Literature Review

Architecture for the Elderly: Through the lens of

Multisensory Design

Name: Muskaan Rampal

Roll Number: A/3137/2018
Year: 5th Year
Date of Submission: 31st August 2022

RESEARCH QUESTION: With the world experiencing a dramatic shift in the

demographic trends, what role can architects play in redefining spaces for the
welfare of the aging population through multisensory design?
KEYWORDS: Multi-sensory design, elderly, physical and mental wellness,
barrier-free architecture
Our world is quickly aging, and the number of people over the age of 65 is
increasing at an unprecedented rate. In today’s time, there are 703 million
people aged 65 or older, a number that is projected to reach 1.5 billion by
2050. The world’s senior population is growing in absolute and relative terms,
according to a recent analysis, with the fastest growth rates in Eastern and
South-Eastern Asia, Latin America, and the Caribbean. (Our world is growing
older: UN DESA releases new report on aging | UN DESA | United Nations
Department of Economic and Social Affairs, 2022)

The population’s aging phenomenon is occurring worldwide. We say

phenomenon because all population pyramids are reversing, which means
birth rates are steadily decreasing over the years, and at the same time, life
expectancy has been increasing. Thus, the elderly population is growing at a
faster rate than children.
The world's population is currently undergoing two historically significant
demographic shifts – rapid ageing and urbanization. As a result, the number
of older people living in urban environments is growing dramatically. As these
two major demographic shifts continue to affect many parts of the world,
ageing and health in urban settings are increasingly becoming a priority issue
in both developed and developing countries.
Our old age is the result of our environment and the choices we have made.
According to the WHO (World Health Organization), six items influence how
we will age. These determinants are social, economic, behavioral, personal,
available social and health services, and the physical environment. We can
reach old age as active individuals or as having an advanced level of frailty
that compromises our functional abilities. Keeping the elderly population
healthy and active is a necessity and not a luxury.
(https://www.archdaily.com/900713/how-to-design-for-senior-citizens)

However, the parameters used in designing any built environment are based
on normal, healthy, and active human beings. The architects as well as the
end users are just unaware that all of us will age sooner or later. In recent
years we have all witnessed a spectacular improvement in medical
technology which resulted in a change in world demographics dramatically.
(DESIGN & ENVIRONMENT FOR ELDERLY, 2022)

As one grows older they gradually lose a lot of abilities in daily life activities.
Many chronic diseases and disabilities become more prevalent as people get
older. This situation has an impact on how elderly individuals interact with
their surroundings. They may struggle to move around (mobility deficits),
manipulate objects (dexterity deficits), and receive accurate information from
others (sensory deficits). (2022)
When it comes to designing for this group, architects have a whole new role
to play. Architects have found themselves confronted with new and intriguing
design difficulties for seniors, and they are inventing fresh blueprints that are
modern and ingenious. (How Architects Design For An Aging Population, 2022)
With the increasing worldwide population of older adults, interventions that
directly affect their physical, psychological, and emotional well-being are
needed to help them keep or regain their independence and autonomy.
Active Ageing
As populations age, there is an increasing need to ensure that this segment of
the population stays active and healthy. The World Health Organization
(WHO) defines ageing as a gradual and irreversible process that involves
changes in tissues and body functions over time. The ageing population will
increasingly need special attention, in order to reach not only an increase in
life expectancy, but above all, so that they can live with more quality, in line
with the tenets of active ageing.
In an age-friendly city, policies, services, settings and structures support and
enable people to age actively by:
• recognizing the wide range of capacities and resources among older people;
• anticipating and responding flexibly to ageing-related needs and
preferences;
• respecting their decisions and lifestyle choices;
• protecting those who are most vulnerable; and
• promoting their inclusion in and contribution to all areas of community life.

Active ageing depends on a variety of influences or determinants that

surround individuals, families and nations. They include material conditions as
well as social factors that affect individual types of behavior and feelings . All
of these factors, and the interaction between them, play an important role in
affecting how well individuals age. Many aspects of urban settings and
services reflect these determinants and are included in the characteristic
features of an age-friendly city.
Housing
There are now many kinds of senior housing in different parts of the world,
but irrespective of cultural and social differences, all these new models share
the same goal, that is, to support aging in place and independent living.
Some of the models also aim to increase reciprocity and mutual help at the
same time
Aging in place (AiP) has become a policy goal around the world. The aim of
AiP is to ensure that older people can continue living in their homes and
familiar neighborhoods without having to move due to health problems and
care needs (1–5). According to the World Health Organization (WHO) it means
that by providing appropriate services and assistance it is possible to support
older people's desire and ability to maintain relatively independent living
arrangements within the community either in their current home or one that
is more suitable to their current life situation.
Several aspects of housing design are considered to affect the ability of older
people to live comfortably at home. In general, it is considered important for
older people to live in accommodation that is built from adequate materials
and structurally sound; has even surfaces; has an elevator if it is multi-level
accommodation; has appropriate bathroom and kitchen facilities; is large
enough to move about in; has adequate storage space; has passages and
doorways large enough to accommodate a wheelchair; and is appropriately
equipped to meet the ambient environmental conditions.
Ownership
Generally, housing affects people’s health at several levels. Housing tenure is a
structural variable; houses are usually the largest capital asset owned by
families and this wealth can be used to generate a stream of income, in
addition to salary, wages and benefits.
Those who rent, whether from a private landlord or a social housing agency,
are likely to be poorer, although in some cases they may be trading off more
income for less wealth There is also a possible cultural effect of tenure choices
on mental health. In England, people generally aspire to home ownership and
renting is seen as a temporary measure. Renting permanently is more
unusual, or may be seen as a sign of failure (particularly renting in the public
sector).In common with most populations, those who owned a house in study
had better mental health and this effect increased as they aged. However,
housing quality and financial problems became more important in explaining
older people’s health in the latest wave of the cohort than tenure.
Social Relationships
The quality and extent of social relationships and participation in social
activities affects the well-being and quality of life for elderly people (8–10). The
availability of social support, social networks, and social activities can also
affect health and functional ability (11, 12). The physical environment and
geographical features of one's domestic surroundings can either enable or
hinder physical activity. Since physical activity is not only linked to
independent mobility, but to a general sense of autonomy and having some
control over one's daily life, studies of older people's health and well-being
need to look at the physical realities of their living environments

Affordability
Older persons experience another very different category of housing-related
problems when they have physical or cognitive limitations that make it
difficult for them to conduct their usual lifestyles, take care of themselves, or
maintain their dwellings without the help of others. Older persons may find
that they have significantly less disposable income if they incur out of pocket
costs for home- and community-based care and health care expenses, in
particular prescription medicine costs. Those on fixed incomes may find that
paying for these expenses results in their once tolerable housing costs
becoming a new burden, and in the case of older homeowners, make it
difficult for them to afford their dwelling’s maintenance, upkeep, and
upgrading costs.
Security
Researchers have identified the elderly population as being more vulnerable
to crime than other age groups because they are socially isolated, tend to live
in urban areas, depend on public transportation, and follow predictable
behavior patterns. The physical and mental weaknesses caused by old age
also contribute to the visibility of a potential victim. Other theories claim that
the elderly only become vulnerable to crime when they leave the protection
of their homes, exposing weaknesses to persons with criminal intent.
Burglary, robbery, and fraud are the crimes most frequently committed
against the elderly. Older individuals placed in extended care facilities may be
physically abused or defrauded of personal possessions by staff members. The
failure of family and friends to visit patients frequently not only causes
emotional suffering but also permits abuse to continue. Fear of crime is a
major problem for the elderly and has increased over the last decade.
Most prevention activities include public education, neighborhood watches,
improved external lighting, provision of escort services, home security
inspections by police, and public information on fraud schemes.
Physical Environment
The physical environment of the dwelling has the potential for worsening the
effects of these physical and cognitive limitations. The design features and
overall physical condition of a dwelling and its location relative to everyday
needs may offer new obstacles or even an unsafe environment for impaired
older persons to conduct their accustomed life-styles. Among the possible
consequences: a car or a bus route may become unusable and accessing
everyday community needs may become very difficult, an upstairs of a
dwelling may suddenly become inaccessible, throw rugs may become a
walking hazard, using a stove may become unsafe, or a bathroom’s shower or
toilet may be difficult or impossible to use.
Maintenance
Being unable to maintain one’s home is a major barrier for some older
people. In Cancún, older people say they are unable to make repairs owing to
the cost involved. In Melbourne, they are likewise concerned about costs of
maintenance and suggest that the local municipality provide a home
maintenance service for a nominal fee. In Rio de Janeiro, the high cost of
condominium maintenance fees is considered to be a barrier, although it is
pointed out that it is possible to sublet condominiums to assist with the cost
of the maintenance fees.
Community and family connections
Familiar surroundings, whereby people feel part of the local community,
contribute to the age-friendliness of a city. For this reason, older people are
reluctant to move. In Udine, older people mention they have a kind of
“psychological safety” in their environment. In Tripoli, older people highlight
the importance of their neighbors. In Dundalk, service providers recognize
the need to locate new homes close to where older people have lived in order
to retain links with family and the community. In Himeji, concern is expressed
that older people lose their connection with the community when they move
to another facility

Multi Sensory Design

Multisensory stimulation in older persons is an effective practice that helps to
train the mind and motor skills through elements that stimulate the senses of
the people. However, the majority of architecture is designed for the eye of
the beholder and tends to neglect the nonvisual senses of hearing, smell,
touch, and even taste. (2022)
Our understanding and experience of the built environment primarily revolve
around multisensory, emotional, and symbolic modalities of communication
with the built environment. The immediacy of people's multisensory and
affective experiences can be tapped into, through architecture. Contemporary
urban environments are often either sensory overwhelming or depleting
resulting in physical, mental and emotional stress. Furthermore, given the
decrease in sensory, motor, and cognitive functions accompanied by aging,
meaningful and active conversation with all environmental stimuli is crucial in
mediating urban experience and, ultimately, molding the overall well-being of
people of all ages. (Studying Multi-Sensory Neighborhoods and Aging-Friendly
Design: Methodological Propositions | ScholarBank@NUS, 2022)

The main premise in this study is that passive and non-integrated ageing
support through the provision of healthcare and eldercare facilities or
barrier-free design may not be sufficient for new generations of the elderly.
Current planning and design practices do not fully leverage on the potential
of housing neighborhoods to become enabling means for building up
physical and mental capacities at different stages of ageing that could
thereby promote walkability and inter-generational social interaction,
inclusion and care. Therefore, the agenda for new neighborhood design that
is sensitive and supportive to all ages needs to include a more indepth and
holistic understanding of multi-sensorial urban experience. With an aim to
discuss the role and capacity of multi-sensory approaches to design and
planning of aging-friendly neighborhoods, this research outlines the process
of developing an urban design framework that sets multi-sensory experience
as a key means of documenting and guiding place-making practices for
diverse and active elderly communities.
With ageing, the ability to navigate in the physical environment safely starts
to weaken. This often leads to increased confusion, anxiety and fear, which
eventually may affect the elderly’s desire to leave their homes and perform
basic activities independently.
An “age-friendly city” is an inclusive and accessible community environment
that optimizes opportunities for health, participation and security for all
people, in order that quality of life and dignity are ensured as people age.
More specifically, in an age-friendly city, policies, services, settings and
structures support and enable people to age well by:
● recognizing the wide range of capacities and resources among older
people;
● anticipating and responding flexibly to ageing-related needs and
preferences;
● respecting older people’s decisions and lifestyle choices;
● protecting those who are most vulnerable; and
● promoting older people’s inclusion in, and contribution to, all areas of
community life

Calmenson (37) states four criteria, named as “the four A’s” of universal design,
as follows: accessibility, adaptability, aesthetics, and affordability. Accessibility
enables a person to fully utilize the entire space, whether they have failed
vision, are pregnant or use a wheelchair. Adaptability is important especially
when the current or future residents plan to live in a house for many years,
thereby ‘aging in place’. Aesthetics refers not only to making a universally
designed environment beautiful, but also to making it helpful without
appearing different or utilitarian. Affordability promotes an idea that an
adaptable home can be built for the same cost if it is properly designed at the
beginning. (file:///D:/Fifth%20Year/Dissertation/Reading/1.pdf)

Designs to Aid Mobility

Mobility is one of the bigger challenges that designers face. In order to make
a home more accessible, architects are creating designs that are stair-free;
designs with larger hallways or more open floor plans; designs with wider
doorways; designs with no-step entries; designs with lower sinks and safety
showers & bathtubs, and even designs with wireless video monitoring so that
relatives can catch falls or trouble.

Lighting
As people age, they experience a plethora of vision problems from macular
degeneration, neuro-degeneration and reduced retinal illuminance
(essentially, smaller pupils and a thicker eye lens cause everything to appear
less vivid and bright). Seniors have a whole other idea of what is attractive and
functional when it comes to optimal lighting. Seniors prefer light sources
that are shielded with a shade as it tones down on harsh glare, and they
prefer overall ambient light versus dramatic high-contrast lighting. Most
importantly, high-quality light is needed throughout the home—LED or
fluorescent light bulbs are probably best, and large windows are a must.
Overall, seniors need more light to make their homes functional. The home
should be well-lit along the walls, ceilings, hallways and stairs— ensuring
unobstructed views and optimal safety.

Color Designs For The Elderly

Colors used within a home can actually help improve a seniors visibility.High
contrast colors can really help someone with poor eyesight—For example, a
darker color on the bathroom walls allows for a senior to easily see the white
toilet seat or white porcelain sink.Color also affects mood. Seniors can
become depressed or lonesome as they begin to feel shut-off from the
outside world. Soft pinks and greens can help you feel at peace, while red
and orange can improve energy levels. The senior population is readying to
double over the next 25 years, so modified home design that improves quality
of life will be something on every architect's radar. Architects need to design
for the aging population with inventive ideas that aid in mobility and ease of
use.Through proper lighting, designs that optimize mobility, and remodeling
plans that make a home functional—seniors can happily age in place
throughout their retirement years.

In order to assist cities to become more age-friendly and to facilitate mutual

learning and support, the WHO established the Global Network of
Age-friendly Cities and Communities (GNAFCC) in 2010. The GNAFCC
connects cities and communities which share a commitment to become
more age-friendly. The network’s objective is to facilitate the exchange of
information and best practices, provide technical support and training, and
help cities ensure that interventions are appropriate, sustainable and cost
effective.

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