How architecture can improve the quality of life of individuals showing challenging behaviour: a case study at a Dutch very-intensive-care facility

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Challenging behaviour, such as aggression towards oneself, others, or objects, arises in interaction with the environment and may prevent individuals from participating in society and compromise their quality of life (QoL). Literature suggests that architects can contribute to prevention, by influencing challenging behaviour before rather than after its occurrence. By conducting a case study at a very-intensive-care facility, we explore how architecture can contribute to the QoL of intellectually impaired (and autistic) individuals showing challenging behaviour.
The case study is based on interviews with residents and care providers, and direct observations of their daily life.
Preliminary findings confirm the relevance of architecture in influencing challenging behaviour. They suggest that the residents are dependent on the (visual and auditory) connection with the care provider. Also, care providers confirm the importance of this connection for the quality of the care they provide. At the same time, residents may experience anxiety triggered by fellow residents and their challenging behaviour.
Residents may also feel stress when faced with unexpected situations and this may lead to an onset of challenging behaviour. Sensory sensitivity, specifically to noise and heat is also relevant for their QoL.
The findings will be further substantiated through multiple triangulation with available data (personal files, incident reports, photographs). Future research, specifically focused on intellectually impaired individuals showing challenging behaviour, is needed to better understand the similarities and differences between their needs and the needs of autistic people.
Translated title of the contributionHoe architectuur kan bijdragen aan de kwaliteit van leven aan verstandelijk beperkte mensen met moeilijk verstaanbaar gedrag; een case studie in een Nederlandse VIC unit
Original languageEnglish
Title of host publicationProceedings of the 6th International Conference on Design4Health Amsterdam 2020
EditorsKristy Christer, Claire Craig, Paul Chamberlain
Place of PublicationSheffield Hallam University
Number of pages7
Publication statusPublished - Sept 2020


  • facilities management
  • architecture


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