Chapter II: Systems of Research and Data Gathering Procedures

The research methodology was guided by Deductive method of research wherein

theories gathered will be used to formulate hypotheses and further testing it and

examining the outcome.

Method of Research and Sources of Data

1. Deducing hypothesis from theory. Theories were derived from various books

and researches available online. Theories are based on healing architecture

concepts.

2. Formulating hypothesis. Hypotheses will be formulated based on the existing

theories.

3. Testing hypothesis with the application of relevant methods.

4. Examining the outcome of the test and thus confirming or rejecting the theory.

Dementia in the Philippines

 This statistic displays the projected number of people with dementia in the

Philippines in 2015, 2030 and 2050. According to the source, approximately 1.15 million

people are projected to have dementia by 2050 in the Philippines.

The number of elderly Filipinos or those over 60 years old is projected to

increase by 0.23 percent over 2017 and will most likely be over 8 million Filipino senior

citizens by the end of the year, POPCOM said.

Theories

Theory 1: On Music

Music as therapy deals to the influence of music upon the psychological attribute

of an individual; it can be used to enhance mood, normalize emotion and decrease stress.

Sacks (2008) states that the purposes of music therapy are ‘to address the emotions,

cognitive powers, thoughts and memories, the surviving ‘‘self’’ of the patient, to stimulate

these and bring them to the fore. It aims to enrich existence, to give freedom, stability,

organization, and focus. Music can arouse and provide pleasure. Emerging before

evidence supports the benefits of music for people with dementia. Indeed, music therapy

is now a valid treatment option.

Hypothesis

It is hypothesized that music, as a form of art and one of the components of healing

architecture, brings positive impacts on people with dementia therefore promoting

restorative effects.

Collected Data
Music therapy studies are now focused more on the long-term effects of music therapy

rather than short term, immediate effects. Recently, music therapy in which the elderly

with moderate to severe dementia can enjoy themselves has been found to be effective

in preventing cardiac and cerebral diseases (Cevasco, 2010). Playing a musical

instrument and singing, which requires breathing out long and controlling exhalations,

can be seen as forms of exercise, which diminishes stress. Music therapy has been

found to bring systolic blood pressure closer to a normal value (homeostatic effect

found). Behavior of eager participation led to improvement of cognitive function. Active

reminiscence music therapy using the familiar-song singing method contributes to

emotional stability, improvements in socialization. In addition, lower cortisol levels found

in saliva of those participating in music therapy (Cevasco, 2010).

Theory 2: On Nature

According to Kaplan (1995), nature is restorative and has healing powers.

This is true for both those who are afflicted with dementia, but also for well

individuals who seek to escape the pressures of everyday life by interacting with nature.

Research indicates the physical and visual access to nature can have the following

positive impacts in individuals with dementia:

- Helps patients to recover

- Reduces stress and lowers blood pressure

- Helps a patient maintain circadian rhythms

 - Aids in the natural absorption of Vitamin D when exposed to sunlight for brief

periods of time, which is important for maintaining strong bones.

Hypothesis

It is hypothesized that nature has its own healing characteristics that help improve

the state of health of an individual living with dementia.

Collected Data.

Figure 1 Means for improvement in cortisol Table 1: Measures of center and spread for improvement in cortisol
levels for non-garden and garden groups

Figure 2 Means for reduction in anxiety Table 2: Measures of center and spread for reduction in anxiety level for non-
garden and garden groups. level for non-garden and garden groups.
Figure 3 Means for reduction in negative Table 3: Measures of center and spread for reduction in negative mood level for non-
garden and garden groups. mood level for non- garden and garden groups.

Music therapy studies are now focused more on the long-term effects of music

therapy rather than short term, immediate effects. Recently, music therapy in which the

elderly with moderate to severe dementia can enjoy themselves has been found to be

effective in preventing cardiac and cerebral diseases (Cevasco, 2010). Playing a

musical instrument and singing, which requires breathing out long and controlling

exhalations, can be seen as forms of exercise, which diminishes stress. Music therapy

has been found to bring systolic blood pressure closer to a normal value (homeostatic

effect found). Behavior of eager participation led to improvement of cognitive function.

Active reminiscence music therapy using the familiar-song singing method contributes

to emotional stability, improvements in socialization. In addition, lower cortisol levels

found in saliva of those participating in music therapy (Cevasco, 2010).

Background of Healing Gardens

Healing garden is designed as a place for activities like "observing, listening,

strolling, sitting, exploring and so on. A beautiful space that attracts individuals from inside

out into the garden. It will support the users to both spend time alone or socialize, be
relaxed and enjoy the warmth of the sun or the shelter of the shade. It should be a place

that changes moods and an environment that contributes to a better sense of well being

and improved body function. With the connection of physical and natural environment that

provides healing. It should not be an alternative method of therapy, but a supplementary

one.

Persian gardens are the earliest gardens that are noted for their restorative

qualities. Incorporated lush green vegetation into geometrically designed and ordered

space. The garden elements combined to create a restful place where tensions were

relieved and meditation was encouraged.

Zen garden is another example of early restorative gardens. Gardens and religions

are inseparable in Japan. They believe that gardens are a manifestation of gods, and

many were placed in religious institutions. These gardens are meant to provide guidance

and consolation for the user. Zen is about meditation and connecting oneself as part of

the universe.

Some of the first restorative garden in the western back to middle ages in Europe.

The town providesd hospitals with screening that created enclosed gardens and yards, it

offered residents shelter, sun and shade.

 In the end of middle ages, cloister garden replaced with secular symbols. Spiritual

connections between garden and healing turned into a more humanistic view of medicine.

During the last half of the nineteenth cent, the value of nature as a method of

healing was also appeared in the public parks movement.

The latter part of tthe nineteenth century continued to see nature and healthcare

coexist. Healing gardens in the 20th century started to be discussed and implemented in

other less traditional arenas. Facilities for troubled youth, correctional institutions and

private residences are all being explored for healing garden use.

Theory 3: On Art

Many experts believe that art can help dementia patients express themselves.

Creating art engages a different part of the brain than the part that we use for language.

Creativity can still emerge in people with dementia, depending on where it most affects

the brain.

Even those who have displayed no artistic ability in the past may find an outlet,

with help from trained facilitators. And those who have been artistic can find comfort in

returning to a skill. Whatever the creator’s background, the art can depict memories

from life before dementia.

Hypothesis

It is hypothesized that art helps demented people engage their brain thus

improving their mental state.

Collected Data

The study presented in this part is aimed at gathering initial data on the

effectiveness of sculpting in male dementia patients.

The sculpting of human-sized tree trunks involves a playful approach to the

material. Strength and rhythm are required, allowing the experience of corporality, space

and orientation. An upright posture must be maintained. The creation of figures that

exhibit a resemblance to humans can increase personal awareness, identification with

oneself and relations with others, intensified by group interactions amidst the sensory

stimulation of the outdoor world.

The corporeal memory, also known as ‘implicit memory', stores the sequence of

movements and actions that the body has learned over its lifetime, to be carried out

automatically if needed. The corporeal memory stages what has been learned in a

physical implementation” (Fuchs, 2010).

A patient's personal biography remains present in his visual, audio, haptic and olfactory

perception and in the handling of objects (Fuchs, 2010). The reactivation of the corporeal

memory can also form a doorway to

the explicit memory. The implicit

memory remains available significantly

longer than the explicit memory in

patients living with dementia (see Figs.

1 and 2).
Theory 4: On Lighting

Dementia can disturb the biological clock even more than in normal ageing.

Several mechanisms have been postulated for this effect such as a more severe

degeneration of the retinal ganglion cells and greater loss of functionality of the biological

clock located in the suprachiasmatic nuclei. Therefore, people with dementia are at

increased risk for a distortion of the circadian rhythm.

All these together leads to a biological clock that is not stimulated enough by light,

which can have huge consequences for the person with dementia. The disruptions of the

circadian rhythm can lead to problems in the sleeping pattern manifested in symptoms

such as nightly wandering, daytime sleepiness and daytime napping. Studies have

demonstrated that light is a promising non-pharmacological intervention to improve the

sleeping pattern of elderly people with dementia.

Hypothesis
 It is hypothesized that lighting affects individuals including persons living with

dementia. Improper lighting leads to multiple concerns to the patients.

Collected Data

The aim of this study is to investigate if biodynamic lighting, resembling a normal

daylight curve in light intensity and colour in a fixed programme, objectively improves the

sleeping pattern of patients with dementia.

 In conclusion, the results of this study is promising to improve the sleeping pattern

in people with dementia by exposure to biodynamic lighting. It supports the premise that

biodynamic lighting could be a possible (early) intervention for people with dementia in at

home situations. In at home situations, biodynamic lighting could also result in less

disturbances during the night.