Rendre possible l’engagement en familiarité dans les CHSLD : les savoir-être d’une pratique de design centrée sur l’usager

The phenomenon of an aging population brings with it a whole host of diverse challenges. Some of these challenges are of a general nature, such as those related to economics, while others are much more specific, such as the conditions and procedures needed to ensure that vulnerable individuals receive adequate care and services. For instance, a symposium entitled “Providing a quality experience for users and loved ones: personalization of care and social services,” held during the fall 2014 Entretiens Jacques-Cartier, aimed to examine personal user experiences pertaining to the delivery of health care services and the organization of social services. This meeting’s initial hypothesis underscored the need for a more balanced power dynamic with caregivers or in the delivery of care. This hypothesis is based on the concept of user capabilities, achieved through the adoption of practices which enable professionals to provide personalized care. Further exploration of this particular issue is at the core of this doctoral thesis. This research aims to examine the conditions which would allow people living in long-term care facilities to engage with their environment in a way the sociologist Laurent Thévenot categorized as “familiar engagement.” Familiar engagement refers to realities in which people are able to rest on an accustomed dependency with the things and people that surround them. In other words, this type of engagement refers to a relationship with one’s environment which allows individuals to take part in their usual habits, and where they feel at home and at ease in their surroundings. As Thévenot’s analysis shows, this type of engagement requires the  conception of a world which allows people to frame their actions around reference points which are personally relevant to them. Thus, this research aims to better understand the role of designers in the conception of nursing homes where this type of pragmatic engagement is made possible. The guidelines for the development of residential facilities able to satisfy these criteria are largely in line with the expectations surrounding the development of user-centered design, experience design, and empathic design. That being said, despite the efforts put forth towards this initiative, self-identification with one’s environment remains an unresolved problem. Our hypothesis is that the evolution of user-centered design is too often restricted by methodological or procedural issues. Development in this direction has been done to the detriment of the precise examination of the virtues needed by designers in order to be able to seriously take on the issues associated with the goals of this design approach. More specifically, this research identifies the qualities of long-term care facilities’ experience whose design allows for familiar engagement. For our study, we analyzed the findings and judgments of living environment evaluation teams concerning the quality of living environments of the long-term care facilities in the Montreal area. Through this survey, five qualities have been identified: welcomeness, conviviality, flexibility, thoughtfulness and stability. Finally, as a reflective essay, a portrait of virtues is suggested as a way for designers to implement facilities that share those qualities. The dissertation also presented a reflexive tool for a virtuous design practice and pedagogy.

Keyphrases: design social, social design, moral sociology, long-term care facilities, user centered design, empathic design, ageing