Memories are Designed by Experiencing Places
“Social problem-solving design” that changed our everyday life — cognitive health design
Korean has entered an aged society in 2017. Korea is estimated to become a super-aged society, defined as a society where over 20% of the population are seniors 65 years or above, in 2025. The city of Seoul is where population aging occurs at the fastest rate, with the aging index having increased rapidly by about 127.3% in the last ten years. Dementia is the most common disease in the elderly population, which is increasing at a fast rate. What would be necessary to prevent dementia, a disease that gives pain and burden to patients, their family members, and even society?
An adequate balance of three aspects — the body, mind, and social stimulus — is necessary. When the overall balance is broken by a deficiency in one of them, it shows a warning sign for the cognitive health of seniors. Even if there is no problem in physical health, one can be endangered by the deficiency in social stimulus from interacting with other people. It is similar to how the entire shape of a triangle gets deformed when one axis collapses. For instance, a falling accident regarded to be trivial can lead to dementia. Furthermore, the progress of dementia is accelerated by the decline of cognitive abilities due to the imbalance of stimulus.
The SMG promoted the cognitive health design project as a part of the social problem-solving design policies since 2014. This project was started to respond to social problems that arose from aging and the rapid increase of seniors with dementia by developing designs that reflect physical, emotional, and social characteristics of senior citizens. The representative examples include safety crosswalks for safe walking, mailboxes of memory to improve cognitive abilities and visibility, and exercise space to foster physical activities.
Cornerstone of well-being for healthy old age life — cognitive health design
The ultimate goal of the cognitive health design project is to delay the time of entry into senior care facilities by maintaining adequate activities of daily living (ADL) through the physical, emotional, and social stimulus of seniors. Furthermore, the project aims to create an Aging in Community (AIC) environment where seniors can maintain their remaining abilities in the residential community.
Each year, a cognitive health design solution was applied throughout the entire living environment of seniors by type, including apartments, detached houses, and parks. The SMG aimed to delay or prevent dementia by securing safety and emotional stability through the improvement of the everyday life of seniors. In Gongneung-dong in Nowon-gu, Seoul, where an apartment-type solution was applied in 2016, the cognitive disabilities and safety accidents rates in residents applied with the cognitive health design decreased by 30.8% and 24.4%, respectively. The ratio of seniors going outdoors at least twice a day recorded 39.9%.
Recently, new proactive designs have been suggested in response to quarantine and sanitation measures under the circumstances of COVID-19. They offer clues for solving problems from the warm perspective of understanding human behavior and emotions deeply. We will look into three types of cognitive health design projects carried out to change the everyday scenery of seniors and protect their body, mind, and relational health.
Part 1. Apartment Type: Making Memory Growth Village in Singil 4-dong, Yeongdeungpo-gu (2016)
The cognitive health design pilot project began with Singil 4-dong in Yeongdeungpo-gu, a rental apartment complex. Singil-dong in Yeongdeungpo-gu was an area crowded by seniors and high dementia risk groups. This neighborhood had pedestrian safety issues of seniors because of unclear distinctions between pedestrian passageways and roads. In addition, seniors with relatively poor cognitive abilities had difficulty finding their way as visual information at small and high places was designed mainly for young people. The region also lacked safe and comfortable shelters for communication, green or horticultural space to provide emotional help, and exercise space to maintain everyday life. A comprehensive approach to maintain and improve the self-esteem and cognitive ability of seniors was needed.
Accordingly, the “Making Memory Growth Village” solution was applied to the rental apartment in Singil 4-dong to grow cognitive health with seven types of memory. The “Memory Dulle-gil” formed to provide a safe pedestrian passageway for seniors is a 220 m walking path that circles the apartment complex. The pedestrian passageway was marked in green on the floor, and the parts with road bumps were marked in yellow. One-person benches were installed every 100 m to take care of seniors who became tired while walking. The “Memory Growth Entrance” leading to the residential area applied a separate name and sign design. The Dulle-gil course was installed with bollard lights of low heights to ensure safe use.
Making Memory Growth Village in Singil 4-dong, Yeongdeungpo-gu (2016): Before and after applying Memory Dulle-gil (above), Memory Growth Entrance (below)
The existing resting area for residents that showed a low use rate and frequent visits by outsiders was turned into the “Memory Shelter” for communication. The abandoned badminton court was transformed into the “Memory Garden.” The Memory Shelter played favorite songs of seniors through speakers. The Memory Gallery displayed good old items recalling joyful memories from the past. It was a strategy to encourage communication through cognitive stimulus. Due to the building structure, parking lots and entrances are divided into three parts. Each of the three parts was named the Sun, Moon, and Star to create cognitive bases. This place planned out detailed elements by installing safety handrails, anti-slip floors, benches, and lighting fixtures. Large signs indicating the floor number, household number, and directions using noticeable colors were furnished on the walls of every floor to help seniors find their house without getting confused.
“Memory Doorplates” drawn by illustrators were installed in 50 householders of seniors who requested them in advance. Doors that were confusing to distinguish were added with the individuality of seniors, improving cognition, pride, and self-esteem at the same time. The Korean Dementia Association conducted a survey on 286 residents, and the rate of satisfaction on cognitive bases and reduced confusion stood at 75.9%.
Making Memory Growth Village in Singil 4-dong, Yeongdeungpo-gu (2016): Guide signs on each floor, Memory Doorplates, and Memory Gallery
Part 2. Park Type: Centenarian Garden in Siheung-dong, Geumcheon-gu (2019)
The SMG created a more active cognitive health design model by establishing the “Centenarian Garden” outside of Cheongdam Social Welfare Center in Siheung-dong, Geumcheon-gu. Siheung-dong in Geumcheon-gu is a region where 13% of the entire population comprises the high dementia risk group. This region clustered with low-rise dwellings did not have safe walking places like parks, and roads were not distinguished from pedestrian passageways. In this environment, seniors were forced to avoid outdoor activities due to the fear of motorcycle accidents. There was a growing tendency to continue the isolated lifestyle confined in the daily space.
The Centenarian Garden opened in 2019 was the first case in Korea that introduced the concept of a healing environment. The place was planned out using the external space of Cheongdam Social Welfare Center in Siheung-dong, Geumcheon-gu. The Centenarian Garden was named to mean a garden that is safe to approach until the age of 100.
Centenarian Garden in Siheung-dong, Geumcheon-gu (2019): Circulatory moving line according to 24 solar terms in the spring, summer, fall, and winter
The 240 m walking path was planted with around 100 species of flowers and trees representing the 24 solar terms to stimulate the five senses of seniors. Five customized pieces of exercise equipment and the Leaf Diary Gallery of Artist Huh Yun-hee were installed along the walking path to induce physical, emotional, and social stimulus. An information board indicating that walking five laps of the 240 m walking path (1.2 km) a day increases the healthy life expectancy by 15 minutes was provided, encouraging seniors to use this place on a daily basis. Regarding such a healing environment, Professor Choi Jin-young from the Department of Psychology at Seoul National University said, “Seniors whose senses have declined due to aging can be stimulated intellectually through multiple senses, nature can reduce stress, and solitude can be alleviated by meeting other people.” Choi explained that a healing environment can ultimately lower the risk of dementia.
Centenarian Garden in Siheung-dong, Geumcheon-gu (2019): Flower garden comprising plants that stimulate five senses (above), horticultural therapy class to encourage social activities (below)
Upon opening, the Centenarian Garden provided a docent program run by seniors for seniors visiting the garden and exhibited horticultural therapy works from the welfare center. The garden allowed visitors to experience the five senses with auditory stimulations including the sound of a water fountain and the sound of birds, tastes of persimmon trees and jujube trees, and natural content to perceive seasons three-dimensionally. Physical exercise equipment installed all around the garden adjusted the level of difficulty so that seniors can follow easily, intending to improve balance, enhance vision, correct posture, and increase brain health.
Centenarian Garden in Siheung-dong, Geumcheon-gu (2019): Leaf Diary Gallery with Artist Huh Yun-hee and Flower Blossom Gallery with Artist Lee Yoanna
Part 3. Issue Response Type: Family Living Room for Contact-Free Visits (2021)
A cognitive health design project for seniors who have moderate to severe dementia is also underway. Particularly in the midst of the COVID-19 era, people who sent their parents to care facilities had to suffer the pain of forcible separation. Seniors with declined cognitive abilities could not understand the circumstances surrounding COVID-19 and believed that their children abandoned them after not seeing them for over a year. Even when face-to-face visits were allowed, it was difficult to have an enjoyable time. They were separated by a glass or vinyl wall, and microphones were of inferior quality. They often could not even spend more than 10 minutes for visitation. All of a sudden, approx. 60,000 citizens of Seoul became families dispersed by COVID-19.
Family Living Room for contact-free visits (2021): view of interior and exterior, quarantine gloves
The “Family Living Room” was born as an exclusive space for contact-free visits. The SMG attempted to make a comfortable space similar to an actual living room so that families could spend valuable time together. It is a new form of living room produced by the COVID-19 era. In this place, people can hold hands together while talking, which is not allowed in existing visiting rooms. It was made possible thanks to the quarantine gloves used to collect samples at screening clinics. The visiting space is completely separated by a glass window, and there is a high-performance sound system to aid seniors with poor hearing ability.
A large-sized screen was installed to view photos and videos on smartphones. The SMG also considered the interior design so that seniors in wheelchairs and movable beds can see visitors conveniently. The Family Living Room installed as a demonstration project at the Seoul Dongbu Senior Care Center provides free design manuals to desiring facilities. Besides care facilities, any place where face-to-face visits are restricted can utilize this living room, including facilities for seniors and persons with disabilities.
Family Living Room for contact-free visits (2021): Video calls and mirroring
According to Statistics Korea, Korea will become a super-aged society as the ratio of the elderly population is expected to reach 20.3% in 2025. That is, one out of every five Koreans will be a senior. In this sense, existing urban and residential spaces must be redesigned. It is impossible to prevent the super-aged society, but we need to prepare more actively. Designs can be the best method of providing solutions to problems. The SMG plans to expand the cognitive health design project further by disseminating the guidelines and casebooks to other cities, provinces, and public agencies.