Healthcare environments in South Africa are designed with the main focus of primarily receiving patient satisfaction and furthermore providing shorter healing processes (Life Healthcare Group, 2017). Medical centres are designed according to functional requirements that ensure their efficacy. As a result they have been established as institutions designed according to established universal standards.
This becomes problematic in facilities for people with Alzheimer’s disease. In these facilities, the patients are usually elderly people whose perception of the world and surrounding environments have been reoriented and compromised by a neurological disease (Gramegna & Biamonti, 2017). Patients with Alzheimer’s have not only lost their reference of spatial satisfaction, but also their reference of self-dignity. Alzheimer’s is an incurable disorder. Thus the institutionalisation of these facilities needs to be diffused to directly ameliorate the loss of independence and individuality that these elderly patients experience.
This dissertation aims to investigate how to achieve a diffusion of institution and the resulting ill-effects through the thorough investigation of the literature on healing environments and design for wellbeing, including salutogenic design and theory on institutionalisation. A salutogenic approach to design will be taken in an endeavor to design spaces that ensure the wellbeing of the elderly patients residing at the facility.
A site for sanctuary to empathetically facilitate this diffusion is identified. A dissertation done by Natasha Laurent in 2014 was chosen, which is located at the disused mining compound in Cullinan, 30 km east of Pretoria. The tangible and intangible heritage of the site will serve as conceptual generator, acknowledging the silence that fills cognitive space through the gradual erosion of the mind as memory is lost.
As a theoretical departure, the execution of Aaron Antonovsky’s Sense of Coherence model (1996), and the application of Roger Ulrich’s theory (2001) regarding visual access to natural elements, are both components that are related into design principles that could increase patient wellbeing.