Another bedroom for the hospice …

Looking towards the bathroom, the glass tiles shine like jewels. The bedroom door is open, making the open couryard visible. Refracted light from the clerestory windows shines on the outside of the bathroom wall. A Kereru print by Shane Hansen hangs on the marble wall.

Renders coming through

It’s been an intensely busy week trying to get everything done for my final presentation next Wednesday. We had practice final crits this morning. I need to work on my speech. OK feedback though.

I’ve been working on my renders hard out. Here’s a couple I’ve completed so far.

First, the Contemplation Place located at the south end of the hospice at 81 Fort Street. The gold leaf, 6 metre high wall, at the end of the room is the highlight of the space. Natural light enters through thin windows in the ceiling along the existing brick wall and gold leaf wall.

This second image shows the interior of the south-western bedroom looking through large glass doors into a courtyard. Walls are off-white to absorb light. A marble wall adds texture as well as a feeling of opulence. Coloured, refracted light is visible on two of the walls from the green and blue clerestory windows.

More to come …

Heading towards final crit

12 days to go until final crit. I’m feeling both anxious and excited. I’m working furiously on plans, sections, elevations, perspectives, and renders. I’ll post them as I think they’re finished.

First up, the facade.

81 Fort Street facade – design includes larger windows and front doors and large picture and coloured windows on a new first floor.

How’s This Position?

In Narratology, by Mieke Bal,[1] Bal proposes that, any given art work provides a narrative, with each viewer, depending on their own socio-cultural history, reading a different story.

I would like to propose, that any given urban site does the same. One space, in this case 81 Fort Street, offers different narratives to different people – depending on their own story. Where one sees a dark and dangerous corner site, another sees warmth and a place to safely hide.

These multiple narratives intrigue me and have become a driver within my design.

A hospice tells so many stories. Not just the stories of those that have arrived as patients for palliative care and everything that involves, but also of families who just need a little respite.

Cynthia Leibrock[2] alludes to another side of the dual dialogue hospice offers. Referring to patients whose death is drawing near, she says, “Each moment takes on greater importance, each sensory experience a special meaning. A window is not just an opening for light and air; it frames a vista of the last sunrise. A door is more than a functional entrance; it brings in friends and family members.”

And so this hospice is designed with all these things in mind. There is plenty of light but then there are shadows to retreat to. There are communal spaces for sharing food and supporting each other but then there are private spaces for a little time out.

Any hospice is a large facility and palliative care has very specific requirements. This presentation concentrates on just a few of those requirements. I have focussed my design on the family room, the gardens, a contemplation place, and most importantly, the bedrooms.


[1] Bal, Mieke. Narratology: introduction to the theory of narrative. 3rd ed. Toronto: University of Toronto Press, 2009. eBook.

[2] Leibrock, Cynthia. Design Details for Health: Making the Most of Design’s Healing Potential. 2nd ed. Hoboken: John Wiley & Sons, 2011. eBook.

Bulk Planning

An update on my studio work – I know you’ve been gagging for it (is that too familiar?).

The past two weeks have been spent head down, arse up, doing bulk planning for my hospice design at 81 Fort Street. I won’t bore you with all the iterations but here is the final set of drawings I presented at crit yesterday.

I haven’t posted the basement and ground floor drawings. They’re done, but they’re not exciting as I’m not really designing into them for this project.

A few tweaks to complete the planning and on with final drawings and renders. Not long to go now …

A Slight Programmatic Change

So, I presented my hospice precedence research last week. I received good feedback on the precedence I presented, especially the Maggie’s Centres. I only had 5 minutes to talk but I did point out that my programme would have to include at least 25 different kinds of rooms (you know, the ones I listed last week (and still managed to leave some out)).

My teacher spoke to me later in the day about this was too big a project for one semester and that I had to think about changing my programme (to something similar of course, we don’t want all that research to be in vain). We talked about day centres and about centres with less bedrooms but realised that these spaces still need all the requirements of a hospital and so it would still be a huge undertaking for the short space of time we have remaining (4 weeks, agggggghhhhhhhh).

After talking about making this a whole year project – not sure that’s what I want to do with the rest of my year – we decided to keep the hospice for this one semester but just concentrate on designing specific spaces within the facility.

Therefore, recognising  and acknowledging that hospices have particular requirements, I will now be concentrating my design on a small part of the hospice centre.

My bulk planning has allowed me to organise the hospice so that the ground floor is primarily focussed on entry and reception. The first floor is for administration and functional facilities. The top floor – the floor I’ll be directing my attention to – will house bedrooms, a nurses station / drug room, a family room with shared kitchen, cleaners’ cupboard and linen storage, the chapel / meditation space, and a courtyard/garden.

Within these new parameters, I will be focussing my design specifically on the bedrooms, chapel, family room, and gardens. This should be more manageable. (Fingers crossed.)

Hospice Precedent Analysis

The five design precedents I’ve focused on include more than just hospices. I’ve also included designs of other buildings used for health care because I’ve found most hospice design more focused on ticking of boxes than actual good design. Either that or it’s just really outdated.

Precedent Examples

The first example I’m including is Maggie’s Gartnavel by OMA. Maggie’s Cancer Care Centres are now scattered around the UK. When architect Maggie Jencks, wife of architect Charles Jencks, was diagnosed with terminal cancer in the mid 1990’s she found the gloomy NHS facilities anything but healing environments. It was Jencks’s belief that good architecture can help make a distressing situation more manageable. To date, fifteen Maggie’s Centres have been built in the UK, each by a leading architecture practice.

Maggie’s Garnavel was designed by OMA, Rem Koolhaas’s practice. The building is designed as a sequence of interconnected spaces. Outside walls are predominantly glass, both transparent and translucent. The translucent glass offers light & shadow with privacy – all things that become increasingly important the closer to the end of one’s life one gets. Maggie’s Gartnavel is designed around a central garden courtyard. Hospice designers seem to agree that garden and central open areas are an essential part of good hospice design.

Aires Maleus Arquitectos’s House for Elderly People is designed to be something between a hotel and a hospital. The designers understand the need for both a social life and solitude and so have included spaces within the complex that allow for both. Whilst most hospices tend to shy away from corridors, wanting to create spaces that are more open, Residências Assistiadas welcomes the corridor, seeing it as an analogy of the path into life, turning time into form. To illustrate this, a line of light, recessed into the ceiling, follows the path of the main corridor.

Estudio Entresitio have designed three health centres with the same floor plan for three different sites. The buildings differ in the materials that have been used. Usera’s centre is clad in perforated metal panels with a gold finish, San Blas’s concrete construction with horizontal timber casting is finished with blue tiles, and Villeverde is finished with varying degrees of translucent panels from opaque through to transparent.

These buildings offer privacy from the outside and an openness within. The design is loosely based on a grid form that allows for both public and private spaces within. Courtyards throughout provide light and create a feeling of openness so that corridors are not just uninterrupted, visually limiting walls.

WE’s Cancer Care Centre in Denmark is designed around a figure 8. The space is divided into three parts: user facilities, common zone, and staff area. Once again, courtyards and gardens are an integral part of the design. Rooms are light and warm. Timber is used on the ceiling and the floor. The inside and outside are indistinguishable in parts, adding to the design’s atmosphere of openness.

The Maitri AIDS Hospice in San Francisco is especially interesting to me. Like my own site, this one is in the inner city and is adapted from a former garage. Unlike my site of 488m2 the Maitri AIDS Hospice is 4,450m2. That’s a huge difference.

Kwan Henmi Architecture have designed a space that, once again, revolves around a central courtyard. The interior is designed to have a residential feeling with lots of soft furnishings included. Patients are welcome to bring their own furniture and other personal items for their bedrooms.

Spaces & Services Required

Last Thursday I was lucky enough to be given a two and a half hour tour of Mercy Hospice on College Hill in Ponsonby. This provided me with invaluable information on what spaces and services are required to best run a hospice.

In Hospice Architecture, Stephen Verdeber writes that there are seven different areas to take into account when planning a hospice. My own visits to hospices have given me examples of the rooms that fall within these areas.

  1. Site & context
    close to hospital care
    parking
  2. Arrival spaces
    reception
    ambulance bay
    expressions of remembrance
  3. Residential milieu / common spaces
    family rooms
    kitchen / dining room
    resource library
    art therapy room
    aromatherapy room
    dayrooms
    activity rooms for children
  4. Residential milieu / private spaces
    bedrooms
    bathrooms
    nurses’ station
    staff kitchen
    drug room
    hydrotherapy room
    laundry room
  5. Transitional spaces
    circulation paths
    elevators
    chapel / meditation room
  6. Connections with nature
    gardens
    courtyards
    large windows
  7. Administration / total environment
    sluice room
    cleaner’s cupboard
    storage
    offices
    bereavement counselling room
    backup power generators

That is a LOT of rooms. At this stage, I’ve no idea how I’m going to fit all of those spaces into my small site (and it seemed so big to start with).

Lighting

Natural daylight is essential for mental well-being. However, more is not better. When patients first enter hospice they are often drawn to natural daylight but as their health diminishes they often seek out darker spaces to retreat to. Private spaces especially need to be designed so that both natural and artificial lighting can be controlled by the resident.

Refracted light through recesses and skylights is a good way to bring light into a space without being drowned in it. Directional wall-fixed lighting helps to create a more tranquil atmosphere than overhead lighting whilst leaving the ceiling free from glare. Hospice patients spend a lot of time on their backs in bed looking at the ceiling. Overhead florescent lighting or strong halogens are not comfortable to be staring at for any length of time.

Plumbing

Every bedroom needs its own bathroom. This includes a sink, toilet, and shower with floor waste. NZ regulations state that all hospital rooms (and hospice falls within that category) must also have basins within the bedrooms. Taps should have motion sensors for operation as strength is reduced.

Larger hospices will have full kitchens and laundries but many smaller facilities house these offsite. Family kitchens need dishwashers and sinks for both food and for cutting flowers. The art therapy room will need a sink and running water. The hydrotherapy room, depending on the type of bath may need special plumbing. Walk in baths, with doors, need especially large wastes so water can drain quickly allowing the patient to stay warm. Even if laundry is done off-site a small laundry should be available to families who may be staying with their loved one. A sluice room and a cleaners’ room are needed for keeping everything clean and sparkly. At the very least, plumbed cleaners’ cupboards should be available on every floor.

Ventilation Requirements

Bedroom windows should be easily operated by patients. Remote control operation would be optimal. Each bedroom also needs to be individually controlled. As people’s health declines their temperature can fluctuate. As the body shuts down they can feel very cold so it’s important that they are able to turn the heat up if they want. Once the patient dies, it’s important to keep the room very cold so that family can come and visit and say goodbye before they body is transferred to the funeral home.

Although hospice have a policy of no resuscitation, oxygen still needs to be available in all rooms for those with respiratory disease. Piped oxygen can be expensive to install and maintain so individual bottles within rooms may be a better option for smaller facilities.

Summary

“Each moment takes on greater importance, each sensory experience a special meaning. A window is not just an opening for light and air; it frames a vista of the last sunrise. A door is more than a functional entrance; it brings in friends and family members.”
- Cynthia Leibrock, Design Details for Health.

It’s important that one’s last days are comfortable. This comfort can come from a soft bed, time spent in the garden, the sound of a crackling fire or one’s favourite music, a loving touch. Personal photographs can trigger comforting memories.

What’s most important is that the patient, and their family, feel cared for. An environment that is tranquil and calm – a shelter from the storm.

Analysis of Atmosphere in Drawings and Models

So, the brief for this week is to research 5 images of drawings and models for interior or architectural projects. I thought this would be easy-peasy – it wasn’t.

Here’s what I’ve got so far (just click on the images to make them bigger) …

Next step … make a response to the drawings and models above by doing my own drawing and model making.

I’ll keep you posted.

The judges have convened and decided …

… the programme I’ll be taking through for the rest of the semester is the third option I presented. But with some changes – of course.

I am to design a hospice. Any advice anybody can give would be very much appreciated.

Very much.

Really.

Much love.