Mobility and independence are important for our quality of life, but they are not a given for everyone. Think of people with a brain disorder, the elderly, and the challenges of an increasingly complex world. Prof. Dr. Ineke van der Ham helps people to set off confidently on their own.
She researches how the space around us can contribute to a healthier life, combining psychological insights with technologies such as virtual reality and game design. "What I find especially interesting: what happens when people get lost?"
Ineke van der Ham is a professor of Technological Innovations in Neuropsychology at Leiden University. She is involved in the Medical Delta 'Healthy Society program' and was also appointed as a Medical Delta professor this year with a position at the Faculty of Architecture at TU Delft.
What does being appointed as a Medical Delta professor mean to you?
"It means that with my existing chair in technology in psychology, I can more easily bridge the gap to technological applications. As a Medical Delta professor, I am now also connected to the Faculty of Architecture at TU Delft. At the same time, Machiel van Dorst from that faculty has been appointed as a professor at Leiden. In a way, we are exchanging roles, strengthening the connection between our fields. We had already worked together a lot, and through Medical Delta, we can now further cement that collaboration.
It also shows that our fields are deeply interconnected. Science goes beyond your own lab or department. TU Delft has technical facilities that are very valuable for us as neuropsychologists. At the same time, we at Leiden have extensive knowledge on how to measure behavior in different contexts, and we do a lot of research on building for healthcare. So, it’s logical—and inspiring—to establish a connection with architecture. We are at the start of several new projects, and it is incredibly valuable to be able to approach them with a broad perspective and easily involve each other in the process."
Could you briefly describe your area of expertise?
"My expertise is twofold. On one hand, I focus on spatial cognition: how people interact with the space around them. Where did I park my car again? Where are my keys? And what I find especially interesting: what happens when people get lost? This applies to both people with brain injuries and those without. We actually know surprisingly little about getting lost. For example, how do you design a parking garage where people can find their way? Designers and psychologists look at this very differently.
Virtual environments offer great possibilities: they are easier and more controllable than a real environment. And you can analyze behavior much better.
Initially, I focused on very fundamental research, experimenting with abstract shapes like lines and dots. But the real world, the space outside, is much more complex and interesting. From my interest in this, I started to delve more into virtual environments. They offer great possibilities: for instance, you can have someone walk through a virtual maze, which is much easier and more controllable than a real environment. And you can analyze behavior much better.
This also offers advantages in rehabilitation. If someone finds a supermarket overwhelming, you don't have to give them a paper map. You simply let that person walk around in a digital supermarket and can see exactly where things go wrong. This is where my two areas of focus come together: spatial behavior and digital technology."
How did you start focusing on the medical context in your work?
"I am a neuropsychologist and have always been interested in the effect of brain damage on behavior. Take, for example, people who suddenly get lost after brain injury. This happens more often than you might think, but until recently, it was hardly documented. For this, we have developed digital tests and training tools.
At the Faculty of Architecture, they focus on designing healthcare facilities based on how buildings work well. From my expertise, I know how a space affects people. This knowledge is especially valuable in dementia, as it's important to know which elements to apply or avoid. This is where Machiel and I also connect.
A concrete example: in hospitals, you often see long corridors with identical doors and just a number on them. That abstract design works very poorly for people with dementia. It’s much better to distinguish by color and shape. Or consider the use of light and dark. People with dementia are often attracted to light. Knowing this, you can design cleverly: make the exit darker and less visible, and ensure the shared spaces are light and inviting. This will attract people to those areas."
What is it like to start collaborating with someone from a different discipline?
"I’ve actually always collaborated with people outside my own field. With the police, artists, dancers. It’s part of how I approach my work: being in conversation with as many people as possible, from different perspectives.
I also really enjoy stepping outside my own field because it means you're truly discussing the problem, not immediately getting caught up in the details of a solution. This transdisciplinary collaboration is an essential part of how I work. Even when it comes to using digital tools. For example, I worked with the police on augmented reality applications and with a dance company that wanted to use VR for the audience. They seek knowledge, and we can contribute our experience and expertise. Our strength lies in experimental design.
We can also contribute a lot in education. We’re developing ways to present information to students in 3D. In fields like the sciences and medicine, you often need to understand complex structures, like anatomy. When you present them in 3D, it becomes much more accessible. Learning from 2D, such as from a book, requires a lot from the brain and imagination. Not everyone processes that easily. By presenting information spatially, the learning process becomes much easier for many people."
The healthcare system is increasingly under pressure. How can your research contribute to this?
"Digital tools make it possible to provide remote care and to accelerate or streamline certain steps. This saves time and relieves the healthcare system. Active screening also helps: if you can identify early on that someone, for example, is having trouble with a visit to the supermarket, you can offer targeted exercises to make that person more resilient. This is more about prevention, intervening before major problems arise.
Digital tools make it possible to provide remote care and to take certain steps more quickly or efficiently.
There is also quite a lot that can be done without always needing one-on-one contact. If you give people the right exercises, they can work on them independently at home. Especially if you present it in the form of a game, it works well. Often, just one session together is enough to get someone started, after which they can practice on their own."
What will a Dutch person notice from your work and this collaboration? What do you hope to have achieved for them in 5 years?
"I hope that digital tools, such as virtual reality, become more mainstream. That we use technology more often and more intelligently, for example, for remote care. The quality may not always be 100% the same as in a physical setting, but you can still do a lot with it.
Regarding the care centers of the future: the reflex is often to build as cheaply as possible, in inexpensive locations. I hope we move towards a different starting point: that people can live in their own environment for as long as possible, and that buildings are designed with that in mind. Flexible and adaptable. The use of green spaces should also play a larger role. It’s more than just putting a plant somewhere; it needs to be an integral part of the design.
The architectural firm I’m working with now correctly says that a building that takes residents and users into account is initially more expensive. But that investment pays off quickly, for example, by reducing employee absenteeism. When patients feel calmer, caregivers are happier. Ultimately, this leads to profit. We are currently working on quantifying this as well.
What I also hope is that we will start looking at the exterior spaces of buildings differently. Architecture naturally looks at this, but there’s still a lot to gain. It can be designed in a way that encourages people to move more. That’s another form of prevention."
How do you incorporate the needs of healthcare practice into your research?
"I work closely with rehabilitation centers in the region. Our goal is to integrate digital training into regular care processes. We do this together with healthcare staff: what do you need? What do we know about this training that works?
That turns out to be quite a hurdle. You can claim you have something good, but that doesn’t mean it automatically becomes part of the healthcare offering. Especially with digital tools. There are many rules and conditions for that. You really have to carve out a place for it in the system from a policy perspective. That's why, together with the institutions, users, patients, healthcare providers, and insurers, we are mapping out: where is the resistance? What works for you, what doesn't, and where can you find room to move?
There is often little time and budget for improvement, so we have to keep pushing that first step. Medical Delta is a very useful vehicle in this. It helps to build bridges between knowledge and practice."
What do you still miss in your collaboration to achieve your goals?
"We need to see implementation as a shared responsibility much more. Right now, it often falls through the cracks because no one thinks, 'This is mine, I need to do something about this.' There's no time or money for it, while in the end, everyone benefits if it works.
We need to view implementation much more as a shared responsibility. Right now, it often gets overlooked because no one thinks: this is mine, I need to do something with it.
It would really help if we could find each other better in that regard. And that needs to happen right at the beginning of a project. We should ask the question right away: if we find a solution here, how will we implement it later on? Instead of discovering at the end that something doesn't actually fit into practice.
So, involving everyone from the start. Collaboration is so important. Sometimes it's seen as a formality, but it definitely isn’t. As soon as you identify a problem, you should immediately ask: who are all the relevant people here?"
What role does collaboration between higher education, universities of applied sciences, and vocational education play in your work?
"At universities of applied sciences, for example, you find the applied psychology research group. They focus on practical problems. I enjoy working on a real issue, and naturally, that brings you to the practical side.
I think we complement each other very well. We provide a theoretical foundation, understanding how something works mechanistically. They know what works in practice, in what context, and for whom."
You will probably meet more scientists but also practice partners from other disciplines and institutions now. Whose work has truly surprised you and why?
"Two examples stand out. First, the architects from Tangram, with whom I am currently collaborating. They design progressive healthcare facilities. What surprised me: when we look at the design of a building, we would often make the same choices, but from different reasoning. Apparently, there is a shared starting point, but we each come from our own expertise. At the same time, they sometimes make choices that I don’t find logical, and I find that fascinating.
Additionally, I learn an incredible amount from healthcare professionals, such as those who provide training to patients or guide them. They often come up with practical insights that I would never have thought of myself. That makes collaboration so valuable."
Would you like to add anything?
"What I also find remarkable: within our department, we now have four Medical Delta professors: Judith Rietjens, Andrea Evers, Machiel van Dorst, and myself. This shows that our field is gaining more recognition. Social sciences are essential to the issues we are tackling, and therefore to the solutions. For example, think about technological acceptance. Do people even want to use new technology? What do they need for that? If someone says, 'I don’t want to work with a computer at all,' then that’s the end of the discussion. That’s exactly where we need to focus our attention."
