15 | Soundscapes and dementia (with Arezoo Talebzadeh)

People with cognitive issues also have special needs for their sonic environment. Arezoo Talebzadeh is an architect who designs soundscapes for people with dementia or autism. In this episode of Soundproofist, she describes how personalized soundscapes can improve their quality of life.

Transcript

Cary (00:06):
This is episode 15 of Soundproofist, and my name is Cary.

Phill (00:10):
And this is Phill.

Cary (00:12):
We're going to talk with Arezoo Talebzadeh. She's an architect and a soundscape designer based in Toronto. Arezoo specializes in designing assisted living spaces and soundscapes for people with dementia. And we're going to talk about some of those special needs of people who have cognitive issues. Particularly with sound. Arezoo was also working on a collaborative research product with a colleague at the University of Ghent. We'll also cover that topic in this episode.

Phill (00:39):
It was so interesting talking to Arezoo about her research. And I was especially excited to hear from an architect and how they can incorporate acoustic-minded design into their work, especially in a healthcare setting where it is most needed.

Arezoo (00:59):
I am an architect and I've been practicing architecture for years. And then at some point I realized that when I went to architecture school, I was thinking that I want to be outside of the box because architects and designers are usually not -- artistically -- they are not in the box. And then at some point I realized that I'm making another box on myself. It's a box of my clients, other architects, engineers. And I don't really realize what's going on outside that. So I was like, okay, I need to reimagine my life and what I want to do. So I said, okay, I'm going to go back to school and learn all this stuff that's new. So I went back to study, got a Master in Design for Health. I wanted to do something for people, more human touch to bring into the design.

Arezoo (01:43):
So I went back and studied at OCAD University in Toronto. And my idea was that I'm going to go and work with the walkability in the cities. And how we can make cities more usable for people who are aged a little bit, or who have difficulties or on a wheelchair, maybe -- how we can make the city work for them. But when I was in this school, we had a project that we had to do at Toronto Rehab Center for people with dementia. So when I went to do the literature review for the people with dementia, I figured out that, "Oh, perception is something completely different if someone has dementia." So for architects, we always think that people have the same perception of a space as we intended to design. It's something that we usually don't think that people may have a completely different perception of space, especially when it comes to other stimuli, not just vision, sound or smell.

Arezoo (02:41):
So I was reading about dementia and how the perception of a space, especially the audio perception and the sonic environment has changed for the people with different types of dementia, because they cannot make that relation that everyone else make between the source of the sound and the sound. And that's very confusing to them. And that's one of the reasons that they get lost, or they cannot understand the time of the day -- because sound doesn't have the same meaning for them. So that was very interesting and I got more into it. And at the time I was working on the sound on that unit and one of my cohorts, she was looking at the light. So we working in those together. And then I thought that maybe I'd continue on it and make it my final thesis for that program. So then I start to learn about the soundscape and at the moment, at the time I thought that, "okay, soundscape is like landscape, right? For architects."

Arezoo (03:35):
So I'm just going to do a sound map of the units. And everyone was like, "yeah, that's fine. Come and do it for our unit." And then I went into more literature and learning about soundscapes. And then I figured out that, "Oh, that's really something more than just a sound map." So I was very interested to know that the soundscape looks at...I mean, I'm pretty sure you know what the meaning is of soundscape, because everyone talks about it. It's about how people perceive the sonic environment. It goes back to the individual perception of the sound in any context. So it's not just about me, who are from the outside designing for these people. But it's about how people who are in this space perceive the sound. That's the basic of soundscape design and soundscape approach.

Arezoo (04:22):
So it was very interesting because it's...exactly goes back to how I feel about architecture and how we have to, when you're designing a space, you need to look at those who want to go back and use those spaces. And that gets me very interested in the whole idea. I started doing some research about it and I became soundscape researcher, besides my own architecture background. So when I'm trying to put them together on how we can help people to enjoy the places that we designed for them. And in some cases, especially for people with dementia, that's my research right now is how we can help them through the soundscape of the space that we designed. So they can be less agitated or we can help them to navigate through the day. Just giving them some signal of the time of the day through the soundscape. So that's how I got into the whole researching soundscape researcher.

Cary (05:15):
Can you give an example of how, for example, a person with dementia would through the soundscape of a space, understand the time of the day?

Arezoo (05:25):
So this is actually what my next phase of the research that I'm doing is going to be about. And I'm just going to say that this is not something that I'm only doing. I'm doing it with a researcher from the University of Ghent in Belgium. So they started to do the same idea for years. They are working with people with dementia in senior housing. And -- through the co-design with the nurses who work with people with dementia, their caregivers, and all the psychologists who worked with these people -- they came up with this -- that if you design a soundscape, that it can give you a little clue of the time of the day, for example, in the morning, if there's a sound that tells you that this is the morning. Like the kettle is boiling, or it's a bird singing in the background.

Arezoo (06:15):
It gives the people with dementia the idea that, "Oh, this is the morning. This is a sound that I am very familiar with." And the whole point is that this soundscape design has to be very individual, based on the individual perception. So I cannot design one soundscape that works for everyone. Of course, everyone has a different background, different culture. It depends on where you grow up. If you grow up in the broader area or in the city -- your whole life, you had a different soundscape background. So that's something that we always have to do at the beginning. So we have to go through the questionnaire, ask either the people that have dementia if it's not too advanced, or the caregiver, or people who work or the family members to get a background of the culture of the person and the place that they live, the type of activity that they used to do, if they are into sport or not, if they are like active people or passive people during their life.

Arezoo (07:11):
And then we put this soundscape and design it to the way that from the morning we put different sound of the day, like birds singing in the morning. And then it goes to some time in the day, maybe the church bell. It depends if that person is a person who used to go to church, that can help. Or if it goes to the end of the day and we want to make them ready to go to bed. Then we can put sounds that are more relaxing. If they used to listen to music, music can be very helpful. I know Phill probably has more ideas about the music part. Just help them to calm down and get ready for bed. And then there's an idea that even during when they're asleep, we can use them like heartbeat, maybe.

Arezoo (07:55):
I'm not sure about that part. We have to test it. If a heartbeat can help them to have the more relaxing time to sleep., Because we know that sound during sleep affects people, and then it gets them agitated. Even if you think that you're asleep and you're not listening to anything. Because your ears, our ears are always on and there's no need for it. So you can hear it. This is something that we say in the cities when we live beside the highways, even if you're asleep, the sound of the highways and the noise is going to bring our heartbeat up and give us a kind of agitation and anxiety when we're asleep. So we try to bring it back to the soundscape that is more calm during the sleep and help them to, in a nutshell, to improve the quality of life for these people with dementia.

Cary (08:45):
So does this include sort of having sound that is playing inside of the rooms and inside of the unit? So you're controlling kind of the soundscape of the space that they live in so that it's not randomized anymore. What about during the day? Not just when they're sleeping or waking up, but what's happening throughout the day. And again, you say it's personalized, but I'm curious to know what some of those solutions are.

Arezoo (09:13):
So there is a... Actually, when you work with soundscapes, there are two things that we can do. We can reduce the noise that is agitating for people by stuff that architects do and acoustic engineers help to do. So putting the sound masking for example, or change the STC of the wall. So we make sure that the unit has, or the room or the living room of senior housing -- it doesn't bring all the sound of the HVAC or air conditioning in to disturb the people. This is one way. The way that we're doing it with the soundscape is that we're adding a positive sound to the space, to the sonic environment. And it can happen along the way. In the living room, for example. The study that I'm part of, at the beginning, they did it in the living room of the senior housing when they added some other noise to give them a clue of, is this the lunchtime coming?

Arezoo (10:09):
So now I can hear the sound of cutlery, for example, or the dishes happening, so people get ready for the meal. And then, so it can happen at all around the unit. In my study that I'm doing in trying to rehab we're just gonna focus on the rooms that is individual are in, because we want to do the clinical trial. We want to get the data that is more, it's not descriptive, kind of a research is more like we want to be more precise. So we can really use our data to have a kind of a clinical trial research as evidence-based design for our theory. So we are doing just in the bedroom, but of course you can do it all around the unit. And if it works and if we can find a way that we go forward with it, then you can just get this device, install it in your home.

Arezoo (11:02):
If you have a problem with dementia or you have someone, your loved one has dementia, you can put it in your home and just design it to the way that it plays the soundscape that the individual prefers. And it helps them to sleep better. Or if they're very agitated, it can help them to lower their agitation. Because one of the things in dementia, it's called BPSD, which is the behavioral and psychological symptom of dementia. It's something that 80% of people who have dementia go through this, that they have. They get very agitated or anxious, and this number goes up. And one of the things that we always -- I mean, not me, I'm not the clinical -- but in healthcare, they always try to lower these BPSD numbers and we think that this soundscape can help to lower their BPSD numbers and help people. So, yes, just to answer your question. It's going to be an extra sound that we're adding to the sonic environment.

Cary (12:02):
How is the BPSD -- this is probably outside of your wheelhouse -- but do you know how the BPSD is measured? The level of agitation?

Arezoo (12:12):
There is a different chart. Let's just call it... Like geriatric, psychiatric. They know how to deal with it. And I have it in my research, but this is not a part that I'm very familiar with. So it's a different type of method to... you can, for nurses, go to their room, they witness what's happening for that patient. And then they fill in the chart. And that chart is going to get used to evaluate the BPSD. So it's for their agitation, for anxiety, even for heartbeat, for the way that they sleep, the different aspects. And there's a long list of it. They always use it in the unit where I'm doing my research. That's one of the purposes of this unit, that people with dementia who are very agitated and they have BPSD, a number that's a very high number. And they come to this unit, they stay six weeks in that unit. And not through the drugs, but through the ... they're not doing environmental change in their life. They're more like through the OTs or occupational therapists or all this stuff that's happening in the unit, they lower the BPSD. So now we want to think about the environmental aspect that we can help. We can use it to help the people to lower their BPSD.

Phill (13:21):
And in these facilities where the dementia patients are housed, are there existing acoustic standards from an architecture standpoint for these healthcare facilities? Does Toronto have specific guidelines for these things?

Arezoo (13:34):
In Canada, we don't have a specific guideline for people with dementia. There is some that exists in the UK and probably in the US. I know that AIA has some recommendations. We just follow the healthcare recommendations for when we design these units. So that's one of the things that probably is going to come very soon. We can just design it specifically for the people with dementia and how the environment can help.

Phill (14:00):
And when you were starting this investigation, how did you measure the acoustic environment or get a sense for the auditory environment of the ward?

Arezoo (14:09):
So in soundscape research, you do a measurement of the sonic environment, the dBA, the loudness, and everything. And at the time, because I wasn't too much familiar with the soundscape research, I did it through the sound measurement. So I would go to the unit and do the sound measure for the dBA and the loudness. And then I would do the other part that's the more subjective part of the soundscape research as just my own view of the people around it. So I look at the timeline: are the people agitated, are they anxious, are they happy or sad, or... ? And then I would relate them together and see if the level of the sound in that unit at that time has anything to do with how people respond to the sound. Which I realized at the time that... It's very subjective, because it was a time that the sound level of the unit would be very high.

Arezoo (15:07):
Because for example, there was a time for the music and everyone played music, and it was so agitating for me as a researcher to sit there and do it. But when I was looking around, I see the people are really happy. So people with dementia were really happy and they were really enjoying their time. And then I realized that perception is really important. So it's me looking at it with the people who are there and then enjoying is really different. And when I did more research and I went to the next phase, I realized that we need to do the binarural measurement when we do the measurement of sound in this level. So it's not just about how the... it has to be really the way that the head of the human being hears the sound level of the space. So that's the one that we do. But in the research that I'm doing, you're not going to measure the level of the sound in the unit.

Arezoo (15:55):
So yes, of course, they're going to be some noise that's going to always be in the room. like they have the air conditioning unit. It's a hospital unit that I'm working on. So there's going to be lots of buzz happening during the day because of the alarms going off. We understand that, but we know that if you really want to do something for the environment of this unit, we need to figure out that part, too. I mean, these alarms should not go off all the time. It can be just be just a vibration to the nurses. And there's lots of research on that, or how we can lower the sound of the HVAC in these units or how we can make a better STC for the walls, for example. So the sound won't go from one room to the other.

Cary (16:39):
It didn't occur to me that there might be alarms and things going off in a dementia ward. It seems like that would be, it's hard for anybody to listen to. And certainly for someone who's anxious, that would be extremely difficult.

Arezoo (16:50):
Yeah. They always have the alarm, especially because some of them have to... Because of the specific requirements, they have to always be seated on their wheelchairs. And these are the kind of features that if they try to get up the alarm goes off. So you can always hear all of these alarms going off. That's one of the things that you need to realize when you're working with designing for the sonic environment.

Phill (17:12):
I'm curious about that with your background as an architect. Is there any reference, I guess the question is the soundscape has so much of a temporal aspect to it. It changes over time. And I'm curious as, as an architect, is that something that is traditionally considered when designing a facility, that how the facility will be at different times of the day or the season?

Arezoo (17:36):
It's interesting that you said that. I was recently listening to another podcast about sound and noise, and a guy was talking about how people ask an architect to design a space and they want to know how it's going to look, but they never ask how it's going to sound. So I think it's just because the sound is something that we don't see that much. So people don't think about it. We know that if we design a building close to a highway, it's going to be noisy. Or the rail, it's going to be noisy. But we never try to tell them or represent how it's going to sound in the future. So it's not something that architects design. Usually we bring the acoustic engineers to help us to make sure that everything's just vibration works. And we don't hear the noise of the elevators going up and down, or is the garbage chute very close -- how can we just make sure that the noise is not going to come into the unit.

Arezoo (18:30):
And then it goes to all the hospitals. It's more like they have something to say, acoustic engineers, but architects traditionally don't design for a better sonic environment or look at it. But it's something that is coming to play somehow. And that's something that I hope that I can bring into the architecture design for a client, for example. Not only would we show them the visual or usually walk them through the space. It's easy right now -- you give them the headset and they can walk through the space. But now they can add the sound to it, and show them how it's going to sound at a different time of the day or what they want to hear during different times or different rooms. Do they want to hear the sound of outside coming in or not? For example. And that can be very helpful. Especially -- I'm working in an office in Toronto called Kasian architecture, and we do healthcare, we do senior policy, we do education and workplaces.

Arezoo (19:22):
And one of the things that recently we started to work on is a workplace for people with autism. So when you design a place for people with special needs, you need to be careful about politics. The space looks like even the color that you use, but also the soundscape of that space. Especially the people with, for example, with autism, they can have hypertension or they can be on the other side of the spectrum. So you have to give them this choice that if they want to work in this space, they can choose the sonic environment. Do they want it to be loud and noisy, or do they really need it to be very quiet so they can focus and work? And the same thing when we design a workplace for people with dementia, because the sonic environment really affects their life.

Arezoo (20:14):
If we can make this space, somehow that they can control the sonic environment and they can make it really quiet if they need to, so they can work better. So it can give them more opportunity to work a longer time, even when they're diagnosed with dementia. And that's the whole idea of the inclusive design, too. So every individual has a say when they want to go into a space. So it goes back to their perception of the space, the kind of ... when they have a disease and their difficulties, cognitive difficulties. This is not something that people see. And you can just say that, OK, I want to design a building that's wheelchair accessible. It's easier for people to understand and see it when it comes to something that is cognitively related to people, you have to architect and design. This is our responsibility to tell our client that someone may have a problem with the sonic environment and you have to design it for their needs. I don't know if I answered your question.

Phill (21:08):
No, that's really interesting. And it makes me think, especially what you were saying earlier about an individual's perception and background is very important in the way that they perceive the Sonic environment. So I guess that leads me to the question of when you're designing these things, or specifically in the dementia ward, do the patients themselves have some control over like the example of when you said they were all playing music and that made them happy that they had some control. Is there some way that in the design you can give an individual control over the environment in a certain way,

Arezoo (21:41):
In some places, yes. In the traditional way of designing places for people with dementia or Alzheimers or usually, it's just design as it is. And there is no way that we can change it or someone can go change it. But now with the idea that spaces have to be individualized, so many researchers and designers are looking at how we can make the place so everyone can choose what they like. Even it's the color of the room or the texture. The texture is very important for people with dementia and autism too. So if you can give them the texture that they want and then how we can educate the designer and the clients -- all the stakeholders, basically that the sonic environment is as important as everything else. And then maybe they can give them this option in the near future, that they can even choose the sonic environment that they want. If they want it to be real quiet or not. If they want it to have background music or not, or if you can use this, the one that I'm using in my research, if we can give them the clue of the time of the day in the space and it can help them. So not at the time, it's not really happening, but it's something that everyone is talking about it, they're trying to design around it. So in the future, it comes to play.

Cary (22:56):
I think that some needs of some people with dementia would be also different if they have hearing impairment versus sensitivity to certain noises. Because I've read that in some cases, dementia can be a result of living with hearing impairment for a long time. Because you have a certain amount of cognitive decline when you can't hear very well. So I would imagine that some of these environments, you probably have to design for people who can't hear very well, versus those who need to block sound. Certain types of sounds. Is that true?

Arezoo (23:30):
That's true, and hearing impairment is one big theme in dementia, and it plays a big role in dementia. So that's another thing that if we think the place is loud, or if the person has dementia, how that person feels. So and that goes back to the idea of you have to go and talk to the people who are using that space and get their perception. And then look at that. And it may sound a little unusual and not doable. Because then you think that, okay, I'm going to design the senior housing with a level for people with dementia. And so the people are going to come and go, and they're going to change. So how can I design and that design changes with people who come and go... In the architecture part of it, we play with drywall. I mean, how can I change that drywall all the time? It's not going to happen. And that's true, but then something like the soundscape can play a really big role, because that's something that we can change. You install the player in the room, and then you can just design the soundscape all the time, based on the data of the person who's going to use that room or that unit or that space. And that's sounds more doable.

Cary (24:43):
I remember, uh, gosh, this was a few years ago, some study or some group that had created iPods with playlists specifically for people with dementia, from the time period of their lives when they were young, the music that they might enjoy that would possibly trigger memories and make them feel comfortable. Have you ever heard of doing anything like that?

Arezoo (25:08):
I actually thought of doing it for myself. Because I was. Involved with people with dementia. And I always think that I may be one of them in the future. I always think that I have to put the playlist for my future. If someone in the future has to deal with me or be my caregiver. So they know what type of music I love so they can play it because music has a big role. My research is not in that part, but there is so many research on the music and for the people with dementia. And it's ...of course, as you said, it goes back to their culture and their background, and usually goes to when they were young, what kind of music they used to listen to. And it brings the memory and the whole thing about the dementia is that the memory plays the most important role, especially in Alzheimer's.

Arezoo (25:54):
For example, with music, you can bring the memory and it's so helpful. But as you said, there should be a way that you have a playlist, so you can go and play. And then I'm working in Toronto. Toronto is a very diverse city. And so many of the people who come to these units or to senior housing, they have a completely different background. They don't even speak English anymore because when you get dementia, there's a good chance that you'll stop speaking English and you go back to your native language. So how can we communicate with them and get this out? So we can design a better soundscape, for example, for them. So that's very interesting what you said. I didn't know about that research, but I'll go and see how probably they advanced now.

Cary (26:41):
Because it was on iPod, so I'm thinking it was probably the mid 2000s. I should, if I can find the information, I'll send it to you. I thought it was really interesting though, because it did seem like it had a really soothing effect and a helpful effect on behaviors of people with sort of advanced dementia who were wheelchair bound. And it calmed them down to be able to hear, maybe big band music or whatever was important to them. And each one was kind of customized. I think it's a great idea. Actually. I want somebody to do my soundscape for me, you know, the soundscape for when you're trying to get work done, but there's construction going on outside. That sort of thing. You said, you know, a few months ago, when we first began talking about doing this interview, you were about to begin a research project. I believe it's the one you were referring to with the University of Ghent. That is underway now, is that right? Or you're still going to begin that project in the future. I know we got interrupted by the pandemic,

Arezoo (27:39):
Yeah. The pandemic just slowed down everything a little bit, but it's under way. We have to get the research ethics approval because we are doing it of course, with the people with dementia and in the hospital setting. So getting that REB approval, we have to tell the people exactly what we want to do. So it took a while because this is a research happening between, as you said, University of Ghent with engineers, from them and from Toronto rehabilitation Institute, all the healthcare providers. And then I am just not taking the middle and trying to get them all together so we can all understand each other. That's always very interesting and challenging for any research and it's multidisciplinary because people have to get to the point that they all have the same say and same language. So it took a little while for us to get to the point that we all understand what we want to do. And then we put this REB into place. So now it goes to the longtime of reviewing the REB to make sure that what we do is not really going to harm anyone during this research, which is very important. So it's still going on. We are still in the starting phase, but hopefully in the couple of years, we're going to have the data and then we can talk about the results.

Cary (28:56):
I just had another thought about creating playlists sort of soundscape. And you mentioned the multicultural aspects of living in Toronto. I wonder if there's a way you could sort of have a citizen science project where people would contribute their knowledge of soundscapes from their homelands to help people who have dementia, who probably can't tell you anymore what it is that's important to them from their culture that they want to hear.

Arezoo (29:25):
That's a very interesting idea, actually. I like it because you're right, because people are the best resource that you can go and ask. And if we can put them all together. So if someone's coming from the Middle East just completely different background during their life. And then we can put them all together and they can go and use them. I'm a big fan of citizen science. Yeah. That's a good idea. Maybe someone will just hear it and just go ahead and do it.

Cary (29:53):
I know, it'd be fun to participate in. I mean, I know sometimes it's not just music, but also like the sounds of the street, the marketplace.. Just sounds that we might not think of. So we can't guess what that might be for them. I think that would be a really cool project, also.

Arezoo (30:09):
When we were talking about my project at the University of Ghent in Belgium, the whole idea was that, okay, we want to use the sound of birds. But are they always going to be the same birds? Is the European birdsong same as Canadian birds? So that was a very interesting topic that we went through. And I still don't know. I mean, you're just going to have, give it a try and use the birdsong that everywhere sounds the same. But I mean, when we talk about the soundscape, it's just not one answer. It's just lots of things that come into play. And then all of these, even if you do the perfect soundscape design for one person, sound is not the only thing that's going to affect their life. Because it's still going to be in the room. There's going to be light. There's going to be a smell has a big deal in it. So it's not just one thing that's going to happen. So they all have to come together, but they all have to do a little bit of it and help into the whole process.

Phill (31:04):
That makes me think that I should plug the Macaulay Library in the Cornell Lab of Ornithology. They have a huge online database of bird recordings from all over the world. And you can look for specific regions and get recordings of birds from certain geo locations. They have a massive library.

Arezoo (31:23):
That's very interesting.

Phill (31:24):
I can send you links to that as well.

Arezoo (31:27):
I appreciate that. Yes. So they are not all the same, right?

Phill (31:32):
Definitely not. Definitely not. Actually, there was an interesting article that in Canada, that some bird song was traveling from Western Canada to Eastern Canada and they were tracking it over 10 years that these bird songs were changing. It's very preliminary research. So the journalist is always the one trying to make it a sensational finding in the scientists are always the ones that are like, "we don't know, we don't know... Like calm down. Maybe this has been happening always." But anyways, definitely the songs are different. I mean, we were talking with Dan Dugan and he was talking about the variation in bird songs, in different neighborhoods of San Francisco and how some areas, the same species of birds will have different songs. So I think there's quite a bit of variety.

Arezoo (32:20):
That's why it's good, really, to talk about this research. Some people don't like to talk about their research when it's in the beginning. Because as you said, they say that, "Oh, we don't know. We may not have the good data." But I think that... I mean, we talk, we learn through the process and I think that this is a process that we all have to go through and everything that we learn is going to help. So I appreciate your thoughts.

Cary (32:43):
You also do some work don't you with the Hush City and the Hush City app?

Arezoo (32:48):
Yes. With Dr. Radicchi. Antonella. Well, I wish I could work more. I am using the app that they have -- the Hush City app in Toronto. But I live in downtown Toronto and finding a quiet space...I mean, it doesn't have to be quiet space in the case of Hush City app, but really like, I don't want to record the sounds of traffic in Toronto for someone to go and look at it. But every time I find a place that is quiet and it's makes me happy or makes me calm, I try to do my part as a citizen scientist and put it in the app. So everyone who's looking for it in Toronto, they can go and find it. And it's very interesting. Once in awhile, when someone else puts something there I go and listen to it. And it's usually, it's very interesting to see what's going on around the board.

Cary (33:36):
It is, I do it also for San Francisco. I don't always remember when I find a quiet space to pull out my phone and do that. But I have,...not very many people are doing it here, but at least they're being recorded. And especially during COVID, there were a lot more quiet spaces than normal. And I tried to capture a few.

Arezoo (33:54):
For awhile, it was very quiet. Yeah.

Cary (33:57):
For awhile it was. Not anymore. Now it's all starting up again. In fact, I was wondering also, if some of the learnings from a lot of the outbreaks, especially the earlier outbreaks of COVID-19 were happening in assisted-living facilities. And I'm wondering if some of that learning has informed you going forward about design for assisted-living facilities.

Arezoo (34:22):
Yeah. Unfortunately, Canada was hit very hard in the senior living sector with COVID-19, and it was so sad. And as a designer and architect, what we want to do, we want to just put all of these in better designs for the future. And mostly it goes with the infectious disease, and how we can stop it. Because that played a big role, how we designed the spaces and how people come and go, and then bring the virus in. But now that we're looking at the guidelines and how we can go forward, especially because the Canadian government wants to really do something about it. So we are all so sad about it and we know that we have to do something. So that's something that it's going forward. And of course that we start to design them for a better future. We cannot just look at one ... and say that, okay, "infection is important," because of course the next time maybe something else will come and hit us.

Arezoo (35:17):
So we have to be prepared. So we are looking at the sound. Not only the sound -- it's just more like all the aspects of the environment. Light and the noise, and then the HVAC system, for example. How we can make something better for them. And yeah, we are looking at it, but it's just, we are so much into it right now. Everyone's talking about it. We have to like step back and look at what happened, and why it happened. And then hopefully in the future, we can do much, much better for the people living in the senior housing.

Phill (35:48):
I'm curious, I was looking through some of your publications and it seemed like you were doing some research with Exergaming. Can you tell us what that is or about that research at all?

Arezoo (35:58):
I used to do it. I had to stop it because I couldn't just do all of my interests in research and my everyday job, which is an architect. But I did some because I was working in a senior population. We had an opportunity to work in a research group with some of them, people who are in healthcare and who are, much more familiar with people who are older age. And we are trying to find a way to make them be more active, especially when they live in a senior housing and they don't have that much ability to, for example, go out because of their problems. Or the way that the house is just regulated. So we were trying to come up with an idea of exercise for them to be more than just play for example, with the computer. Something that is a little more doing exercise and makes them happy.

Arezoo (36:45):
So we came up with the idea of making them like a bingo. But we put it on the floor. So they have to walk and play the bingo. And we did a prototype of it and we tested in a couple of senior housing room in Toronto. And we got the data, and everyone was so excited. Our prototype was just very simple at the time. But really we didn't even have a game in it. We just had to explain it to people to play, but they would go and play. And I think it's just something that my research is just about the people who are aged and they are senior living and they really want to do so much more, but sometimes they live in a place where they don't let them to do it. Not because they don't want them to do it.

Arezoo (37:29):
It's just that they don't have the facilities to help them, to support them. So this was one of the things that we said, how we can bring some excitement to the exercise. So people can as a play or game do some exercise, and not just to put the headset the virtual reality on it. So make it more tangible, especially because the population that we have in Canada right now, as seniors, they didn't grow up with virtual reality, right. They want everything to be tangible. So if they can walk on something and then play with that, and just turn it on and off, or make a sound or play a sound, that can be more exciting. So, but I had to leave that research because I really wanted to focus on the soundscapes. But, yeah, it's nice that you found it. It was very interesting research at the time.

Cary (38:16):
It's interesting because I wonder if some of that would also work for dementia patients getting their bodies involved in a game. Or is that, are the people that you work with more advanced than that, wheelchair bound? Even in a wheelchair though, you might be able to play a game.

Arezoo (38:36):
The people that I'm involved with are very advanced, but not all of them are in a wheelchair. And some of them actually are too active and they walk around the whole day. And actually the soundscape can help them to calm down and sit down. Because sometimes really you need to force them to sit sometimes. Because they walk all day around the units. But of course, exercise is one of the things that for people with dementia is as important as everyone else. So anything that we can do to make them to enjoy when they do exercise. And there are some researchers who work, especially on exercise for people with dementia, and there is some way to do it. And we are not, in my research, we are not looking at the daytime for the people with dementia and the soundscape. But I'm pretty sure that the soundscape can help people to get excited and start dancing, because people with dementia, I mean, like anyone else they love to dance.

Arezoo (39:30):
I mean, everyone loves to dance and you just need to put the right music in, or make them excited. So that's something that definitely, we need to look at.

Phill (39:38):
Thanks so much for sharing your research with us and talking with us. It's so interesting.

Arezoo (39:42):
Thank you too so much. I really enjoy your podcast by the way.

Cary (39:46):
Thank you. And I like yours. Actually. We didn't even talk about your podcast, but that was interesting because you have interesting topics. It sounds like other people sometimes do some of the interviews, but it's a wide range of topics.

Arezoo (40:00):
That's more like inclusive design. And then I don't interview them. We always bring two persons to talk to each other. So it's a conversation, not an interview. That's the basis of the podcast.

Cary (40:12):
And thank you so much for your time and taking off your Saturday afternoon for us.

Arezoo (40:16):
Oh, thank you. It was very enjoyable talking to both of you, actually.

Cary (40:27):
I'd like to thank Arezoo for joining us today on Soundproofist and for sharing her ideas and insights on soundscapes for special needs. As always, we'll put some notes on the Soundproofist blog with links for more information. Thanks for listening. And remember to stay safe and be kind to each other. See you next time.