HOME WITHIN A WALLED GARDEN A PALLIATIVE CARE FACILITY JOHN DOLECHEK 5TH YEAR MASTERS OF ARCHITECTURE SIEPL-COATES ARCH DESIGN STUDIO 7
TABLE OF CONTENTS SECTION ONE RESEARCH Hospice and Palliative Care Healing Environments Healing Concepts
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SECTION TWO SITE Context Description Building Codes
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SECTION THREE PROGRAM EVALUATION Spatial Requirements Analysis Building Users
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SECTION FOUR DESIGN ELEMENTS Precedents Materials Design Patterns
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SECTION FIVE PROPOSAL Architectural Idea Creating Healing Environments Model Photographs
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CONCLUSION Significance of a Garden
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figure 1. Redwoods National Park 4
SECTION ONE RESEARCH The quality of space and act of healing go together. Some places nurture healing while others hinder it. A hike through a forest offers a much different experience than lying on a hospital bed. Death is a very difficult situation to deal with, by the patient, family member, and even care taker. As our perception of the world shrinks to a single space in these precious moments, the significance of the quality of space becomes more so. This section describes the relationship between hospice care and palliative care, as well as the different types of healing environments and concepts. It, then, discusses the importance of a garden in relation to healing.
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HOSPICE AND PALLIATIVE CARE Death is a feared end, but imminent. It is not an easy topic to discuss, but it is healthy to listen, communicate, and cope with patients in these difficult situations. Hospice derives from a Latin term that means guest house. Originally, these hospices housed sick travelers who were on pilgrimages throughout Europe. The first modern hospice was founded by Cicely Saunders in southwest London. She recognized the significance of dignity, respect, and compassion in relation to the process of dying. This first modern hospice is the initial precedent to providing end-of-life care through physical, emotional and spiritual means. Today, hospice care facilities recognize the significance of allowing the patient to be at ease in the final moments of their life (WHO). The focus of palliative care is not to escape death, but improve the quality of life among patients and their loved ones. It is a fundamental shift in focus for health care as it copes with death by regarding it as a natural process of life, and it offers physical, psychosocial and spiritual support. Palliative care is provided by a team of doctors, nurses, social workers to attend the needs of one who is usually experiencing a life-
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threatening illness. While it sometimes works along with curative treatments, its main goal is to improve the quality of life by relieving stress and all the symptoms associated with the dying process. Patients may suffer chronic illnesses such as cancer, cardiac disease, kidney failure, Alzheimer’s, Parkinson’s, and many more but palliative care can benefit any type of patient at any stage of their illness. The last 15 years has seen an incredible amount of growth in the field of palliative care. As the baby boomer population is reaching retirement age and beyond, the demand for hospitals, retirement homes, and assisted living establishments will certainly continue to rise. Facing these difficult situations allow patients and their families to make timely and informed decisions about their health and well-being. As the exact time and manner of death is uncertain, the ability to function and understand the situation properly gives the patient and their family a small sense of control through all the uncertainty. In even the most difficult and helpless situations, we can always experience the slightest bit of hope in our final moments.
figure 2. Hope 7
HEALING ENVIRONMENTS
The environment is very important when dealing with healing. When people think of healing they want to be in a place suitable for well-being, such as nature. Unfortunately, hospitals rarely are a place for comfort, but many believe that fresh air, adequate lighting, and good accommodation for staff are changes that can be made to improve the environment of a hospital.
Healing in a built environment affects all the senses and gives pride and symbolic power. Natural and built environment are tangible unlike symbolic and social environments. The symbolic environment focuses on the importance of meaning. Physical objects seen in a place hold a meaning and are symbolic to the healing process.
Healing is multidimensional, which includes physical, biological, mental, spiritual, emotional, and social. All these elements must be cured to complete the healing process. Many focus only on the physical cure for health while many things can also be effected. Achieving health must be synergistic from these elements. Healing is also an ongoing experience and must come from within the patient.
Symbols can be more abstract through rituals and ceremonies. The final aspect of the healing environments is social. Good relationships are essential to a therapeutic community. This aspect also looks for an equality in social relationships by breaking down hierarchies among patients and staff. Social support is very essential in this aspect. These four aspects are all contributed when finding the healing sense of place.
There are four environments (natural, built, symbolic, and social) that contribute to a healing sense of place. Nature is perceived as a healing environment in many societies. Being outdoors and seeking remoteness helps the person become immersed in nature. While nature is more secluded, the built environment is focused more on the sense of trust and security.
People have positive experiences in certain places and look to those same places when they look for health. For example: humans feel more comfortable and are healed more quickly in natural environments. Place matters for health. A healing sense of place must be established to achieve the sense of identity, security, and ultimately health (Gesler).
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figure 3. Built Environment
figure 4. Natural Environment
The built environment is structured around the idea of protection and safety to nuture healing.
The healing qualities of a natural enivornment allow the inhabitant to feel a sense of remoteness and solitude.
figure 5. Social Environment
figure 6. Symbolic Environment
The relationships among family members, friends and community foster a social healing environment.
Elements in a space or nature of the space can represent the symbolic healing environment.
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HEALING CONCEPTS
Feeling is significant to a patient’s well-being, whether its on a moment-to-moment basis or long term. The palliative environment must aim to create a comfortable atmosphere, becasue the feel of a place is improtant in relation to healing. Ian Clarke introduces five concepts of healing that are beneficial to health and wellbeing, especially in times leading to the iminent end. The five concepts are intimacy, trust, empowerment, compassion, empathy and coping. Many hospitals and healthcare facilities tend to completely disregard the significance of these concepts. Because the intangible concepts of healing are generally not considered to being as important as tangible objects that actually put a
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building together, most healthcare facilities are perceived as uncomfortable, clinical mazes where human patients are seen as objects. It is essential to recognize the significance of how humans react and fit in to our surroundings. These concepts are beneficial not only to the patient, but also to the family members and providers of care. It is useful to describe the qualities of discomfort as well as the qualities that nuture a healing environment. As all humans can easily explain what discomfort is, each concept provides a short list of undesirable experiences patients and families feel when placed in difficult situations.
A healthcare facility must express intimate qualities for the inhabitant. Feelings of separation, loneliness, out of contact, and coldness are often experienced. Spaces should be designed to fit the personal needs of its user, rather than feeling part of an impersonal situation. Trust deals with wayfinding. One may feel lost when moving through a large hospital. This invokes feels of anxiety, instinctive unease, or senses of confrontation or threat. Healthcare facilities must become relatable to an unfamiliar visitor in order to present the feeling of trust and belonging. When a patient is diagnosed with a terminal illness, they feel restricted or disabled, and lose
confidence. A healthcare facility must allow the patient to feel in control and engage their surroundings when dealing with an uncertain situation. Patients lose their sense of self and become detached to everything around them. It is important for the patient to feel no lack of support and to be the center of care. Compassion allows the patient feel like a human rather than degrading to an object. Coping is how one handles the situation. By disregarding the topic, the patient suffers by losing out on the beautiful qualities of life. Healthcare facilities must present to the patient the home-like qualities in a clinical facility (Clarke).
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figure 1. Berkeley 12
SECTION TWO SITE ANALYSIS
The proposed site is in the Bay Area of California. Berkley is in the Mediterranean climate zone, and the mild annual temperatures and small amount of precipitation create a pleasant living environment for all inhabitants. The natural, steep slopes of the Bay Area help shape the identity that is given to this region.
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CONTEXT MAPS
Pacific Coast
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Berkeley Bay Area
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SITE DESCRIPTION The unique characteristics of the site brought up several challenges while just as many opportunities arose. The site is currently used as a garden for the University of California Berkeley horticulture students. The student organic garden and university greenhouse are the adjacent neighbors to the north and south of the garden site. The nearest major intersection is Oxford and Virginia to the northeast. Two streets directly accessible from the site are Oxford and Walnut. Oxford is a much busier street with bus stations lined up and down the street and apartment buildings hugging the street edge. Walnut is a much quieter street with smaller scale housing and utility services being present on the lower street. The natural features of the site also play a large role in the description of the site. Located in North Berkeley, the hills are very prominent throughout the Bay Area and the contours on this site relate to the relatively steep slopes of its greater context. The bay is located to the west while hills set in the background to the east, which causes the eastern edge to be roughly 11 feet higher in elevation than the western edge. The ocean breeze prevails from the northwest while the cold winter winds come from the southeast. Mass and Void
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The eastern and western side of the site contained very different elements, but the duality of the two helped facilitate much of the intial organization of the project.
Context
Public Services
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BUILDING CODES MULTI-FAMILY RESIDENTIAL DISTRICT
The site south of Virginia Street between Oxford and Walnut is categorized as R4: Multi-Family Residential District. The maximum building height allowed is three stories or 35 feet above ground. The footprint of a one or two-story building may not exceed 45% lot coverage while a three-story building may not exceed 40% lot coverage. At least 40% of the total lot area must be usable space and landscaped. Landscaped areas shall incorporate irrigation and drainage facilities adequate to assure healthy growing conditions for plants. Any usable open space which is not planted must be developed to encourage outdoor use, including elements such as decks, sport courts, outdoor seating, and decorative paved areas and walkways.
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The building on the lot must separate itself from neighboring lots. The front and rear setbacks are 15 feet, and the side setback is five feet. Nursing homes within this district require one parking spot per five residents in addition to one parking spot per three employees. Hospitals require the same ratio of parking spots per patients and employees. The garbage services are located on Walnut. The garbage dumpsters must be effectively screened from view from the public right-ofway and surrounding properties
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SECTION THREE PROGRAM EVALUATION
This section discusses the spatial requirements of a hospice care facility within the context of Berkeley, California. specific to this project. It is also an analyzation of the user groups within the program.
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SPATIAL REQUIREMENTS The program is organized into four categories: Administration, Daycare Hospice, Patient Shared, and Patient Private. Each function is assigned certain outdoor spaces specific to their needs.
ADMINISTRATION Indoor spaces
Outdoor spaces
DAYCARE HOSPICE Indoor spaces Outdoor spaces
PATIENT SHARED Indoor spaces Outdoor spaces
PATIENT PRIVATE Indoor spaces
Outdoor spaces 22
This part of the program houses all the office functions that run the entire organization. The administration core is the only public function of the program. The entrances all lead to the same reception lobby located adjacent to the main street. The administration acts as a threshold from public to private. Daycare hospice houses daytime patients. Functions here allow the patient to recieve counseling, therapy, and home-cooked meals from the kitchen. The user must enter through the administration before arriving at the daycare hospice. This is a space shared by all the patient residents. The shared spaces allow for large gatherings to take place by families of the patients. The user must enter through the administration before entering into the patient shared spaces. The patient private realm is the most private function of the program. The user must enter through all thresholds before arriving to the patient suites. The patient private realm houses 12 permanent residents until their peaceful departure from the site.
ADMINISTRATION
Reception Area - 600 sf Entrance lobby for all user types. It is the only indoor space open to the public. All users are provided direction by receptionist upon arrival. Office Support - 500 sf Open work place, furnished with copiers, flex space. Easily accessible from all other office functions.
Mechanical Room - 400 sf Hidden from the public. Serves entire building.
Break Room - 300 sf Space for office staff to temporarily escape from work duties. Located adjacent to office gardens. Conference Room - 300 sf Space dedicated for larger office meetings. Accessible from all other office functions. Director’s Office - 300 sf Slightly larger individual office space for the director of operations. Volunteer Coordinator Office - 200 sf Recruits and organizes volunteer programs. Chaplain Office - 200 sf Provides spiritual advice and facilitates services. Patient Navigator Office - 200 sf Coordinates appointments and communicates with family throughtout entire process of patient Counselor Office - 200 sf Provides guidance on all personal and social hardships Office Storage - 200 sf
Bathroom - 100 sf
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...ADMINISTRATION SPACES Parking - 4000 sf Provides 14 total parking spaces, including 2 ADA spaces, along with a bicycle rack. Hidden from the public
Entrance Garden - 3000 sf The main outside entrance utilized by all user types. It is the only outdoror area open to the public.
Delivery Drive-Through - 900 sf Vehicle drive through located adjacent to the public entrance and main street of the site.
Office Gardens - 400 sf Private outdoor spaces utilized by office staff. Provides an escape from work duties and a place of prospect and refuge. Trash and Recycle - 200 sf Equipped with large trash and recycle dumpsters. Provides extra space for smaller dumpsters. Hidden from the public and located adjacent to utility street.
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DAYCARE HOSPICE SPACES Living Area - 600 sf Large welcoming entrance space with comfortable seating for daycare patients to utilize throughout the day. Kitchen - 450 sf Large, open space for cooking and dining. Furnished with large working surfaces and a large dining table.
Patient Rooms - 150 sf Private spaces for daycare patients to utilize throughout the day.
Consult Room - 150 sf Utilized by a patient and counselor. Therapy Room - 150 sf Utilized by a patient and counselor. Bathroom - 100 sf
Courts - 100 sf A place of prospect and refuge that provides outdoor experiences for daycare patients. Adjacent to main living areas of daycare and allows natural light to flood the interior spaces.
SHARED PATIENT SPACES Living Rooms - 600 sf Main space of shared patient program. Located adjacent to central court and larger gardens. Two separate spaces allow for utilization of multiple groups. Chilrden Play Area - 600 sf Playroom with access to assigned outdoor area. Visibly enclosed space for children’s safety.
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...SHARED PATIENT SPACES Private Dining - 400 sf Separate dining dining space for families not utilizing the kitchen. Good for catering services
Theatre - 400 sf Large, enclosed room used for showing movies, watching television. Used by patients and families.
Nurse Station - 400 sf Open workspace, adjacent to oxygen tank storage and pharmacy. Accessible to patient suites.
Chapel - 400 sf Peaceful, private space for individual contemplation and group services.
Storage - 400 sf Acessed only by janitor and nurses. Provides storage space for cleaning supplies and oxygen tanks.
Kitchen - 300 sf Space used by families cooking meals for large groups.
Kitchen Dining - 300 sf Open dining area adjacent to kitchen area.
Pharmacy - 200 sf Closet locked and accessed only by nurses. Spa - 200 sf Private relax luxury for patients. Furnished with spa tub. Laundry Room - 200 sf Equipped with two washers, two dryers, and large table. Bathroom - 100 sf
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...SHARED PATIENT SPACES Social Garden - 7000 sf Main outdoor space of shared patient program. Located adjacent to central court and larger gardens.
Contemplative Garden - 3600 sf Large, peaceful contemplative area. Accessible only through the chapel to escape main flow of traffic.
Departure Garden - 900 sf Final place of deseased patient before departing from the site. Used for private service for servivors of the patient.Located adjacent to private street.
Central Courtyard - 400 sf Center of shared patient program. Equipped with a fire pit to symbolize a central hearth. Allows natural light to flood into main living spaces. Outdoor Storage - 200 sf Storage space for outdoor activities. Equipped with grill and gardening supplies.
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PATIENT PRIVATE SPACES Patient Suite - 600 sf The user must pass through many thresholds to enter the most private function of the program. Private living quarters for patient. Equipped with bedroom, bathroom, kitchenette, storage and living space for small family gatherings. Provides direct access to private garden.
Greet Space - 200 sf Open space to separate patient suites from main flow of circulation.
Private Garden - 300 sf Private outdoor space assigned to a specific patient suite. It is the most private outdoor space in the program.
Shared Court Garden - 200 sf Outdoor court used to allow natural light to flood into circulation and greet spaces. Used as a place of refuge for family members.
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DAILY OCCUPANTS Office Staff This set of occupants includes all nurses, the receptionist, the director, chaplain, counselor, navigator, and volunteer coordinator. Many arrive to the hospice care facility on a daily basis and leave to their homes each evening. Some of the nurses may possibly work unusual hours on weeknights and weekends to ensure the health and safety of the patients. Other employees arriving on a daily basis include a chef, janitor, and security guard. Daycare Patient Some patients come and go on a daily basis. These occupants are people who need assistance performing daily functions such as cooking and exercising. Family members drop them off at the hospice care facility if there are not able to take care of their loved one during the day. Permanent Resident A person in need of in-patient hospice care may qualify for permanent residency. In most cases, a permanent resident has been diagnosed with a terminal illness and is dealing with difficult emotions. The hospice care facility is designed to help the patients through these difficult times.
Family Members This group of occupants includes both family members of the permanent residents and daycare patients. Many times they are responsible for the initial or daily tranpsortation of the patient to the hospice care facility. In many cases, they are affected more so with the emotional hardships of the entire process. Volunteers This group consists of college students of Berkley, neighbors, or anyone wanting to assist the daily functions of the building. Work done by volunteers includes gardening, cleaning, or assisting in daily operations of the building. Their helping efforts are planned and organized by the volunteer coordinator. The daily operations of the organization include 12 permanent residents and four daycare patients. At all times, there must be at least two nurses on duty to ensure the health and safety of all patients. The office employees w. The office hours are 8am - 4pm on weekdays, the daycare hospice hours are 7am -6pm on weekdays, while the building is open everyday 8am - 9pm. Nurses attain key cards for entering the building during after hours, and they also have the ability to allow family members enter whenever.
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PROGRAM ANALYSIS PROGRAM ADJACENCY
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USER CIRCULATION
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figure 1. Windhover Center 32
SECTION FOUR DESIGN GUIDELINES This section introduces two excellent case studies for the Berkley Hospice Care Facility. The Maggie’s Centre and Windhover Center exemplify a healing environment in many ways. The inspiration from these projects have helped determine the organization of program and improve the quality of experiences throughout spaces. Research on design patterns also helped navigate the development on elements of the project dealing with natural lighting and the significance of a walled garden. The role of materiality is very significant in architecture. Inspiration was also received when closely considering the materials of surfaces and structures that use the natural palette.
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PRECEDENT STUDY:
WINDHOVER CENTER Public Gallery 4,000 sq ft Stanford, California Aidlin Darling Design The Windhover Contemplative Center is an art gallery in Stanford, California. It was designed as a place of emotional refuge for students, faculty and staff at the University of Stanford through its strong connection of nature in the space, natural analogues, and nature of the space. All of its qualities create a healing environment and a strong precedent study. All of these qualities help reduce stress, increase physical performance and mental attentiveness, and positively influence emotion and mood; therefore, it enhances the quality of life on its occupants. All interior spaces have a visual connection to the adjacent landscape. Presence of water articulated by the reflection pool creates a
peaceful, healing atmosphere. Contrast of dark natural materials with natural light create dynamic and diffuse light throughout the spaces. The Windhover Center also imitates biomorphic forms and patterns with the pattern of vertical louvers mimicking tree trunks. Its material connection with nature includes stone, wood, glass, and rammed earth. Humans’ have an innate desire to see beyond our immediate surroundings while being protected from overhead or behind. Prospect and refuge are experiences that can be created by spatial configurations that enables security without surveillance.
figure 2. Vertical Louvres The pattern of vertical louvres along the eastern facade represents an abstract pattern of a forest of trees. The organic pattern filters in natural light to provide a very peaceful ambience. 34
figure 3. Water Garden Experiences of prospect and refuge are created in the organization and nature of spaces.
figure 4. Gallery The entrance of natural lighting into the interior creates a dramatic affect when it touches the dark, natural materials of the gallery walls, floors, and ceilings. 35
PRECEDENT STUDY:
MAGGIE’S LANARKSHIRE Cancer Support Center 3230 sq ft North Lanarkshire, United Kingdom Reiach and Hall Architects
The Maggie’s Centre located adjacent to the Monklands District Hospital is a cancer support center that offers emotional and social support to those in need. It exemplifies all four types of healing environments throughout the project. The building is enclosed by a perforated brick wall that also surrounds the gardens. The protection of the brick wall expresses the built healing environment. The presence of natural elements—shrubs, trees, water, brick, wood, and stone—reinforces the sense of a natural healing environment. The dining table and fire place are located in the center of the plan and both represent symbolic aspects of a
healing environment. The social environment is introduced by the domestic scale and homelike environment of an organization offering clinical care. As the garden creates the perfect combination of human control of nature and sense of protection from the built environment, it creates a paradise. The literal meaning of paradise is “walled enclosure” while the literal meaning of garden is “fenced enclosure.” The perforated brick wall and presence of natural elements of the Maggie’s Centre perfectly assembles the ideas of paradise, enclosure and garden into one healing experience.
figure 5. Plan The main, public spaces of the program include two gardens, kitchen and dining room, living room, library and offices. The two large gardens are an extension of the built interior. 36
figure 6. Garden
The materiality of the project strengthens the presence of nature within the built environment. Danish hand-made brick create the garden wall the encloses rich vegetation within and is surrounded by the presence of mature lime
trees. The interior is finished with the same limed oak on the floors and Finnish Birch Walls, and white stained pine ceilings.
figure 7. Interior figure 8. Court The four courts allow natural light to flood the interiors. Glazing from multiple sides creates a pleasing quality of natural light throughout the interior. 37
DESIGN ELEMENT:
WALLED GARDEN A successful outdoor space must have a definite shape and it must provide the sense of protection from the exterior public realm. The sense of protection and enclosure creates peace of mind and fosters a healing environment. The built and natural environment
figure 9. Garden Wall Exterior
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contain healing qualities. These healing environments are both expressed with a walled garden. Users grasp a sense of protection and refuge from the built qualities of a wall while also experiencing the natural qualities of a natural garden.
figure 10. Garden Wall Interior
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DESIGN ELEMENT:
MULTIPLE FRONTS OF NATURAL LIGHT
Natural daylighting must enter the interior space on multiple sides. The full immersion of natural light dissolves shadows, improves sight lines, helps way finding, and allows inhabitants to participate in a natural process daily. Daylight and sun exposure are vital for wellbeing, health and of humans, and patients prefer windows illuminated by clear light conditions rather than shade. Evidence strongly indicates that we heal faster in the presence of nature, we learn better and faster with natural lighting and respond more sociably in settings that reflect natural systems and lighting. Exposure to light reduces depression and improves mood, minimizes pain, and improves health outcomes.
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Humans are psychologically and biologically attuned to light and changing cycles of light and darkness. Circadian lighting is a 24-hour natural light cycle and it affects melatonin. While artificial lighting causes drowsiness and depression, natural lighting will increase daytime alertness and foster sleep quality at night. The contrasts of light and dark also effects quality of lighting . It is essential for natural light to reach all areas of a space. Our stereoscopic vision requires us to have evenly distributed lighting to form 3D imagery and depth perception. Having too great of a contrast will put strain on one’s eyes, but evenly distributing light throughout a space presents much more pleasant experience.
figure 11. The Lawrence Public Library reading room wraps around the entire existing library. The space is naturally lit on both sides of the room, which improves people’s sight and way finding within the space.
The Hospice Patient Room achieves the same natural lighting quality by introducing daylighting to multiple sides of the space, makes shadows within the rooms less harsh. 41
MATERIAL PALETTE
figure 12. Rammed Earth
figure 13. Stacked Stone
figure 14. Black Stone Pebbles
figure 15. California Live Oak
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figure 16. Water
figure 17. Purple Three Awn
figure 18. Stained Wood
figure 19. Gingko Tree 43
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SECTION FIVE PROPOSAL
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ARCHITECTURAL IDEA Home Within a Walled Garden
GARDEN WALL place of refuge
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BUILT mass
The architectural idea of ‘Home within a Walled Garden’ is expressed in the parti. The living spaces comprise of natural and built environments surrounded by a protective barrier. The protective barriers act as thresholds from public to private as one passes through from one realm to the next.
The daycare hospice is located on the top bar as it separates itself from the rest of the hospice program.
The organization is split into four separate bars. The entrance is located in the second bar, which houses the administration offices.
The final bar houses the 12 private living suites of the hospice facility. Each suite acts a home within the garden wall.
The in-patient hospice spaces becomes its own realm of natural and built environments with the protection of the garden wall.
1/2" = 1' 1/8" = 1' 0 6" 1'
NATURAL garden spaces
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4'
PROGRAM 0 2.5' ORGANIZATION 5' 10' circulation
20'
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MECH/ STOR
DINING
THEATRE
KITCHEN
CONTEMPLATIVE GARDEN
DEPARTURE GARDEN
CHAPEL
PATIENT SUITES
SOCIAL GARDEN
GREAT ROOM
ACTIVITY
PATIENT SUITES
bottom Floor Plan 48
CHILDREN'S PLAY AREA
COUNSEL
MECH/ STOR
COUNSEL
STOR/ NURSE BATH PHARM STATION LAUNDRY
PATIENT SUITES
SPA
THERAPY
COUNSEL
COUNSEL
KITCHEN LIVING ROOM
ACTIVITY ROOM
STORAGE
OFFICE
CONFERENCE
OPEN OFFICE
ENTRANCE LOBBY
BREAK ROOM
top Floor Plan 49
ADMINISTRATION
The administration is the only portion of the program that opens itself to the street as users may enter it from either side as they meet at the reception lobby. The reception lobby at the front of the administration core is the only public space within the building envelope. All users of the facility first enter into the reception lobby before entering any other part of the building and are given direction by the receptionist from there. The administration is the part of the program that houses all the office functions that run the entire organization. As ceiling planes are raised slightly higher than any other part of the building, the atmosphere is more open and welcoming to guests. The attitude of the offices—while it is more of a corporate setting
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than the rest of the building—still provides the home-like atmosphere to fit the rest of the program.
Built - structure - symmetry organization
Nature - views/ access to courtyards
1/2" = 1' 1/8" = 1' 0 6" 1'
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hospice entrance
Using nature to assist in wayfinding 52
The proper entry and balance of light in space is essential to nurturing a healing environment. Natural light helps improve memory, mood, performance, logical reasoning, and helps mitigate stress, reduce pain and improve health outcomes in patients. While artificial lighting causes drowsiness and depression, usage of natural light is essential for a palliative environment. As humans are psychologically and biologically attuned to light and the
changing cycles of light and darkness, circadian lighting—the natural daily cycle of light—helps residents produce proper levels of melatonin to stay awake during the day and sleep at night (Ulrich). Proper levels of natural light also assist in wayfinding. The ability to find one’s way around reduces anxiety and puts the user at ease. The healing concept of trust deals with comfort of wayfinding with the assistance of natural light (Clarke).
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HOSPICE DAYCARE
The next threshold leads either to the daycare hospice to the north or in-patient hospice spaces to the south. Each are equally removed from the entrance and administration of the Palliative Care Facility. The daycare hospice
houses daytime patients. Functions here allow the patient to receive counseling services, therapy, and home-cooked meals from the kitchen during the daytime.
Intimacy - sharing smaller garden courtyards
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Nature - views/ access to courtyards
1/2" = 1' 1/8" = 1' 0 6" 1'
0 2.5' 5'
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daycare hospice
Reaching the end of this inevidable journey can be intimidating. This provides the opportunity of making the journey along the circulation spaces meaningful. The symbolic environment focuses on the importane of meaning related to healing (Gesler). While there are many objects and patterns symbolic to the healing process,
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the nature of this space itself is symbolic as a healing environment. The living room looking onto the sculpture garden in the daycare hospice peacefully caps the end of a long circulation path at the edge of the building. The end of this circulation path copes with the circumstances the patients and their families are dealing with.
As human beings desire to see beyond their immediate surroundings, it is reflective of our fear for death. The two long concourses were given careful consideration to how they terminate. The sculture gardens and social spaces are placed at each end are symbolic in a sense of a promise of more information.
The healing qualities of the built environment are present in the mass created by the rammed earth. These walls form the interior space while framing the view of the sculpture garden and natural scene beyond (Gesler).
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IN-PATIENT HOSPICE
The in-patient hospice provides many shared spaces for residents’ use. The in-patient spaces allow for large gatherings to take place by families of the patients such as the living
room, kitchen and dining, meeting room and theatre room. As mentioned earlier, the inpatient hospice spaces are equally removed from the public as the daycare hospice.
Intimacy - sharing smaller garden courtyards
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Nature - views/ access to courtyards
1/2" = 1' 1/8" = 1' 0 6" 1'
0 2.5' 5'
2'
4'
10'
59 20'
in-patient hospice
Built - centrally located social spaces
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“Design must be influenced by health and social aspects of life no less than by the aesthetic and financial aspects of architecture.� A healing environment allows people to move around and interact unselfconsciously, to combine the lives with the lives of others (Salingaros). Good relationships are essential to a therapeutic environment. The placement of social spaces breaks down hierarchies and barriers among patients and staff (Gesler). The
centrally located living and kitchen space within the shared hospice are supportive of the social aspect of healing. As the outdoor courtyards give access to nature from each space, the greenery reaching upwards towards the skylight is symbolic towards the shared belief of ascending to another state after the pasing of this life.
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IN-PATIENT PRIVATE SUITES
The final piece of the program is the private hospice living. The patient living realm is the most private function of the program. The user must enter through all thresholds before arriving to the patient suites. The patient private realm houses 12 permanent residents until their peaceful, private departure from the site. Creating a space for a patient with a homelike atmosphere is an essential way of coping with the patient in their most difficult times. The thought of suffering and losing out is typical in a hospice setting, so creating qualities present in a home is a way of coping with the situation (Clarke). Each patient suite is given spaces resembling a front porch, living room, and backyard of a home, while being equipped with all the necessary tools to foster a comfortable and sustainable living situation even though it
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may be brief. As the patient suite is a place of withdrawal from the main flow of activity of the rest of the program, the patient experiences the qualities of prospect and refuge in their temporary home. The user of the space receives the comfort and security of the built environment while the space seems to reach outward to the private garden—ultimately including natural and built environments in the same space (Browning).
Modifying Sunlight
Nature - Access to natural light/ gardens
1/2" = 1' 1/8" = 1' 0 6" 1'
0 2.5' 5'
2'
4'
10'
63 20'
private suite
Prospect and Refuge
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The built environment is focused on the sense of trust and security (Gesler). This healing environment is also related to the concept of prospect and refuge. Prospect is an unimpeded view over a distance, for surveillance and planning. Refuge is a place in which the individual is protected from behind and/or overhead. Browning describes that being able to see beyond our immediate surroundings
while setting within an element of safety is achieved with the creation of deliberate and engaging spatial configurations to create the nature of the space. The patient experiences the qualities of this concept by taking refuge within the garden walls and experiencing the prospect onto the private garden, a successful healing environment.
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Natural daylight and direct sunlight is carefully filtered as it enters the spaces throughout the program. Controlling how light enters a space creates dynamic and diffuse lighting as it creates varying intensities and shadows throughout interior spaces. The eastern and western facing glass walls with the vertical
louvers create this dynamic usage of lighting as shadows are placed on the floor and gradually change throughout the day. Users of the spaces experience a connection with nature with natural daily cycle of light and shadow (Browning).
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southeast arial
east elevation
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western facade southwest envelope
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in-patient private suites
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CONCLUSION:
SIGNIFICANCE OF A GARDEN
Gardens are necessary because they reveal the relationship between culture and nature (built and natural environments). Healing is multidimensional: it is physical, mental, spiritual, emotional, and social. The garden considers faith, power, ordering, cultural expression, personal expression, and healing. Every one of these concepts written by Hester about gardens align with Gesler’s and Clarke’s concepts of healing. In gardens, we create our own idealized order of nature and culture. It is the balancing point of human control on one hand and wild nature on the other. The garden is represented safety from the threat of wild nature. A
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garden
requires
intimate
and
direct
involvement (digging, planting, watering, harvesting). It has social and psychological benefits: its relaxes, teaches and connects. Gardening reduces stress and contributes to wellness. We observe, sense, and participate directly in natural processes. A garden is also privatization of public life. While this communal space within a private realm offers social benefits, it is protected from the security threats outside. A walled garden is also a place to meditate, reflect, escape from conflict, or prepare for death. This protected paradise gives the inhabitant a sense of control over a small patch of earth despite all that is left to chance (Hester).
figure 1. Garden 75
BIBLIOGRAPHY
SECTION ONE TEXT “About Palliative Care.” Center to Advance Palliative Care, CAPC, 2017. Gesler, Wilbert M. “Introduction.” Healing Places, Rowman & Littlefield, 2003, pp. 1–19. “Palliative Care.” World Health Organization, WHO, 2017. Refuerzo, Ben and Stephen Verdeber. Innovations in Hospice Architecture. Taylor & Francis Group, 2006.
SECTION ONE GRAPHICS figure 1. ‘Redwoods National Park.’ Solo Learn. figure 2. Hope. Flickr. 2005. figure 3. ‘Built Environment.’ Grandorge, David. ArchDaily. 2015. figure 4. ‘Natural Environment.’ Tree Canopy. Soul Alchemy. figure 5. ‘Social Environment.’ Designing for Dementia. Click NL. 2017. figure 6. ‘Symbolic Environment.’ Grandorge, David. ArchDaily. 2015.
SECTION TWO TEXT “Building Codes.” City of Berkeley, CA, 2016.
SECTION TWO GRAPHICS figure 1. ‘Site.’ Alec Mackay. Kansas State University. 2017.
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SECTION FOUR TEXT Alexander, Christopher. A Pattern Language. Oxford University Press, 1977. Digital. “Maggie’s Centre Lanarkshire.” Reiach and Hall Architects, 2015, Orr, David, and Michael Pyle. “The Extinction of Natural Experience.” Biophilic Design: The Theory, Science, and Practice of Bringing Buildings to Life. Terrapin Bright Green, “Windhover Contemplative Center & Art Gallery”. William Browning, Catherine Ryan, and Joseph Clancy, “14 Patterns of Biophilic Design: Improving Health and WellBeing in the Built Environment”.
SECTION FOUR GRAPHICS figure 1. ‘Windhover Center’. Matthew Millman Photography. ArchDaily. 2015. figure 2. ‘Vertical Louvres.’ Matthew Millman Photography. ArchDaily. 2015. figure 3. ‘Water Garden.’ Matthew Millman Photography. ArchDaily. 2015. figure 4. ‘Gallery.’ Matthew Millman Photography. ArchDaily. 2015. figure 5. ‘Plan’ ArchDaily. 2015. figure 6. ‘Garden.’ Grandorge, David. ArchDaily. 2015. figure 7. ‘Interior’. Grandorge, David. ArchDaily. 2015. figure 8. ‘Court’. Grandorge, David. ArchDaily. 2015. figure 9. ‘Garden Wall Exterior.’ Grandorge, David. ArchDaily. 2015. figure 10. ‘Garden Wall Interior.’ Grandorge, David. ArchDaily. 2015. figure 11. ‘Library.’ Griffith, Tim and Mike Sinclair. ArchDaily. 2016. figure 12. ‘Rammed Earth.’ Digital Tools for Architects. 2017. figure 13. ‘Stacked Stone.’ Eldorado Stone. figure 14. ‘Black Stone Pebbles.’ India Mart. figure 15. LoCascio, Giovanni. California Live Oak. 2012. figure 16. ‘Water.’ Photos Public Domain. figure 17. Purple Three Awn. Wildflower Center. figure 18. ‘Stained Wood.’ Iunuidaragon. 2015. figure 19. ‘Gingko Tree.’ Nature Hills. 77
SECTION FIVE TEXT Browning, William, Catherine Ryan, and Joseph Clancy, “14 Patterns of Biophilic Design: Improving Health and WellBeing in the Built Environment”. Clarke, Ian. “Healing Concepts.” Building with Feeling. Wiley Inter Science, 2006, pp. 100–105. Enku Asefa and David Seam on, “Karsten Harries’ Natural Symbols as a Means for Interpreting Architecture Hosey, Lance. Shape of Green: Aesthetics, Ecology, and Design. Orr, David, and Michael Pyle. “The Extinction of Natural Experience.” Biophilic Design: the Theory, Science, and Practice of Bringing Buildings to Life. Reiach and Hall Architects. Maggie’s Lanarkshire. 2015. Ulrich, Roger S. “Biophilic Theory and Research for Healthcare Design”.
SECTION FIVE GRAPHICS --
CONCLUSION TEXT Hester, Randolph T. The Meaning of Gardens: Idea, Place, and Action. MIT Press, 1995.
CONCLUSION GRAPHICS figure 1. ‘Garden.’ Grandorge, David. ArchDaily. 2015.
all other graphics produced by John Dolechek
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