More effective healthcare systems improve a society’s economy, some of the XXI century’s achievements of effective healthcare include a reduction in infant mortality, and a growing number of adults living longer. However, these achievements are not without their challenges, for example, an ageing society substantially increases the rates of acquiring long-term disorders such as dementia. In addition, the ageing society agenda is blurring the line between normal and pathological ageing, this has led to a stigmatisation of older adults as a social and economic burden. A way to address this process of stigmatisation is to consider an interactive theme, which has occurred in a number of studies, the recurring relationship between older adults, space, and wellbeing. Reconsidering this theme provides an opportunity to explore the potential of a care-model–shift and any inevitable architectural repercussions. This shift necessitates a move towards the adoption of an ‘open care model’, which focuses on care at the individual scale, this way of working could have a positive impact upon older adults’ mental and physical wellbeing; but it also has the potential to address high-dependency, high-cost services, and stigmatisation.
To critically consider the potential of this approach this paper analyses within two settings the relationships between the care model, personal experiences, and the environment. The two settings explored are the Humanitas in Deventer (the Netherlands) and the Gojikara Mura in Nagakute (Japan). The Humanitas is a nursing home with a total population of 166 residents (50 older adults with dementia, 80 people with long-term physical conditions, 20 people with social difficulties, 10 people in short stay for recovery and 6 university students). The Gojikara Mura is a cross generational community which provides diverse services such as child day-care, adult day-care, assisted living, nursery school and nursing home. These services not only accommodate older adults but also their families and visitors.
Methodologically this process of exploring the two settings is underpinned by the adoption of the ‘thinking-making-living’ method – post-occupancy evaluation framework. The three parts of this method are equally decisive in the analysis stage. The strength of this method, which is characterised by a modernist specialization, is that it allows for the opening-up of narrow functional labels. These labels are constantly associated with specific architectural typologies. An ‘open typology,’ based on the notion of an open system, encourages the diverse exploration of the different aspects of a setting such as the physical environment, its occupants, and their relationships. The environment as physical and the environment as ‘unphysical’ – ‘heterotopia’. Through the lens of heterotopia a new way of being and caring in a setting is revealed. This new way or new paradigm is characterised by participatory collaboration among the different groups of people within the setting – health care providers, volunteers, residents and their family. The potential of this new paradigm of care is that it normalises ageing, with or without related mental and physical impairments, rather than medicalising and stigmatising ageing.