University of Southern California Dissertations and Theses

Healing Spaces: re-imagining dementia care through playful, multi-sensory experiences

(USC Thesis Other)

Healing Spaces: re-imagining dementia care through playful, multi-sensory experiences

PDF

Download a page range

Download transcript

Copy asset link

Request this asset

Transcript (if available)

Content

HEALING SPACES:
RE-IMAGINING DEMENTIA CARE THROUGH PLAYFUL, MULTI-SENSORY
EXPERIENCES

by
Gabriela Purri Rosas Gomes

Master of Fine Arts
Interactive Media & Games Division
School of Cinematic Arts
University of Southern California
May 11, 2018

i

Each person with dementia is traveling a journey deep into the core of their
spirit, away from the complex cognitive outer layer that once defined them,
through the jumble and tangle of emotions created through their life
experiences, into the centre of their being, into what truly gives them meaning
in life. Many of us seek earnestly for this sense of the present time, the sense of
‘now’, of how to live each moment and treasure it as it were the only
experience to look at and to wonder at. But this is the experience of dementia,
life in the present without a past or future.
(Bryden)

ii
Acknowledgments
This thesis is one of the most challenging endeavors I have ever taken on. Healing Spaces
wouldn’t have been possible without the relentless support and guidance of all of those who in
one way or another were part of this wonderful collaborative process.
To my thesis chair, Marientina Gotsis, thank you for being my compass on this journey.
Your sincerity and sense of humor have brought me much comfort and joy. Thank you for
always being so generous with advice and time, no matter where in the world we would we both
be.
A very special thank you to my amazing thesis committee: Dr. Donna Benton, for your
continuous enthusiasm and encouragement throughout this process. As soon as I saw the Totoro
posters in your office, I knew we would be good friends. Dr. Leah Stein Duker, for being so
patient and for giving me the opportunity to become a better researcher. It has been a privilege to
work under your guidance. And Andreas Kratky, for always challenging me to not settle for the
obvious, and for sharing your own personal experience, which truly enriched this project.
Beyond my committee, I also had the privilege to be mentored by other brilliant minds at
USC. Dennis Wixon, thank you for helping me navigate uncharted waters, before I even knew
what I was doing. Maryalice Jordan-Marsh, thank you for being so incredibly supportive and
always finding time to meet and share your insights. You planted a seed when you first showed
me the Hue Go light and look how far it has grown! And finally, Margaret Moser, I am so
grateful for your mentorship through the turbulent waters of development. Thanks for sharing
your programming expertise but also for just listening to my struggles and frustrations.
iii
I also want to take a moment to recognize those who have helped mold the designer I am
today, through their lectures and precious advice – Tracy Fullerton, Richard Lemarchand, Peter
Brinson and Sam Roberts.
And of course, to the wonderful team behind Healing Spaces - thank you for baring with
me and for all your dedication to the project.
Finally, for turning this dream into a tangible reality, a very, very special thank you to the
amazing team behind the Front Porch Center for Innovation and Wellbeing. In particular, Davis
Park and Megan Park for going above and beyond to support this project. I’m also grateful to the
Villa Gardens team - Dmitry Estrin, Irma Canon, Keith Church, Tanya Mazzolini, Elizabeth
Colunga and Vincent Rosales – for this precious partnership and for welcoming me so warmly
into your community.
To my parents, thank you for always supporting my wildest dreams, wherever in the
world they might take me. You’re my greatest inspiration.
To my sisters, thank you for your endless encouragement and for always being beside
me, even though we find ourselves in different continents most of the time.
To my friends scattered around the world or around the corner, thank you for your
thoughts and messages along the way.
And finally, my wonderful husband, thank you for believing in me like no other, and
keeping me afloat during one of the most challenging years of my life.

iv
Table of Contents
ACKNOWLEDGMENTS ......................................................................................................................... II
ABSTRACT ................................................................................................................................................. 1
CHAPTER 1: INTRODUCTION .............................................................................................................. 2
ARTIST STATEMENT .................................................................................................................................. 2
DEMENTIA & SENSORY IMBALANCE ........................................................................................................ 3
MULTI-SENSORY ENVIRONMENTS ............................................................................................................ 4
CHAPTER 2: THE JOURNEY TOWARDS HEALING SPACES ....................................................... 6
MY PATH TO USC ..................................................................................................................................... 6
THE PATH WITHIN .................................................................................................................................... 7
LIFE-ENHANCING DESIGN ........................................................................................................................ 9
CHAPTER 3: PROJECT OVERVIEW ................................................................................................. 11
HOW IT WORKS ...................................................................................................................................... 12
One app, one connected space ........................................................................................................... 12
Setting an Ambiance ........................................................................................................................... 13
App Experience Flow ......................................................................................................................... 14
Play .................................................................................................................................................... 17
RESEARCH & COLLABORATION .............................................................................................................. 18
OPENIDEO CHALLENGE ........................................................................................................................... 20
CHAPTER 4: POST PARTUM ............................................................................................................... 21
WHAT WENT WELL.................................................................................................................................. 21
Sharing my idea early and widely ...................................................................................................... 21
Sustainability over Innovation for the Sake of It ................................................................................ 22
WHAT COULD HAVE GONE BETTER ......................................................................................................... 22
v
Lost in ideation ................................................................................................................................... 22
Wearing too many hats ....................................................................................................................... 23
WHAT NOW? ............................................................................................................................................ 24
BIBLIOGRAPHY ..................................................................................................................................... 25

vi
List of Figures

Figure 1. The IDEAS framework from Mummah, Sarah Ann, Thomas N. Robinson, et al.
“IDEAS (Integrate, Design, Assess, and Share): A Framework and Toolkit of Strategies for
the Development of More Effective Digital Interventions to Change Health Behavior.”
Journal of Medical Internet Research 18.12 (2016): n. pag. Web. ......................................... 8
Figure 2. Early Healing Spaces prototypes during Ideation phase. ............................................... 9
Figure 3. Erik Asmussen’s words on architecture and healing environments. ............................ 10
Figure 4. User Story. .................................................................................................................... 11
Figure 5. First digital prototype of Healing Spaces using the Philips Hue lights. ....................... 12
Figure 6. The main components of Healing Spaces. .................................................................... 13
Figure 7. The Forest experience (dawn and dusk modes). ........................................................... 14
Figure 8. Initial UI mock-ups. ...................................................................................................... 15
Figure 9. Beta screenshots of Healing Spaces app....................................................................... 16
Figure 10. Playtesting Healing Spaces with Dr. Donna Benton and staff from the USC Family
Caregiver Support Center. .................................................................................................... 18
Figure 11. The Sensory Room at Villa Gardens. ......................................................................... 20
Figure 12. The Sensory Room at Villa Gardens. ......................................................................... 20

1
Abstract
Healing Spaces is a smart platform that allows caregivers to transform spaces through
light, color, sounds, and visuals, turning any environment into a place where people with
dementia can focus, engage and relax. Inspired by the research legacy of Multisensory
Environments (MSEs) and existing therapeutic activity-based interventions, this project focuses
on the design of sensory experiences that may address the behavioral and psychological
symptoms of dementia, and also serve as a toolkit for caregivers to better manage and conduct
sensory-based activities. Above all, Healing Spaces is about creating restorative environments
where people with dementia and their caregivers can find respite and heal.

2
Chapter 1: Introduction
ARTIST STATEMENT
As an artist and designer, I am inspired by connections. The connections between us and
the world around us, the connections within ourselves, and above all, the connections we
establish with those we encounter in our lives. Having lived in different countries and cities
throughout my life, a perpetual feeling of foreignness follows me wherever I go. It’s an odd
paradox – to belong everywhere but nowhere. For the most part, there is wonder, anticipation,
and gratitude. At times, there is disorientation, nostalgia, and fear. These feelings come upon me
when I am most disconnected from my surroundings and are often accompanied by moments of
longing for the people and places I have left behind, and a sense of transience that suddenly feels
very tangible and real.
In recent moments of disconnect, I found myself thinking about my late grandmother in
the last years of her life. She had Alzheimer’s disease and, at the time, I didn’t fully understand
what was happening to her. When I look back with more conscious eyes, I realize that she too
experienced foreignness, but in a much more devastating scale. Little by little, she lost the ability
to connect with the world around her, to her grandchildren, to the person she once was. From the
outside, I was unable to comprehend these changes due to a lack of awareness of her condition,
and I cannot even begin to imagine her own distress in being unable to connect with everything
she once knew.
This is the case for the estimated 47 million people currently living with dementia
worldwide, a number that is set to increase to 75 million by 2030 (“WHO | 10 Facts on
Dementia”). For my MFA thesis, I wanted to challenge myself to create work that would truly
have the potential to improve people’s lives as well as touch upon connections I hold very close

3
to my heart. In feeling disconnected and foreign, I found a way to reconnect with my purpose as
an artist and designer.
Healing Spaces is my attempt to create a tool to help older adults living with dementia
and their caregivers reconnect, even if just for a brief moment. It is also about making research
and knowledge about dementia care and sensory stimulation more accessible to the public in the
form of a product, one I wish I had access to while my grandmother was still alive.
While millions of dollars are invested in research to prevent dementia, I want my focus to
be on improving the lives of those who are bound to live with this condition for the rest of their
lives, and those who face the challenging task of caring for these individuals. However, before I
could do that, I had to take the time to understand why persons with dementia are no longer able
to connect.

DEMENTIA & SENSORY IMBALANCE
Dementia is the name for a group of symptoms that commonly include problems with
memory, thinking, problem-solving, language and perception (Green). These symptoms are
caused by different diseases that affect the brain, including Alzheimer’s disease, which is most
common and most studied form of dementia (Green). In those affected, there is a progressive
loss of nerve cells, and the symptoms gradually affect one’s ability to take part in everyday
activity and leisure (Taylor). There is currently no cure for dementia. There are, however,
pharmacological and non-pharmacological treatments that can help reduce a person’s symptoms
(Green).
We experience the world through our five primary senses – hearing, sight, smell, taste
and touch. It is through them that we interact and respond to our surroundings. Older adults
living with dementia, especially in later stages, are especially vulnerable to sensory imbalance, as

4
progressive neuronal losses affect their ability to process sensory stimuli (Baker, Holloway, et
al.). Research shows that both sensory deprivation and overstimulation often result in similar
behavioral and psychological symptoms exhibited in those suffering from dementia, including
agitation, depression and so on (Milev et al.). By the time individuals reach the later stages of
dementia, it’s increasingly difficult for them to engage in cognitive-based or social activities, and
they may appear to be completely unreachable and isolated, making it challenging for caregivers
to engage and interact with them (Ellis and Astell). As the need for non-verbal communication
increases due to cognitive decline, it’s very important that individuals have access to balanced,
meaningful sensory stimulation, in line with their cognitive level (Baker, Holloway, et al.).

MULTI-SENSORY ENVIRONMENTS
Multi-sensory environments (MSEs), previously referred to as Snoezelen, are spaces
designed to gently stimulate the senses and alleviate both overactive and underactive behavior
(Jakob and Collier). They were developed in the early 1980s and were traditionally used for
leisure activities involving adults with learning disabilities (Jakob and Collier). In these spaces,
visual, auditory, olfactory and tactile stimulation can be offered using a variety of equipment
patients can engage with, such as colored lights, optic fibers, bubble columns and solar
projectors. There is no intellectual demand upon patients, and an “enabling approach is adopted
by the carer, allowing the patient to lead the session and make choices, while promoting a
trusting relationship” (Baker, Dowling, et al.). Although research in this area is limited, studies
and anecdotal evidence suggest that these environments may be an equally appropriate
intervention for managing the behavioral and psychological symptoms of dementia, especially in
the later stages where there is severe cognitive impairment (Baker, Holloway, et al.). After

5
spending time in these sensory rooms, persons with dementia show “positive changes in mood
and behavior, and also an increase in attention to their surroundings” (Jakob and Collier).
In their guidebook, Jakob and Collier provide best practices regarding how to make a
sensory room for people living with dementia. Based on a research design conducted in several
care homes in South England, this guidebook also documents aesthetics and functionality-related
issues (e.g., spaces being too cluttered / having too much emphasis on visual stimulation / having
equipment older adults find difficult to connect with) (Jakob and Collier). What was most
interesting to me, however, was the part when the authors explained that “the success of these
spaces is very much influenced by what staff think the room is for, how it is understood and
consequently used by care workers – not just in times of a resident’s distress but also as a means
of positively enhancing peoples’ lives” (Jakob and Collier). This statement was the ‘aha’
moment I had been waiting for. What they describe is the very core of user experience design,
the field I had come to love and embrace during my MFA years at USC.
In the weeks and months that followed, prior to the beginning of my final year of my
MFA, I immersed myself in research about sensory environments and sensory interventions in
the realm of dementia care. This enabled me to better understand the successes and challenges of
these types of interventions as well as the needs of my target population. In order to do this, I
also had to step outside the boundaries of my own discipline, and reach both ends of the art and
science spectrum.
In the next pages, I will discuss my journey in stepping out of my comfort zone to bring
Healing Spaces to life. The ups and downs, the unexpected challenges, the small victories along
the way and, most importantly, what helped me venture far beyond my initial expectations.

6
Chapter 2: The Journey Towards Healing Spaces
MY PATH TO USC
My journey in the creative world started in film. Inspired by Aronofsky’s Requiem for a
Dream and documentaries like Baraka and Samsara, I wanted to be an editor and visual
storyteller. But the film industry didn’t live up to my expectations, and I decided to move on to
the Fine Arts, where I found my voice and developed my perfectionist’s eye for detail. I loved
making art and telling stories but I still felt something was missing. It was only towards the end
of my undergraduate studies that I finally understood what moved me more than anything else;
tackling complex challenges through all forms of design. I realized, however, that I did not know
how or where to begin. I knew the visual tools, but I didn’t know the process, until I got the
chance to experience it first-hand, in one life-changing workshop in Dresden, Germany.
In 2013, I was invited to be part of a program called ‘The Dresden-Damascus Room – the
right object at the wrong time and the wrong place’, organized by the Media Design Department
of the Technische Universität Dresden, one of Germany’s leading institutes of technology. The
week-long workshop had 12 students from different fields and cultural backgrounds combining
skills and knowledge to activate the Dresden-Damascus Room, once a reception room (or Majlis)
from a luxurious home in 19
th
century Damascus, Syria, and now exhibited at the Ethnographic
Museum in Dresden. The goal was to find ways to preserve the context in which the room was
originally found using advanced and conventional media technologies. Working with different
departments and fields, we spent the first days immersing ourselves in the museum installation,
while also engaging in creative brainstorming and prototyping sessions. Finally, students were
split into multi-disciplinary groups to design and present a project proposal for an exhibit design.
At the end of this experience, I headed home knowing I had finally found my true calling.

7
It was during this trip that I had my first contact with an Arduino, an Oculus DK1, and
tangible user interfaces. I was fascinated by the collaborative environment between artists,
engineers, designers, and historians. I saw incredible work at the intersection of art and
technology and knew that this is where I wanted to be, exploring the edge of things. I realized I
could only thrive in a field that had yet no boundaries, and this is how I found my way to USC’s
MFA Interactive Media program.

THE PATH WITHIN
During my formative research months prior to this thesis, I took some time to reflect on
my first two years in the MFA program. How different was I from my 2014 self who wrote that
application to USC? What were my goals? Did I achieve them? Did I find new ones along the
way? I spent a considerable amount of time revisiting my journals, class notes and projects,
looking for the things that had a transformative effect on me, both personally and professionally.
I started with an experience goal – to help older adults living with dementia and their
caregivers to reconnect. After months engaging with current and past research on multi-sensory
environments and bouncing my ideas off others across campus and beyond, Healing Spaces
started to take a more defined shape, and the time came to figure out what would guide me
through its development.
If you would ask me to talk about my process of bringing this project to life, it would be
impossible to mention one specific framework or step-by-step approach. My starting point was
the IDEAS framework, which “builds on design thinking and user-centered design in that it is
iterative” and that “facilitates the creation of more effective interventions by using strengths
from a combination of disciplines at the intersection of digital health” (Mummah et al.).

8

Figure 1. The IDEAS framework from Mummah, Sarah Ann, Thomas N. Robinson, et al. “IDEAS (Integrate, Design, Assess,
and Share): A Framework and Toolkit of Strategies for the Development of More Effective Digital Interventions to Change
Health Behavior.” Journal of Medical Internet Research 18.12 (2016): n. pag. Web.

Under the guidance of my Chair and using this framework as a foundation for my
development process, I was able to better define my scope and start building my plan of action. I
developed a custom Agile project plan to guide me through production, and adopted the
playcentric approach I had learned and applied to my projects at USC. While confident in this
direction, I could only describe the Healing Spaces design process as some sort of ‘organized
chaos’. Throughout the year, I found myself constantly shifting between different project
methodologies, and working on multiple stages at once. Although the latter is a natural part of
the iterative design process, it was certainly one of my biggest challenges. I often found myself
overwhelmed and unsure I was on the right track. But I’ve always loved the adrenaline rush that
comes from not knowing where a path will take you, and I think that’s what kept me going
through the ups and downs of the project.

9

Figure 2. Early Healing Spaces prototypes during Ideation phase.

LIFE-ENHANCING DESIGN
I’ve always had a fascination for projects where the line between physical and digital is
blurred, where one is used to transform or augment the other. In thinking about how individuals
with dementia interact with their physical surroundings, I started looking at the field of
architecture and how they might have addressed the same challenges that inspired Healing
Spaces. This is when I came across Erik Asmussen, a Danish-born Swedish architect whose
work was fundamentally about creating “environments that support and enhance the process of
healing” (Coates). In his paper about the seven principles of Asmussen’s healing architecture,
Coates writes about the relationship between health, architecture, and design:
Health can be described as a living process of adaptation to constantly shifting
inner and outer conditions, rather than as a stable and fixed state of a separate
and autonomous “self”. To create environments that support and enhance the

10
process of healing, therefore, architecture must be concerned with creating a
total environment that both supports and images this dynamic process.
Asmussen believed that it is the special task of a living organic architecture to
stimulate all the senses, while simultaneously engaging will and understanding
of the user in a conscious process of re-balancing body, soul and spirit.
(Coates)
While Asmussen design principles spoke mainly to the field of architecture, it all comes
down to how users interact with a space. The essence of his work is about combining
functionality and spiritual balance, in line with the healing qualities we find in nature (Coates).
These guiding principles were very much aligned with my own goals for Healing Spaces,
especially when it comes to reinforcing our connection to the natural environment.

Figure 3. Erik Asmussen’s words on architecture and healing environments that served as inspiration for Healing Spaces.

11
I have always been drawn to the convergence of science and spirituality in many aspects
of my life, and through Erik’s philosophy of healing architecture, I saw the opportunity to also
brave into this realm through my own work. Instead of physically modifying existing spaces,
could I use digital technology to transform our environments in a meaningful way that would
enhance one’s ability to heal and reconnect with their inner self?
By attempting to create a sense of place through different sensory experiences and
mediums, Healing Spaces is about transforming any space into an environment that evokes the
mindfulness and peace we often find in nature, contributing to one’s ability to heal, focus and
relax.
Chapter 3: Project Overview

Figure 4. Healing Spaces User Story.

12
HOW IT WORKS

One app, one connected space
The Healing Spaces iOS app built for the iPad works together with the Philips Hue smart
lights and allows caregivers to take persons with dementia to different ecosystems and worlds
through light, colors, visuals, and sounds. It’s about extending the virtual experience into the
physical space. With the Philips Hue wireless lights, the goal is to explore light as a storytelling
tool and to connect users to different emotions and places.

Figure 5. First digital prototype of Healing Spaces using the Philips Hue lights.

To address accessibility and scalability, I chose to use commercially available off-the-
shelf components and take into consideration the reusability of each component in other aspects
of care. The same applies to the choice of platform, as the iPad gives caregivers and our end

13
users instant portable access to not only our experiences but also to a whole ecosystem of
applications and resources. We also adopted a modular design approach, so Healing Spaces can
work with both low-end and high-end setups.

Figure 6. The main components of Healing Spaces.

Healing Spaces is also a toolkit for caregivers to better manage and conduct sensory-
based activities. With this platform, caregivers can create a 'healing space' for their loved ones or
care-recipients wherever they are. By providing guidance and facilitating the setup of multi-
sensory experiences on a technical level and by combining all components into one easy-to-use
package, the goal is to leverage one's ability to provide and conduct sensory activities for persons
with dementia in a wide range of care situations.

Setting an Ambiance
In the current scope, caregivers can choose between two natural settings: forest and
seaside. They may also choose a time of day, dawn (more stimulating) or dusk (more calming).
With the tap of a button, the chosen ecosystem is brought to life through color (Hue lights),
natural soundscapes (speakers) and peaceful visuals (projector, TV or on iPad itself).

14

Combining these digital experiences with themed sensory boxes and tangible elements
that address touch and smell, the goal is to make multi-sensory sessions more focused and
meaningful, and to harness the power of our non-visual senses - sound, smell, taste, touch - to
instill a greater sense of wonder and play, while exploring the convergence of physical and
virtual layers. These are inspired by sensory activities that are already popular in dementia care,
and my goal was to leverage what we know works already and give additional value to
experience design and our non-visual senses. In Healing Spaces, immersion is about infusing
storytelling in every detail possible - in how the space feels through light and color, and in the
smells, textures, and tastes.

App Experience Flow
To create a good user experience for both caregivers and persons with dementia, we
decided to break down our interaction flow into four phases:

Figure 7. The Forest experience (dawn and dusk modes).

15
Preparation phase
This is where we work with caregivers to discuss what is needed for the experience. In
this section, we outline early set-up requirements. It’s recipe-like content - preparation
time, what ingredients are needed to conduct the activity. We outline the physical props
that are needed, any food or drinks that might go along with the experience and might
need to be ordered in advance. Through an intuitive interface, we try to make the
planning process as straight-forward as possible.

Figure 8. Initial UI mock-ups.

The Warm Up phase
The caregiver has all the props, the space is set-up and it is now time to bring in the care-
recipient. Our warm-up phase is the invitation to play. With the tap of a button, the
warm-up phase begins as the lights and sounds set the tone for the upcoming experience.
The idea is to create a comfortable and inviting environment for the person with

16
dementia. It’s a ritual phase, where we slowly bring both caregivers and care-recipients
into the magic circle.

The Experience itself
As the person with dementia is settled within the space and the caregiver judges it’s a
good time to start the pre-set experience, it’s another tap of a button and it begins. At any
moment the caregiver may pause, restart or stop the activity altogether.

The Cool-Down phase
As the experience ends, this is the moment for dialogue and discussion. Lights and
sounds go back a similar subtle state as in the warm-up phase, and we provide prompts
for the caregiver to engage with the care-recipient and reflect on what they just
experienced.
Figure 9. Beta screenshots of Healing Spaces app.

17

Play
In our early meetings, my advisors had really emphasized the importance of listening to
and learning from caregivers, involving them in my design process from the very beginning.
Although individuals with dementia are ultimately the end users of Healing Spaces, caregivers
are at the center of the experience. It was only when I started my field research, observing
sensory sessions at a memory care neighborhood, that I truly understood the crucial role they
would play in designing this intervention.
Before this MFA, I had never given too much thought to the word ‘play’. In Portuguese,
my native language, we have more than one verb that translates to ‘play’, all with their implied
and contextual meanings. But none of them spoke to me as a form of expression, or as a way to
understand and connect with the world. I’ve always loved games, and it was only after my first
game design class at USC, taught by Tracy Fullerton, that I realized how little I knew about
something that had always been inherently part of my life. Little did I know that such a small
word would fundamentally change the way I thought about design and interpersonal
relationships.
When I had the chance to witness sensory sessions and other types of activities in a
memory care facility, I saw a very tangible manifestation of play. When interacting with a person
with dementia, especially those who have significant cognitive decline, a caregiver is, in other
words, actively creating play to connect with that person. And they’re incredibly good at it. This
is when I realized that Healing Spaces had to be more than just another fun gadget. Instead, it
had to be a tool, one that would help amplify a caregiver’s ability to create play.

18
RESEARCH & COLLABORATION
Healing Spaces is about embracing technology, and making it more accessible, engaging
and impactful. I strongly believe in design thinking as a foundation for new ideas and responses
to challenges. To even attempt to create meaningful experiences, one needs to connect and work
together with users and stakeholders alike.
The development of Healing Spaces involves a team of USC students from various
disciplines, and professionals in the realms of gerontology, occupational therapy, games and
media design as advisor

Figure 10. Playtesting Healing Spaces with Dr. Donna Benton and staff from the USC Family Caregiver Support Center.

19
Healing Spaces is also coming to life with the help and support of the Front Porch Center
for Innovation and Wellbeing, which is part of Front Porch, one of California’s largest non-profit
providers of senior housing. The Center explores the innovative uses of technology to empower
individuals to live well, especially in their later years (“About Us - Front Porch Center for
Innovation and Wellbeing”). This collaboration has been crucial in establishing a connection
with the population we are designing for. As an intern, I have been able to connect with some of
Front Porch communities in the LA area, and through observation and field research, to infuse
my design process with insights from staff and caregivers. My goal was to bring as much of their
own caregiving experiences to the platform, to facilitate integration our experiences in their day-
to-day practice.
In the upcoming months, we will pilot Healing Spaces at Villa Gardens, a Front Porch
community in Pasadena, CA. This will be our first step in developing a replicable and
sustainable program for other communities in the Front Porch network. The pilot will target
residents of the community’s Summer House, a memory care neighborhood, and will be divided
into two phases.
Phase I, starting in the first week of April 2018, is the first usability study with residents
and caregivers. We will be gathering user feedback on our latest prototype through direct
observation and interviews with caregivers, to refine essential features and make final design
decisions. The goal is to evaluate usability, identify potential improvements and unexpected
insights. The data collected will inform future design decisions.
Phase II, starting early summer, will be a small-scale evaluation to test the potential
efficacy and feasibility of Healing Spaces in improving our target health behavior. The study is

20
being collaboratively designed with researchers from the USC Davis School of Gerontology and
the USC Chan Division of Occupational Science and Occupational Therapy.

Figure 11. The Sensory Room at Villa Gardens.

Figure 12. The Sensory Room at Villa Gardens.

OPENIDEO CHALLENGE
Healing Spaces has been recognized as a Top Idea winner in the Caregiving for Dementia
OpenIDEO Challenge, which focused on innovative solutions to support those caring for people

21
with dementia. A total of 251 ideas were submitted in the Ideas phase, and Healing Spaces was
among the final six Top Ideas. The challenge was sponsored by AARP Services Inc. and
UnitedHealthcare.

Chapter 4: Post Partum
WHAT WENT WELL
Sharing my idea early and widely
I always find it incredibly daunting that first time when we get to release an idea into the
world. It’s that moment when you take responsibility for your vision, even when you’re not sure
how you’re going to achieve it. It often comes with some sort of emotional risk, and that mild
fear of not living up to the expectations. Even though I love working in collaborative
environments, this is something I have always struggled with, even throughout my MFA years.
The moment I decided I wanted Healing Spaces to try and have a practical outcome, I knew I
had to make myself vulnerable from the beginning and embrace the rollercoaster of emotions I
thought was about to come. But, even with the ups and downs, it all turned out ok. My fears and
insecurities still exist, and at this point, I don’t even know yet if Healing Spaces will be
successful or not. I have only come so far because I’ve had the privilege to be surrounded by the
most wonderful advisors and mentors from the very beginning, and this multi-disciplinary
collaboration has been so far, the most rewarding part of the journey. As I started sharing my
idea beyond the USC community, to the staff at the Front Porch community I’ve been working
with and to the thousands of people who visit the OpenIDEO Challenge online platform, the
project suddenly grew richer in meaning and purpose.

22
Sustainability over Innovation for the Sake of It
Prior to the beginning of thesis year, I had very ambitious plans for Healing Spaces. I was
very much into the world of smart and sentient environments. I wanted to experiment with
sensors, interactive projection mapping, and biomarkers, to create spaces that would
acknowledge a user’s presence and state in real-time and provide meaningful multi-sensory
experiences. I won’t go into details on how ridiculously out of scope this obviously was, but it
led me to my first ‘fork in the road’ moment. I had this personal connection with my audience
and I had this drive to try and make something that would help improve their lives. The question
was … did I want to improve their lives now or in 100 years? As an experience designer, I am
interested in both directions. I love the thrill of working with emerging technology, but by
having no real constraints in this particular project, I started to lose my sense of purpose. In
choosing to make something that is first and foremost sustainable, I ended up going through a
much richer learning experience. Constraints can be challenging and incredibly frustrating at
times, but they fuel my creative process in a whole new way.

WHAT COULD HAVE GONE BETTER
Lost in ideation
My favorite project phase is ideation. It is also the one I tend to get most lost in. I love
brainstorming, rapid prototyping and whiteboards full of post-it notes. It’s beautiful when
everything comes together and your idea finally starts to become tangible. But then, the time
comes to make decisions. And as the say goes, one is not designing until one makes decisions. I
had been warned by many to avoid this pitfall, but once I noticed I had gone too far, it was too
late to change the outcome. I had fallen into the research rabbit hole and spent too much time

23
perfecting something I didn’t even know was good to begin with. While I think uncertainties and
changes are a natural part of the iterative design process, Healing Spaces could have been at a
more advanced stage at this point. Looking back, I see that I was overwhelmed by research and
expectations, and kept delaying the decision-making process, as I struggled to find the
confidence to stick to one direction. This also really affected my role as a Project Lead. If I had a
stronger vision earlier in the process, I could’ve better utilized my team members’ time and
avoided the stressful weeks of development and production.

Wearing too many hats
I love project management, I love art direction, I love to design, I love to program. But
doing all at once has proved to be one of the most challenging, unhealthy experiences I’ve had in
years. Although I was lucky enough to have talented students who volunteered their own time to
be on my team, the project demanded more hours than they could offer, and I suddenly found
myself with an enormous pressure on my shoulders. I was tempted to look for more people to
contribute to the project, but I was already struggling to manage our small team as it was, and I
decided that this would only take more of my time. I was also working closely with Front Porch,
which added another layer of project management I wasn’t fully prepared for. The evaluation
part was also something very new to me, and navigating IRB requirements and research
terminology was almost a thesis itself.
The heavy workload took a toll on my work-life balance and all the plans I had to
maintain a healthy lifestyle while working on this thesis went completely off rails. I found it very
difficult to lead the team while also struggling to keep my own motivation up, and this made me
more aware of my flaws as project manager.

24

WHAT NOW?
As I write this, we are less than two weeks away from the first usability pilot at Front
Porch’s Villa Gardens community. I’m anxious and have absolutely no idea what to expect. I
know there’s much to improve and rediscover, but my hope is that it becomes a creative catalyst
for new ideas and solutions. If I can generate conversation and get all of those involved to
problem-solve together, then I think I achieved my goal for this thesis. If anything, I hope that
Healing Spaces inspires other designers, artists and creative technologists alike to address the
challenges of a population that is often forgotten in our practice.

25
Bibliography
“About Us - Front Porch Center for Innovation and Wellbeing.” N.p., n.d. Web. 19 Mar. 2018.
Baker, Roger, Jane Holloway, et al. “Effects of Multi-Sensory Stimulation for People with
Dementia.” Journal of Advanced Nursing 43.5 (2003): 465–477. Web.
Baker, Roger, Zena Dowling, et al. “Snoezelen: Its Long-Term and Short-Term Effects on Older
People with Dementia.” The British Journal of Occupational Therapy 60.5 (1997): 213–
218. Web.
Bryden, Christine. Dancing with Dementia: My Story of Living Positively with Dementia. N.p.,
2005. Web.
Coates, Gary J. “Seven Principles of Life-Enhancing Design.” (1998): 239–254. Print.
Ellis, Maggie, and Arlene Astell. “Chapter 8: A New Approach to Communicating with People
with Advanced Dementia: A Case Study of Adaptive Interaction.” Making Contact
September (2008): 119–136. Print.
Green, Kathryn. “What Is Dementia?” n. pag. Web. 12 Mar. 2018.
Jakob, Anke, and Lesley Collier. “How to Make a Sensory Room for People Living with
Dementia. A Guide Book.” (2013): 70. Web.
Milev, Roumen V. et al. “Multisensory Stimulation for Elderly with Dementia: A 24-Week
Single-Blind Randomized Controlled Pilot Study.” American Journal of Alzheimer’s
Disease and other Dementias 23.4 (2008): 372–376. Web.
Mummah, Sarah Ann et al. “IDEAS (Integrate, Design, Assess, and Share): A Framework and
Toolkit of Strategies for the Development of More Effective Digital Interventions to
Change Health Behavior.” Journal of Medical Internet Research 18.12 (2016): n. pag. Web.
Taylor, Robin. “Dementia – Signs, Symptoms, Causes, Tests, Treatment, Care | Alz.org.” Ecos.

26
N.p., 2008. Web. 15 Mar. 2018.
“WHO | 10 Facts on Dementia.” WHO (2018): n. pag. Web. 12 Mar. 2018.

Abstract (if available)

Abstract Healing Spaces is a smart platform that allows caregivers to transform spaces through light, color, sounds, and visuals, turning any environment into a place where people with dementia can focus, engage and relax. Inspired by the research legacy of Multisensory Environments (MSEs) and existing therapeutic activity-based interventions, this project focuses on the design of sensory experiences that may address the behavioral and psychological symptoms of dementia, and also serve as a toolkit for caregivers to better manage and conduct sensory-based activities. Above all, Healing Spaces is about creating restorative environments where people with dementia and their caregivers can find respite and heal.

Linked assets

University of Southern California Dissertations and Theses

Conceptually similar

PDF

A full body game for children with attention deficit hyperactivity disorder: adventurous dreaming high-flying dragon

PDF

Alma: designing compassion for healthcare workers through interactive play

PDF

Infrastructures of the imagination: building new worlds in media, art, & design

PDF

Palimpsest: shifting the culture of computing

PDF

Public awareness campaign for dementia in Taiwan

PDF

Collectivizing justice: transmedia memory practices, participatory witnessing, and feminist space building in Nicaragua

PDF

Transference

PDF

Paralect: an example of transition focused design

PDF

Coding.Care: guidebooks for intersectional AI

PDF

Working through death and grief with a video game: the design and development of Where the sea meets the sky

Asset Metadata

Creator Gomes, Gabriela Purri Rosas (author)

Core Title Healing Spaces: re-imagining dementia care through playful, multi-sensory experiences

School School of Cinematic Arts

Degree Master of Fine Arts

Degree Program Interactive Media

Publication Date 04/18/2018

Defense Date 03/27/2018

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag Alzheimer's,dementia,experience design,Interactive Media,multi-sensory,OAI-PMH Harvest,sensory

Format application/pdf (imt)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Gotsis, Marientina (committee chair), Benton, Donna (committee member), Kratky, Andreas (committee member), Stein Duker, Leah (committee member)

Creator Email gabipurri@gmail.com,gomesg@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c40-493838

Unique identifier UC11266781

Identifier etd-GomesGabri-6259.pdf (filename),usctheses-c40-493838 (legacy record id)

Legacy Identifier etd-GomesGabri-6259.pdf

Dmrecord 493838

Document Type Thesis

Format application/pdf (imt)

Rights Gomes, Gabriela Purri Rosas

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA