Increasing Connection by Design

The Sonnweid is Switzerland’s first care home developed solely for people living with dementia. And, according to Carolyn Kerchof, a writer and designer in Boulder, Colorado, it is considered in Switzerland to be a “flagship institution for dementia care.” She should know, she wrote her master’s thesis about it. Kerchof’s awareness of the Sonnweid first came about while she was working on Zeitgeist magazine, a publication for elder care settings. During her time at the magazine, she collaborated with Zurich’s public elder care system, Zürcher Alterszentren, designing and gathering personal anecdotes from care home residents. As she listened to stories and insights about the Sonnweid in particular, her curiosity grew.  

Then, in 2019, Kerchof began a Master of History and Philosophy of Knowledge at ETH Zurich university and chose the history of the Sonnweid as her thesis, looking at it from a design and history of knowledge perspective. 

For research, she walked around Sonnweid’s property with the facility’s former director, Michael Schmieder, and learned that, along with architect Enzo Bernasconi, Schmieder spearheaded the home’s innovative renovations in the late 1980s because of his strong belief that built environments can influence experiences for those living with dementia. 

“The [Oasis rooms] are designed to facilitate relationships, interaction and contact, even if people cannot engage or initiate contact with others how they used to."

– Carolyn Kerchof

Schmieder believed dementia care home residents should have the same essential needs attended to as anyone else: light, movement, good company, respect and to feel valued. 

“Caregivers collect their experiences and work together with designers and architects to find solutions to concrete problems, making the Sonnweid an important site for knowledge about dementia and the built environment,” Kerchof wrote in her thesis. “[K]nowledge about what people with dementia want and need from spaces has largely been collected in context, or through trial and error.”

Photo courtesy of the Sonnweid.

Renovation choices were strongly impacted by the culture, interactions and opportunities Schmieder wanted staff, residents and visitors to experience while on the premises.

This meant going against traditional care home design and making all rooms shared spaces, meaning even residents in early stages of dementia have twin rooms.

“They don’t believe in the narrative that having your own space is a luxurious thing to celebrate,” Kerchof explains. “They recognize the very strong need of people living with dementia to engage with each other … and how detrimental loneliness can be.”

Roughly 155 in-patients at the Sonnweid are split into three housing forms chosen to best support their current care needs. 

Residential Groups (a.k.a. Living Groups) consist of about 20 people living with early-stage dementia. The Supervision and Support Groups have 100-plus residents who have increased support needs.

And then the Care Oases “are shared living spaces for people who are in the most advanced stages of dementia,” Kerchof says, noting there’s evidence of residents presenting less distress in this style of living with about eight people per Oasis.

The Care Oases’ furniture is light, modular, and easily repositioned by a single care person when needing to create private spaces, or to roll beds onto the terrace for residents to feel the sun (or rain) on their faces. Visual and acoustic design touches also help make the spaces highly functional and stimulating. 

“The [Oasis rooms] are designed to facilitate relationships, interaction and contact,” Kerchof says, even if people cannot engage or initiate contact with others how they used to.

Staff at the Sonnweid feel walking and wandering is normal, healthy and should be encouraged, even though “wandering” is traditionally viewed negatively. To safely champion this idea, all staircases that residents could access were removed and replaced by ramps. 

Photo courtesy of the Sonnweid.

Also, a 1.5-kilometre “Neverending Loop” was built with wide ramps and walkways for residents living with less severe dementia to stroll on, with options to pause along the way at designated rest stops and activity centres, or to enjoy a passing visit with a care aide or other residents. Natural elements — light, earth and water — are intentionally integrated into the loop and throughout the site’s landscape to invigorate the senses.

When Kerchof met with Schmieder, he explained that real fire, water, flowers and stone are critical in the home over the use of fake flowers or digitized fires, maintaining that simulated, inexpensive decor can stir aggression in residents while real materials have the opposite effect. 

“They’re very deliberate about these kinds of aesthetic choices because they see it as part of the broader philosophy of real encounters, real experiences,” Kerchof explains, adding that Schmieder had said to her, “When you look around and see that you are in a valuable space, that has an effect on you. Being in more valuable environments makes us feel more valued ourselves.” 

This same idea spills over into the cafeteria’s table decorations, spa-like bathrooms, three-storey ramp lit by numerous skylights and windows, and a lovely interior courtyard that serves as a welcoming gathering space. This, of course, is in addition to the facility already being situated in a quiet, rural location with peaceful views of pastures, trees and the Alps. 

Here in Canada, cost often remains a barrier to innovation and implementation in the care sector because good staffing is usually the highest priority and investment. Therefore, replicating some of the Sonnweid’s design choices can seem like too lofty a goal for most long-term care-home owners and operators. But, for Kerchof, that doesn’t mean the Sonnweid’s success should be ignored.

“When people say to me that this is too expensive, it’s not even worth talking about, I say ‘No, it is worth talking about; it’s so important to understand what possibilities there are,’” Kerchof says.