Research advances in understanding Psychology, Cognition and Neurological Marketing are rapid, there's a lot of money there to accelerate it.
Let's turn this to our advantage... We take look at some of these advances and knowledge gains relevant to dementia, care, architecture and environments that enhance wellbeing.
Interesting things for your care team to try
Mimicking at Key moments (before a difficult task), helps to build trust and confidence. If you subtly copy the gestures of an individual directly before supporting them through a challenging event or activity, they are likely to feel more positively supported by you.
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Dining together and eating similar foods promotes trust and a sense of friendship.
Eating together promotes trust - when we eat similar foods. i.e. foods that look the same. So when your care team eats with the people they care for and share the same food together, your carers and those they work with will more easily build trust and friendship with one another.
Themed meals or snacks to promote healthy activity. If you connect a training concept, care idea, or activity for your care team or the individual/s you care for, with a free snack or meal together, you will be considered much more persuasive and influential. This leads to a much greater likelihood that concept will be made use of.
Belief in Repetition ‘Availability Cascade’… When an idea or activity is repeated this repetition builds trust and plausibility. This is why a clear care model is so important. If your team understand and are able to thoroughly and repeatedly apply your care model. So long as that model of care is effective, this repetition builds trust and belief in the system, leading to happier staff, and so long as residents are a good fit for that model, they will have more trust and happiness in each day going well. This doesn’t mean that each day is the same, just that your approach to care is consistent, a happier caring community. For example, Hammond Care have a very strict care model focused on cooking and eating together, their staff retention is close to 100%.
Bizarness Effect: Bizarre is memorable, much more so than anything common, and gives people a sense that they can be free to be themselves too. This is a quality Dementia Care Matters pioneered the use of in dementia care, encouraging care teams to have fun, with costumes and decoration, encouraging positive stigma free mind sets, a cheerful mood, free expression and emotional expression, that emotional expression is proven to be a key tool in breaking ideological barriers formed by entrenched attitudes in service users and staff that may be blocking their pathway to better wellbeing.
The environment and it's effect on Psychology & Cognition:
We are working with leaders in care excellence, they hire us because they know that the status quo of care is broken. The boring, institutional buildings of the past and that continue to be put up today re-enforce dysfunctional care methods. People are inclined to limit their use of an object only to the way it is traditionally used. There are many reasons we need to transform caring environments, but a key one, is that institutional buildings, or office like buildings or buildings that smack of any form of commerce actually psychologically encourage behaviours related to those building types, making it an every day challenge to retain any advanced approaches to care. Especially in the public view, in my conversations with service users, people feel as though they are made commodities of by the standardised care environment. Young people are known to fear these places. A growth in late age suicide rates in men have been linked to this fear, this stigma with entering care. If we change the buildings, we change the face of care, we create new environments that encourage and support new forward thinking care culture.
The best and most effective examples of care models, focus on engaging individuals in positive activity. But this can be a challenge, and often it is an expensive one. It can take a lot of work on behalf of your care team, and often models that use this method effectively are expensive to run.
These models require extra effort because of certain cognitive bias, such as ‘Pessimism Bias’, ‘Pseudocertainty Effect’, ‘Reactance’, ‘Neglect of Probability’, ‘Loss Aversion’. These describe how there is a tendency for people to feel / fear that bad things may happen to them, that when action is needed to gain positive outcomes people remain risk averse, that if someone wants you to do something specific people are liable to resist that perceived attempt to constrain freedom of choice, if a decision is made under conditions of un-certainty then that decision is liable to be to not take any action at all, and when confronted with giving up what you already possess for something else – perhaps in a residential care setting, the relative contentment of being in your own room or bed, verses the uncertainty of leaving it, people will be liable to seek to retain the contentment they already have rather than risk it. Combined with ‘Impact Bias’, which is the tendency to over-estimate how feelings will effect you, the risk of an un-happy experience can become exaggeratedly scary and worrying.
But we can create environments that reduce fear, support confidence, build trust and make it highly attractive for an individual to spontaneously engage with their surroundings. This is because of cognitive factors such as ‘Risk Compensation’, ‘The Loss Aversion Antidote’, ‘Hyperbolic Discounting’, ‘Decoy Effect’, ‘Conjunction Fallacy’, ‘Bandwagon Effect’ and ‘The Backfire Effect Antidote’. These describe how, when an individual feels safer they are increasingly able to take risks, if someone can approach a new idea a little at a time they are able to give up ideas to which they are clinging more easily, if someone can see something good, and that it is easily attainable, now, then they are much more likely to get involved, a clear choice of at least two good options compared directly with a third less beneficial option will generate a greater appreciation for and selection of one of the more positive options even when more effort is required to do so, directly seeing that an individual is having a good experience is much more persuasive in getting someone to engage than presenting them with just the idea of something they might like, people tend to do and believe in what they see others are doing and believing in, when a belief is entrenched for example that it is better for me to stay in my room – the only approach for effective change is through engagement with emotional factors – sights, sounds, smells of good, happy, exciting, interesting things.
Our designs work with your care model to cognitively support individuals to be more able to engage spontaneously and directly with the world, step by step from private spaces outwards. Supporting sense of safety and the development of personhood. We have developed a five point model which acts as a basis for empowerment from the room, and a second five point model to develop natural, active choice and encourage spontaneous engagement with meaningful activity around the wider care environment. The models support service users and staff alike, supporting a non-adversarial, community/team approach to living well.
Long term, meaningful activity around the wider care environment:
Life in care, as for life for all of us, is informed by our daily experiences. In this way care environments and care models create self-perpetuating good or bad lifestyles and behaviours. Because of ‘Attentional Bias’ our recurring thoughts are the ones that affect and tint our experiences. Therefore the sensory cues our environment gives us on a daily basis play a major role in the development of long term behaviours, moods and overall activity.
Getting people confident to explore and engage with their surroundings means reducing the ‘Ambiguity Effect’ which describes how unknown outcomes create aversion. In care, to encourage natural engagement, it is vital that each place is clearly meaningful, we also believe in corridor free environments wherever possible, so that unknowns are reduced. Any doorways or intermediary spaces need to be very carefully designed to allow individuals to understand and build confidence in where they are going before they make that decision to move from one space to another.
The effect of ‘Anchoring’ means that the first experience of an event, place or thing tints everything that comes after, this means that entrances are important, but not in the way you might imagine – in that grand entrances imply and tint everything with the status of the institution, not the opportunity for an individual to rebuild their wellbeing and sense of self, in this regard entrances should be on a normal personable scale, warm, homely. Rather than a sense of being enveloped by a large entity an entrance should give you a sense this is a place you can enjoy and be you.
The opportunity to make your own spontaneous choices and have those choices appreciated is vital in developing wellbeing, ‘Choice Supportive Bias’ means that you remember your choices as better than they were – when you choose something to have or do your experience of that thing is better, and more so if your choice is supported and celebrated, but many environments do not offer opportunity for spontaneous choice. We design environments centred on sensory scale, sensory wayfinding and decision making, enhancing freedom of choice let’s you tap this vital resource fundamental to wellbeing.
Environments must offer the basic happiness we all enjoy, that of choosing for ones-self the right thing to do right now. In most environments choices are hidden or minimal, in ours Key choices lead to a journey that invites the selection of a range of levels and styles of engagement on that theme, this process is a part of what gives us greatest satisfaction in life, so let’s make it possible for someone living in a residential care environment to engage with their life in this most natural way.
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