Nature and Service of Senior Care
An exploration of care-models to encourage community-building amongst
seniors in care home premises and give them agency.

Srushti Kulkarni
MDes 2020
Supervisor

Internal Reviewer

Eugenia Bertulis

Hélène Day Fraser

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Nature and Service of Senior Care
An exploration of care-models to encourage communitybuilding amongst seniors in care home premises and give
them agency.

by
Srushti Kulkarni
B.Des (Industrial Design)
Symbiosis Institute of Design, 2017

Supervisor
Eugenia Bertulis

Internal Reviewer
Hélène Day Fraser

This thesis is submitted in partial fulfillment of the
requirements for the degree of Masters in Design.
EMILY CARR UNIVERSITY OF ART+DESIGN
2020
© Srushti Kulkarni, 2020
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Acknowledgement
To my supervisor, Eugenia Bertulis, thank you for pushing me to think critically and
guiding me throughout. Without your patience, motivation, enthusiasm, and immense
knowledge, my thesis would not have reached fruition. For that, I am truly grateful.
To Hélène Day Fraser, thank you for supporting me. Our conversations were vital in
inspiring me to look through multiple perspectives to form a comprehensive and
objective critique.
To Keith Doyle, Gillian Russell, Craig Badke, Louise St. Pierre and all my other professors
at Emily Carr University, thank you for challenging and motivating me through your
valuable critique throughout this journey and your thought-provoking questions.
To the MDes cohort, specially Josh, Nandita, Medha, Damien, Andrew, Eric & Amen, I
have never felt a stronger sense of support and openness before. Thank you for being so
comforting, warm and receptive and helpful.
To my roommates Laura, Sheen and Camilo, thanks for all those amazing conversations
at such odd hours, for staying with me, being patient with me throughout.
To the Health Design Lab’s Director Caylee Raber, Co-ordinator Nadia Beyzaei and
Manager Lisa Boulton for your constant support. If it was not for your provision of
opportunities and your active participation in terms of the research area and progress, I
could not reach this stage in my research.
To the team at De Hogeweyk (Dementia Village); especially Yvonne van Amerongen,
Jannette Spiering and Barbara Zanga-van Leeuwen, who allowed and helped carry my
observations and discussions with the management team for five consecutive days in
Weesp, the Netherlands.
To my parents, I truly am honoured to have you two as my parents. Without your
nudging and helping me rise from my falls, I could never climb these stairs. Thank you
for believing in me.
To Trita Maushi, for your constant supply of food; the Panse-Phadke family for your local
support and my mini-breaks with the late night card games; To the Elder Deshpandes
and the Jogalekars, for your constant whispers of positivity.
To all of my friends from Pune, thank you for listening to me talk about my research
work for two years and encouraging my progress.
And lastly, to the University for our resourceful library that I have relied constantly for
exploring and developing myself as a designer and researcher.

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Glossary of Terms
Nature

All the animals and plants in the world and all the features, forces, and processes that exist or
happen independently of people, such as the weather, the sea, mountains, reproduction, and
growth.( https://dictionary.cambridge.org/dictionary/english/nature)

Ecosystem

A system, or a group of interconnected elements, formed by the interaction of a community of
organisms with their environment. (https://www.dictionary.com/browse/ecosystem)

Service Design

According to the Nielsen Norman group, ‘service design’ is that which improves the experiences
of both the user and employee by designing, aligning, and optimizing an organization’s
operations to better support customer journeys. (nngroup.com)

Community

A group of people living in the same place or having a particular characteristic in common.
(https://www.lexico.com/en/definition/community)

Multiculturalism

According to Lexicon-Oxford Dictionary, the presence of, or support for the presence of, several
distinct cultural or ethnic groups within a society.

Long-Term Care
Homes

A facility that provides rehabilitative, restorative, and/or ongoing skilled nursing care to patients
or residents in need of assistance with daily living activities. Long-term care facilities include
nursing homes, rehabilitation facilities, inpatient behavioral health facilities, and long-term
chronic care homes. (https://www.medicinenet.com/script/main/art.asp?articlekey=24859)

Caring and
Accomodations

Caring is the work or practice of looking after those unable to care for themselves, especially sick
and elderly people.
Accommodation is the provision of room or lodging. (Oxford Languages; languages.oup.com)

Care Staff
Members

A person whose job involves helping people who have particular problems or special needs, for
example in a care home. (Collins Dictionary)

Actors

People playing a role at all levels in the institutions. According to the Merriam-Webster
dictionary actors are the ones that take part in any affairs.

Organizations

A systematically organized collection of people, with a common goal and identity associated
with an external environment, like a business entity or a government department (www.
differencebetween.com)

Institutions

A form of organization, which is set up for an educational, religious, social or professional cause.
(www.differencebetween.com)

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Abstract
An aging population leads to challenges in long-term care homes such as social
isolation in multi-cultural communities. While working in Mumbai, India, I
observed this social isolation of seniors in long-term care homes first-hand.
Familial and financial limitations are insufficient in providing seniors shelters in
their own homes, leading to greater demand for ‘nursing homes’ in India. The
seniors in care homes with smaller populations were more likely to quickly find
relationships among their neighbours. In larger-scale care homes hosting more
than 100 seniors, the feeling of institutions, unfamiliarity kept the seniors socially
disconnected, in Mumbai as well as the care homes I visited in Vancouver, BC.
The policies about eldercare are not updated, leading to insufficient resources
and outdated norms.
As part of my MDes research, I also visited De Hogeweyk (a dementia village) in
the Netherlands. I used methods like observational research, fly on the wall, and
interviews with the management members. As a designer, I explored and made
iterative design objects and experiences for human-human and human-nature
connections. This thesis describes design research activities and prototypes such
as guided outdoor walking and reflection practices, using peer designers as proxy
participants. I describe my service design workshops and architectural space and
layout discussions. This thesis work includes historical perspectives and personal
reflection on nature-human connections such as described in the Bhagavad Gita
and practiced in traditional Ikebana.
One significant insight through the research was that experiencing time in nature
might solve institutional issues, whether in India, Vancouver, or the Netherlands.
The second important lesson learned as a designer, addresses how time pressure
makes people take shortcuts, such as overlooking the importance of material in
concept review and testing and too little or too much preparation in developing
interview scripts and protocols. The research also reflects on iterations of
different design concepts, repeating and improving, recognizing the failures and
appreciating them. It is an essential step as a designer to learn from the process,
especially when it is imperfect. Lastly, through this research, I found that nature,
space, memory and social connection are interconnected, intricately woven
together to help humans survive independently and with fellowship.

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Keywords
Social isolation, long-term care homes, De Hogeweyk, senior
care, nature, human-nature connection, human-human
connection, community, policies, care models, service design,
collaborative making.

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Foreword
The following is a reflective master of design thesis that draws on insights I have
uncovered through my making process. As a designer, I feel my making process
goes hand-in-hand with receiving feedback and critique from others. I use this to
help refine my design concepts further.
Through the work I have done over the past two years, I learned about the
material process, service design and policy methodology. I also learned the
importance of being imperfect, sharing fragmentary work and developing it.
Throughout this document, I have used secondary literature as an understructure
of several phrases, statements and/or words.
Theoretical references from these sources also help to ground my methodology
and add a richer historical context to my personal multi-cultural experiences and
observations.

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Contents:
1. Introduction

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1.1 Unfamiliarity to a Sense of Belonging:
My Vancouver Diaries
1.2 The Institutional Life

2. Hindu Philosphy & Nature

15

2.1 Hindu Philosophy and Nature’s representation
2.2 Social Isolation in India

3. Making Objects: The Product Design Approach

21

3.1 Making products for seniors

3.2 Design Sprints and Iterations of Planters

4. Artificially-Natural Making

29

5. The Ikebana Case Study

32

5.1 Ikebana Activity One

5.2 Ikebana Activity Two & Three

6. Visiting De Hogeweyk, Discovering Communities and

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7. Service Design Methods

49

Service Design in Care Home Settings

7.1 Layout Mapping Introduction
7.2 Outdoor Walking Activity One

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Contents:
8. A re-defined segment of Trout Lake Activity

53

8.1 Outdoor Walking Activity Two

8.2 Outdoor Walking Activity Three

9. Conclusion

57

10. Bibliography

60

A. Appendix 1

67

Section 2: The Hindu Philosophy
Section 3: Product Design
Section 4: Artificially-Natural Making

B. Appendix 2

69

Section 5: The Ikebana Activity (Process)

C Appendix 3

75

Section 7: Service Design Methods;
Layout Mapping Exercise

D. Appendix 4

77

Section 7: Service Design Methods;
Follow the Green prototype

E. Appendix 5

80

Section 8: A New Trip to Trout Lake
Outdoor Activity Two & Three (Process)

F. Appendix 6
Policies & Triangle of Care Concept, Tree of Care Concept

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1.
Introduction

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Unfamiliarity to a Sense of Belonging: My Vancouver Diaries
In 2018, when I first arrived in Vancouver for the master’s program, I was inundated by
my surroundings’ unfamiliarity. Living in the same city for twenty-four years of my life
and instantly relocating into this new place, to my new ‘home’ (temporarily even) was
quite bewildering to me.
Overwhelming feelings led me to disconnect myself from the outer world socially. One
incident, however, had me rethinking the connections I had discovered at a particular
place in my new city. During the first month in Vancouver, I visited a local park close to
my house called the Trout Lake. Gradually, this place became a regular visiting site for
me. A sanctum, if you will.

(Image 1: Trout Lake during the observations in Fall of 2018)

What was so special about the lake? Nothing!
In India, tall buildings and a vast valley surrounded the house that I lived in for most
of my years. There was no scope for a lake, neither natural nor artificial. I asked myself
why my attraction towards this lake - why does it provoke such a strangely comforting
feeling?
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The more I visited the lake, the more I started enjoying observing little incidences in
that space like a breeze softly touching your face in summers, the raindrops creating
a seasonal petrichor throughout. Noticing these things made me think about what
would happen if I based my design research work around these incidents and how an
ecosystem, ‘nature,’ can help in my research in eldercare. My graduate studio professor
Louise St Pierre suggested observing the same ecosystem (Trout Lake) throughout
the changing seasons. This suggestion served as a starting point to my beginning to
understand what nature was to me; and realization that it might help me with my work
connected to dementia care.
Early on in the process, in the fall of 2018, I noticed a tree close to where I sat down to
take my observations. Unsure as to why I marked that tree, I tried to look for the reason.
The tree had big branches that split right in the centre and rose high to the skies. It
reminded me of an incident from my childhood when my cousin would put me up on a
similar-looking tree that seemed to be sliced int between for fun at night. It gave me the
same comfort I had when I was a child looking down at my family.

(Image set A: Photographs taken at Trout Lake during the observations in Fall of 2018)

While growing up, I had the view of woodland from my window kept untouched by the
city’s government. We would visit the forests for outings and morning walks. I found a
sense of belonging to the place and land through my connections to similar actions in
my memory.
After developing a sense of comfort in my newfound sanctum, I began noticing a change
in myself. I was initiating conversations with people passing by, people with whom I was
sharing a seat at the lake, merely enjoying my social time while conversing with people
sitting around the lake.

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Leaving our homes and entering unfamiliar surroundings
At this point, I began to see some parallels between my experience of unfamiliarity
and my observations of seniors in long-term care homes in Vancouver. I could see
a correlation between how I was learning in an institutional space where it was
comparatively tough to establish a sense of familiarity other than my experiences at
the lake. Even when I was around familiar faces, I had a hard time connecting with my
institutional university surroundings.
Could it be the white walls, the separated spaces, or the different awareness in this
space?
Leaving the sanctum one calls home, (similar to my migration to a different city after two
decades) and establishing a connection to the people around and the surroundings of
this new space could be a difficult choice to make because, in the end, it may be out of
our comfort zone.
If going to Trout Lake helped me build a particular scope of comfort within myself, would
it serve a similar purpose to the seniors living in the long-term care homes in Vancouver?
“A sense of belonging characterizes several constructs in environmental psychology
to the natural world, or of viewing oneself as a part of nature” (Schultz, 2002; Mayer
and Frantz, 2004; Nisbet et al., 2009; Kibeom Lee et al., 2015). In retrospect, observing
organisms growing in abundance, such as the moss on the trees, the ducks in the lake,
dogs playing around, helped me acknowledge that I was now part of it.
According to Aron Gurevich, a medievalist historian, ‘man thought of himself as an
integral part of the world. His interrelation with nature was so intensive and thorough
that he could not look at it from without; he was inside it.’(Aron Gurevich, 1992). An
individual, in medieval terms, is someone who is ‘indivisible.’
Following this notion, it seems that an individual undergoes a “natural inclination to
feel connected to humanity and the natural world have a common psychological basis.”
(Kibeom Lee et al., 2015)
Based on this understanding, one cannot be separate from nature but is, instead, always
a part of it. The individual understood as indivisible and not apart from ‘nature’ makes
this ‘nature,’ a community that embraces everything, including our sheer existence. The
trees, the ocean waves, all seem to be one significant entity. Our shared experiences, our
natural sense of storytelling, make us believe that we are part of a bigger picture, which,
perhaps, is what makes us empathetic towards other stories. I think the term ‘nature’
falls under various contexts based on the situations to imply nature. For example,
considering the current scenario in 2020, wherein we are asked to stay home due to
the pandemic situation, watching the outdoors from our windows is also considered
a pleasant activity. Living in Vancouver, where nature has played an important role
in creating a comfortable space for me to correlate, even five minutes in the outside
environment feels good.

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However, people who are used to living close to the outdoors would find looking outside
their windows an undistinguished routine. For them, living in an entirely untouched part
of nature, wilderness perhaps, would be pleasant, calming and ideal.
This perspective led me to thinking about the implications when we understand
ourselves as apart from nature and the inverse,when we consider that we are not apart
from but part of nature. If our individuality is not separate from ‘nature,’ how is it that
we have separated ourselves from our one community, ‘nature’?

Then, how does being outside, feeling connected
to nature, provide us with a sense of belonging
that helps us feel a part of something, a place, a
community? (March 2019)

Research Questions:

How to cultivate the learning from ‘nature’ into
dementia care, and what are the implications?
(March 2019)
How might we encourage seniors to form a sense
of connection in and around the premises of their
care homes? (March 2019)
How can a ‘walk in the wilderness’ experience help
them become familiar with their surroundings and
connect with people inside and outside the care
home premises? (June 2019)

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2.
Hindu Philosophy about Nature
&
Social Isolation in India

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Hindu Philosophy & Nature:
According to the Hindu philosophy, shifting focus and spending time in the forest
in older age was given importance which is commonly known as “Vanaprastha” in
different stages of human life, adolescents, childhood, teenage years and adulthood. A
Vanaprastha (Sanskrit) is a person who is living in the forest as a hermit after partially
giving up material desires. (Priyadarshani N., 2010)
Another such excerpt referring to the importance of trees in our learning of life around
us would be the ‘Asvattha tree,’ which is also known as the Peepul tree or sacred fig tree,
has the Latin name Ficus religiosa, and is native to India and Southeast Asia. The Peepal
tree is essential, both practically and symbolically, to contemporary Indian religious
belief and practice. “But the Asvattha tree’s importance goes back to the most ancient
recorded history of India.” (Sahota P., 2019)

अस्वतथा सर्व वर्कसासना
देवर्सिनम का नारद:
गंधर्वनाम चित्ररथ:

सिद्धानम कपिल मुनी:
Translation:
Of all trees, I am the holy fig tree, and amongst
sages and demigods, I am Narada. Of the singers
of the gods [Gandharvas], I am Citraratha, and
among perfected beings, I am the sage Kapila.

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(Image 2: A visual representation of the ‘Asvattha’, the Peepal tree in Bhagavad Geeta)

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For me, this verse talks about the path of enlightenment by representing the parts of
a ‘peepal’ tree, and portraying the ties one has with the materials (the mediums that
make us feel connected to our surroundings) this world. The idea of the tree is to see
yourself and understand your progress towards this path.
Similar to the metaphor about liberation shown through the Peepal tree in Hindu
philosophy, we often find ourselves learning from the “trees as an important
metaphor for knowledge-classification systems” (Maria Popova, 2020), a visual
representation of laws or hierarchies, for example, the tree diagrams, a family tree.

For thousands and thousands of years, trees have
provided us with not only shelter, protection, and
food, but also seemingly limitless resources for
medicine, fire, energy, weaponry, tool building, and
construction. It’s only normal that human beings,
observing their intricate branching schemas and
the seasonal withering and revival of their foliage,
would see trees as powerful images of growth,
decay, and resurrection. In fact, trees have had such
an immense significance to humans that there’s
hardly any culture that hasn’t invested them with
lofty symbolism and, in many cases, with celestial
and religious power. The veneration of trees,
known as dendrolatry, is tied to ideas of fertility,
immortality, and rebirth and often is expressed by
the axis mundi (world axis), the world tree, or arbor
vitae (tree of life).
(Lima Manuel)
Like the connections trees possess with the land through their roots, flowing in all
directions attempting to find links to minerals or other organisms, humans crave
connections. Connecting to other people and other living beings is an instinct. “The
human being is born with the need for contact and tenderness.” (Heinrich and
Gullone 2006). If we don’t have those connections, we feel lonely, a critical concern
for eldercare. As Hawkley and Cacioppo write in ‘Loneliness Matters’ (2010), “a
particularly devastating consequence of feeling socially isolated is cognitive decline
and dementia.”

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Social Isolation in India:
I come from India, where building communities is quite an organic process. In Pune, a
city in Maharashtra, I grew up in a neighbourhood where most of the families within one
apartment building were familiar with each other. In my childhood, the seniors in our
area were the neighbourhood grandparents. As kids would visit their homes at any given
hour and would always be treated with love. In the evenings, the children and seniors
would come out of their homes to a central meeting point, a park, an empty parking lot,
or even the reception lobby and sit together. The kids would play near the adults. On the
other hand, the adults, with one eye on the kids, would enjoy their own conversations.
More recently, due to various economic factors the traditional Indian family structure
consisting of three generations engaging and living together has been left behind and
replaced by the nuclear family concept. It seems the rising middle-class population
has led to a multi-generational family structure that encourages living in separate
households pertaining to the nuclear family concepts. In a household, where four
generations would be living together, the nuclear concept talks about these generations
living separately, by themselves. For example, when my grandmother was newly married
around 60 years ago, she was living not only with her husband, my grandfather, but his
parents and all the other siblings. However, In this age, my grandmother lives along with
her son and we, belonging to the same household, live separately. The idea of living in
a separate lifestyle forms a question of ‘seeking solutions for taking care of their elders’
(Celine Thomas, K. Samuel, 2017).
I visited long-term care homes in Bombay and Pune (cities in Maharashtra, India) in 2017
while working on an industrial design project in the SINE incubator at the Indian Institute
of Technology, Bombay. I realized that the concept of social isolation in ‘old age homes’
depends on the care homes’ scale of operation. I noticed that small scale nursing homes
with 10 to 15 seniors, were open and community-oriented. Seniors living in old age
homes that were larger and more crowded often seemed to be socially disconnected;
be it in metropolitan cities or small towns. When I visited smaller care homes, I could
observe the seniors socializing, sitting together for breakfast, enjoying their evenings
with coffee or tea. However, when I visited the care homes that hosted around hundred
or more seniors, the corridors were rather empty. The seniors preferred staying in the
radius of their rooms. I also observed that the situation varied from care home to care
home but in a nutshell, followed similar patterns of socializing seniors.
Due to community-dwelling adult generations, being lonely or socially distant was not
something I witnessed in the care homes with a smaller community because of the
closely connected seniors. What was evident through my observations in these ‘old age
homes’ was the buildings and institutions’ structure. The care homes where I observed
conversations and engagement were ones built either on a small platform (a house
turned into a care home with multiple facing rooms) or interconnected dorm systems,
almost like a hostel.

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Care homes in India are struggling for necessities like financial and material resources.
They also face institutional challenges. In the paper “Overcoming Social Isolation in
Indian Care Homes,” the authors highlight that - “firstly, there is not an adequate social
welfare system to support poor and middle-income older people in dealing with changes
in family care.
Secondly, within old age homes, there is a lack of regulation concerning basic hygiene
rights and limited activities that promote social connectedness”. (Celine Thomas, K.
Samuel, 2017). The seniors’ lifestyle and sentimental focus prior to going to the care
homes, often revolve around their families.
Leaving this feeling and moving into an old age home might be quite frightening and
distancing from everyday bonds with families, thus feeling socially disconnected.
Consequently, seniors suffer from social isolation, which hinders them from accessing
basic needs and the reciprocal relationships necessary to continue living a meaningful
life. (Celine Thomas, K Samuel, 2017).
Indian care home organizations struggle to accommodate the essential resources like
the senior’s medical services, infrastructural developments. It has been identified
that organizations and the government must fabricate policies towards the security of
vulnerable seniors grappling with changing social conditions in their lives. In appendix 6,
I address the implications of policy issues for design that I considered while conducting
my thesis research.

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3.
Making Objects:
The product design approach

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The theories and lived insights I describe above, starting
with my observations at Trout Lake and reflections on social
isolation for elders in India, are tightly connected to many of
the design activities, making and testing I have conducted. As
I moved through them I also began to draw on other insights
from locations and circumstances connected to care of elders in
Canada, the Netherlands.

Research Questions:

Accordingly, how can we transfer the essence of nature
and open spaces to concrete square interiors?
Could small pieces of nature collected along the way
such as Soil, moss, leaves, flowers, twigs be a means?
When I think of nature, the first thing that pops into my
mind is the colour green and a giant tree. So how do we
bring parts of this interpretation into an indoor setting?
(June 2019)
How can the culture of sensory therapy form a platform
for connections amongst seniors in care homes? (July
2019)

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(Image set B: generative user tests/contextual cold reads of design sprints based on making
objects related to connecting seniors to nature for encouraging collaborations or associations
with fellows seniors in the care homes.)

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Planter Story 1.0
My planter 1.0 prototype, thinking about the giant tree, was creating scaled-down
pocket-edition trees for the seniors to hold, feel, gather around and engage. These were
to be objects handled while within the premises of an elder home. I used play-doh to
create a tree-like structure and leaves with moss around the tree for this activity.

(Image 3: The female bodies of the planter concept created out of play-doh)

Buying play-doh from a dollar store was an easy and accessible option to explore the
physical forms. I was creating multiple female bodies out of the sculptor’s wax—the
malleability of the plasticines seemed corrupted in comparison. However, my primary
intention was to develop female bodies with what was readily available. I addressed the
prototypes as ‘female bodies’ with regards to the shape of the planters centered around
the pre-existing trees and bushes. A part of the reason was also that I interpreted’ female
bodies’ as the planter’s flowy and organically curvaceous built. It also created an image
that represented the feminine features of Mother Earth.

Considering the material medium while synthesizing the idea was not my primary
concern at that moment.
After sharing my activity with others, we realized that while I was thinking about nature
and aiming to bring small amounts of natural essence into the care homes. The strong
rubbery smell of the plastic-like material felt like a conflicting usage of material, which is
entirely artificial, opposite to the idea of natural elements.

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Planter Story 2.0
Thinking about how the seniors would engage with only a shell of the planter, brought
me to the idea of adding an interactive experience in addition to the body of the planter
itself.

(Image 4: Ideation; Digital sketch of the planter concept)

My first planter concept was based on incorporating a music system, acting as a catalyst
to gather the seniors around the object. My idea was that it would hum tunes of songs
from different decades, the 50s, 60s, to more recent ones, and that doing so would help
forming a non-verbal connection amongst seniors who gathered around it. This idea
emerged as I often find myself building faster relationships with people of similar music
tastes. Our moods are oftentimes determined by the genre of music or songs associated
with our current feelings. Music relaxes us. It teleports us to connected incidences in a
few beats (Harvard Health Publishing, 2016).
My idea was that this musical planter could promote natural sentience and bring
comfort to seniors.
In ‘‘Where Are the Missing Masses? The Sociology of a Few Mundane Artifacts’’
Bruno Latour discusses how technologies play an essential role in mediating human
relationships.

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Latour argues that we cannot understand how societies work without an understanding
of how technologies shape our everyday lives (Latour, B., 1992).
Latour talks about the relationship between humans and technologies and the process
of building technology that starts with an idea, moves to a paper drawing and then to a
concrete technological machine or object. The values that we share with the technology
is quite similar to those we share with others. I assume that technology is the vessel
and the creators and makers share the values through it. The origin of the technology,
starting from the ‘nature,’ natural ores turned into metal and other materials that
originate from the land, essentially creates a connection between us.
To test this idea, I developed a low fidelity paper prototype. Bill Buxton’s idea of
“sketching UX” influenced me to create a broader and more interactive sketch than the
traditional approach of a rough drawing. Buxton defines sketching along a continuum,
which he calls the “design funnel”, which starts with rough drawings (ideation stage) and
increases in the fidelity to the point of the prototype (usability stage) (Buxton, 2012).
My interactive sketching consisted of a generative user test with the paper sketch
prototype, called a “contextual cold read”. It was shared with a participant who
responded with a short anecdote about their grandparent when they were a toddler.
Their grandparent would always sit with them in the evening with a radio in their hand.
He was a classical music fanatic and would ask my peer to be all ears and listen to
the melodies. This act later turned into an evening tradition between my participant
and their grandfather. Running this exercise helped me to realize the implications
and limitations of my conceptualization and making. Through the responses of my
collaborators, such as the one noted above, I recognized that my concept prototypes
worked well toward connecting nature and seniors. I also began to realize that
external factors, such as added technology or functionality, might be distracting. I
began to understand the need to limit the scope of my research by exploring the nontechnological approaches.
While I was working on my planter concept, I was also volunteering in a care home and
working as a research assistant for the Health Design Lab. This gave me the opportunity
to observe Canadian care homes. The lobbies, beautiful rooms, multicultural
environments of these facilities were impressive but I soon learned that social isolation
was (as in India) still a critical challenge for these organizations. Grappling with this,
care home organizations have developed many innovative methods to counter this
problem, including games like Bingo and exercises. Therapy sessions with art and music,
gardening, and animals are used to help alleviate this problem of social isolation of
residents. While this was good, I also observed that once these activities were complete,
many of the seniors would disperse reluctantly, to their respective rooms for the night.
I became interested in the dispersion of seniors to their respective quarters. It reminded
me of the time when I moved into a new house in Vancouver in 2018. Since I was not
familiar with anybody, I would eat with my roommates while immediately heading to my
room. I returned immediately but also with reluctance. I left because it was an unfamiliar
community for me; I did not feel like a part of the group.
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This exercise helped me to better understand the implications and limitations of my
conceptualization and making. Through the responses of my collaborators, I realized
that my concept prototypes worked well toward connecting nature and seniors.
Potential external factors such as added technology or functionality might only distract. I
began to understand the need to limit the scope of my research by exploring the nontechnological approaches.
My reason behind this action was because I wasn’t comfortable with these new
roommates.
Is it possible that the seniors feel similarly?

To further understand the senior’s perspective, I read ‘Negotiating Tensions in Long-Term
Residential Care: Ideas Worth Sharing’ by Pat Armstrong and Tamara Daly, which talks
about the experiences of seniors and the care staff members. They attempt to address
challenges like reintroducing independence of the seniors, tensions over risks and safety.
Monique Lanoix, author of Chapter Nine, ‘Robotizing Social Time, A Way Forward?’
states Many long-term care residents have few visitors. Many long-term care homes have
social programs and group activities such as bingo or singalongs; however, the plans
do not always fill the void of companionship. The short time given to specific activities
means that residents must find other ways of occupying themselves, either sitting by
themselves clustered around the nursing station or in front of a television-set passively
watching whatever is on.
(Monique Lanoix, 2018; ch 9)
According to a few care homes in Vancouver BC, they promote recreational activities
like - Hangman, board games, friendly visits (families, volunteers visiting seniors) music
sessions, ice-cream social events, movie afternoons, social gatherings. Based on my
observations, In small scale care homes the seniors often gather in cozy living rooms, the
dining arrangement is often set together since there are 20-30 seniors living in the care
homes. The seniors often come across one another because of semi-private rooms, and
also because of the common social routine. That gives a platform to be socially active.
On the contrary, I observed, in larger scale care homes, the dining setting is completely
different, based on the area. The seniors may acquire their personal rooms which
may result in isolation. The social programs are marked on the calendars and proceed
accordingly reducing an organic flow of connection between seniors.
Filling the void of companionship was becoming central to my design work. For me,
fellowship is important for establishing a connection with space. I also find myself
looking for people with similar interests, lifestyles quite often.
Then, what roles do ‘natural collectable items’ play in this setting?
How do we form an organic flow of connection between the seniors in the care homes?

27

Much like this poem, my intentions behind the concept was to form organic
conversation, free-flowing, eventually forming long-lasting ties.

Excerpt from ‘Flow” by Derrick Jones
Floating in the breeze
Filtering through your fingers
Flowing through the trees
Flowing all around
Floating down the river
Flying oh so high
Falling oh so low
Feelings, thoughts, emotions
Full of experience
Flowing consciousness
Flowing down the streams
Forming together, falling apart
Filling the earth
Floundering, faltering, but always flowing
Flow flowing through the field
Flowing far and wide
The flow of the human condition
Full, overflowing, boundless
Finite infinities
The flow of human life…
(Image 5: Reference of a poetic representation that resonates when I think about organic,
flowing interactions)

28

4.
Artificially-Natural Making

29

While making the objects, discussed in the above section, imitating nature, my choice of
materials led my work to almost point in the opposite direction. I used Plasticine to form
a fake “tree” shape, industrial fertilized potting soil, instead of dirt (with worms), bowls
made of plastic instead of terracotta, which all read as a contrast to my intention.

(Image set C: Soil bowl in plastic coated terracotta bowl; Plastic plant pot with fertilized potting
soil)

Why did I choose plasticine? Why did I not use terracotta? - Cost; Time; Unfamiliar
market search; the ease of access of just one trip to the dollar store. The rush of
contemporary life - a set and limited time frame, the activities to be done; preparing
materials and working on a limited budget - all took precedence over the reason I was
doing the exercise in the first place.
I could understand the interconnection, but had difficulty practising it. Why? Could it be
these are the same difficulties the designers of long term care homes have? Issues of
time, cost, ease of access to the dollar store?
Does the sense of belonging form a space of comfort for us to live in?

What is Nature?
‘Nature can be that small plant sitting in your built environment, a flower pot sitting on
your window sill. It is also the space outside the walls of the house you live in, where the
trees grow and build a shelter for many organisms. Nature is the creepers and climbers
clinging on your wall, the birds chirping in the distance, but it’s also the brick of your
walls, the wood in your home, the paper you write on, and you.’

30

(image set D: depictions, photos, sketches, and concepts that were worked on throughout the
project wherein I focused on understanding the importance of trees. The picture of what comes
to my mind when somebody says Nature is the ‘trees’.)

How does it fit into Dementia Care?
Now that I look back at this picture, I realize that I was in some ways unable to draw a
connection between Nature as a theory and Dementia Care as a practice. How would
Nature help? What happens when we understand Nature not as apart from all of us ( as
individuals) but in fact, a part of ‘all of us’?
In the planter and the product design activity from the previous section, my main
objective was the idea of exploring the idea of nature in a simpler manner, this, however,
led me to overlook the material aspects of my design. Material appropriateness was
something that did not cross my mind.
How to cultivate the learning from ‘nature’ into dementia care and what are the
implications?
Subsequently, in feedback from one of my research presentations, I was asked why I was
aiming for designing extended nature experiences for seniors when I had been avoiding
natural materials in favour of imitative ones. Louise St Pierre explained it in a beautiful
analogy:
“Gardening activities are like writing a novel, I would suggest writing a poem instead.”
When Louise gave me this comment, she was remarking on the way I was approaching
nature. My secondary research into definitions of nature, wilderness, wildness, etc.
had made me aware of how vast an area this was to explore theoretically. In contrast,
my making activities were fleeting rather than elaborate and thoughtful; I was taking
shortcuts. Louise’s insight about following a poetic format and making smaller activities
instead of latching onto big ideas, much like a novel, helped me see through my making
into actions like gardening, community gardening.
Keeping this analogy in my mind and looking for poems, I discovered the method of
Ikebana when I was also told the story, by my supervisor, of a designer who had a
tradition of making ikebana arrangements together with their grandparent as a way
to connect with them. The grandparent, who had memory issues, did not have a
conventional sense of time passing or understanding from a calendar when the designer
would next visit. However, the grandparent would be reminded of the approaching next
visit by the progressive wilting of the flowers in the ikebana arrangement. After hearing
about this example, I started doing activities around Ikebana.
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5.
The Ikebana Case Study

32

What is Ikebana?
Ikebana is the Japanese art of floral design, translated as arranging flowers. In Japanese
‘ikeru’ means to organize and ‘bana’ origins from the word ‘Hana’ meaning flower, i.e.,
giving life to flowers and arranging flowers. (Editorial, Cenci N., 2018)
Ikebana is a composite art of natural flowers and artificial technique, and thus a mutual
creation between nature and human beings. Collaborations in Ikebana arrangements are
considered to be quite a spiritual and calming experience, often looked at as therapy.

(Images 6a: Left image source - Wikipedia; The founder of Sogetsu, the school for ikebana, Sōfu
Teshigahara in 1948. Image 6b source - wiki commons; Illustration of Japanese women working
on an ikebana arrangement together.)

My Ikebana activities included- activity one that was collaborative; activity two and three
that I continued working on a year later. Activity one was focused was on interactions
and conversations. I also aimed to observe the relationship-building while making
something together that became ikebana collaboration. At that point in my research, I
was (in a way) trying to figure out if interactions between humans was the main focus
of my work or if it was, a concentration on the role of human-nature connections in
encouraging interactions between humans.
Later in the Second Activity B, I realized that the philosophy and connections with nature
in Ikebana play quite a vital role in the organic flow of both human-human and humannature relationships.

33

Research Questions:

How can the culture of sensory therapy form a
platform for connections amongst seniors in care
homes? (August 11, 2019)
How can ikebana become a platform for seniors to
connect socially while making? (August 22, 2019)
How can ikebana build a relationship between two or
more individuals through collaborative making with
sensory therapy? (August 22, 2019)

The Ikebana Activity One: Collaboration
In my first Ikebana Activity, I quickly chose my materials from things that were ready at
hand. I used a pseudo-ceramic pot, a twig found near the university and cuttings from a
fake plant in my studio.My focus, during this phase, was not on the materials so much
as the actions of assembling the materials and how to engage others in the activity. I
enlisted two of my peers in the design lab. I introduced them to the exercise on Ikebana,
then the activity I had planned and the time we would require for each task. I then
spread the materials out on a desk and asked them to make an arrangement, using a
hard sponge as a base and adding in the fake ‘flora’ on top. I was interested in observing
how the actors (the two personas my peers were taking on) connect and engage in the
making process without any personal relationship with each other before the activity.

34

After the activity, we discussed and mapped their actions and thoughts about
collaboratively making the ikebana arrangement on an ‘experience mapping template’
according to the set of pointers. The idea of mapping their experience on the template
was to understand the outcome of the activity and to produce content for the
brainstorming session that followed.
In this first phase of this activity I had, due to time constraints, used non-organic
materials in order to achieve my end goal. However, in a paper by designer Rachel
Kelly titled “Ikebana: A Collaborative Design Pedagogy”, which I came across later, an
important insight was made. Kelly observes that ‘Non-organic materials were tested
as an alternative to branches, but the most successful work resulted when organic
elements featured. The organic forms lend themselves to the structures the students
wanted to create’ (Rachel Kelly, 2017).
Inadvertently my first ikebana arrangement activity without the use of real flowers was
disconnected from the ikebana art form.
The materials I used: fake leaf strings, dried twigs - were not living. The arrangement
materials did not follow the traditional ikebana method.

The Ikebana Activity Two: Personal Explorations
In my second phase exploring ikebana arrangements, I researched more about the
philosophy behind Ikebana as well as the technique of moribana arrangements.

“Moribana, the ‘piled-up flowers’ style of Japanese flower arranging.” ( P. H.
2020)

In researching types of Ikebana, I came to understand that moribana is an arrangement
using a shallow container with a needle-point holder or kenzan, while nageire ( another
style of ikebana) is composed in a tall vase with a variety of methods used to keep the
materials in place.

(Image 7: An illustration of Kenzan, needle-point holder to pierce the stems of the flowers and
plant)

35

When using a kenzan, thick branches are cut on a diagonal, and the cut end is split
lengthwise so that it can be inserted easily into the needle-point holder. Flowers and
other materials with soft stems are cut horizontally, inserted directly into the needles in
an upright position, and then slanted forward or backwards to the desired angle. With
materials such as grasses, which are thinner than the individual needles of the kenzan,
an additional short piece of the same or a different material can be tied to the base for
added thickness. (Jeffrey Hays, 2009 [factsanddetails.com])
“Water is an essential visual cue for the moribana style of arrangement. The short and
open container displays reflective water in the bowl to show the perfect branches.”
(Roman M., 2017)
The ‘shushi’ are the three main branches – the shin (truth) branch, the ‘soe’ (supporting)
branch and the ‘hikae’ (moderating) branch. (Jeffrey Hays, 2009 [factsanddetails.com];
Ohara, 2015)
Having found out more about types of Ikebana I chose Moribana for my next
exploration. I did so because the flowers and branches used in Moribana arrangements
are chosen not only for their beauty but also for how they interact with one another
and with the style of Moribana as a whole. (ftd.com, 2015) Considering I was exploring
the relationship between the making, the arrangement and the makers, to me, it was a
visual representation of my research.
As a set-up for activity two, I brought some flowers from my neighbourhood florist. As
low bowls, within a price I could afford were difficult to find, I settled for one readily
available at the dollar store. Similarly, instead of buying a kenzan, I settled for a sponge
and toothpicks which I broke into small segments and placed these into the sponge, so
that just the tip of the toothpick segment rose above the surface to provide needle-like
concentric circles.
Because of the challenges, I faced while acquiring the Ikebana apparatus, I settled for
the easily accessible items from the dollar store and created my own apparatus which
follows the ‘do-it-yourself’ method. Another reason to make my own apparatus was that
I had to bear in mind that it would be difficult for seniors in long-term care homeless to
head out and buy their own apparatus.
When the arrangement was complete, I placed it onto my window sill. In the entire
house, this small window is quite special to me. Strangely, I could not sit through keeping
the arrangement of organic flowers anywhere near closed corners. My intentions were
to keep the arrangement in light. The corners were too dark for the arrangement. It felt
restrictive while keeping the arrangement in the corners of my room. The window sill
was instinctively comforting, free. Keeping it outside had the possibility of being mauled
by the cat.
As I placed the Ikebana arrangement in my special spot, I could see the freshness of the
leaves already fading away. After three days, I could see the flowers in the arrangement
shrinking, bending downwards. A few days later, the petals of the flowers started
wilting, withering away. I feel this transition from fresh upright flowers to shrunk, wilted
nothings gave me an idea of how life and death works. I wanted to create something
for the seniors to explore the same experience collaboratively to strengthen their
relationship with others through this short representation of life and death.

36

(Image set E: Timeline photography of the Ikebana arrangement placed in the special spot, the
window sill)

The Ikebana Activity Three: Design
My final Ikebana design activity was to draft a how-to guide to help caregivers do
ikebana activities with elders. This was informed by my earlier activity with one of my
peers.
While collaboratively making the Moribana arrangement described in the section above,
my peer and I, both seemed to develop a new form of respect for each of our ideas
about the arrangements. We were both patiently waiting for the other person to finish.
During the making, we talked about her reflection on the activity in reference to the
book, ‘The Re-enchantment of everyday life’, by Thomas Moore that talks about specific
aspects of daily life such as clothing, food, furniture, architecture, ecology, language, and
politics, Moore describes the renaissance these can undergo when there is a genuine
engagement with beauty, craft, nature, and art in both private and public life.
After developing my digital mock (see image set J in appendix 2) of a how-to guide for
collaborative Ikebana arrangement making, I realized that unlike Ikebana, which is a
respected ancient tradition, my version wavered from the ancient traditional method
and moved towards a contemporary, commercial driven, design approach to sharing
knowledge. I needed to make some aesthetic shifts. When a person picks up my how-to
guide, they should have a publication in their hands that feels like a parchment sheet or
handmade paper - something that gives a traditional, cultural, as well as a personal feel
to it. My illustrations, drawings, steps all needed to be changed. I decided to work up
a second iteration drawing on original paintings of ikebana that showcase the art style
followed in the early 1910s in Japan and attempted to maintain a similar form for the
method.
37

This revised how-to guide show below can be used individually by seniors on their own
or collectively by seniors and their friends, as a means to create something beautiful
together.
The social nature of every senior seems to be a subjective factor. Therefore, this how-to
guide helps the seniors create their connections with flowers, as well as others around
them through the clear instructions in the booklet. In care homes that host more than
hundred seniors, I believe it would help strengthen the connection between seniors
sharing the how-to guide without any forced arrangement.
Over time, as I engaged with Ikebana through my different activities and my secondary
research, I came to understand Ikebana as a medium of connections, be it with people,
be it with natural elements, be it with the containers. Key to all of this, what matters
most, is the making, the experience, the journey.

(Image set F: The final digital mockup of the How-to guide for Moribana (type of Ikebana)
arrangement with company)

38

Concluding Questions:

How do we bring Ikebana to the seniors in care
homes in Vancouver for collaborative sessions
amongst themselves to encourage social
connections?
How do we bring the material, the people and the
instructors to come together and create something
beautiful and long-lasting in its own way?
The idea of building boxes for Ikebana, special
packages for seniors, seemed to come organically
to me while I asked myself these questions. And
of course along with my new idea a new set of
questions:
So how do we make these boxes?
What comes in these boxes?
How does it connect to activating sensory receptors
though Ikebana?

39

I also returned to the question of how to bring nature into care homes for seniors. In my
mind, one way to do this, to provide the smallest meaning of bringing nature to seniors,
could be through twigs, leaves, mosses, flowers, plants, ground soil.

(image set G: An initial concept of ‘bringing nature into a care home; Sketch of natural elements
like leaves, moss-ball, twigs, stems, rocks, and small plants that can be turned to a mini-moss
garden; References of the sketched items [all images are photographed during research])

My Ikebana kit, inspired by these images above and my earlier Ikebana activities (1,2,3),
can be found in :appendix 2: Section 5. My Ikebana kit, which I only hint towards here,
led me towards a product outcome and somehow sat uneasy with me as it seemed to
contrast with other ideas and wisdom that nature seems to bring. Instead of continuing
with the kit, I shifted my focus towards a bigger question; one about the space,
community and service design that came up during the experience of Ikebana making.

40

6.
Visiting De Hogeweyk,
Discovering communities and
service design in care home
settings

41

In Summer 2019, shortly after my early Ikebana explorations, I had an opportunity to
visit a well-known example of successful design for senior care, De Hogeweyk, in the
Netherlands. De Hogeweyk is a recognized, innovative, senior healthcare offering.
(Larsen D., 2019) It is a care space for seniors living with complex dementia that has
been carefully considered. Spaces are designed so that all the lanes, passages, lobbies,
garden spaces interconnect. It creates a dynamic platform for residents to interact with
their fellow seniors and care staff who, unlike in conventional care home settings, are
dressed in casual outfits. The result is a nursing home setting that has a village-like feel.
Despite a considerable amount of rainfall in the Netherlands, the seniors, with their
‘formed’ social circles, also enjoy taking walks and sitting in the open outdoor spaces:
near a fountain, in an outdoor cafeteria area, in multiple garden spaces. This situation
enables seniors at home to easily occupy spaces outside of their rooms and houses
(ones with selective lifestyle).

(Image 8a: Observation spots inside De Hogeweyk’s Premises and layout)

This situation correlates with informal and formal observations I had previously made
while living and working in India. In India, apartment settings and community habitats
enable homeowners of multiple generations to establish a similar pattern to De
Hogeweyk. People are familiarized around an individual’s home due to the structure of
the building. Indian apartment complexes consist of three to four houses on one floor
facing one another due to the space challenges in metropolitan cities like Mumbai.
The windows are like a portal into the neighbour’s house, which invites conversations.
Interestingly, In the Indian context, living in a similar housing complex entails not just an
exchange of dialogue but also commodities.
42

(Image 8b: Reference for the layout of apartments on one floor in Indian buildings)

During my time at De Hogeweyk, I had the opportunity to observe seniors freely
conversing with each other without prompting via care home methods/activities.
They were able to create their own connections. I saw seniors who knew each other,
meet each other casually as friends in their De Hogeweyk spaces. They were open to
connecting with one another, comfortable in their new home environment and easily
able to do so thanks to their meeting ardour space and being in a situation with new
people of the same age and lifestyle. Interestingly, much of their communication was
non-verbal.
The anecdote below is from my experience at De Hogeweyk. It demonstrates an
interaction I had with a senior living there. Amongst several other seniors that I spent
time with, one in particular gave me much pause for thought. One morning, Auntie
Helda (pseudonym) sat next to me and talked to me in Dutch. I attempted to convey that
I do not speak or understand Dutch but she continued none the less. All the while she
greeted several of her friends strolling in the sun while continuing to talk to me. After a
while she left me only to return, take my hand and then seem to indicate “Would you
like to walk with me?”

43

While I could not understand her words, her hand held out, gesturing towards a nearby
open lobby letting me know what she wished. We walked, sat down and ‘talked’ more.
Well, she talked! I just nodded because even after I told her that I didn’t understand
Dutch, she continued speaking with me. It turned into a fun conversation with some
gasps when I tried to answer her questions. I think I answered them wrong. She showed
me a picture frame of a young girl who I think she introduced as her granddaughter. She
also showed me a picture of a dog.
During my conversation with Aunt Helda, I also met Uncle Albert (pseudonym). Unlike
Aunty Helda, I think he noticed that I didn’t understand Dutch words, still, he kindly
played along, glancing towards me every now and then to see how I was doing. Through
this experience, it became evident to me that even when you don’t share a common
language, the efforts you take in accepting that fact and remaining comfortable is
worthwhile. In these instances visual cues and gestures are not missed. They become
key communicators. I did not understand what Aunt Helda told me, in great detail and
with enthusiasm but I still understood her openness, her gestures, smile and was able, in
my own way reciprocate!
“A visual-based language can lead to a more universal form of communication, or
provide a more coherent approach, thus creating greater chances and facilitating easier
integration for individuals in various domains.” (Nawar, H., & Gabr, H., 2013)
Further, Psychologist David Matsumoto, an expert on non-verbal behaviour, culture and
emotion has noted that, “the majority of people in the world want to get along. As with
all relationships – communication is key. That’s when our non-verbal abilities can help
us to better relate to other members of our human family. Even when words fail us.”
(Pogosyan, M. Ph.D., 2017[psychologytoday.com])
Revisiting my observations, I realized that it was not ‘Nature’ that kept them connected.
Instead, it was the human-human connection and the comfort of being around a place
with a touch of familiarity essential at De Hogeweyk. That, regrettably, seemed to be
lacking in the care homes I had visited in Vancouver. I also remembered the examples of
connections that I had seen in the care homes I researched during my job as an industrial
design at an incubator company in the Indian Institute of Technology in India in 2017.

The human to human connection; Feeling of comfort and
belongingness.
Because of this, my research began to include community; I began to think about
the layout of care homes. I reflected on the different spaces I had observed: in India,
in Canada, and in the Netherlands. I began to consider the use of Open Spaces as a
significant site for encouraging community for building meaningful connections for
elders.
During my time at De Hogeweyk, I also had the opportunity to attend a dementia care
conference in Eindhoven. Here, I had a conversation with a fellow designer from Zurich
that resonated. The designer observed the factors associated with policies different
countries use to address models of care and building care homes. This led us to discuss
different relations with the notion of risk - in particular - Risk-taking Culture.
44

“A positive risk-taking culture looks beyond the potential physical effects of risk, such
as falling over or wandering to consider the mental aspects of risk, such as the effects
on well-being or self-identity if a person is unable to do something that is important to
them.” (Croft, J., 2017)
We were both interested in how seniors and their family members address and respond
to notions of risk. What does it mean to let a senior walk around the care home without
assistance from the care staff members or to let them help in daily schedules inside the
care homes?
My design colleague reflected that, in the Netherlands, and places such as De Hogeweyk
(which I had just visited) and Sonnweid (A care home in Switzerland), family members
are aware and accept the consequences of the risk of seniors falling, wandering around.
Whereas, in Canada, family members are not accepting these circumstances due to a
fear of possible consequences. Similarly, the care home organizations also seem to be
careful in maintaining the risk safety methods to ensure the seniors do not undergo
fall, get hurt in the process or wander off. ‘Falls are a major safety concern for nursing
facilities. Injuries resulting from falls are a major reason for lawsuits against facilities
and staff, which can result in the loss of large sums of money and higher insurance
premiums.’ (Agency for Healthcare Research and Quality, 2012)
During my time as a volunteer in Vancouver, I observed quite a few measures taken by
care staff members to alleviate these fears, such as the use of wheelchairs to avoid the
risk of seniors falling. In contrast, in De Hogeweyk, the number of wheelchairs used was
relatively low, and the seniors were encouraged to walk around freely without the use of
wheelchairs or assistance, if at all possible.
While talking to one of the founding nurses at De Hogeweyk, I inquired, ‘if the seniors
feel the need to get out of the premises leading to wandering?’ It opened a discussion
about how, although some seniors, time and again find a need to be outside, most
seniors enjoy their time inside the premises. For them, it is their daily routine. These
‘white lies’ help them stay inside and have a good life around seniors of similar cultures,
age groups,and lifestyles.
I thought about the acceptance of the surroundings and the people in the care homes in
Vancouver. Do they feel the same way?
Are they content with their care home surroundings, are people who accept inside the
care homes of their ethnic backgrounds, cultures, and lifestyles?
To understand in-depth how the surroundings and a fresh environment inside the care
homes can help seniors connect amongst themselves, I took on two sketch exercises
linked to an imagined campaign, ‘Follow the green.’ Details of this exploration can be
found in appendix 4 (Section 6).

45

How to cultivate the learning from ‘nature’ into dementia care
and the implications of dementia care if we methodize these
learnings into our service systems (into care homes)?
How do we interpret learning from ‘nature’, such as,
acceptance to the dynamic change, accepting the ecosystem
and interconnection between the various organisms residing
in the ecosystem, change being a constant factor in the
surrounding?

If nature accepts all the changes around, how can we use
similar ideals in a human-human setting?
In nature, some changes are drastic while some are gradual. In
dementia, individuals gradually begin losing fractions of their
memories. How can we find a common ground between these
phenomena of accepting gradual change? Even the cycle of day
and night, the change occurs over a period of twelve, giving a
sense of progression. How do we bring this sense of gradual
change in relation to the day-to-day change in the seniors lives.

Accepting oneself, accepting the abilities that seniors (in the
care homes) are/were experts in, throughout their lives, could
accepting the surrounding through changes in the way the care
homes are decorated or constructed change their perspectives
towards living in these care homes?
Why is Dementia Village an example of good stories of
acceptance?
46

(Image 9a: Pictures from De Hogeweyk premises under the consent of De Hogeweyk’s team)

47

(Image 9b: Pictures from De Hogeweyk premises under the consent of De Hogeweyk’s team)

48

7.
Service Design Methods

49

In the context of health care, service ecosystems are typically comprised of wildly
divergent actors, (a person playing a role in the system) including patients and their
families and friends, other patients, healthcare professionals, hospitals, health support
agencies, professional associations, health insurers, healthcare authorities, government
agencies, and regulatory bodies (Frow et al., 2016; Litovuo et al., 2016; Jaakkola, E. et
al., 2018). One actor alone cannot maneuver such structures. A dynamic and iterative
process involving multiple stakeholders in the ecosystem with varying views on value is
needed to maintain or change practices, thereby ultimately institutionalizing innovation
(Vargo et al., 2015; Jaakkola, E. et al. et al., 2018).
I developed a workshop-led practice for long term care homes, inclusive of the
stakeholders mentioned above, to help sustain a sense of community. A vital element
of this workshop was a service design layout-mapping exercise to encourage all
stakeholders to discuss the care homes’ current scenarios and propose changes by and
for the seniors. I based this activity on my observations of the De Hogeweyk’s seniors’
connections to their surrounding space. I wanted to investigate the importance of
creating a comfortable surrounding space inside the care homes premises to make
seniors sense familiarity and comfort.
In the exercise that I conducted with my peers and a few passersby, I tracked the way
emotional connections are formed in open spaces. It allowed me to investigate alternate
perspectives on ways of creating comfortable and familiar spaces inside care home
premises for seniors. For more details, please refer to Appendix no.5.

Connectedness with Nature:
One early design activity that I developed in my summer 2019 service design workshop,
which I briefly described above, became essential to further developments in my work:
a Walk in the wilderness. This activity became a necessary means for me to return to
themes of connection, nature, and eldercare.
“Green space is emerging as a powerful force for good mental health. Exposure to green
space can help alleviate depression, ADHD, Alzheimer’s, and more.” (Hendriksen, E.,
2018).
According to Vancouver’s Greenest City Action Plan Part Two (2015-20), Green spaces
have been proved beneficial for the people’s physical as well as mental health. According
to me, green spaces can be the greenway along the side of your block, they could be
dozens of plants alongside your community garden spaces, or they could be the little
park around your neighbourhood. Not only do they serve as a space where the trees,
different plant-based ecosystems help in reducing stress, but they also help us humans
socialize; forming a sense of community. (Simon Evans, et al., 2019 ;City of Vancouver,
2020 Plan Action)

50

Outdoor Walking Actiivity One: Trout Lake in 2019
The outdoor walking activity’s objective was to enable people to think about humannature relationships and how being connected in nature helps one’s wellness by walking
around in the outdoors around a local lake. It was based on my personal experiences
(see section one above) and my De Hogeweyk observations of seniors (living with severe
dementia).

(Image10: Trout Lake; ‘walk in the wilderness’ activity space and the common sitting area near
the lake)

Unlike in the Vancouver care homes, I visited where people were confined to
wheelchairs, the seniors in De Hogeweyk would sit outside with their friends, take
rounds along the premises’ circumference, and engage in conversations openly with
passersby. Seeing this had made me wonder: was the idea of being outside, even though
it was within the care home walls, what helped the seniors cope with getting familiar
with the surroundings? In addition to familiarity, this first walk in the wilderness activity
was also a means for me to better understand the human-nature relationship in terms of
sensory receptors and seniors’ therapy.

51

The activity consisted of a participant being given a persona and then invited to walk
around ‘Trout Lake’ for a quarter of an hour (to activate sensory receptors). After this,
we sat down on a park bench, and I asked my participant to reflect and respond in
writing to the following question “What things triggered your five senses during our
walk?”
Later, while discussing reflections on the experience, my participant observed that the
persona I had given them became almost non-existent as our conversation went on,
carried-forward along a different route. My participant also noted that being outside and
hyper-aware of sensory reception was a significant takeaway.
I also realized that the instruction to sit and write in one spot during the second part
of the activity, in some ways, restricted the urge and possibility to further explore the
surroundings - that this may act as a hindrance in understanding how a person forms
connections with nature or open space. The script for the activity did not provide a clear
understanding of what I, as a researcher and facilitator, expected. “It’s (referring to the
activity) a bit mechanical.” She said. When I repeated the activity, the next iteration was
more defined, clear about the research’s anticipated outcome based on the previous
feedback and reflection.

52

8.
A New Trip to Trout Lake:
Lessons about Methods

53

Outdoor Walking Actiivity Two: Trout Lake a year later
One year later, I returned to my walking activity. I aimed to understand by reiterating
the role of open spaces for an individual and the urge to connect with nature to build a
sense of familiarity and comfort to sustain while living in unfamiliar surroundings. Both
my peers, engaging in the activity were in their twenties. My peers were only given the
senior’s persona to base their embodiment of the role of seniors during the activity.
Since I wanted to understand what part of my persona-making helped the peers engage
with the role, and in what ways they were understanding the proxy senior’s perspective,
I avoided using additional tools in the exercise such as glasses, walking canes or
restricting their movement as I had arranged in the ‘Follow the Green’ activity. I looked
forward to observing their interaction with the persona and the activity with a nonmeddled interpretation of their role.
This time I divided the session into three parts: sensing, collecting and reminiscing.
My peers completed all these new activities while acting as a proxy senior based on a
persona I provided at the beginning of the exercise. (refer to image 17a)

Sensing
I first asked the ‘seniors’ to survey their surroundings: Trout Lake for one participant and
a bench outside a suburban home for the other. (refer to image 19a & image 24)

Collecting
I followed up this activity by asking my proxy seniors to collect items from these spaces
that encourage their connection to the particular space. (Image 21 & image 27)

Reminiscing
After they had finished this, I asked them to identify five things they had seen, four
things they touched, three things they heard, two things they smelt, and one thing they
tasted. I asked them to tell me stories about these things. I intended to understand
if explicitly activating their senses helped them recollect a few resonating memories.
Image 23 & image 29).
For more details about the workshop process, please refer to Appendix 5 (Section 8).

Post-Activity Observations and Thoughts:
Several different participants using the same persona

Persona Feedback: (A senior lady in a long term care home)
During my second set of outdoor activities, the personas I had developed helped my
participants clearly understand the scenarios I had set out. While the first participant
brought in an imaginative narrative to the persona, the other personified their past
relations with women in their own family.
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Observations: Collection of items
Through the activity, the first proxy senior developed into an individual who was
enthusiastic about collecting multiple items around Trout lake. However, in the end, she
only took back a pebble. The first proxy senior had a special connection with the pebble
as she shared multiple memories on the beach with her and her family. The pebble
was a saccharine reminder of these memories. During activity three, the second proxy
senior with the same persona walked around the block and did not consider collecting
anything apart from a small rosemary piece. Later my participant (who had taken on the
proxy role) observed, “Your increasing age is also losing control over things, sometimes
yourself, and that is quite scary. So you hold on to the small things just like the rosemary
- your little victories. It reminds me of all the times I plucked rosemary for my aunt to
make her special recipe when I was a kid.” she said.

My Thoughts
I started thinking about how these small items in the spaces around a natural habitat can
bring numerous memories back to us through this process. It was evident that the space
you feel comfortable in is connected to the feeling associated with memories that we
have spent our lifetime building.
Even for me, if I think about it, outdoor spaces bring me back to this memorable incident
with my grandmother—a feeling of laughter and security of being with my close ones.
My grandmother’s backyard gardening lessons are connected to the green (naturerelated) experiences in my life. My grandmother is an avid gardener! I remember when
I was a teenager, I would enjoy spending afternoons in the summer holidays at my
grandmother’s home and specifically digging her garden under her instructions. More
recently, in a conversation with my grandmother, she made the following observation
“Gardening is a very meditative experience. When I would fight with your grandfather,
I would come to the garden with a shovel. I would dig and plant new seeds until I was
calm enough to go back inside. It’s my haven.” This personal perspective offered up in
my everyday life, all salient and relevant to me as a designer.
Even my decision to move to Vancouver is connected through the green living
phenomenons of nature; just like the tree, I drew connections from Trout Lake. But was
it the tree that brought comfort in me, or was it the people I shared my memories of
being around the tree with? Fellowship, that is what the tree reminded me of.

55

(Image 11: My grandmother in her garden; Picture credit: Eesha Pendarkar)

56

9.
Conclusion

57

My research developed into an exploration of how natural settings might help overcome
one’s social disconnections by drawing onto personal feelings of unfamiliarity and
uncertainty from being in a new space and situations. What interested me most was
the contrast of education’s institutional space and the social disconnection I felt in that
place. Thinking back on the experience of senior’s disconnection in India’s care homes, I
drew parallels to the institutional setting of my university and the long-term care homes.
I found myself asking how natural elements and spaces, for example, the moss, flowers,
potted plants, stems and leaves of trees outside, could help the seniors connect in the
care home premises?
Carrying forward this thought about community and comfort as facilitated by nature and
natural elements, I developed a series of research actions using walks, trees or smaller
elements; like moss balls, flowers, ground soil, leaves and plants, from the outside to the
participant designers as prototypes to connect with a non-verbal, (Pogosyan, M. Ph.D.,
2017) visual language (Nawar, H., & Gabr, H., 2013). After getting feedback from my
participants, I gained some insights about how much the particular materials I brought
to sketch and prototype influenced the actions. I came to understand how dollar store
shortcuts and plastic imitations of natural forms might undermine my efforts to bring
nature to my users. As I proceeded in my activities with the mentioned materials, I
observed that flowers were the first point of interest and thus interactions. The feeling
one gets while looking at the bright colours in flowers, the velvet-like touch of the petals
is what makes flowers pleasant enough to generate an interest in, connecting to brighten
up our mental wellness.
As a designer, becoming aware of material practice details and careful vetting of
scripts provided using experiential research methodologies became vital to creating an
experience for my participants and understanding their feedback.
I refined my designer practice through several iterated activities: first, my work in
the series - ‘Nature: A Collaborative Method,’ in which I learned about sourcing and
consistent material use, especially the flowers. During this Ikebana activity, an exciting
realization was observing how, when we talk about nature, I often find myself referring
to life and abundance, the freshness. There is something quite awe-inspiring about
making an arrangement together as a collective ritual that one knows will fade away,
much like human life grows and fades. It also encourages a long-lasting bond between
the collaborators, creating a bridge, the starting knot of their connections.
Moreover, creating a connection with fellow seniors in the care homes without forming
a verbal connection (in reference to section 6) to associate with each other allowing
multicultural seniors in one space to collaborate, connect without a language barrier. My
intent with bringing the outside in care homes through natural elements was to provide
seniors with an experience of being in nature while carrying these items in their hands.
Considering the physical and/or cognitive limitations of the seniors, bringing these small
elements for seniors who were unable to take themselves outdoors often, was my idea
of helping them cope by feeling the elements, or by making something with them,
creating a connection in the end.

58

Similarly, inspired by my research trip to De Hogeweyk in the Netherlands, I continued
my work to understand what community is and how one finds oneself in a community. In
my view, ‘community’ is an invisible space where we meet people with similar interests,
cultures as ours; A space to encourage openness, comfort.
What I first noticed, which was different from the other care homes that I visited since
my project in Bombay in 2017, was openness. I could almost feel the freeness, the
independence in the space (if it creates the picture). The seniors were walking around
casually, either alone or with their companions. I brought the question to my studio: Was
it the feeling of being a part of the community?
What began as a discussion session with my peers in one of the graduate studios later
turned into a series of activities, including layout exercises exploring architectural design
potentials, service design mapping, and policy design research and workshops.
Finally, while reflecting on the idea of belongingness in patios or gardens, I was inspired
to iterate the walk in the wilderness exercises. The purpose of exploring the walking
research activities was to observe the participant’s connection to outdoor space; that
could be a park or even space around the block near their home. After practicing the
repeated activities, I realized that space appeared as a portal to memories of past
incidences and the feeling associated with those memories.
During the activity, one of the proxy seniors kept a pebble she found around the lake.
Though the pebble was not something she harboured for her entire life, now that she
found one, she wanted to keep it as it acted like a portal into her memories pertaining to
the moments spent with her family. It was the newly found elements in the surrounding
space, and the space itself, that encouraged the senior to reminisce.
When both peer research participants collected items to keep with them, they had
stories to tell about items that they picked up. The natural, open space connected to
memories with people and events from previous times in similar spaces. In summation,
as quoted in one of the research activities, “sometimes all a senior wants is to connect,
communicate, be heard, and be independent.”

59

10.
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Appendix 1
Section 2
The Hindu Philosophy:
According to Indian philosophy, the entire universe is created out of the conglomeration
of the subatomic particles which influence the five gross elements - earth, water, fire, air
and space.
All living beings, animate or inanimate, come under this classification.

So, life forms are created on the backdrop of the gross elements. The five gross elements
do inherently carry a link with the five human cognitive organs. The nose carries an
inherent relationship with the earth, the tongue with the water, the eyes with the fire, the
touch with the air and finally, the ear with space. (Dr. J.S.R.A. Prasad, 2015)
Regular visits to the now preserved outdoors are good for your help according to modern
science. The quasi-spiritual atmosphere afforded by forests and trees also impressed
ancient peoples in many parts of the world, leading to worship and spiritual retreat in
woods and groves. (Peter Sahota, 2019)

Section 3. Product Design
I continued to find scientific support for the idea of bringing nature to the eldercare
environment, to “retrieve the benefits of nature and green spaces for dementia” (Dr Ellen
Hendriksen, 2018) and senior care. Natural surrounding spaces, green spaces, encourage
seniors to uphold their daily regime, a structure, in their retirement. It gives them an
opportunity to attempt various activities outside of their homes. The action of being in
green spaces motivates the seniors to be active physically, spiritually and also socially
which can offset chronic illness, physical and cognitive challenges and most importantly
isolation. (Jessica Finlay, et al., 2015) Research also states that people living in green areas
have a lower risk for several challenges such as depression, cardiovascular diseases and
asthma. (School of Population and Public Health, 2018)

67

I was interested in exploring nature’s insights because of what I had experienced
throughout my life. My experiences of/with/in nature are ones I associate with a
feeling of security: They are often small but never insignificant. The small portion of
“wilderness” outside my apartment in India, trips to wildlife sanctuaries with my friends,
walks I have taken along trails in forests around the city of Pune, climbing solo or with a
company and sitting at the top of the small hill next to my recent home in India, have all
left me secured by a feeling of belonging to the space I have been in.

Section 4. Artificially-Natural Making
The material practice has been an important aspect in the way designers carry out
activities, prototyping. It is often linked to material culture in such a way that the cultural
component is foregrounded and where the properties, causal chains, physics, resistances
or even affordances (action possibilities) of the material are not in discursive focus.
(Michael Filimowicz, unknown) The material practice is central in a designer’s material
practice as designers articulate meaning through the materials that embody a design.

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Appendix 2
Section 5. Ikebana Case Study
The deeper I looked into the history and theory behind Ikebana, I began to understand
that Ikebana is an art, a creative activity in which calculation serves sensitivity and
inspiration.” Ikebana, the art of Japanese flower arranging, is a creative and symbolic form
that uses plant materials to express awareness of nature and human life” (Moriyama
& Moriyama, 1999; Allison M. Watters et al., 2012). Ikebana is a way of looking at and
presenting the form of life itself, both human and blossom. Ikebana is not just an aesthetic
and spiritual therapy, but it can also be seen as a reminder that we are all a part of nature.
Keeping nature close to us even through our cemented walls is our natural instinct and
need.
My objective behind researching into a collaborative practice of Ikebana for the seniors
My intent towards this research was to understand the connection two to three people in
groups would share with these small pieces of nature that are built through the ikebana
arrangements. I was aiming to understand the relationship a person forms between parts
of natural elements that bring the essence of being outside (flowers, plants in this case)
and also with others; whether it is long-lasting or as long as the flowers wither is another
question.
The following section presents the two Ikebana activities as mentioned below
My ikebana design activities unfolded in three phases:
1. A collaborative prototype with the members of the Health Design Lab
2. Creating an Ikebana arrangement:
A moribana arrangement with my peer as a collaborative activity

Ikebana Activity One:
Phase One: The first phase of the activity was arranged with members of the health
design lab at Emily Carr University.
I began by presenting two personas to help my participants embody the perspective and
experiences I was designing for.

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(image set 12a: personas for (left)a care staff member; Image 12b: (right) senior living with
dementia)

“The engaging perspective is rooted in the ability of stories to produce involvement and
insight. Through an understanding of characters and stories, it is possible to create a vivid
and realistic description of fictitious people. The purpose of the engaging perspective is
to move from designers seeing the user as a stereotype with whom they are unable to
identify and whose life they cannot envision, to designers actively involving themselves in
the lives of the personas.”
- Lene Nielsen from NN group (Esser, P.)
In this phase, due to time constraints, I chose to use a pseudo-ceramic pot, with a twig
found near the university and cuttings from a fake plant in my studio. My focus, during
this phase, was not on the materials as much as the actions with assistance from the
materials. At first, I introduced the activities and the concept of Ikebana with the time we
would require for all the tasks. Then, I spread the materials in front of them and asked
them to make an arrangement, using a hard sponge as a base and adding in the flora on
top. The purpose of the activity, for me, was to observe how the actors (two personas)
connect and engage in the making process without any personal relationship before the
activity.

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(image set H: personas for (left)a care staff member, (right) senior living with dementia)

(image 13: personas for (left)a care staff member, (right) senior living with dementia)

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Ikebana Activities Two & Three:
Later, I explored a collaborative moribana arrangement activity with a participant, a
fellow designer. While engaging with the arrangement, I explained to Sheen what Ikebana
is while sitting in the front yard outside her house. I talked to her through the connecting
theory of Heaven, Earth and Man and how Ikebana is a visual representation of those
three spirits. Then I explained to her the technique of Moribana and what the style
stands for. However, she did prompt that she would want me, as a researcher, to provide
an in-depth description of the philosophy about Ikebana and moribana.
Early in the morning, I engaged in making the ikebana arrangement with available
materials - flowers, the blue-mist plant, sponge, bowl and tape to stick the sponge
to the bowl. The reason behind ‘making’ in the morning was to experience a serene,
quiet surrounding and the freshness of the flowers, myself and the surroundings was a
different experience altogether.
While I was making the arrangement individually, unexpectedly, I did not feel that I was
alone. Be it the surrounding grass, the flowers in the arrangement, the wooden table, I
felt a different gush of liveliness.
Getting the materials for the second activity ready, involved purchasing a sponge,
two holding cups, One bowl/container and scissors, sponge (preferably taped to the
container), Flowers, Plants, and yourself.

Image Set I: Ikebana Activity Two: Collaborative Moribana arrangement with fresh flowers.

I chose the open space to experience the previous serenity and calm atmosphere to
observe how that affected our collaboration. However, during the making of the Ikebana
activity, it did not occur to me that I would perhaps get a different outcome after
changing the surrounding space into an indoor setting. One of the reasons probably being
my interest in finding how the cool breeze and the shining sun could affect or change the
activity. The ambience had quite a significant role to play as we walked around finding
flowers to add into the already colour-driven arrangement.
So, can we use the same technique for the Ikebana Kit? Yes, Ikebana Kit!
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Based on the insights and feedback from the first two phases, while thinking about
how we could integrate Ikebana in the regular routine of the seniors in care homes, I
could visualize a kit forming with bowls acting as trays of moss for activating the sensory
receptors in the seniors which can be later converted into containers for the Ikebana
arrangement.
‘Nature: A Collaboration’ came into action. Looking at it sort of like a bundle of social fun
for seniors.
It got me thinking about the previous explorations of the soil bowl, touching and sensing
the outdoors through these little elements, pieces of nature that would be set in front of
the seniors in the care homes through the concept of Nature: A collaborative method.
Why not design and experiment on this idea of bringing the outdoors (of sorts) to the
seniors through a kit of containers, a holding base and flowers, plants?
Then, thinking about the idea of collaboration while engaging in this activity, I thought
about adding three containers for the seniors to work in pairs and remember their
ikebana partners the next time they come across. The contents of the packaging would
be the kenzan, short containers made out of wood, with the hole in the middle of keeping
the kenzan and/or the soil to place the materials for a moribana arrangement and water.
The idea is to propose the kit as a six-week or yearly program for the seniors to engage
with each other and make together to bring themselves closer to nature as well as their
fellow seniors that comes with a how-to guide for their reference.

Image Set J: Digital Mock Up [Version One] of the how-to guide for Ikebana

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Considering that the items can be bought from the closest dollar store, it seemed like
a cheaper option for me as a researcher. However, if the idea was to proceed into care
homes, depending on their accessibility and affordability, they could proceed to purchase
the Ikebana apparatus directly. What makes the kit different from the conventional
Ikebana arrangement is the factor of tactility that I introduced in the form of moss-filled
container for the seniors to interact with. The moss patch would later turn into the kezen
for the flowers that the seniors would place to form an arrangement of their preference.
However, one of the reasons I chose to discontinue the concept of ‘Ikebana Kit’, was the
physical and cognitive challenges of the seniors. Since I did not have the opportunity
to substantiate the kit in an existing long-term care home, I could not understand the
material and monetary shortcomings of this project. I was interested in Ikebana for the
philosophy behind the arrangement more than the cultural implications. A significant
aspect of Ikebana is the spiritual connections and the non-verbal collaborative methods.

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Appendix 3
The Layout-Mapping Activity (Open Studio)

Image set K: The layout-making exercise where I set up a section of my studio with a bed, a side
table, in an attempt to create a care home’s room-like structure. Then I asked people to fill out the
two layouts based on their emotional and pragmatics connection

After my short introduction, I gave each person who visited my space two sheets (see
fig. below). One of the sheets provided a layout of a two-bedroom apartment house out
of my secondary study of apartments in Vancouver BC, the other showed a layout of the
ground floor of a care home based on my observations of care homes in the same city.
For sheet one, I asked each individual to mark the areas in the home layout where they
felt an emotional connection and the areas that they had pragmatic connections to using
a green and orange marker respectively. After completing the first sheet, I asked them
to repeat the exercise of identifying emotional and pragmatic aspects of a lived space
on the second sheet, which had the care home layout. This time, rather than drawing on
personal memory and experience I asked them to imagine a hypothetical situation in the
future where they might be living in a care home.

Image 14a: [left]: A general layout of the first floor of a care home; Image 14b [right] a layout of an
general apartment plan

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Later in the Fall, I had the opportunity to expand on my earlier exercise with my peers. At
Emily Carr’s Open Studio I presented a layout-marking workshop as a collaborative, open
and person-directed exercise to passersby through my studio space.
While discussing how communities are formed and methods used to research how
humans acknowledge and encourage the feeling of belonging to specific locations. place/
spaces peers and studio faculty began reflecting on the possibility of mapping a space
according to the emotional connections people form with it as a way to help establish
what being comfortable in that space means. While some people instantly realized what
the arrangement (the set up of a bed referring to a room in the care home in Vancouver)
looked like, some were oblivious to it. I realized, people who were accustomed to the
care homes due to prior contact and personal experience noticed and identified the
setting immediately while others were asking for an introduction and means to better
understand the context.
The responses I received about the care home layout exercise, showed that almost
everyone indicated that garden spaces, in both the home and the care home layouts,
were linked to emotional connection. One person referred to it as a ‘porthole back into
their own house when they are away.’ It reminded the person about their home, space
they had grown attached to and were familiar with.
It allowed me to realize how important it is to make connections to spaces in new
situations seemed to be for people. Facing a new phase in life, where everything is new,
we seemed to be drawn to comfort memories and these are often connected to the
feeling we experience in a space. I was reminded of my own relation with Trout Lake, a
place I often found myself going to as a way to find just that one connection that would
take me back home; a porthole. I realized that the care homes themselves, the way
they are built, decorated, sometimes fail to comfort a person or help them to find a
connection to the place and their past. According to Yvonne Amerongen: “The dementia
village [is] redefining elder care”, she says, “Red curtains are as expensive as the grey
ones.” Dementia Village’s concept was based on creating a comfortable environment
for seniors. Be it through building interconnected lobbies leading to open spaces or
be it through building different lifestyles. What mattered most was the comfort and
connection of the seniors in the space.
What happens when we use similar ideologies in Vancouver’s care home culture? What
happens when we drop the grey curtains and use the red ones instead?
It was at this point that it dawned on me that when I was looking at nature, I was
perhaps not solely looking at it as a means to an insight into the community from nature
but rather as a way to find comfort built on past lived, sensory experiences in other
communities. In other communities that comforted me!.
So how do we proceed in understanding which red curtains form the same kind
of curtains in the care homes to tackle social isolation? What happens when the
management and seniors sit together and discuss how to bring in the comfort in their
care homes?

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Appendix 4
Section 7; Follow the Green Prototype
One activity I facilitated in my MDes studio was designed to understand the participant’s
views about the community. I asked them to answer the following questions on a sheet
for the first ten to fifteen minutes of the session. The latter part of the peer review went
into discussing as a cohort what their views about community was and how the project
was closely working towards fostering a multi-cultural community just like Emily Carr
University’s closely tied community with making people joining from all parts of the
world, comfortable and welcomed.
“Ask your neighbour, Ms.XY, if you can borrow a bowl of sugar.” said my mother once
when there was a shortage of the same in our house. This exchange encourages a feeling
of community into our life long before we even acknowledge it. Seniors living in care
homes in India are often found meeting people of the same socio-cultural and economic
backgrounds forming their mini-communities in the care home to encourage a dialogue
that is a part of their cultivated habit. This is also largely attributed to the seniors sharing
a common language.
While comparing the scenarios in Vancouver and De Hogeweyk, I found that De
Hogeweyk is majorly populated with people who can speak dutch in the care home
premises. Therefore, the language barrier was not a severe challenge. Whereas,
in Vancouver, the city’s cultural variations are quite large. The seniors come from
different ethnicities such as - Chinese, English, Canadians, Punjabis. That creates some
communications problems and hence, socio-cultural challenges.
What community? How do I define community? In what context was I referring to
community-building?
This really helped me understand the idea of community was very comprehensive and
I couldn’t narrow it down just yet. However, I knew the main aspects that I needed
to consider like the stakeholders concerning the care home, the premises and the
observations from De Hogeweyk as well the care homes in Vancouver.
I began to include service design activities along with the object-focused activities of
making planters, soil bowls, and ikebana arrangements. The Follow the Green campaign
was one such effort:
How do we foster community engagement amongst seniors while using open spaces as a
platform inside care homes in Vancouver?
How do we take the learnings from the details of De Hogeweyk’s visit and try to design a
better care environment for the seniors in long term care homes in Vancouver?
Result: The campaign, “Follow the green.”

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Image set L: [clockwise] Follow the green activity with two peers to understand the limitation
of both sides, the senior and the care staff member, during an action of assistance for going
outside to the garden space.

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The campaign was a platform to make iterative prototypes that were created with an
emphasis on the word ‘Green.’ Following the greenery, the sense of freshness, the feeling
of being outside, would work on a campaign through posters, and arrangements that
were later user-tested.
The first activity was a task given to two of my peers. The participants were given
personas where one was a senior with physical limitations and the second was the
care-staff member. The idea was to embody the limitations that seniors and care staff
members might face in their routine. For the purpose of drawing a clear picture of the
scenarios, I asked the peer, who was acting as a proxy for a senior, to be tied from her
torso to restrict the flow of her actions. Then I handed over a script to the care-staff
member role player, and tasked her to wheel the senior from their room (studio space) to
the garden on the top floor.

(Image 16: Notes and feedback for the ‘Follow the Green’ activity

This helped me understand one important factor that I was not following from the
derived pain points - The shortage of Care Staff Members. Also, factors such as
miscommunication between care staff members, seniors and the administration team
of the care homes needed to be considered as a result of the activity with my peers.
In this case, hypothetically, the message about the inaccessible garden door was lost
in the hierarchical system of the care home. The care-staff member was not aware of
the change in access points. In the end, a care home is an organization that consists of
numerous actors that work together towards the success of their service. If anywhere
the messages are lost in the journey from management to board to the seniors or the
volunteers, there will be a hindrance in the system, and further service design activities
such as journey mapping and service blueprints would consider multiple stakeholders in
the eldercare experience.

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Appendix 5
Section 8; Outdoor Walking Activities
Two (around Trout Lake) and Three (around the block)
While brainstorming about the outcome of this approach, my friend asked me to expand
the walking time to fifteen minutes and suggested that the volunteering peers I invited
to take this walk might do better with being allowed to move around the lake freely, at
their leisure, in their own way. All the while collecting samples that connected them to
their past experiences caught their attention. Later they could analyze why they’d pick
those samples based on the sensory reception and brewing any anecdotes related to the
objects (leaves, moss, plants, flowers, water) and talking about these memories and the
senses that are highlighted during the sample gathering.
I learned the prompts I provided to my peers during my prototyping activities were vague
and they did not convey a lot of information or direct cues to people about how they
should participate or engage. The ambiguous aspect of my interventions helped me to
see different avenues used by my participating peers. While this vagueness was useful, it
also conflicted with the idea of giving them a general idea behind the project.

Image 17: The second version of the script for activity: ‘Walk Around the Lake’

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Making of the persona:
While discussing with my Supervisor, Eugenia, an extensive persona for proxy research
was an important step. So I started researching on how to build a comprehensive persona
for the participants to understand and incorporate it. According to an online article
‘Personas Make Users Memorable for Product Team Members – ”A persona doesn’t need
to document every aspect of the imaginary individual’s life, but rather should focus on
those characteristics that impact what is being designed.” (Aurora Harley, 2015) So, in
order to bring to life the experiential role play for my participants, I created two storytelling personas - one of a senior living in the care homes and one of a care staff member
to assist the senior. I added details about their background, their medical challenges,
their interests, and some of their activities.

(Image 18a: Persona of the senior living in a long-term care home in Vancouver;
Image 18b: Persona of the care staff member in the same long-term care home)

Outdoor Walking Activity: Around Trout Lake
Research question focused on the research pertaining to the activity:
How might a walk in the wilderness encourage seniors to reminisce?
The purpose of this activity is to understand, by reiterating, the role of open spaces for
an individual and the urge to connect with nature to build a sense of familiarity and
comfort to sustain while living in unfamiliar surroundings.

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Following up on the second version of the script for the activities, I decided to proceed
with setting-up the activity in two different spaces:
1)Walk around the Lake at Trout Lake as an elaborate recap and more to the first trout
lake activity
2)Walk around the block (consider the participant’s house as the care home premises)

(Image Set M: An introduction and general description of the design research activity for the
participants with an overview of the activities.)

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Like the first version, ‘walk in the wilderness’ the participant, my peer Sheen and I walked
from the nearest long term care home to Trout Lake. Although the walk from that exact
point was not planned purposely, the intent was to understand the close proximity of the
lake to it and the surrounding neighbourhood. Once we entered Trout lake, we instantly
found ourselves walking towards the bench where we conducted the previous exercise.
It was quite organic that we found ourselves sitting in the same area, on the same bench
space. After settling down, I handed the first two scripts to my peer and asked if she had
any questions about the same. Once we were clear about the idea of the activity and the
persona, the first phase commenced.
Phase One at Trout Lake

(Image 19a: The script to phase one of the activity with Aunty Zee’s persona to remember the
proxy. Image 19b: The first ten minutes of the entire session.)

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(Image set N: (Left) while reading the persona of aunty Zee. (Right) Peer reading the script for the
first activity.)

(Image 20: Notes and feedback of the activity with one of my peer at Trout Lake for the iterated
activity: Walk around the Lake)

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(Image 21: The script to phase two of the activity with Aunty Zee’s persona to remember the
proxy alongside the lake. Taking a walk in the park while collecting items that are interesting/
associative to the seniors was the main purpose of the activity.)

(Image 22: Notes and feedback of the activity ‘Let’s talk by the lake’ with one of my peer at Trout
Lake)

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(Image set O: Phase two of the activity: The peer while embodying the role of Aunty Zee, giving
back most of the collected items back to the park; ritualistic, white-surrender; give back)

(Image 23: The script to phase three of the activity with Aunty Zee’s persona to remember the
proxy wherein my peer noted the observations associated with the five classic senses.)

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In the third phase of the activity, I asked Aunty Zee (my peer) to note the things she could
identify and associate with her five classic senses - sight, hearing, smell, touch and taste
in a chronological-descending order. We were seated on the same bench as for the first
activity. It seemed like a quiet place and also a center point to look over the park and
the lake’s circumference. It was also the same location where I would sit to observe the
surroundings and also where I conducted the initial activity (the first version). The idea
behind asking my peer to jot down these associations was to understand how these
observations help them connect with the space they’re in and what I, as a designer, can
do to encourage these observations. I noticed that while observing the space, my peer
was attentive but equally relaxed compared to the moment she walked to Trout Lake.
According to Aunty Zee’s observations:
In sights she wrote about the dogs and ducks swimming in the lake, a couple taking
photos with their dog, the surrounding trees, the ducks flapping their wings in the water,
people sharing drinks.
In hearing she talked about the groovy-jazzy tunes, people chatting, dogs running around,
and rustling leaves.
She could smell a faint fishy smell of the lake, and dirt from when she touched the
collected items.
In touch she mentioned the feel of the pebble’s roundness, it’s smooth surface, instantly
bringing up memories from her past and the grains of sand on the bench we were sitting
on. She couldn’t identify any particular taste from the surrounding space. Although she
did contemplate about tasting the pebble but decided against it.

(Image set P: My peer noting the senses that she could identify while the third phase of the
activity while speaking them out loud)

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The second round of the activity: Walk around the Block
Phase One around the block:

(Image 24: The script to phase one of the activity with Aunty Zee’s persona to remember the
proxy within a different setting. This activity was arranged around the block of my peer’s house to
notice reactions about activity after living in the neighbourhood.)

(Image 25: Notes and feedback from the second phase of the activity ‘Around the block’ with one
of my peers around the premises of her house.)

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(Image 26a: [left] Introductory session; Image 26b: [right] My peer observing the surroundings
during the first activity)

(Image 27: The script to phase two of the activity with Aunty Zee’s persona to remember the
proxy around the block. Taking a walk in the block while collecting items that are interesting/
associative to the seniors was the main purpose of the activity.

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In the second phase of the activity, I introduced myself as the care staff member’s
persona to Aunty Zee (my peer) and asked her if she’d like to go for a walk around the
block. We started our walk from the bench where she had been sitting and extended it in
any direction she wanted to explore. “Good weather today!” Aunty Zee mentioned but
she pointed out that she loves the cold weather even when she and her relatives have
a condition where their hands and feet get swollen due to lower temperatures. To me
personally, now in 60 years, I like to see the house. (what is interesting to you in houses?)
I like how defined they always are. They look like they are doll-houses. I have them in
a high standard that I imagine myself living the life of a doll in a doll house, that sort of
life, pampered and pretty. When asked about her feelings on her current living space,
“It keeps growing on me.” She said. At this point in the conversation, she continued the
conversation as my peer and not Aunty Zee. The conversation led towards their personal
idea of houses and the current house and the neighbourhood.
We talked about the weather but I was unsure if I was talking to Aunty Zee or my peer.
However, when we started talking about the beauty of fall, I asked what she in particular
likes or remembers about fall having lived such a long life. “Halloween!” she exclaimed.
Continuing our conversation, I asked if she enjoys coming out of your room and the
care home to walk. She replied that she doesn’t do it regularly. Sometimes she wants
to come out, sit around or walk but sometimes she wants to be inside and lay down, in
the warmth of her room. It’s a spur of the moment because if she does it every day at a
particular time, then it becomes a chore which she would not be happy engaging in. Then
I attempted to subtly hint or prompt her to pick something up from the area that we
were walking in. However, she seemed reluctant to the idea of picking something up as
she couldn’t connect with anything except for flowers; there were none on the pavement
and she wasn’t comfortable like plucking them from someone’s garden or otherwise.
When I asked her what was so intriguing about flowers to her. She said, “They’re
aesthetics, beautiful. They remind me that I have been outside and that I would want to
go again. I would love to bring a part of it with me and keep it in the room for as long as I
can. It then becomes a reminder when the petals wilt that I should go out.”
Then suddenly, she stopped and spotted a rosemary shrub. She instantly plucked a small
piece and smelt it. She organically put it in her pocket. Later she revealed that she would
always have a piece of rosemary herb in her pocket. Sometimes she would even forget
and be surprised to find it there. She stated there was something about the smell that
reminds me of her mother who kept a small shrub of rosemary in the house for the smell
and the taste of her aunt’s cooking recipes topped with rosemary that she (Aunty Zee)
would bring from her house.
Then, while continuing our walk, she remarked that this neighbourhood is very homely
and calm with small convenience stores close by. To which I asked if it is hard to
acknowledge that living in a care home she might not be able to go out anymore to get
milk for example. “It’s just a habit of the past. Sometimes it is frustrating. People, my kids
patronize me, tell me that you cannot go out, you need assistance. But my body and mind
works and I trust myself in getting milk. You become a kid to them. It’s just surprising how
at one point in your life you are successful, with a lot of responsibilities, achieving your
goals and you feel you’ve made it but then a day comes when it’s taken away from you.

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(Image 28: my peer as Aunty Zee during the ‘walk around the block activity, plucking rosemary.)

(Image 29: The script to phase three of the activity with Aunty Zee’s persona to remember the
proxy wherein my peer noted the observations associated with the five classic senses.)

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(Image 30: my peer as Aunty Zee smelling the rosemary that she picked during the previous
activity)

(Image 31: Notes and feedback from the third phase of the activity ‘Around the block’ with one of
my peer around the premises of her house)

Discussion about the Activities with the first participant:
After the completion of the activities, we sat down for a feedback-discussion about
her (Sheen’s) experience during all three phases of her activities. While addressing the
persona and script, she felt the persona needed a character sketch or a personality
description for her to better understand the role.
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We discussed adding physical and emotional traits or stories to add a more specific
understanding of Aunty Zee. However, she also mentioned that the pointers in the
persona were quite helpful and an open-ended area of creating her own story of Aunty
Zee was interesting to work around. It helped her immerse herself into the role of a
senior living in a care home without any prior awareness of life in care homes. I could
notice that she was imagining and exploring the persona’s life-story, past memories,
family specifics which were part of the conversations between us.
Connected with her experience about the personas, she thought about working on a
similar activity for seniors living in care homes who are given a proxy of younger people,
encouraging them to reminisce their youth through the same set of activities. She also
suggested that instead of saying, “I have a question for you”, I could try to channel the
questions into a conversational approach. Comparing the activity to the first version
which she had experienced, she was less confused and dedicated to performing the proxy
given to her without any reminders that she is role-playing and she also thought the new
script helped her understand the purpose of the workshop and also encouraged her to
answer freely without doubts.
Outdoor Walking Activity: Walk around the block
After the first activity with one of my peer, I met the head of recreational therapy
at Three Links mirror and while discussing challenges related to going outdoor, The
recreational therapist said, “the fall to winter season is tough since the seniors living at
the care homes cannot afford to be outside for a long time due to their deteriorating
health.” That got me thinking about an opportunity to conduct this activity around the
block, just outside the premises. Hence, my supervisor suggested that I try the activity
within a different space.

During the activity a few significant moments were as follows:
The peer needed was thinking about surroundings not based on the incidences but
correlating it to a feeling associated with an incident.
The senior did not feel like collecting anything while walking around the block but
instantly plucked some rosemary when she spotted the herb.
According to the proxy senior (my peer), she has a lot of memories with Rosemary and
the women in her family.
The proxy senior also talked about how she would have collected flowers but doesn’t
want to pluck them. She mentioned that flowers are a reminder when the wilting petals
reveal the time to head back outside for her tying back to the idea of Ikebana.

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Discussions about the Activity with my second participant:
According to my peer, the persona was thorough and she liked that as a facilitator, I gave
them space to draw from their own memory of their grandparents, aunts.
“I read that it was an Indian senior’s persona, I have no idea how that person could be.
But I thought about my grandma and I understood where I could situate this.
She also suggested, like the other peer in the previous activity, that a more conversationbased approach could help bring multiple segments of stories in this activity. Propose
the idea as ‘I would like to spend an afternoon with you,’ which would become a
conversational and engaging story-telling; it’s more than just a design approach but
narrative.
Natural spaces, outdoor spaces were the key takeaways from this activity. However, due
to the senior’s physical limitations and to consider striving for lower reliance on the staff
and equipment, another way of trying to create this exercise could be to bring the natural
elements to seniors. The activities I conducted under ‘Making objects that stand in for
open space (Section 3)’, project would be my way to approach the ‘Outdoor Walking
Activity’ in an indoor setting.

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Appendix 6
Section 9: Policy design activities for senior wellness in long term
care homes.
My research activities and my designerly reflections repeatedly demonstrated that
connections to nature are critically important to human flourishing. My own failures in
material exploration due to time, money, ease of access, and convenience let me wonder
if perhaps the issues facing designers working on elder care were similarly constrained
by utilitarian neo-liberal principles. Perhaps the way to bring nature-connections to
eldercare would be most successful not through product design, nor service design, but
through systemic changes brought about by policy design?
A question I constantly asked myself after studying the policies in Vancouver, India
and the Netherlands was - Are the challenges in making and reintroducing policies
governmental or is it the issue of social isolation amongst seniors at an organizational
level?
In Spring 2020, my shift to consider care home management let me seek out how they
perceive the community and tackle isolation and led me to research policy-making
practices of care home organizations. I wanted to know more about ways to innovate
policies. I was interested in brainstorming tactics that might be used by senior advocates
and management alike. My aim had shifted to include finding ways to help develop
community models in care homes. I was interested in finding ways to connect care home
residents irrespective of their language and background: cross-cultural models because
of the demographics of Vancouver’s seniors. This led me to consider Person-directed care
(Virgil Thomas, 2014). In my view, person-directed care typically encourages seniors and
their caregivers to practice their power to choose and exercise their independence.
Policy design techniques are similar to other design methods. Even though design
methods encourage us to look for opportunities to bridge the gaps, and policy-making
methods help us prevent the unfavorable outcomes, policy design together can help
create a platform where the bridge itself helps create a preventive circumstance through
a collaborative approach.
“Approaches, methods and techniques used include interviewing or doing field studies
of users, creating personas, visually mapping customer journeys, making and reviewing
mock-ups of future services, devices or artefacts, organizing cycles of feedback and
iteration, and stakeholder engagement. (Lucy Kimbell, Jocelyn Bailey, 2017) Before
engaging in some of these design activities, I began to research what policies existed on
elder care. In India, there is one national policy that has existed since 1999, titled The
National Policy on Older Persons, envisioning affordable long-term accommodations, a
new ‘architecture’ for ageing, to encourage healthy ageing. Therefore in my opinion, in
1999, the government policy recognized the necessity of seniors turning towards longterm care homes. However, in, ‘The foundation of National Policy for Senior Citizens
2011’, the policy encourages healthy ageing and other provisions to ensure ageing at your
own home. According to the policy, ‘care of senior citizens institutional care as the last
resort. It recognises that care of senior citizens has to remain vested in the family which
would partner the community, government and the private sector.’ (Vikaspedia.in)
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How can policies help bridge the dialogue about the community through all ethnicities
for a stronger connection?
It is evident that a suitable policy needs to be framed towards restoring familial care
of the elderly in view of the drastic social changes that have taken place in the wake
of modernisation. It goes without saying that prompt action for the provision of social
security to the vulnerable poor elderly is called for before things worsen.
(Nil, Irudaya Rajan, 2006)
Even though the ‘familial care’ policies have been changed to ensure families/kins take
care of their seniors, the government seems to overlook the trending concept of nuclear
familiar and changing familiar structure. The government also left the voice of seniors
in India out of account through the law of familial care, allocating their independence
elsewhere if they are dependent due to monetary limitations.
Besides, “the laws and policies derived for residential care in long-term care homes in
India, are most of the times lacking in regulations.”(Celine Thomas, K Samuel, 2017) The
reason behind it might be due to the limitations on basic resources like medical supplies,
infrastructural support, qualified workers, that are the priority of these organizations.
“A lack of government regulation of these homes creates a precarious situation, wherein
the basic rights of older people are often violated and are not provided with the utmost
opportunities to enhance social connectedness.” (Celine Thomas, K Samuel, 2017)
From what I gather, not only the organizational and governmental policy-makers but even
the stakeholders, all have a role to play in making and designing a policy that best suits
the needs of the seniors.
Policy-Making Exercise:
Considering the situation of social isolation amongst the seniors living in long term
care homes and knowing that service delivery is also connected to needed changes in
government-regulated health care policies I decided to undertake a policy prototype
activity. Through this policy-making prototyping and discussion, my intent was to explore
experimenting with policy-making and understanding the process in hypothetical
situations. For the prototyping, the BC government’s transparency in providing
information about the process of policy-making and the stakeholders as well as the
protocols to the development. This exercise was a method of exploring policy-making and
its implications as a service design researcher.
Insights: Policy-Making Experience (Creating a service experience through policy)
The prototyping policies activity was more of a reflection of how I perceive policy-making
to be and after experiencing the policy-making in a collaborative setting, it showed me
how extensive and iterative only the initial stages of setting an agenda and formulating
the policy were.
The policy-making discussion during the cold read amount of information about policymaking from the BC government in terms of residential care, long term care services and
also the home and community manuals. Looking at the Model standards of care, while
going through the sections from the start of the service of the care home system to the
end of the senior’s journey with the care-home leading to building of a service blueprint.
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(Image set Q: Outcome of the policy-making collaborative exercise)

(Image 32: service blueprint based on the model standard of care policy book of Govt of BC with
participants)

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(Image 33: Brainstorming activity: Touch points marked on the service blueprint based on the
model standard of care policy book of Govt of BC)

This prompted me to build on the end-to-end process of the care home service and build
a service blueprint of a care home. Insights included that Seniors and actors at the base
levels of the organizations are often unaware of what the licensing department is about
and how collaborating with them can bring changes to the system.
Although it is not necessary for the seniors and their families or the other actors in the
organizations to know what the licensing department accomplishes, I feel it is important
for the actors to be aware how their responsibilities are administered and corresponded
within the system. While discussing this factor, the collaborator presented an example:
“If we consider an event in an organization and the care staff members are helping the
seniors create a festive interior for the said event, then the actors in the scenario need
to know what can be included in accordance to the safety regulations provided by the
government.”
The other critical topic for discussion was the comparative narrative between the
policies in the Netherlands and the ones in North America, specifically catering to British
Columbia. The long term care homes in Vancouver hold different levels of care such as
assisted living, independent living and residential services. While De Hogeweyk only
caters seniors living with severe stages of dementia. The stakes in both cases are quite
different is something that was highlighted in the conversations. The discussion also
tapped the points that recreational therapists’ jobs are to keep the seniors engaged
in activities that they are interested in. However, the job does not specify the role of
recreational therapists in terms of encouraging conversations. So how can we cater that
service through readdressing the care policies?
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How can policies about community partnership make a difference in the culture of care?
According to the director of Social Design Institute, Lucy Kimbell and a designer and
researcher, Jocelyn Bailey’s paper, ‘Prototyping and the new spirit of policy-making’, they
talk about the ways government actors try to accomplish policy intent can include passing
laws, publishing regulations, commissioning or running public services, and stimulating
business or civil society to provide solutions (e.g. by providing funding or publishing
data)—or doing nothing. On the other hand, they state that services might result from—
or failures in their design or delivery might lead to—public policy.
To my understanding, policies play an important role to secure a certain outline for the
organizations to operate. They do not directly incite the organizations to perform in a
particular manner but they ensure that the organizations work within acceptable limits
preventing unfavourable outcomes.

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Section 10: Traingle of Care
In Spring 2020 I began to consider the insights I had gathered in these two years of
activities and through my observation visits to De Hogeweyk in Weesp, and subsequent
visits to long term care homes in Vancouver as The ‘triangle of care’.
This ‘triangle of care’ made up of Acceptance, Community and Open Spaces was a means
for me to understand and consider the differences between an acclaimed ‘successful’
care model like De Hogeweyk and Care Homes in Vancouver while also keeping in mind
the cultural and dementia-related differences between these two care home models.

(Image 34: The three vertices of the ‘Triangle of Care’ model)

The three vertices of the triangle are interlinked. I considered the triangular structure
to ensure I attend to the three mentioned aspects from a starting point. The triangle is
a representation of the three different cities that I are the basis of my research. Though
separate in geography and culturally different, there were quite some commonalities
in these three cities relating to the care home organizations. Hence the three vertices,
Acceptance, Community and Open Space, though separate meet at one point to share
all the common factors. While I was working on the ‘triangle of care’ I did not consider
the categories acceptance, community and open spaces would fall into. My focus was
to analyse the observations and while doing so, I discovered the three primary factors acceptance in care homes and amongst seniors, the communal feeling and the necessity
of open spaces to create the feeling of community and acceptance.
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Acceptance: Towards people, towards the surrounding:
De Hogeweyk concept branding ‘BE’ promotes the idea of accepting the people/seniors
living with dementia as they are to help them be comfortable even when they are losing a
part of themselves.
Community:
The idea of belonging to something, something bigger than ourselves. I was looking at
nature as a place to belong, however, what I realized is that the people around us help us
become familiar to a surrounding; in this case, the care homes.
Open Space:
When you are accepted, you are familiar with the people, where can you be free?
Spaces that are free like your mind and your soul, the open spaces, close to nature where
you can be the most unapologetic version of yourself. While acceptance inclines towards
accepting change, open spaces impel the idea of being in a surrounding that encourages
us to be the most authentic versions of ourselves.

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(Image set R: The vertices: Acceptance, Community & Open Space respectively; The second and
third images represents the comparison between De Hogeweyk, in blue and Vancouver’s care
homes, in red, according to the three target areas, namely the vertices)

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(Image 35: Tree of Care concept; A visual representation of the tree of care concept showing
seasons as sections to the three main target categories: Spring for community, Summer for open
spaces and fall for acceptance.)

Tree of Care:
Trees have a special connection with me, from helping me associate myself in new
surroundings to bring back nostalgic memories. Memories of time spent in open spaces
with my families, trees have been a part of my life experience. Why?
I believe the tree gives you a sense of shelter, protection. Whenever people take
refuge underneath a tree, the rain or the harsh sunlight negatively affects them. Trees
create a platform for other organisms to create an entire ecosystem around them.
Even the interconnectedness of the roots that showcase this beautiful idea that we are
interconnected in many ways intrigues me. When I started creating a visual image of the
‘triangle of care,’ I understood how interrelated and co-dependant the three vertices
(Acceptance, Open Spaces and Community) are. I started visualizing the trees, the
branches and roots acting like veins, connecting every segment together, simply like the
observations linking in specific actions.
Thus, I worked on creating the ‘Tree of Care.’ I wanted to also embed the dynamicity of
seasonal change in the visual representation as a way of showing how one needs to be
open to change (in this case, the organizational change) just like the tree is acknowledges
and gracefully accepts the periodical variations in it’s appearance.

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EMILY CARR UNIVERSITY OF ART+DESIGN

© Srushti Kulkarni, 2020

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