Listening as Agency
A Participatory Approach to Designing Institutional Soundscapes

By Logan Wilkinson | BScH 2021, MDes 2025

A critical process documentation paper
submitted in partial fulfillment of the requirements
for the degree of Master of Design

© Logan Wilkinson, 2025

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Abstract
Approaches to designing for sound in long-term care have
often prioritized external and infrastructural aspects of the
auditory environment, while overlooking how residents actually
experience and interpret their auditory environments. This study
shifts the focus to the residents' experience, integrating
participatory design with sound studies to explore the relational
and subjective dimensions of listening. Drawing on the concept of
sonic agency, it examines how residents of a Vancouver long-term
care home perceive and shape their auditory environments. It also
seeks to draw insights into changes residents would like to see
within their daily soundscape, setting the foundation for future
participatory prototyping.
The research involved two workshops. In the first workshop,
residents took part in facilitated “sound explorations,”
recording sounds that held personal significance. Following the
sound exploration, residents shared insights in interviews
regarding their reasoning for recording the selected sounds.
These insights informed the development of a framework called the
Sonic Ecology of Care, which conceptualizes the interconnected
layers of institutional soundscapes, shaped by internal beliefs,

3
social interactions, physical infrastructure, and policy-level
factors. In the second workshop, residents reviewed the
recordings and mapped the changes they would like to make in the
home onto the Sonic Ecology of Care model. They also engaged in
discussions about ways to improve their sonic agency.
By applying listening-centered sound studies practices,
Listening as Agency presents a new approach to participatory
design. Setting the foundation of future participatory
prototyping, the affective nature of the audio recordings
communicates resident experiences beyond typical ocular-centric
modes of design research. The mapping of desired changes to the
Sonic Ecology of Care highlights the role of intermediary objects
and actors within institutional contexts, as well as the role of
designers as intermediary actors. The study’s findings and
methodological insights open valuable paths forward for the
design and services of not only long-term care homes, but for
institutional spaces in general, where sonic agency faces
hierarchical divides.

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Acknowledgements
This thesis is a product not only of academic inquiry but of
sustained relationships, institutional negotiations, and a belief
in the value of listening as a method for both design and care.
It reflects a commitment to process over outcome, and to the
creative possibilities that emerge when we attune ourselves more
deeply to sound, to others, and to the systems we seek to change.
This research was conducted on the unceded, ancestral territories
of the Musqueam, Squamish, and Tsleil-Waututh Nations. I am
deeply grateful to live, learn, and conduct this work on these
lands. I acknowledge the long histories of care, stewardship, and
resistance that precede and continue alongside this project. This
thesis explores practices of listening, and I hold with humility
that such practices must include listening to Indigenous voices,
histories, and knowledge systems—especially in the context of
institutional care, which settler-colonial structures have
shaped.
I extend my sincere gratitude to the residents and staff of
the long-term care home where this study was based, especially to
the participants in the Listening as Agency workshops. Thank you

5
for sharing your time, perspectives, and stories with me. Your
experiences and voices are the heart of this project.
Thank you, Fiona Lastoria, for your warmth and unwavering
commitment to person-centred care. Without Fiona, this project
would not have been possible. Thank you to Samson Chu and
Alexandra Grace for taking on this project and generously sharing
your time and expertise. Your presence in the research team made
a world of difference in facilitating meaningful and safe
experiences for residents involved in the project.
I would also like to thank the faculty and staff at Emily
Carr University for their patience, support, and encouragement
during the development of this thesis. I am deeply grateful to my
wonderful thesis supervisor and mentor, Peter Bussigel, who was
willing to go above and beyond in countless ways to bring this
project to life. I would also like to thank Caylee Raber for not
only providing guidance and expertise as an internal reviewer but
also for welcoming me into the Health Design Lab, where I gained
key inspiration and built transformative community connections.
Thanks to Lois Klassen for helping me navigate the complex Ethics
Board approval process. Thank you to Bobbi Kozinuk for the
skillful and adventurous spirit provided in our valiant attempt

6
to put a radio antenna on the roof of the school, even if my
final thesis ended up being free of free radio. I am also
grateful for the financial support of the Future Creative
Catalysts Graduate Research Fellowship, which helped bring this
work to its full potential.
To my MDes cohort and to my friends Nat, Irfan, Julie, Liv,
Arlette, Inna, Vincent, Sam, Myshia, and Katie—thank you for
grounding and inspiring me.
Finally, I would like to thank my family for their endless
support and love, and for teaching me the meaning of care.

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Table of Contents
Title Page ……………………………………………………………………………………………………………………………………… 1
Abstract …………………………………………………………………………………………………………………………………………… 2
Acknowledgements ……………………………………………………………………………………………………………………… 4
Table of Contents …………………………………………………………………………………………………………………… 7
List of Figures ………………………………………………………………………………………………………………………… 9
0. Prologue ………………………………………………………………………………………………………………………………… 10
1.0 Introduction …………………………………………………………………………………………………………………… 14
2.0 Theory and Context …………………………………………………………………………………………………… 15
2.1 Theory ……………………………………………………………………………………………………………………… 16
2.1.1 Integration of Subjectivity …………………………………………… 16
2.1.2 Sonic Agency and Democratic Design ………………………… 19
2.1.3 Intermediary Objects and Actors in Design ……… 22
2.2 Context …………………………………………………………………………………………………………………… 24
3.0 Methodology and Case Study ……………………………………………………………………………… 26
3.1 Stage One: Recording Current Soundscapes …………………………… 34
3.1.1 Workshop One …………………………………………………………………………………… 34
3.1.2 Workshop One Results and Analysis …………………………… 39
3.2 Stage Two: Imagining Soundscape Shifts ………………………………… 47
3.2.1 Workshop Two …………………………………………………………………………………… 49
3.2.2 Workshop Two Results and Analysis …………………………… 53

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3.3. Applying Design: Intermediary Objects and Actors …… 62
3.3.1 Intermediary Objects ……………………………………………………………… 63
3.3.2 Intermediary Actors ………………………………………………………………… 63
4.0 Discussion ………………………………………………………………………………………………………………………… 65
4.1 Sonic Ecology of Care ……………………………………………………………………………… 65
4.2 Participatory Design and Sonic Agency …………………………………… 69
4.3 Methodological Reflections ………………………………………………………………… 72
5.0 Conclusion ………………………………………………………………………………………………………………………… 76
References …………………………………………………………………………………………………………………………………… 79
Appendices …………………………………………………………………………………………………………………………………… 87

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List of Figures
Figure 1: Listening as Agency overview of activities.
Figure 2: Workshop invitations for participants.
Figure 3: Participant’s Listening Journal, completed between the
consent session and the first workshop.
Figure 4: Workshop One overview of activities.
Figure 5: Summary of Sound Exploration recordings from analysis
of Workshop One.
Figure 6: Sonic Ecology of Care: A Model for Mapping Soundscapes
of Institutional Care.
Figure 7: Workshop Two overview of activities.
Figure 8: Objects for sound making provided during warm-up.
activity at the start of Workshop Two.
Figure 9: Digitized version of sticky notes mapped to the
Workshop Two mapping exercise.
Figure 10: Sonic Ecology of Care with the incorporation of
intermediary objects and actors.

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0. Prologue
Listening as Agency grows out of nearly a decade of
interdisciplinary practice at the intersection of psychology,
philosophy, and design. From the outset, I have been fascinated
by questions of subjectivity: how people perceive and interpret
their realities, rather than the phenomena themselves. My
undergraduate thesis investigated how women with low sexual
desire attributed the cause of their low desire, using a
combination of quantitative and qualitative approaches. During
this time, I also worked as a support worker, also known as an
“Intervenor”, for deafblind clients, many of whom were nonverbal.
This work challenged me to communicate and care beyond spoken
language, nurturing a deep sensitivity to the nonverbal and
multisensory dimensions of human experience. This thesis is the
culmination of an almost decade-long interdisciplinary practice.
After graduating, I worked as a Clinical Research Project
Assistant at a children’s hospital. Observing the psychiatric
research wing’s unwelcoming atmosphere revealed how poorly
designed spaces can add stress for already vulnerable patients.
Coupled with frustrations surrounding the technologies used to
conduct research and connect patients with services, I began to

11
investigate how healthcare spaces and systems might be better
designed.
In 2023, I began studying interaction design at Emily Carr
University, exploring healthcare innovations through a creative
lens. The method for Listening as Agency developed organically
over the first year of my master’s program, shaped by a series of
workshops and personal practices that deepened my engagement with
listening as both an artistic and design-oriented inquiry. I
facilitated Deep Listening workshops inspired by the work of
Pauline Oliveros, guiding peers through meditations, soundwalks,
and improvisational composition practices. I began maintaining a
listening log, documenting my daily sonic environment to
cultivate sustained attention to sound in both my creative and
service design practices. Simultaneously, I was involved in codesign initiatives within the university, including the codirection and revitalization of the student radio station, Radio
Emily. The combination of these experiences deepened my
conviction that listening practices and participatory design
methodologies are deeply interrelated.
I also had the opportunity to serve as a teaching assistant
in an undergraduate health design course. As part of the

12
Perspectives program, the course supported students in codesigning tools for connection alongside residents of a local
long-term care home. My teaching led to a key connection with
Fiona Lastoria, the Senior Recreation Therapist at the care home.
I proposed a project focused on the participatory design of sound
within the care home, and Fiona generously offered her support. I
spent the summer of 2024 developing the project methodology and
deepening my understanding of service design and participatory
methodologies through my work with the Health Design Lab.
The ethics review process, however, introduced significant
delays. The project was one of the first formal research
collaborations between an Emily Carr Graduate Student and the
Vancouver General Hospital. As such, the Research Ethics Board
required an extended institutional agreement, which they expected
to take up to a year to finalize. In Fall 2024, faced with this
unforeseen delay, I shifted my thesis focus temporarily on other
participatory sound projects, such as the revival of Radio Emily.
While these initiatives carried their own value, my commitment to
the long-term care home project remained central.
By Spring 2025, the administrative agreements and ethics
approvals were finally secured. Although I had spent the

13
intervening months developing other participatory sound projects,
I remained convinced that Listening as Agency belonged in the
context of long-term care, where questions of sound and agency
are most urgent. By this time, Fiona had transitioned to a new
care home in Vancouver. She invited two colleagues, Certified
Therapeutic Recreation Specialists Samson Chu and Alexandra
Grace, to join the study team. Nearly a year after its initial
conception, the project officially began in May 2025. The delay,
while difficult, reinforced the very premise of this work: that
listening requires patience, persistence, and openness to
shifting conditions. What follows is an account of how these
principles guided the development of Listening as Agency within a
long-term care setting.

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1. Introduction
This thesis explores how designers can reimagine
institutional spaces and services by considering the role of
sound. By combining participatory design and sound studies
methodologies, I focus on the sonic dimensions of care
environments, asking how residents can have greater agency in
shaping the acoustic conditions of their daily lives. The work is
grounded in the overlap between participatory design and sound
studies along two interconnected axes: a commitment to subjective
individual experience, and a focus on increasing the agency of
those traditionally disempowered within institutional
hierarchies. A theoretical overview of sound and agency in longterm care provides the context for the case study.
The methodology and practice section outlines the main case
study, which consisted of two workshops held in a publicly funded
Vancouver long-term care home. In the first workshop, residents
participated in a facilitated sound exploration activity,
recording and reflecting on the sounds they considered
significant in daily life. I conducted individual interviews with
residents to discuss the recordings and gain insight into how
participants experienced and interpreted their sonic

15
environments. The second workshop built on these insights by
introducing The Sonic Ecology of Care, a framework for
reimagining soundscapes. Residents used it to imagine changes to
their environment and to reflect on their sense of agency over
sound.
In the analysis section, I identify patterns and reflections
that emerged from the workshops and interviews with residents. I
examine the ways participants described and responded to their
sonic environment, the strategies they used to manage their
soundscapes, and the types of changes they envisioned. These
insights suggest how participatory sound design might contribute
to a broader rethinking of care environments not only in terms of
sound, but in terms of who gets to shape the conditions of
everyday life within them. The conclusion considers the
contributions of this research to design knowledge and
participatory practice, and points toward future possibilities
for listening-based design in institutional settings.
2. Theory and Context
Through this project, I have uncovered theoretical
connections between sound studies and participatory design,
specifically regarding 1) methodological integration of

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subjective, individual human experience, 2) modes of increasing
agency of individuals whose voices have traditionally gone
unheard in institutional hierarchies, and 3) reframing
institutional design within the context of intermediary objects
and actors. This theoretical blending underscores my primary
research question: Can applying sound studies methodologies to
participatory design practices help improve sonic experience and
agency in institutional spaces?
The main case study used to investigate this research
question is a series of participatory sound-based workshops in a
long-term care home. For context, I provide a brief overview of
long-term care in Canada and its relevance to current
developments in participatory design and sound studies.
2.1 Theory
2.1.1 Integration of Subjectivity
Participatory design (PD) emerged in the 1970s as a
democratic approach to designing products and services,
emphasizing collaboration between designers and end users. Early
PD practices in Scandinavia aimed to empower workers by involving
them in the design of workplace technologies (Bødker et al.,
2022). Recent developments in participatory design have

17
demonstrated the effectiveness of this approach in driving social
change. Ezio Manzini’s 2015 book, Design, When Everybody Designs,
describes collaborative processes for change-making among
individuals and organizations, where designers facilitate the
diffuse design efforts of non-experts. This shift redefines the
role of the designer, emphasizing collaboration and collective
empowerment.
One of the key overlaps between sound studies and PD is
their shared emphasis on individual subjective experience. In
sound studies, an auditory environment refers to the physical
presence of sound waves in a space, whereas a soundscape is the
contextual and individual experience of that auditory environment
(Schafer, 1977/2006). While an auditory environment lends itself
to more quantitative modes of measurement, soundscapes are
qualitative. Culture, beliefs, social circumstances, and the
listener’s general relationship to their environment shape
soundscapes (Thompson, 2002). Critiques of Schafer’s soundscape
have also led to the idea of “acoustemology” (Feld, 1996), which
describes the dynamic and relational process of knowledge
production through listening, rather than the creation of a
static and external experience as the term “soundscape” suggests.

18
PD expresses this notion of subjective human experience through
democratic approaches, where empowerment and mutual learning are
employed to foster a cohesive understanding and collaboration
among individuals towards shared goals and future alternatives
(Bødker et al., 2022). Input from varying viewpoints is a key
feature of participatory methodologies.
Given their inherent acknowledgement of individual
differences and subjective experiences, both sound studies and PD
emphasize listening practices – that is, modes of understanding
the subjective experiences of oneself and others, whether sonic
or otherwise. As such, field studies are a core method within
both schools of thought. Sound studies draws its insights from
practices such as reflexive interpretation (e.g., Schafer,
1977/2006), sonic ethnography, field recording, and acoustic
analysis. Soundwalking, a method developed during the Vancouverbased World Soundscape Project (Schafer, 1977/2006), is a mode of
exploring one's soundscape as one moves through a physical
environment. Recordings taken during soundwalks have been
utilized by researchers and artists, such as Hildegard Westerkamp
(Westerkamp, 1974), to create soundscape compositions—sonic
artifacts that convey experiential knowledge or affect.

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In PD, qualitative investigations into the current state of
the design space are an important part of the process. These
methods include ethnographic observations, interviews, and
scenario representations of the current practice (Bødker et al.,
2022). However, the goal of field studies in PD is to support
collective reflection and mutual understanding, facilitating the
following stages of workshops, prototyping, infrastructuring, and
evaluating (Bødker et al., 2022). As such, PD typically seeks to
apply insights gained from early stages through design, creating
democratically orchestrated change.
2.1.2 Sonic Agency and Democratic Design
Developed by composer Pauline Oliveros, the practice of Deep
Listening emphasizes the distinction between hearing (the
physical conversion of sound waves to auditory experiences) and
listening (the psychological experience of paying attention to
sounds). Oliveros created several compositions and workshop
frameworks based on the concept that the deliberate shifting of
attention can alter one’s experience of their sonic environment.
Deep Listening points to what might be the fundamental element of
sonic agency. Sonic agency is a term used to describe sound’s
capacity to shape social dynamics and challenge power structures

20
by political philosopher Brandon LaBelle (2018). By “staying
close to sound and listening”, LaBelle suggests, we may discover
transformative affective processes and new forms of communication
that go beyond what is strictly visible. It is the interconnected
network of individual listeners, acting autonomously upon their
environment, that creates sonic agency. As such, sonic agency is
inherently relational. Through shared sonic experiences,
communities can reveal previously invisible modes of beingtogether and imagine alternative structures of being, especially
in situations of loss and powerlessness.
Before “sonic agency”, initial writings on “acoustical
agency” were developed by Suzanne Cusick (2013). Her
documentation of military use of extremely loud music and sound
deprivation as a mode of torture highlights some of the more
extreme examples of limiting individual control over exposure to
sounds. Social scientists have since emphasized the role of
acoustical agency in other forms of “total institutions”
(Goffman, 1961), such as hospitals (Rice, 2013), prisons (Rice,
2016), and elder care homes (Greubel, 2020). In Tom Rice’s 2013
ethnography of the Edinburgh Royal Infirmary, he noted that staff
maintained patients’ visual privacy through the use of curtains

21
and doors. However, the lack of control over physical proximity
to other patients meant they consistently overheard cries of
pain, bodily functions, and medical operations. Although this
lack of privacy served an informational function, allowing staff
to hear calls for help, it also compromised the privacy of
patients and their control over their auditory environment. Some
patients would use radios and headphones to mitigate unwanted
sounds; however, this was not an accessible option for all
patients. In contrast, Rice’s 2016 investigation into lowsecurity prisons reveals how agency over sound is resilient to
institutional limitations. Modes in which control over the
production of noise, such as using radios, and control over
listening, such as through eavesdropping, serve as tools of sonic
agency, which in turn serve as tools for self-care, identity
construction, and expression of power.
With its historical roots in giving a “voice” to white and
blue-collar workers by actively involving them in the design of
technologies imposed upon them by management (Ehn & Sandberg,
1979; Bødker et al., 2022), PD practices overlap with the
philosophy of sonic agency in using relational methods to
transform existing structures. PD practices emphasize the

22
redistribution of power through collaborative processes that
recognize users not as passive recipients but as co-creators of
their environments. Just as sonic agency involves an attunement
to how sound can be used to navigate, resist, or reimagine
institutional constraints, participatory design foregrounds the
lived experience of participants as a site of expertise. In this
way, PD offers a methodology for operationalizing sonic agency.
By inviting individuals to critique and alter the conditions of
their sonic environments, it enables new forms of autonomy and
relationality. In line with institutional case studies of
acoustical agency, PD has recently incorporated notions of
“Institutioning” (Huybrechts et al., 2017) to describe not only
how designers can shape institutions through PD, but also how
institutional elements such as policy, bureaucracy, or funding
logics are active agents in shaping the outcome of participatory
processes.
2.1.3 Intermediary Objects and Actors in Design
Jean-François Boujut (2003) describes intermediary objects
as not only physical artifacts but also cognitive or symbolic
“objects” that mediate between human and non-human actors. The
meaning of an intermediary object is contingent on its use in

23
interaction: a sound used to express a need temporarily becomes
an intermediary object, but once the demonstration ends, it
returns to being an ordinary object.
In addition to transmitting knowledge, intermediary objects
facilitate the elicitation of knowledge and mutual learning. In
collaborative engineering contexts, Boujut shows how intermediary
objects enabled participants to collectively work on an artifact,
acknowledge the limits of their own expertise while requesting
input from others, and generate new interface knowledge through
collaborative interaction. In this process, designers often serve
as what Boujut terms intermediate actors—facilitators who
structure, translate, and mediate the flow of meaning through
these objects.
Building on Boujut, the Sound in the City workshops with
blind participants foreground the co-creation of meaning through
sound (Steele et al., 2019). Researchers paired recordings of
urban navigation with interviews in which participants relistened to their recordings. These “immersive interviews”
(Grond, 2025) revealed meanings not evident in the recordings
alone—for example, the social significance of hearing footsteps
passing by. Here, the recordings themselves served as

24
intermediary objects, but their power lay not solely in their
sonic content. Instead, their significance emerged in the moment
of shared listening and reflection, which transformed
participants into active co-researchers rather than passive
subjects. The design of these moments is itself a crucial design
act (Grond, 2025).
2.2 Context
Long-term care (LTC) homes in Canada provide twenty-fourhour support to those in need of continuous care. Also called
nursing homes, continuing care facilities, or residential care
homes, they are where eight percent of Canadians aged 65 or older
reside (Public Health Agency of Canada, 2020). Just under half of
the care homes in Canada are publicly funded (Canadian Institute
for Health Information, 2021). LTC serves as a home for a diverse
group of individuals with varying disability statuses. “To select
and extract which sounds in a given environment are ‘unwanted' is
a consequence of one’s situation in time and place” (Kittay,
2008, p. 46). In a space containing as much listener diversity as
long-term care, how can we “improve” the soundscape? Perhaps it
is not so much a question of “improvement” as it is a question of
agency and choice.

25
In the context of long-term care, resident agency refers to
the capacity of residents to make choices, influence their
environment, and participate meaningfully in decisions affecting
their daily lives (Agich, 1990). Long-term care homes exhibit
characteristics of a total institution, as defined by Erving
Goffman (1961), in which individuals live in a closed, regulated
environment where staff tightly schedule resident routines and
may make decisions on behalf of residents. The inherent
limitations of resident agency in inhabiting this institutional
space, paired with potentially limited physical or cognitive
capacity, have led researchers and practitioners to consider
approaches that increase agency in long-term care (Pirhonen &
Pietila, 2016; van Loon et al., 2024). Forms of relational
agency become especially important in long-term care, where
caretakers may make decisions or act on behalf of residents due
to limitations in function.
In the wake of such overwhelming complexity, this thesis
does not aim to provide concrete solutions. Instead, it seeks to
explore the potential in shifting attention towards a subtle yet
pervasive force — sound. Instead of approaching the challenges of
long-term care solely through clinical or bureaucratic reforms,

26
sound offers a way to attune to the lived realities that often go
unheard, both literally and metaphorically. The current study
utilizes sonic ethnography to intentionally listen and relate to
the experiences of residents in long-term care. Sound theorist
Brandon LaBelle writes- “In listening one is situated within an
extremely relational instant… to nurture and care, as well as to
argue and disrupt.” (LaBelle, 2018). As such, the current study
seeks to further embody this relational power through
participatory design methodologies, where residents can plant the
seeds of sonic agency in actionable and collaborative ways.
The intersection of institutional and subjective approaches
to both participatory and sound design provides a theoretical
basis for my work. The context of long-term care and its
potential to benefit from these approaches provides a setting for
advancing my research question: Can applying sound study
methodologies to participatory design practices help improve
sonic experience and agency in institutional spaces?
3. Methodology and Case Study
The current study takes place in a publicly funded long-term
care home in Vancouver, British Columbia. The study team present
at the workshops included myself, F.Lastoria (the Interim Senior

27
Manager of the care home with a background in Recreation
Therapy), S. Chu (Recreation Therapist), and A. Grace (Recreation
Therapist). I recruited study participants in collaboration with
the care home staff study team members. The study participants
included four residents of the care home who met the eligibility
criteria of having the capacity to provide informed consent to
the study activities, the ability to verbally or nonverbally
communicate thoughts and opinions, and an expressed interest in
their home environment. Participants who were deaf or hard of
hearing were not excluded from the study, as they can provide
valuable insight into how sound affects the experience of
differently hearing populations. I did not formally collect
information about the hearing abilities of participants; however,
participant anecdotes revealed a wide range of auditory
processing abilities.
The methods for the case study combine the practice of
soundwalking (renamed sound exploration for accessibility
purposes) with participatory design to understand and to shift
the soundscapes of institutional care. Although this methodology
is suitable for any institutional setting, this thesis focuses on
LTC homes and their residents. The case study contains two main

28
stages: 1) Recording current soundscapes, and 2) Imagining
soundscapes shifts. Between each stage, thematic analysis was
conducted on the output of the workshops and the transcribed
audio recordings of discussions held during the workshops,
informing the next stage.

29
Figure 1
Listening as Agency: Overview of activities.

30
The methodological approach arose from the literature
discussed in the Theory and Context section, in combination with
several small-scale workshops surrounding Deep Listening and PD I
conducted with peers over the first year of my Master's program.
Iterations on the workshops resulted in the final version of the
method used with participants in the Long-Term Care Home.
Guidelines for community-based researchers developed by
Simon Fraser University’s Community Engaged Research Initiative
(Grain et al., 2024) also informed the workshop models. In line
with these guidelines, each workshop began with introductions, an
overview of the session's schedule and scope, and a review of the
community guidelines. Due to the short timeframe of the sessions,
I created an initial draft of the guidelines in collaboration
with study team members and invited participants to suggest
changes as needed. The study team provided refreshments to create
a comfortable environment, and workshops were held in accessible
areas within the home, allowing participants to gather
comfortably and privately. Prior to each workshop, care home
staff study team members provided participants with a printed
invitation that included a reminder of the workshop’s date, time,
location, and the activity that would be taking place.

31
Figure 2
Workshop invitations for participants

At the beginning of each workshop, I led a brief listening
exercise to help participants focus their attention on sound.
These also incorporated a moment in which I shared something
about myself and my own personal soundscape, such as an audio
recording. I gave the prompt for the Listening Exploration to

32
participants after they submitted their consent form, along with
a Listening Journal Card, which they used to track the sounds
they noticed in the care home leading up to the sound exploration
(see Figure 3).

33
Figure 3
Participant’s Listening Journal, completed between the consent
session and the first workshop.

34
3.1 Stage One: Recording Current Soundscapes
3.1.1 Workshop One
Figure 4
Workshop One Overview

35
The first workshop involved a facilitated sound exploration
of the care home. The term “sound exploration” is derived from
Hildegard Westerkamp’s soundwalking, modified to be inclusive for
participants who move through spaces in modes other than walking
(e.g., wheelchairs). The route of the sound exploration was
emergently determined by participants based on their
interpretation of the core prompt of the activity, “What sounds
are significant to your day-to-day life in the care home?”. Prior
to the sound exploration, a study team member paired with a
participant, and each pair took a Zoom recorder. The study team
asked participants to record the sounds they deemed significant
during their sound exploration with the help of the study team
members. I instructed the study team members and participants to
minimize talking during the sound exploration and recording, and
instead focus on listening. Monitoring headphones were provided
for the participants to wear during the recording. However,
participants did not wear headphones while exploring the
environment to ensure their listening was true to their everyday
soundscape (Bull & Cobussen, 2021).
Following the sound exploration, I conducted individual
interviews with each participant to discuss the recordings and

36
their significance. To prepare for the facilitated sound
exploration, I developed training materials such as a guide for
facilitators (see Appendix B) based on guidelines given by
Hildegard Westerkamp in her seminal writings on soundwalking
(e.g., Kits Beach Soundwalk, 1989) and contemporary forms of
facilitated sonic ethnography (Stevenson & Holloway, 2016).
Scripted prompts and technical cues emphasize maintaining the
residents’ agency in determining the route of the sound
exploration and in the recording process, while mitigating any
potential barriers caused by technology or accessibility needs.
For example, the guide prompts facilitators to continuously
check with participants to see if they would like to operate the
Zoom recorder, and to give the resident the option to press the
record and stop buttons. I also led a practice session with the
care home staff study team members to familiarize them with the
equipment and the facilitation process, and I created a
simplified instructional diagram for the Zoom H6 Handy Recorder
(see Appendix C).

37
I had initially planned for a group reflection following
the sound exploration, following the model of participatory
design workshops. However, I decided to change the study design
to individual interviews to provide the time and space needed for
participants to reflect on their experience, given their diverse
modes of listening and communication. In each interview, I asked
participants to describe what they recorded during their sound
exploration, listening back to recordings as needed, and to
explain why they chose to record that particular sound. I
recorded the interviews and later transcribed them. The
interviews took place immediately following the sound exploration
to maximize recall.
Following the workshop activities, I conducted a thematic
analysis of the recordings and interviews. I conducted the
analysis to represent the sounds that were significant to
residents and why, as well as to inform the materials and
activities of the second workshop
3.1.2 Workshop One Results and Analysis
Figure 5
Summary of Sound Exploration recordings from Workshop One.

38

39
Following Braun and Clarke’s (2006, 2021) reflexive approach
to thematic analysis, I transcribed the recordings and
participants’ reflections and repeatedly reviewed the
transcriptions to familiarize myself with the data. I generated
the initial codes inductively, capturing specific references to
sounds and the contexts in which they occurred. These codes were
then iteratively examined, compared, and refined, allowing for
the development of broader candidate themes. Through this
process, two dominant patterns became apparent: references to the
physical aspects of the building, such as mechanical systems and
spatial acoustics, and the social sounds produced by staff and
fellow residents. However, listening to participants’ insights
revealed that their internal beliefs and understandings were also
a factor in their assessment of the soundscape. For example,
every resident either recorded or mentioned in interviews the
significance of the sounds made by other residents in their daily
soundscape. Specifically, sounds that were made by residents who
were likely experiencing a form of dementia, such as calls for
help or repeated “banging” of walls and tables that went through
the day and night. A key feature of many participants’
reflections on the sounds was their confusion about why the other

40
residents made distressing noises. For example, one participant
shared a quote regarding their feeling of worry when they hear
calls for help from other residents at night:
…at nighttime people yell and scream, and I go “oh God, not
again, here we go, jeez”. And I hate that... sometimes I’m
like, are they okay, is there something wrong? But, I can’t
do anything about it, right? So it just, stay in your room
and stay out of trouble. Cause I’m not a nurse, so it’s not
my job, right.
Another resident shared frustration around the sounds from
other residents, saying, “[The resident] screams at everything
and everyone... I just well, I don’t make noise, and I don’t know
why anyone else makes noise. They don’t have to.” As such,
internal beliefs about the reasons (or lack thereof) for the
sounds made by other residents also appeared to influence the
participants’ soundscapes.
Furthermore, although not as directly referenced by
participants as the other categories, policy and systematic
elements underlie the recordings and reflections made by
residents. For example, one participant felt concerned about
staff speaking in languages other than English:

41
[In] the dining room, all I hear is the nurses talking in
their own language. Laughing in their own language and
talking in their language. I feel, I don’t know, what if
they’re laughing at us? Talking about us?
This example most directly touches on themes of internal
experience (e.g., the resident’s preferred language of
communication being English) and relational factors of sound.
However, discussions with study staff revealed that the care home
has a policy prohibiting staff from speaking languages other than
English around residents, unless they are communicating with a
resident who understands the non-English language being spoken.
As such, the resident’s concern also intersected with the realm
of institutional policy.
Sonic Ecology of Care
Given the multi-modal nature of the residents’ recordings,
my thematic analysis resulted in the development of an ecological
framework for approaching the design of sound in institutional
spaces (See Figure 6):

42
Figure 6
Sonic Ecology of Care: A Model for Mapping Soundscapes of
Institutional Care

The model was developed not only to represent the recordings
and reflections of residents collected in the first workshop, but

43
also as a tool of analysis to use when mapping potential
touchpoints for change in the second workshop and beyond. Each
layer is interconnected and overlapping. In the following
sections, I define each layer of the model, using the example of
sounds made by residents with dementia.
Soundscape (Internal Sonic Agency). This innermost layer of
the Sonic Ecology of Care describes changes to individual
beliefs, perspectives, and other factors that can influence one’s
soundscape (that is, their subjective experience of their sonic
environment). For example, residents’ beliefs regarding the
reason other residents make disruptive sounds influenced their
assessment of the sounds. Thus, psychoeducation or other beliefcentred interventions may be helpful.
Interpersonal (Social Sonic Agency): At the relational
level, sonic agency emerges through interactions and negotiations
between people. Participants described responding to disruptive
sounds from residents with dementia by turning up their
televisions, telling the residents to be quiet, or closing their
doors. These strategies reflect attempts to set boundaries or
restore control through interpersonal means. However, they can
also create tension and reinforce isolation. Design interventions

44
here involve structured dialogue, peer support, or staff-led
facilitation to build understanding between residents and
encourage relational forms of coping rather than adversarial
responses.
Infrastructure (Physical Sonic Agency): At the
infrastructural level, sonic agency is linked to the material and
architectural environment. Residents proposed physical solutions
to mitigate unwanted sounds from their peers with dementia, such
as placing “noisy residents” on a separate floor or adding more
soundproofing between rooms. While these changes could reduce
disturbances, they also risk increasing social isolation for
already vulnerable residents. This link highlights the dual role
of infrastructural design: it must consider the implications for
the inner layers of relational and internal care depending on how
it is implemented.
Policy (Systemic Sonic Agency): At the policy level, sonic
agency involves the institutional structures that regulate care
routines and the lives of residents. Encompassing the other three
layers, Systemic Sonic Agency can be powerful as it often
controls the resources and decision-making required to make
significant changes. For example, psychoeducational materials

45
about dementia and the organization of participatory design
workshops must undergo this level of review before being
implemented. In the case of disruptive sounds made by residents
with dementia, the issue often extends beyond personal coping or
architecture to questions of staffing levels, care protocols, and
institutional priorities. For instance, insufficient staffing
might mean residents in distress vocalize for long periods before
being attended to. From this perspective, unwanted sounds are not
only an individual or social challenge but also a systemic signal
of institutional limitations. Interventions at this level include
embedding sound considerations into quality-of-life assessments
or involving residents in discussions about institutional
practices that affect how disruptive sounds are managed.
Outside of the ecological model, the theme of helplessness
over aspects of the soundscape emerged from the first workshop.
Participants expressed in interviews a feeling that there was
nothing that anyone could do about the unwanted aspects of their
soundscape. For example, one participant expressed the following
regarding a recording taken of the loud sound of street traffic
in their bedroom:

46
All I hear is traffic, which can’t be helped. My room is on
the North side, on the main street...and the hospital is
just down, across the street. [laughs] That’s just the way
it is. And they can’t do anything about that.
Regarding the sound of a fellow resident calling out for help
throughout the night, another participant shared: “Nothing I can
do... So, it’s just called life. Maybe they’re in pain or
something like that but what can I do? There’s nothing I can do.”
These comments suggest that some participants viewed certain
aspects of their soundscape as fixed or unchangeable. In these
instances, sounds such as traffic or vocalizations from other
residents were described without expectation of intervention or
improvement. Participants often responded with acceptance,
indicating a perceived boundary around what they could
realistically change in their environment.
3.2 Stage Two: Imagining Soundscape Shifts
The results of the first workshop shaped the structure of
the second. I considered several models of prototype-based
participatory workshop activities, including design futureinspired fictional soundscapes (Lundmark et al., 2023), foley
mockups, and electroacoustic mockups (Hug & Kemper, 2014).

47
However, the creation of prototypes at this stage of the study
seemed misaligned. In the case of sounds participants wished to
change, the barrier to such change was not necessarily a lack of
technological development—it was the complex interconnectivity of
the agents within the sonic ecology of care. Participants’
observations mainly stemmed from internal beliefs and social
interactions, and in the case of infrastructural sounds, it was
policy and economics that prevented change rather than
insufficient technology.
Furthermore, participants’ observations focused on the
presence or absence of a sound rather than its particular
quality. For example, the sound of the air vent was not something
the resident wanted changed; instead, they wanted silence. This
factor made the idea of augmenting the recordings not
particularly compelling. In most instances, residents had made it
clear that the only augmentation they wanted was for the volume
to be set to zero.
With these considerations in mind, I decided to use the
second workshop as an opportunity to understand residents’ ideas
for changes they would like to see in the soundscape of the home,
and how (or if) we could map those changes onto the sonic ecology

48
of care model. I also included prompts regarding sonic agency,
asking how residents might feel more in control of their
soundscapes.

49
3.2.1 Workshop Two
Figure 7
Workshop Two: overview of activities

50
The second workshop took place in the lower main floor of
the care home, and participants gathered around a large table. As
a priming exercise for both creative thinking and attunement to
sound, I began the session by laying out a variety of soundmaking objects on the workshop table (e.g., a mini synthesizer,
wood blocks, a kalimba). When participants arrived, I invited
them to experiment with the different objects and choose one they
felt drawn to. When all the participants had arrived, I asked
each of them to make a sound with their chosen instrument and
share what the sound reminded them of or made them feel.
Reactions varied from laughter to sharing of personal childhood
memories and helped set a tone of openness and connection.

51
Figure 8
Objects for sound making provided during the warm-up activity at
the start of Workshop Two.

Following the sound-making activity, I conducted a second
listening exercise, during which I played clips of the sound
recordings made by the participants in the first workshop. After
each 10-to 20-second clip, I asked the participants to try to
identify the sound. I wrote each identified sound on a sticky

52
note and placed it onto the poster printout for the workshop
under “Our Soundscape”. Assessments of the sounds also came up
during the priming exercise, mostly expressions of dislike (“It’s
terrible! It’s so loud!”). After each sound had been listened to
and identified, I asked the participants if there were any sounds
that they did not get a chance to record in the first workshop
that were significant to their daily lives.
In the second portion of the workshop, I introduced the
Sonic Ecology of Care model, explaining that I had developed it
after reflecting on the insights shared by participants in the
previous workshop. I explained how I wanted to use the model to
map how the participants might want to change their sonic
experience or soundscape at the care home. I also described what
each layer of the model referred to. For example, how “internal”
meant factors that might influence our personal experience of
sound, such as beliefs or preferences. I left pens, stickers, and
sticky notes around the table, and I encouraged residents to use
the supplies provided to express their ideas. During the
conversation about changes to be made, I prompted residents to
consider the different categories of the Sonic Ecology of Care

53
model. As they spoke, I wrote down their ideas and insights on
sticky notes and added them to the diagram.
In the final portion of the workshop, I asked participants
for their thoughts on how they might have more agency over their
sonic experience in the care home. In a similar manner to the
previous portions, I wrote a summary of their ideas on sticky
notes and placed them on a designated spot on the diagram.
The workshop was recorded and transcribed.
3.2.2 Workshop Two Results and Analysis
Figure 9
Digitized version of sticky notes mapped to the Workshop Two
mapping exercise.

54

55
The second workshop ultimately included a discussion of both
the sounds recorded in the first workshop and new sounds that had
not been previously discussed. For example, one of the priming
activities was interrupted by an announcement about a staff
education session taking place later that day. This interruption
led to an in-depth discussion surrounding the issues with the
announcement system and how we might mitigate them. The following
table summarizes the residents’ suggested changes to make to
improve their soundscape, mapped to the Ecological Model of Care.
During the discussion, a few key sounds and proposed changes
stood out as especially prevalent to residents:
Intercom Announcement System: The intercom system, used to make
announcements that project throughout the entire home, is
outdated and of low quality. A participant noted that the person
speaking into the intercom often spoke too fast and too close to
the microphone. In this particular example, a story shared by a
resident highlighted the role of internal understanding and
perception in the experience of sound: “[I heard] mumble mumble
mumble [on the intercom] and then the doors all closed. It scared
the living jebeezus out of everybody! What, is it going to burn
down, or sink, or…?”

56
In this instance, the poor quality and technique of the
announcement affected the residents’ knowledge that the fire
doors were closing as part of an emergency preparedness drill,
leading to fear rather than the usual annoyance.
Potential solutions to the issue touched on infrastructure
(replacing the intercom system) but also included social and
relational approaches. Residents suggested new training
guidelines for those using the intercom, perhaps even led by
residents with relevant experience, that encourage proper
speaking volume, enunciation, and distance from the microphone.
Participants also suggested that for announcements on the
intercoms that are not relevant to residents, staff could
communicate through the “Sonim phones”, private communication
devices that staff already have access to.
Sounds of Street Traffic in Resident Rooms: Regarding the loud
sound of traffic caused by the care home being located on a busy
road across from the hospital, residents were initially resistant
to the idea of any changes being made to mitigate the sound. A
resident stated, “Traffic is traffic, and that’s that. You can’t
do anything about the traffic.” Initial suggestions for change
centred around infrastructure approaches, such as relocating the

57
care home to a quieter part of town and improving the
soundproofing of the windows while allowing fresh air to
circulate. However, when the idea of habituation to the sound of
sirens came up, a more internally based sentiment was introduced
by a participant:
When I hear a siren, I think, oh, somebody needs help. So,
that’s not offensive to me. I can put up with that easily…
We don’t only hear with our ears, we hear with our heart,
too.
Although perhaps not a deliberate “design” solution, this
participant’s internal beliefs helped mitigate the potential
discomfort caused by the sonic environment.
Sounds Made by Other Residents (With Dementia): Participants
expressed frustration regarding sounds made by other residents
who likely have dementia, such as repeated calls for help to
staff and other repetitive vocalizations or behaviours. To try to
assess any internal factors that may be contributing to the
participants’ frustration, I asked why they thought the other
residents were making those sounds. Responses included feelings
that they were trying to get attention from staff, and “Because
they’re not in this world. They’re somewhere else in the past.”

58
When asked to imagine potential ways to reduce the distress
caused by noise from other residents, participants suggested
“putting all the noisy people on one floor”. One participant
shared that they will often turn up the TV in response to the
sounds or tell the residents to be quiet. In response to the idea
of putting residents with dementia on a separate floor, I asked
if participants felt this might further isolate those residents.
A participant responded, “Well they’ve been isolated for so many
years, they don’t know anything else.”
Difficulty Understanding Staff: Participants expressed difficulty
understanding some of the staff, especially when wearing face
masks. Potential solutions included the use of clear face masks,
and providing more training on best practices when communicating
with residents.
Intrusion of Personal Spaces: Several participants shared stories
of distress when staff and residents enter their personal space
without consent. For example, a participant explained how when
they are using the toilet, “[a staff member] puts the key in [the
door], I say, “excuse me, you can’t come in!” And sometimes, they
just keep on coming.” Similarly, a resident shared that staff
will knock and open the door to their bedroom without receiving

59
permission to enter. Regarding staff, it was suggested that more
policies or training be put in place surrounding privacy.
A participant described how they keep their bedroom door
locked at all times because otherwise, residents will come into
their room. Another resident stated, “I have the same thing. I
don’t mind the staff, but that [resident who is calling out], I
have the door closed, she opens that door handle, and clicks the
door open. All the time.”
Ideas Regarding Sonic Agency
In response to the prompt, “How could we have more control
over the sounds at the care home?”, directly touching on sonic
agency, the immediate response of one resident was, “...that’s
something that has to come out of the 5th floor, right, where the
bosses are!”. I responded by emphasizing that I wanted to hear
their dreams and ideas for possible changes. The following
discussion introduced four key changes surrounding sonic agency:
More privacy/less disruption by staff and residents in personal
space: Participants underscored the importance of having their
own private space. They suggested that staff receive training
when hired on respecting resident privacy, such as not entering a
locked room without the resident's prior consent. They also

60
shared frustration about confused residents entering their room,
thinking it was their own.
Mutual support and advocacy among residents: Participants shared
several stories of how they support one another. For example, one
participant shared how they try to help a man who sits next to
them at dinner time, who is partially blind, by describing where
the items on his plate are. Another resident shared a story about
sharing some of his lotion with another resident who had
developed an allergic reaction to the cream provided by the care
home. Furthermore, a participant helped advocate for another
resident to obtain a fridge in their room, as most other
residents already had one. The participant communicated this
request to a nurse, who then had to pass the message on to
somebody who could help facilitate getting the resident a fridge.
This form of relational support amongst residents helped feelings
of agency and control within the care home.
More freedom in routine: One participant emphasized a desire for
more freedom in their routine, particularly regarding social
time. They shared, “This place is such a strict clock. Like, it’s
ten to three. We all have to disappear into the woodwork. Or
else. We can’t stay behind and talk to [resident name] or

61
[resident name] or any other lady.” The participant also
expressed a desire to have more non-medical time with staff:
Well right now they’re so busy that they can’t watch TV with
me. And I keep saying, there’s 22 people on my floor, on
every floor, it’s busy… They have to change the diapers,
change bed sheets, shower people, feed somebody… The staff
are overworked.
Involvement in the PD workshop as agency building: Although
participants often expressed feelings of helplessness regarding
their ability to change their sonic environment throughout the
workshop, conversations at the end of the workshop revealed
feelings of hope and agency through the outcome of the study
activities. For example, the following exchange:
Participant x: We are being given a chance to help
everybody. Is that right?
Participant z: Especially the ones that can’t talk for
themselves. And there’s a lot of them that can’t talk. Too
many.

62
3.3. Applying Design: Intermediary Objects and Actors
Figure 10
Sonic Ecology of Care with the incorporation of intermediary
objects and actors.

Returning to the Sonic Ecology of Care model following the
second workshop, I decided to adjust the model to account for the
concept of intermediary objects and actors. Rather than treating

63
design interventions as fixed affordances, this perspective
emphasizes their mediating role in connecting residents’
experiences to broader institutional and policy layers.
3.3.1 Intermediary Objects
Intermediary objects are materials or practices that
translate lived experience across layers of the ecological model.
They are design interventions that emphasize the contextual and
relational nature of resident soundscapes.
For example, intermediary objects connecting residents’
individual soundscapes with the outer layers of interpersonal,
infrastructural, and policy contexts may include recorded
listening sound explorations and immersive interviewing, which
allow staff or policymakers to encounter residents’ experiences
indirectly through mediated sound and narrative. Other possible
intermediary objects include facilitation guides, workshop
materials, and design artifacts that embody insights and
communication from the inner and outer layers of the Sonic
Ecology of Care.
3.3.2 Intermediary Actors
In parallel, intermediary actors are those who translate and
mediate between groups. If the workshop materials and the

64
facilitation guides are the intermediary objects, then the
intermediary actors are those who facilitate workshops and enable
change. In the context of a long-term care home, intermediary
actors exist in a complex hierarchy of agency. In this workshop,
residents expressed an understanding of this hierarchy, where
they themselves were at the bottom, with staff above them,
followed by management and policymakers. Several residents
mentioned a sense of dependency on staff to implement the changes
they desired, while also acknowledging that factors beyond the
staff’s control were at play, such as understaffing and
architectural constraints. Participants attributed these
limitations to the responsibility of management and policymakers.
Although not related to sound, one exchange between participants
embodied this belief, where a resident shares a story about
trying to help a fellow resident get a fridge for his room:
Participant x: I have a fridge, I don’t see why he can’t
have a fridge. And I was told to talk to the nurse, and I
did that yesterday. I asked her today and she said she
didn’t know what was happening. She has to talk to somebody
who knows. Who knows?”

65
Participant y: Probably on the [floor where the managers
are] *laughs*
The involvement of designers of intermediary actors
facilitates communication between the levels of this hierarchy of
agency. By conducting workshops that involve the expression of
residents’ lived experiences, and through facilitating the
creation of intermediary objects, staff and management may have
more opportunities to understand and act upon the needs of
residents.
4.0 Discussion
This study aimed to investigate how PD methodologies
informed by sound studies can enhance resident agency over the
sonic conditions of institutional life. By narrowing focus to
sound, this research offers a lens for addressing institutional
complexity in ways that center subjective experience and
relational care.
4.1 Sonic Ecology of Care
While subjectivity is central to sound studies, this project
sought to move beyond descriptive accounts of individual
differences by codifying subjective experiences within the Sonic

66
Ecology of Care model. For example, residents’ interpretations of
disruptive vocalizations were mapped not only as personal
perceptions but as relational factors influencing the wider care
environment. By situating subjective experience within the
layered model, these accounts highlight opportunities for
creating intermediary objects and interventions, such as
psychoeducation, infrastructural changes, or policy adjustments.
In this way, subjectivity becomes both a method of inquiry and a
framework for action.
Bronfenbrenner’s Ecological Systems Theory (Bronfenbrenner,
1979) serves as the base for the Sonic Ecology of Care Model.
Originally developed as a framework for developmental psychology,
the theory explains human development as shaped by dynamic
interactions between an individual and multiple nested
environmental systems, ranging from immediate relationships to
broad cultural and historical forces. Designers have used
Ecological Systems Theory in workshops such as Hay and
colleagues’ (2024) study on factors influencing service
designers’ capacity to address power dynamics in their work. The
Sonic Ecology of Care Model incorporates the nested and dynamic
nature of Bronfenbrenner’s model. However, it mitigates its

67
broadness (noted as a pain point in Hay (2024)) by focusing
specifically on institutional soundscapes, which allows for
mapping of current experiences but also provides a way to
communicate and break down design solutions that are complex and
abstract.
In the context of long-term care, where many aspects of the
environment are fixed and funding for infrastructure modification
is limited, considering possible intermediary objects between
internal, social, and policy-based changes that can be made to
improve resident experience is critical. Public health research,
service design, and other fields of practice work extensively
with the interpersonal and policy-based aspects of care homes.
However, the subjectivity of sound, as explored in the current
study, highlights the significance of the internal as a component
within the design of long-term care homes. This subjectivity
echoes the nature of intermediate objects in that their ability
to act as a mediator is not exclusive to a material function, but
also to their contextual meaning that arises through interaction
(Boujut & Eric, 2003).
The layers of this model are overlapping, dynamic, and
contain multidirectional relational factors. For example, in the

68
case of sounds made by other residents with dementia, the most
obvious approach may be to modify the infrastructure rearranging room assignments so that residents with dementia are
separated from other residents, adding more soundproofing between
rooms, or installing white noise machines at night. Ultimately,
these approaches may help address residents’ concerns about
unwanted sounds. Indeed, in the current study, residents
suggested moving residents who make disruptive sounds to a
separate floor.
However, these solutions alone may only further alienate
residents from one another (Graham, 2018) and, in the case of
adding white noise, lead to more unwanted sounds depending on
resident preferences. Beginning at the level of soundscape, as
described by the Sonic Ecology of Care model, we would instead
approach this dilemma by assessing the factors influencing
individual perception of sound. In the current study, many of the
participants’ concerns about other residents making unwanted
sounds were underscored by beliefs surrounding the reason for the
sounds, including confusion, concern, and feelings of anger due
to the perception that the sounds were being made deliberately
and with malicious intent. Without making any change to the

69
physical environment, feelings of disturbance may be reduced if
residents receive resources regarding the nature of dementia, its
effects on behaviour, and the care provided by staff to residents
living with the condition. The reciprocal relationship between
soundscape and interpersonal connections is also made evident
through the development and provision of these educational
materials. The materials, developed by staff or outsourced, would
ultimately be shared with residents, furthering the relational
connection.
Ultimately, designers may still need to implement
infrastructural changes, and not all residents may experience
relief from this internally based approach. However, this
approach underscores a central contribution of the study: by
attending to the internal and interpretive dimensions of sound,
designers can surface previously invisible levers for change. In
care environments where residents’ agency is often limited, these
internal and relational interventions may prove more feasible,
sustainable, and empowering than infrastructural overhauls alone.
4.2 Participatory Design and Sonic Agency
The study workshops offered residents an opportunity not
only to describe their environment but also to imagine and

70
communicate alternatives. The act of recording sounds, listening
back, and discussing their meanings helped surface affective and
experiential layers that would have been difficult to access
through verbal discussion alone. Several participants expressed
appreciation for the space to share, reflect, and contribute
ideas that might help not only their own experience but also
those of others, suggesting that participatory design can be a
form of agency-building in itself.
In this study, I employ the term sonic agency to describe
how residents interpret, adapt to, and seek control over their
sound environments. While Brandon LaBelle (2018) defines sonic
agency as sound’s capacity to shape social dynamics and
redistribute power, I adapt the term to institutional contexts
where physical, social, and policy structures constrain
residents’ capacity for agency.
Sonic agency is not only about the production or resistance
of sound, but also about the interpretive, relational, and
communicative practices through which residents make sense of
what they hear. For example, sonic intermediary objects
exemplified residents’ frustrations regarding privacy, such as

71
doors opening without consent, muffled voices behind masks, and
intercom announcements that were unclear or alarming. By focusing
on a specific, embodied experience, such as sound, concerns that
were previously unarticulated also arose, even when they did not
relate to sound (for example, requesting more respectful
routines).
In this way, sonic agency functions less as a discrete
outcome and more as a dynamic process involving intermediary
objects and actors. Sound reveals broader tensions in
institutional life and becomes a site where residents negotiate
control, belonging, and dignity. The Sonic Ecology of Care model
helps surface these points of negotiation, showing that what
appears at first as “non-sonic” feedback is often inseparable
from how sound structures experiences in care.
By foregrounding listening as a design practice, Listening
as Agency reconfigures the role of the designer. Rather than
acting as a central decision-maker, the designer becomes an
intermediary actor, facilitating communication between levels of
the institutional hierarchy and creating intermediary objects
that enhance the soundscape. The findings of this study emphasize

72
models of “institutioning” (Huybrechts et al., 2017), which
reposition institutions not as fixed systems, but as evolving
networks of human relationships. Participatory sound design, in
this light, is not simply about modifying environments—it is
about co-producing new ways of being in relation to each other
within them. This echoes Brandon LaBelle’s (2018) framing of
sonic agency as harnessing the affective and subjective nature of
sound to build compassion and relationships, which designers can
use to redefine systems of power and control. Indeed, residents
in the current study emphasized relational approaches to sonic
agency, both within the context of PD and within day-to-day
exchanges between residents and between residents and staff.
4.3 Methodological Reflections
Focusing on sound as an entry point to institutional life
proved to be a generative approach. The workshops surfaced not
only specific sonic issues but also broader concerns about
autonomy, privacy, respect, and daily routine. In fact, many of
the ideas for change discussed by residents were not directly
related to sound itself, but to relational and procedural factors
that shape sonic experience. These findings suggest that sound

73
can act as a diagnostic surface, revealing systemic tensions that
remain unspoken.
Although this research draws directly from interaction
design and participatory design traditions, its contribution lies
less in demonstrating adherence to a fixed professional role and
more in the capacity to move across disciplinary boundaries. By
combining methods from sound studies, ethnography, and design
research, the project demonstrates an osmosis between practices—a
fluid exchange of approaches and modes of transmission that
enriches the design process. This flexibility is not a departure
from interaction design, but an expansion of it: a demonstration
that interaction design can include sensory, relational, and
institutional dimensions, and that designers can act as
facilitators of listening and co-creation across complex care
systems.
Several reflections emerged for future iterations of this
methodology. First, providing residents with personal audio
recorders could enable them to document their soundscape more
flexibly (e.g., Bartlett 2023). During the interviews and
discussions, participants noted several sounds as significant
that did not occur within the allotted time for sound

74
exploration. For example, all residents shared frustration around
the consistent slamming of the laundry basket lid in the laundry
rooms, which they could hear in their own personal rooms
throughout the day. One resident made a lengthy recording during
the sound exploration, hoping to capture the sound of the laundry
lid closing, but without success.
Regarding future workshops, I recommend structuring the
second workshop such that the facilitator integrates the
discussion of potential changes into the review of sounds from
the first workshop. That is, the facilitator plays a recording
from the first workshop, and participants immediately discuss
changes that could be made in relation to that sound. This
adaptation would likely facilitate a more direct correlation
between the recorded sound and the changes suggested by
participants. Additionally, not all residents were enthusiastic
about the sound priming exercise with the instruments. One
resident refused to participate, feeling that since he was not a
musician, he should not be playing an instrument. Although I
intended for the exercise to help residents become more
comfortable with creative expression of sound before beginning
the brainstorming session, it may be helpful for future workshops

75
to use creative engagement with the recorded sounds from the
first workshop for this purpose. This adaptation may help
alleviate feelings of confusion regarding the relationship
between the exercise and the workshop activities.
A crucial aspect of the current study was to involve care
home staff as part of the study team. The staff study team
members facilitated the recruitment of participants, booked and
navigated spaces within the home, provided care and accessibility
support to participants, and performed other tasks as needed.
During the workshops, the care staff study team members provided
valuable insights regarding the care home design and possible
changes to be made for Sonic Agency. However, these insights were
not included in the current study, as it focused on resident
insights. In future iterations of this methodology, including
institutional staff and leadership as participants would be
beneficial.
Lastly, considerations arose regarding the ethical
implications of introducing Deep Listening practices to
individuals living in unpleasant sonic environments. At the
beginning of the second workshop, a participant told me that they
had been hearing all sorts of new things since the last workshop,

76
and that most of them were not good. This shift in attention to
listening can be empowering and revealing, but it can also be
distressing and difficult to disengage from once it has been
introduced. Working towards implementing changes ideated in these
workshops, ideally through participatory prototyping, may help
mitigate feelings of helplessness and disturbance caused to new
Deep Listeners.
5.0 Conclusion
Everybody is good here —nice, caring and helpful. Thanks for
sharing the study with [us] here today. So we can all share.
I’m very appreciat[ive]. (Participant, Workshop 1).
This study demonstrates that participatory design methods
informed by sound studies can illuminate new paths for resident
agency in institutional care by attending not only to the
acoustics of a space, but to how sound is interpreted, shared,
and resisted. Through the development and application of the
Sonic Ecology of Care model, this research reveals the layered
complexity of institutional soundscapes. It provides a framework
through which designers, staff, and residents can collectively
map and reimagine their sonic environments.

77
A key future direction is the participatory development of
prototypes based on insights developed from the first two
workshops, ranging from service design interventions to physical
products. These could include training modules for staff on
issues such as best practices for intercom use and respecting the
privacy of residents, as well as physical changes like cushioning
on laundry bin lids to reduce noise when closing. Additionally,
staff could provide psychoeducational materials on dementia for
residents. Facilitation of social and policy-based changes may
also be an outcome, such as support in connecting resident
councils with designers and resources. Further workshops enable
the proposed changes by residents to be implemented, allowing
this new methodological approach to reach its full potential.
Drawing on the structure and materials of this study, I aim
to develop a toolkit for other designers working in care homes
and institutional settings who are interested in facilitating
participatory sound workshops. This toolkit will include
facilitation scripts, accessibility adaptations, and sample
activities. More accessible recording devices may also be
required. The toolkit could also be used in part by non-designers
working and living in institutional contexts. Expanding

78
participation to include staff and institutional leadership as
active collaborators could further enrich the relational ecology
necessary for lasting change. The shift to listening produced by
this methodology can reveal aspects of soundscapes that expand
beyond sound.
Finally, this work suggests that sound can be a powerful
diagnostic and relational medium. The shift to listening produced
by this methodology can reveal systemic patterns that extend
beyond the auditory, touching on dynamics of care, power,
privacy, and belonging. In this way, participatory sound design
becomes not only a tool for environmental change but a practice
of collective attention, attunement, and transformation.

79
References
Agich, G. J. (1990). Reassessing autonomy in long-term care. The
Hastings Center Report, 20(6), 12–17.
Bartlett, R. (2012). Modifying the diary interview method to
research the lives of people with dementia. Qualitative
Health Research, 22(12), 1717–1726.
https://doi.org/10.1177/1049732312462240
Bartlett, R., Koncul, A., Lid, I. M., George, E. O., & Haugen, I.
(2023). Using walking / go along interviews with people in
vulnerable situations: A synthesized review of the research
literature. International Journal of Qualitative Methods,
22, 16094069231164606.
https://doi.org/10.1177/16094069231164606
Bødker, S., Dindler, C., Iversen, O. S., & Smith, R. C. (2022).
Participatory Design (Reprint of original edition).
Springer.
Boujut, J.-F., & Blanco, E. (2003). Intermediary objects as a
means to foster co-operation in engineering design. Computer
Supported Cooperative Work (CSCW), 12(2), 205–219.
https://doi.org/10.1023/A:1023980212097

80
Braun, V., & Clarke, V. (2006). Using thematic analysis in
psychology. Qualitative Research in Psychology, 3(2), 77–
101. https://doi.org/10.1191/1478088706qp063oa
Braun, V., & Clarke, V. (2021). Thematic analysis: A practical
guide. SAGE.
Bronfenbrenner, U. (1979). The ecology of human development:
Experiments by nature and design. Harvard University Press.
Bull, M., & Cobussen, M. (2021). The Bloomsbury handbook of sonic
methodologies. Bloomsbury Academic.
Chaudhury, H., Cooke, H. A., Cowie, H., & Razaghi, L. (2018). The
influence of the physical environment on residents with
dementia in long-term care settings: A review of the
empirical literature. The Gerontologist, 58(5), e325–e337.
https://doi.org/10.1093/geront/gnw259
Canadian Institute for Health Information. (2021, June 10). Longterm care homes in Canada: How many and who owns them?
Retrieved August 20, 2025, from https://www.cihi.ca/en/longterm-care-homes-in-canada-how-many-and-who-owns-them
Cusick, S. G. (2013). Towards an acoustemology of detention in
the ‘global war on terror.’ In G. Born (Ed.), Music, Sound

81
and Space (1st ed., pp. 275–291). Cambridge University
Press. https://doi.org/10.1017/CBO9780511675850.017
DeNora, T. (1999). Music as a technology of the self. Poetics,
27(1), 31–56. https://doi.org/10.1016/S0304-422X(99)00017-0
Devos, P., Aletta, F., Thomas, P., Petrovic, M., Vande
Mynsbrugge, T., Van De Velde, D., De Vriendt, P., &
Botteldooren, D. (2019). Designing supportive soundscapes
for nursing home residents with dementia. International
Journal of Environmental Research and Public Health, 16(24),
4904. https://doi.org/10.3390/ijerph16244904
Ehn, P. & Sandberg, A. (1979). Företagsstyrning och Löntagarmakt.
Prisma.
Feld, S. (1996). Waterfalls of song: An acoustemology of place
resounding. Bosavi, Papua New Guinea. 91–135.
Forbes, M. (2022). Thematic analysis: A practical guide.
Evaluation Journal of Australasia, 22(2), 132–135.
https://doi.org/10.1177/1035719X211058251
Goffman, E. (1961). Asylums: Essays on the social situation of
mental patients and other inmates. Penguin Books.
Graham, M. E. (2019). Re-socialising sound: Investigating sound,
selfhood and intersubjectivity among people living with

82
dementia in long-term care. Sound Studies, 5(2), 175–190.
https://doi.org/10.1080/20551940.2018.1551051
Grain, K., McClelland, K. W., & Mahoney, T. (2024). Facilitation
for community transformation: A toolkit for communityengaged researchers. Community-Engaged Research
Initiative,

Simon Fraser University.

Greubel, C. (2020). Caring through sound and silence: Technology
and the sound of everyday life in homes for the elderly.
Anthropology & Aging, 41(1), 69–82.
https://doi.org/10.5195/aa.2020.229
Grond, F. (2025, September 8–11). Sonic Boundary Objects
[Conference presentation]. Sounding Objects for Societal
Impact: DRS SIG Symposium on Sound Driven Design
IRCAM, Paris, France.
Grond, F., & Devos, P. (2016). Sonic boundary objects:
Negotiating disability, technology and simulation. Digital
Creativity, 27(4), 334–346.
https://doi.org/10.1080/14626268.2016.1250012
Hay, A. F., Vink, J., Thøgersen, D. M., & Suoheimo, M. (2024).
Why do Service Designers Struggle to Address Power Dynamics?

83
Strategic Design Research Journal, 16(1), 172–189.
https://doi.org/10.4013/sdrj.2023.161.13
Hug, D. (2018). From Foley to Function: A Pedagogical Approach to
Sound Design for Novel Interactions. Journal of Sonic
Studies, 06. https://doi.org/10.22501/JSS.237166
Huybrechts, L., Benesch, H., & Geib, J. (2017). Institutioning:
participatory design, co-design and the public realm.
CoDesign, 13(3), 148–159.
https://doi.org/10.1080/15710882.2017.1355006
Iyendo, T. O. (2017). Sound as a supportive design intervention
for improving health care experience in the clinical
ecosystem: A qualitative study. Complementary Therapies in
Clinical Practice, 29, 58–96.
https://doi.org/10.1016/j.ctcp.2017.08.004
Kittay, J. (2008). The sound surround: exploring how one might
design the everyday soundscape for the truly captive
audience. Nordic Journal of Music Therapy, 17(1), 41–54.
https://doi.org/10.1080/08098130809478195
LaBelle, B. (2020). Sonic agency: Sound and emergent forms of
resistance (Paperback edition). Goldsmiths Press.

84
Lundmark, S., Jonsson, M., Myhre, M., Hjuberger, A., & Rodela, R.
(2023). Listening to the future: using participatory sound
fiction to engage young people in urban design. 26th
International Academic Mindtrek Conference, 223–232.
https://doi.org/10.1145/3616961.3616981
Manzini, E. (Ed.). (2015). Design, when everybody designs: An
introduction to design for social innovation. The MIT Press.
Oliveros, P. (2005). Deep listening: A composer’s sound practice.
iUniverse.
Pirhonen, J., & Pietilä, I. (2018). Active and non-active agents:
Residents’ agency in assisted living. Ageing and Society,
38(1), 19–36. https://doi.org/10.1017/S0144686X1600074X
Public Health Agency of Canada. (2020). Aging and chronic
diseases: A profile of Canadian seniors. Government of
Canada. https://www.canada.ca/en/publichealth/services/publications/diseases-conditions/agingchronic-diseases-profile-canadian-seniors-report.html
Rice, T. (2013). Broadcasting the body: The ‘private’ made
‘public’ in hospital soundscapes. In G. Born (Ed.), Music,
Sound and Space (1st ed., pp. 169–185). Cambridge University
Press. https://doi.org/10.1017/CBO9780511675850.009

85
Rice, T. (2016). Sounds inside: Prison, prisoners and acoustical
agency. Sound Studies, 2(1), 6–20.
https://doi.org/10.1080/20551940.2016.1214455
Rice, T. (2018). Acoustemology. In H. Callan (Ed.), The
International Encyclopedia of Anthropology (1st ed., pp. 1–
7). Wiley. https://doi.org/10.1002/9781118924396.wbiea2000
Schafer, R. M. (2006). The soundscape: Our sonic environment and
the tuning of the world. Destiny Books (Original work
published 1977).
Smith, R. C., Loi, D., Winschiers-Theophilus, H., Huybrechts, L.,
& Simonsen, J. (2024). Routledge International Handbook of
Contemporary Participatory Design (1st ed.). Routledge.
https://doi.org/10.4324/9781003334330
Steele, D., Kerrigan, C., & Guastavino, C. (2020). Sounds in the
city: Bridging the gaps from research to practice through
soundscape workshops. Journal of Urban Design, 25(5), 646–
664. https://doi.org/10.1080/13574809.2019.1699399
Stevenson, A., & Holloway, J. (2016). Getting participants’
voices heard: Using mobile, participant led, sound-based
methods to explore place-making. Area, 49(1), 85–93.
https://doi.org/10.1111/area.12296

86
Thompson, E. A. (2002). The soundscape of modernity:
Architectural acoustics and the culture of listening in
America, 1900 – 1933. MIT Press.
van Loon, J., Janssen, M., Janssen, B., De Rooij, I., & Luijkx,
K. (2024). Working together to enhance autonomy: A
participatory action research among residents and staff in a
nursing home. Journal of Participatory Research Methods,
5(3). https://doi.org/10.35844/001c.116934
Westerkamp, H. (1974). Soundwalking. Sound Heritage, 3(4), 18–27.

87

Appendix A
Link to my listening journal:
https://drive.google.com/file/d/1QqDREQ4zwRbjeSsId8H5C_xijyEsEmC4
/view?usp=sharing

88

Appendix B
Listening as Agency Study: Sound Exploration Facilitation Script
1. Introduction (Before Recording)
- “We’ll walk around Windermere for ~25 mins to record sounds
important to your daily life.”
- “Do you have any sounds in mind?”
- “Keep listening as we go — more might come to you!”
- Ask: “Would you like to hold the microphone, or should I?”
→ If they want YOU to hold it:
“Ok, let me know if you change your mind!”
→ If they want to hold it:
“Great! To record, press this red button [point]. Press
it again to stop. Let me
know
before you start.”
2. Recording a Sound
1. Check the sound levels:
- Put on the headphones to ensure the sound is clear and at a
good level.
- Help the participant put on the headphones and ask:
“Can you hear the sound you want to record?”
- Adjust the playback volume on the side of the Zoom if
needed. Ensure the input meter is in the midrange (not
peaking or too low).
2. Starting the recording:

89
→ If you are holding the microphone:
“Where would you like me to point the microphone?”
“Would you like to press the record button when you’re
ready? Or do you prefer if I press it?”
→ If the participant is holding the microphone:
“When you’re ready, press the red record button to start,
and press it again when you’d like to stop.
- While recording, keep an eye on the input meter to ensure
the levels remain good. Adjust the volume dial as needed.
3. Listening Back
- “Let’s listen to the recording to make sure it sounds
right.”
→ If you’re holding the mic:
“Would you like to press play?”
→ If they’re holding it:
Guide them to press play.
- Ask: “Does that sound the way you wanted it to?”
- Press stop (or have them press it)
- Repeat for the next sound.
Prompt questions:
To facilitate exploration without biasing the participant’s
choices, use the following neutral prompts:
- “What area of the home would you like to go to next to
record sounds?”
- “What sound(s) would you like to record?”

90
- “What sounds are significant to your daily life here at
Windermere?”
- “Are there any sounds that stand out to you as part of your
everyday routine?”

Appendix C
Quick Guide for ZOOM H6 Handy Recorder created for use by study
staff while facilitating sound explorations.

91

Appendix D
Description of Participant Sound Exploration Recordings and
Insights from Post-Sound Exploration Interviews.

92
Content of Recording

Participant Insights

Sound of street traffic as

The sound of traffic is

heard in the participant’s

constant. Participant says

bedroom.

they have developed "selective
hearing" and grown accustomed
to it, as there is nothing
anyone can do about the noise.

Persistent metallic clanging

No insights shared.

of another resident hitting
their hand against the dining
hall table, with ambient music
playing in the background.
A staff member speaking in a

Participant dislikes when

different language to a

people around them, especially

colleague with music in the

staff, talk to each other in a

background.

language other than English.
It makes the resident “think
they’re talking about me, and
the way I look.”

93
Gordon Ramsay playing on the

Participant likes Gordon

TV in resident’s bedroom.

Ramsey and keeps his show on
the TV on throughout the day.
They note that at night, the
sounds of people calling out
for help are of concern.

Mechanical whirring and

Participant finds the noise

airflow of HVAC in resident’s

irritating because it never

room.

stops. Feels that the fan
system has worn down with
time, but that no one wants to
spend money on fixing it since
they will likely tear the
building down in coming years.

Recording taken in hallway in

Resident expresses confusion

front of resident’s bedroom,

about why the resident in the

sound of another resident

recording makes sounds when

hitting walker rhythmically

they don’t have to. Describes

against the floor, then

other behaviours, such as

dragging it across the floor

vocalizations, that the

94
to create a loud squeaking

resident in the recording does

sound.

at other times.

Two staff members having a

Participant was trying to

conversation in a non-English

record the sound of the

language. Whir of airflow

laundry hamper lids closing

through vents, occasional

but it was too late in the

noises of doors closing,

day. The hampers make a loud

people rolling carts, keys

thud that the residents can

jingling.

hear in their rooms. The
resident finds the sound
irritating, as it goes through
the walls even when the door
is shut.

Sound of soft resonant bells

Recording is of other

and chatter of different

residents playing games and

voices and people moving

watching TV. The participant

around.

feels that they are all having
fun and that it is good for

95
them to be doing these things
rather than being bored.
Study team member softly says

Elevator up to the 5th floor

"Are you going to say hi?" and

where there is a hair salon.

then we hear 3 knocks against

Participant says they are due

what is presumably a door. The

for a haircut for the summer.

door creaks and we hear a new

They also saw the office of

voice say "Hi" and then the

the participant's social

participant saying "Hiii" in

worker, so they went to say

return. The new voice becomes

hi.

more animated- "Hi
[Participant name]!" and the
participant laughs happily.
"Hi [participant name]!" the
voice says again. "How are
you! You wanted to see me?"
And the participant vocalizes
affirmatively. "Yea, you can
come in". The participant
vocalizes softly.

96
Electrical buzzing, footsteps,

Recording of the 11th floor

staff greeting the participant

because the participant likes

and asking about the study.

the quietness of the floor.

Conversations from a TV or

They said the floor that their

radio.

room is on is okay, but that
there is a resident there who
calls for help all day long,
and in the morning, there are
loud banging sounds of the
laundry lids closing.

Recording begins with a

Recording is of the journey to

conversation between staff and

the lower main floor and the

residents in the elevator. The

sounds of the laundry room as

elevator arrives in the lower

heard from the hallway. The

main floor and the participant

participant felt that the

records their journey down the

sound would hurt the ears of

lower main floor corridor. We

staff working in the lower

hear sounds of them being

main floor. They had only been

greeted by staff, and a loud

down to the lower main floor

mechinical whirring and

once before.

97
banging sound that grows
louder and softer as the
participant approaches and
passes the laundry room.

We hear a loud mechanical

Recording of the participant’s

whirring sound, likely the

encounter with a staff member

sound of the laundry room.

while on the elevator. The

There are some faint voices.

participant recorded the

There is the beep of the

encounter because “I see her

elevator and the announcer

and she knows me since I lived

voice say “going up”, and

here for 3 months- makes me

cheery music suddenly starts.

feel happy."

We hear someone gasp. The
participant says "hiii".
“HeLLO!”, a new voice says,
and the participant vocalizes.
Someone begins to sing.