising need for additional supported living housing for intellectually disabled adults steering towards their social inclusion; besides all the efforts so far, there is a strong necessity to improve the architectural environment offered to this population.
The study of the relevant literature and the fieldwork conducted based on ethnographic methodology guided this inquiry towards biophilic design, a tool that can improve the quality of life of residents in supported living settings.
Taking into consideration the rights of this vulnerable group to independent living, social interaction and well-being, the main research question that guided the whole process leading to the formulation of the qualities on which the design process will be based was: how can biophilic design be implemented to improve the quality of life of adults with intellectual disabilities who live in supported living environments?
The findings of this research indicate that a small-scale living facility located in the heart of a neighborhood, accessible by public transportation and close to public functions, seems ideal for intellectually disabled residents who live in supported living arrangements. The program can benefit from hybridity, combining dwellings with recreational and therapeutic facilities that can enhance the health and well-being of both the intellectually disabled population and the neighborhood community. ...

The design of small-scale youth care facilities

Youth care has undergone a significant transformation in 2015. Secure residential youth care is one of the areas that is currently experiencing difficulties as a result. Research has shown that the conditions in secure facilities often negatively affect the residents. Furthermore, young adults often find it difficult to adjust to independence once they leave the facility. Youth care organisations are currently closing these large secure institutions, and creating small, more customized alternatives called small-scale residential youth care. This type of care accommodates minors who are unable to make use of lighter types of care due to their complex problems and behaviour.

Many have studied the design of healthcare environments. Others have concentrated on the design of mental healthcare facilities or healthcare environments for children and young adults. However, the majority of research still appears to be focused on the design of hospitals and other formal healthcare settings, such as psychiatric facilities. Research on the design of residential care for young adults with mental and behavioural disorders is scarce. There is a need for more specific research and knowledge on this topic. Therefore, this research aims to discover: What location conditions and architectural and built environment features can support the design of open and secure small-scale residential facilities for youth care and increase user autonomy and social interaction? During this research, the following themes will be discussed: location conditions, architectural features, level of autonomy and social interaction.

Four small-scale youth care homes were visited. Analysis of the buildings, semi-structured interviews with caretakers and conversations with residents were conducted. The research showed that users preferred a neighbourhood setting close to public transport and general amenities. Architectural features included spaces that are flexible and adaptable to different users, a domestic and normalised setting, the right balance between privacy and security, sufficient facilities for leisure and materials that are low maintenance. The research showed that autonomy could be enhanced by including safety measures to prevent (self-)injury, as few security measures as possible, security measures as invisible as possible, adaptable and customisable security and safety levels and easily personalisable spaces. Social interaction could be improved by providing opportunities to meet with neighbours and to interact with the social network and other users. ...

Graduation Studio Designing for Health & Care ’Towards a Healthy and Inclusive Living Environment’

Master thesis (2023) - I. Potok, E. Miedema, F.M. van Andel, J.W. Lafeber
This paper has argued that the absence of inter-generational contact and a deficit of care-taking in communities leads to the societal exclusion of the elderly and increases the development of diseases such as Alzheimer’s, dementia and depression. Dementia is a pressing problem of our time. The number of people with dementia is constantly rising and will triple by 2050.1 The understaffed healthcare system can no longer provide enough care in nursing facilities. Therefore, this thesis aimed to discover how to prevent the development of cognitive impairments by implementing design strategies on the neighbourhood and housing block scale.
The main research question to be addressed in this thesis was what inclusive design strategy can encourage daily inter-generational contact, strengthen communities and prevent cognitive impairments?
The research included primary research on the target group’s social needs and future-proof living space design through a one-week observation study, three semi-structured interviews and a questionnaire conducted among 18 participants.
Additionally, secondary research was conducted by analysis of two case studies of community-based design projects.
This study has identified a correlation between staying socially and physically active and has found that the combination of fostering social contact and encouraging physical activity can delay the illness by several years. It investigated the needs and wants of different generations regarding neighbourhood and housing design. It identified that a need to feel like a part of a community is the most important overlap between all age groups.
It also examined how to use the principles of ‘Active design’ and ‘Architecture for encounter’ in a housing block.
As a result, the research provides answers on how the architectural design of a housing block can prevent the development of cognitive impairments and thus enable healthy ageing in place. Conclusively the research identified that it is indeed possible to encourage daily inter-generational contact, strengthen communities and prevent cognitive impairments through a design of a housing block which revolves around the community. ...

Research for guidelines to improve the physical health and mental well-being in dwellings using the passive house concept as basis

This master thesis is about health in the build environment focused on the occupant’s health in their own home. Dou to the increasing research about physical health and mental well-being it is getting clearer what is needed to create a healthy home. However, our homes are not becoming healthier. This is mainly because people do not know or understand how to regulate their indoor climate system to create a healthy indoor living environment. Based on the passive house concept and the growing understanding of health this thesis resulted in healthy design guidelines.

With the growing pressure on the Dutch health care sector, growing climate problems and pressure on the Dutch housing market more should be done to resolve this. Therefore, a project statement has been made of what is technically possible resulting in the use carbon fibre as building material for this project. On a location that because of shortage of space in the Netherlands has been reconsidered and now is approved for residential development. Giving a possibility to deal with the problems of today while incorporating the solution of the future into a new healthy home design.
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Insight into the life of people with Young Onset Dementia and their relatives in order to design a care home facilitating them in their well-being

Master thesis (2023) - N. de Vette, E. Miedema, J.W. Lafeber, L.M. Oorschot
Dementia is a familiar brain disorder, generally seen as a disease of the elderly and care homes are designed as such. However, also people between 30 and 65 can get dementia, called Young Onset Dementia and are overlooked now in architecture. Due to the different life stage in which the disease occurs, these mainstream facilities do not fit their needs, resulting in a decreased quality of life. It is already known how to design a dementia friendly environment, what the different course and impact of Young Onset Dementia is and which supporting facilities in the first stages at home are needed. Knowledge about architecture for later stages of Young Onset Dementia is lacking. This thesis therefore identifies the spatial needs of this target group and their relatives, in order to design a care home that facilitates them in maintaining their quality of life. Important outcomes of their spatial needs are having a purpose, physical activity, social interaction with peers, having a break and expressing dividual elements. These are not met in reality and the institutional setting of care homes are founded to be not suitable too. Provided guidelines for designing a care home for people with Young Onset Dementia therefore focus on dignity and activity. It is important for them to keep an as normal way of living, where young people with dementia and their relatives are brought together and to have a meaningful day and activities. ...

Some researchers claim that the modern landscape of psychiatric treatment is mechanized to approach healing of the patients through the form the chemical treatment (Rhi, 2001). This method does not prove to be efficient for every patient, leaving them in a burdening psychological state. Elements such as holistic practices and spiritual rituals can offer an alternative which is patient-centered, and addresses the patient as a whole (CAN ÖZ & DURAN, 2021). Psychiatric facilities often neglect the need of the user in relation to the healing space. The approach in this field of architecture is often staff-centered, focused on control and safety, but often lacks the qualities that are associated with a holistic view of healing (Connellan et al., 2013). In order to understand and analyze the positive effect that buildings can have onto the patient, case studies, interviews, visits and reference reviews were conducted, which were summarized into design themes that serve as a basic framework for creating spiritual and healing environments. The design themes matrix outlines the qualities of architectural spaces on three different scales, representing the experience and feelings of each location. The most common features were elements such as minimalist, synthetic spaces, emphasized by either monochrome or complementary color schemes, are orchestrated through light and darkness. Thus, immersing the user into the architectural space opens them towards the possibility of experiencing a mystical experience. ...

Designing a community orientated dementia residential care neighbourhood

Loneliness and social isolation amongst elderly is becoming an oppressing problem and could even cause dementia over time. A worrying omen, especially when the growing dementia figures in the Netherlands are taken into consideration. A problem which is even more opressing due to the current- and future shortage of financial funding, healthcare staff, and housing. A relatively new typology which tries to create a partial solution for this problem is the Dementia Village; where healthcare, social functions, and nature are combined with a community based living on a larger urban scale than usual. However, this typology only focuses on patients with advanced dementia and thus only covers a small part of the main problem. Could some of its features be implemented within the current and future built environment, in order to also provide suitable residential care for patients with early stage dementia? Could a neighbourhood be realized where inhabitants form a tight community together, and by that tackling the problem of loneliness and social isolation amongst this patient- and age group? The main question of this research is defined in the following manner: How can the Dementia Village architecture provide residential care for early stage dementia patients and elderly on a larger community orientated neighbourhood scale? By the use of literature reviews, case studies of current Dementia Village’s, interviews with architects, urban planners, and healthcare staff, observations of dementia patients and the current healthcare environment, and location research an answer will be provided to this main question. Eventually this will lead to the definition of design guidelines for the implementation of features of the current Dementia Village typology, location and its architectural elements within the built environment.

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Reborn into Community