With funding from the John E. Fogarty International Center and National Institutes of Health (NIH FIC), a landscape architect and architect will receive one-year research training scholarships to improve the wellbeing of people living with dementia in Peru. These scholarships will go to one Peruvian and one American built environment designer, who will be mentored by Dr. Leann Andrews and Coco Alarcon,  alumni architect and landscape architects of the Fogarty Global Health Fellows program. The team of built environment designers will then design and implement renovations to a home for people living with dementia in Iquitos, Peru and document changes in the physical environment as connected to wellbeing and satisfaction.

DGH professor Joe Zunt is the Principal Investigator on this project, which will run until June 2021. In addition to renovating the home, funding for this project will also support a UW PhD nursing student to be mentored by nurses and social psychologists at the UW Center for Global Health Nursing, the Universidad Nacional de la Amazonía Peruana. This student will implement culturally-relevant assessments that are tailored to demented people and their caregivers. The assessments will administered before and after the renovations to test their effectiveness on overall well-being. 

“There are very few facilities for people living with dementia in low- and middle-income countries,” Zunt said. “We plan to assess the responses of both residents and caregivers to the renovations our team makes – to determine which are most effective and well-received.”

Despite recent medical advancements that have helped identify predictors of dementia, treatment of the disease has been somewhat limited. For many people around the world living with dementia – and their caregivers – having a supportive environment that provides comfort for their remaining years is crucial, but oftentimes daunting. 

“Caring for people with dementia is challenging – we hope that some of our design elements will reduce the burden upon the caregiver in areas such as ensuring safety and engagement of residents,” Zunt said. “For instance, virtual walls or rooms displaying a jungle or river to provide residents with a familiar or nostalgic experience and could be replicated in other homes and institutions anywhere across the globe to engage residents and perhaps also increase caregiver satisfaction and reduce caregiver turnover.” 

In addition, Dr. Leann Andrews notes, “There is quite a bit of research on the positive cognitive and wellbeing benefits of exposure to nature, plants and art for those experiencing dementia. We’re aiming to layer this research into guiding the renovations as well.”

Zunt and his team hope to establish new collaborations for clinical and built environment research in Alzheimer’s and related dementias. Research collaboration within the city of Iquitos, one of the most geographically isolated communities in the world, will involve nursing, social psychology, and population health. These intersections with Alzheimer’s and other forms of dementia will also help set the stage for future research by trainees of the Global Health Fellows Program. 

“Our teams’ long-term goal is to strength the dialogue between health institutions and professional architects,” Alarcon said. “The lessons learned in this project will help advance policies for the development of homes with people with dementia by incorporating the ministry of health perspectives and architectural codes to improve the environmental conditions and quality of life for the elderly.”

Zunt added, “The best way to understand and address a health and societal issue is to start with a multidisciplinary approach to evaluate and incorporate inputs from many points of view. As we move forward, we anticipate this renovation will provide a template for new projects, and research training opportunities for nearly any discipline interested in helping to address the growing problem of dementia across the globe.”

Total funding for this project equals $270,000. The full title of the grant is “Dementia and the Built Environment – implementing and assessing a pilot architectural and landscape design project in the Peruvian Amazon to improve wellbeing for people living with dementia”. DGH’s Jorge Alarcón and Sarah Gimbel-Sherr are also included as mentors on this grant.