How architecture can support self-regulating interpersonal distance for individuals showing challenging behaviour: A case study at a very-intensive-care facility

Challenging behaviour (CB), such as aggression towards oneself, others, or objects, arises in interaction with the environment and is shown in order to escape, increase attention, adjust sensory stimulation, or receive material rewards. CB may prevent individuals from participating in society and enjoying a high quality of life (QoL). Literature suggests that architects can enable prevention, by helping to mitigate CB before rather than after its occurrence. This raises the question how architecture can contribute to creating environments that help reducing such behaviour.By conducting a case study at a Dutch very-intensive-care facility, we explore how architecture can contribute to the QoL of intellectually impaired (and autistic) individuals showing CB. The case study is based on interviews with the residents and their family and care providers, direct observations of their daily life, and incident reports, and their personal files. This allowed for multiple triangulation: a resident-centred mix of data sources, methods, and investigators provides nuanced insight into residents’ life. Findings confirm the relevance of architecture for CB reduction. Individuals showing CB are dependent on the (visual) connection with the care provider and may experience stress from the behaviour of fellow residents. The self-regulation of interpersonal distance, nearness to the care provider and distance from frightful encounters with fellow residents, is crucial for their QoL. Architecture can support this choice in interpersonal distance, for instance, by generous floorplans, various spaces in vicinity of communal rooms, and escape possibilities. Future research is required to substantiate the findings, and to investigate whether a built environment with ample choice in interpersonal distance - designed for individuals showing CB - may also benefit other users.

ISBN:978-1-8381117-0-0

Jaar van publicatie:2020

Toegankelijkheid:Open