Are We There Yet? Exploring how cognitive mapping & wayfinding become important as we age

March 31
Are We There Yet? Exploring how cognitive mapping & wayf...

Are We There Yet?

Written By: Josh Crews & Elizabeth Heroux

By the year 2030, an estimated 20% of the US population will be over the age of 65.  Of those currently aged 50-64, 38% plan to continue working after the age of 65. More seniors are not looking just to live, but desire to have a robust and active lifestyle. As our population ages, the design of our built environments needs to respond by providing elements that support the desired lifestyle of seniors. To accommodate a changing and aging population, specifically those that deal with brain health and injury, the healthcare team implements an evidence-based design process to improve clinical outcomes.

When Emory approached us four years ago, they wanted to create a patient-centered destination for neurocognitive and neuromuscular disorders called the Emory Brain Health Center. The process required to achieve this involved reducing the number of separate clinic locations across the Emory campus and locate them within a single building where Physicians can collaborate to provide a consolidated care plan for patients with a variety of neurological and psychological needs.  The design considered many functions of the brain and how we occupy space. For this article, we are highlighting three:

1.       Cognitive mapping-how the brain maps the space around us as we occupy buildings

2.       Wayfinding and color

3.       Gait- the strides we take and our brain’s relationship to distance as the result of neuromuscular disorders.

As we age, our ability to process information changes. While it is common and for the most part, not anything to be particularly concerned about, it can impact the natural, intuitive process our mind uses to map space and buildings around us based on our life experiences. For all individuals, and particularly brain injury patients, typology and geography are more important than color and texture.  The design team for the Emory Brain Health Center used specific design techniques and evidence-based methodologies to help patients and their caregivers navigate the 118,000 SF space. Extended vistas, central nodes, integrated technology, bold colors, and centralized hubs for check-in help reduce the amount of extraneous information patients need to process while navigating the space.   This allows them to move through the building more efficiently and with confidence.

Understanding how people cognitively map the areas around them helps guide the decision-making process for space planning, implementing technology, and designing a finish palette.

Most of the time, we progress through our environments without giving much active thought to our natural gait – the width and rhythm of our steps- and any variations from yesterday, last month, or even last year. For individuals suffering from brain injury and neuromuscular disorders, gait plays an important role in determining wayfinding and spatial cognition.  At the Emory Brain Health Center, physicians measure gait on a regular basis and tailor treatment plans to the specific needs of each patient. To support this, the design team considered patients’ needs when moving and navigating through the space without a consistent measure of natural gait.  The team utilized extended vistas of the exterior environment at each clinic entry to aid in orientation and distance traveled for each patient.  Creating centralized hubs or wayfinding nodes by consolidating various spaces not only allows space to function more efficiently in terms of cognitive mapping, but also provides flexibility and more opportunity for collaboration among various groups. One of the benefits that the Emory Brain Health Center has seen as the result of their spatial design is doctors treating patients for multiple conditions are now able to meet, collaborate, and create a treatment plan that considers the patient’s overall health – much like a patient-centered medical home model.

Collaboration, cross pollination, mentorship, as well as various spaces where people can quickly gather and discuss courses of care are taking a more prominent role in design choices. Work café, collaboration rooms, and varying sized conference and team rooms with integrated technologies allow caregivers to meet more informally.

Along with some of the conditions highlighted above, in some cases aging increases our desire for social interaction. At the Emory Brain Health Center, patients can be there for several hours for multiple appointments. Built into the design are positive distractions, such as access to natural light and exterior views from all waiting rooms and patient lounges, a café, as well as both quiet and social spaces.

The Emory Brain Health Center is a great step in planning for the future of our aging population.  As the healthcare industry continually evolves to provide care for an aging population, we will be challenged to continue to provide healing environments that support clinical care processes.   

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