The place for elderly people

“Third Place” for elderly people The importance of a community hub in a care facility

Submitted to La haute école d'ingénierie et d'architecture Joint master of architecture in Fribourg Thesis preparation 2017 Professor Florinel RADU Master Student Kosuke Osawa

Master Thesis Preparation

CHAPTER I. INTRODUCTION………...……..…………………...…….....

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II. THIRD PLACE .……..……………….……..……………..…..

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2-1 What is “Third Place”? ............…...……………...……

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2-2 Why “Third Place”? .............…...………….....…...……

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2-3 Characteristic of Third place …............…………...……

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2-4 Summary of Third placey

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...................…….....……

2-5 Some examples of Third place in a city

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..…….....……

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III. AGING SOCIETY .....................................................................

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3-1 A situation behind Swiss aging society …..…………………

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3-2 A situation in the world ….....................…………………

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3-3 Definitions about the population pyramids ………..………

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IV. AGING .……………………..………………………..…………

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V. TYPES OF CARE FACILITIES .……….……........……..…..…

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5-1 A definition in Joseph A. Koncelik .....……………

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5-2 Swiss care facilities ….……..… ……………………

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VI. NEEDS ............................……….……........……..…..…

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VII. CASE STUDIES IN SWITZERLAND…....………………..

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7-1 Case Study 01 ….……….........…………………

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7-2 Case Study 02 …….……..………………………

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7-3 Case Study 03 ……..…..………………………

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7-4 Case Study 04 ……..…..………………………

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7-5 Summary of case studies ….……………………

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VIII. CONCLUSION …………………..........…….………………

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IX. FOR THE THESIS PROJECT ……..........…..……………

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9-1 Introduction …...............……………………

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9-2 Objectivet ……......................................…

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9-3 Strategy of the project …….......................…

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9-4 The project Sites 01 ......….............…………

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9-5 The project Sites 02 ......….............…………

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9-6 The project Sites 03 ......….............…………

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9-7 References of the project 01 ….........…………

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9-8 References of the project 02 ….........…………

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9-9 References of the project 01 ….........…………

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9-10 References of the third place ............…………

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X. BIBLIOGRAPHY .….…………………...................…………

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XI. INFORMATIONS ….…………………................…………

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Master Thesis Preparation

I. INTRODUCTION

The developments of the technology and industrialization gave us a lot of benefits about the life qualities. People got a long life. And they were freed from hard work using by hand and body as before. In same time, some relationships of people via work where were in a local community also released under the this changes. On the other hand, the relationships in a local area and work had a multi helps and supports each other without any benefit about the money. Today we were released from those relationships, so that elderly people got a time which is called “Golden years”1regarding to the changing of the life style and social system. However in the same time this situation occur a thing which is to be disappeared the relationships as a result of this changing2.

In this changing of life system and developments, many care facilities started to construct from many needs from elderly people. Today we have lot of care facilities for differences needs and situations. And for next future also we will need more care facilities. In Switzerland also has same kind of situation such as a growing of the population of elderly people where are happing in all developed country. And the present situation of care facilities have been developed that it realized high quality dwelling environment. But those care facilities still have not been developed to think about the contact with a local community, relation ships with a society and to think how to make a new relationships in a care facility. Under these circumstances we need to crate a place where we can have contact with society in care facilities. Ray Oldenburg3 proposed a definition of three boundaries relationships about a person and society. The one of this boundary relationship which 1

The Ager over 65 years old. This age retired from your work.

2 Young-Old Urban, Utopias of an Aging Society; Deane Simpson; 2016; Lars Müller Publishers 3

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Ray Oldenburg is an American urban sociologist : born 1932

Master Thesis Preparation

is named “The third place” is a tool to keep contact with a local community and relationship and it could make a new relationships. So that how to make a third place in a care facility become more important for our future. This paper is a investigation to know the possibility to design a “Third place” in care families.

This paper will show a process about the possibilities to craft a care facility which could be a 3rd place in a site. First paragraph will discuss about the 3rd place that is to know the references of the 3rd places according to Ray Oldenburg . Second paragraph will use to show a demographic tendency about Switzerland. And also compare with wold demographic tendency. 3rd part will used for the Aging matter reading to the human body changing. Fourth part is to explain about the care facilities in Switzerland which has definitions of care facilities. And next, it has found and describe about the needs from the investigation by NRP54 4. Fifth parts is some case studies, that will analyze four care facilities in each category under the Swiss care systems regarding to architectural aspect. and next it will arrive to the conclusion. And the end of the paragraph of this paper will show the direction of the Master Thesis project that will focus on the transformation of the existing projects. Those existing projects are candidate sites for the project where do not have a space such as a “Third place”. The aim of the project is to create a space to have contact a people who are living there and society.

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II. THIRD PLACE 2-1. What is “Third place” ?

“The third place offer a place where you can have good relation ship for the people who are living in a city. The characteristics of this place is that it can be used cheaply or freely, eating and drinking are possible, easy access, regular meetings gather, comfortable and you can meet olds friends and new friends.”

The Great Good Place: Cafes, Coffee Shops, Bookstores, Bars, Hair Salons, and Other Hangouts at the Heart of a Community : Ray Oldenburg:,; translated by Kosuke Osawa

According to an American sociologist Ray Oldenburg, He proposed “Third place” which is a kind of semi public space or place. He claim that it is going to be very important in our modern society. In his book which is named “The great place”, he explained about basic construction about relationship of a person and a society. To sum up “first place” is that where you live or spend the time for your life such as a home (Fig ; TP01). “Second place” is a kind of an office where you spend time a lot. “Third place” could be a framework which you can crate a new friends, to meet a friend or to talk with neighbor … etc Which is called “community life” .Those are could be Cafeteria, club, park bibliotics ..etc. He claimed that “third place” could occur creative relationship and already various societies have unofficial meeting place that the modern society has to create such a kind of place intentionally. So that we have three places in your life, you can contact with not only your family but also some people related with you work and people where you can meet intermediate friends at third place. During the changing of life situation about before and today, we could find some differences related with three places of Ray

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Oldenburg. Before our society our main work was related with the primary sector of industry5 , this epoch had relation ships with young people and old people automatically by work. When a person passed age, the work role also had changed from physical work to another work which need some knowledges or experiences. A role in a job was more clear and could keep contact with this work community. Today development of social system and the release from the hard work, gradually we do not need to involve it after over 65years old. But in same time, this phenomenon released those relationships which we had before. So that if a person does not have a kind of their place, automatically disconnect from the relationships for a society.

First Place

A kind of a home

Second Place A kind of a office for working

Third Place

cafes, clubs, public libraries, or parks ...etc

Fig ; TP01: Image of the relationship of the first place, second place and third place : Kosuke Osawa

5 A sector of an economy making direct use of natural resources or exploit natural resources; Colin Clark ;https://

www.thoughtco.com/sectors-of-the-economy-1435795

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2-2. Why “Third place” ?

“The third place” is a tool to keep contact with a local community and relationship and it could make a new relationships according to Ray Oldenburg. Present situation of care facility surrounded us show needs of the space where you can have contact with them. When we could realize a third place in a care facility, the place is going to be a place where elderly people can meet olds friends and new friends and also can have contacts with a society.

In generally a lot of care-facilities in Switzerland were used to developed more about the point of life quality and those are tend to combine with another program which is a kind of a challenge to have contact with society. But those are missing to look that Which program could we connect a care facility? , How can we connect? Which kind of space is more appropriate for it? Thus, to transform the care facility via “third place” is necessary to solvate the problem of it.

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2-3. Characteristic of Third place Neutral ground (natural space) 中立領域 Occupants of third places have little to no obligation to be there. They are not tied down to the area financially, politically, legally, or otherwise and are free to come and go as they please.

Leveler (a leveling place) 平等主義 Third places put no importance on an individual's status in a society. Someone's economic or social status do not matter in a third place, allowing for a sense of commonality among its occupants. There are no prerequisites or requirements that would prevent acceptance or participation in the third place.

Conversation is main activity 会話が主たる活動 Playful and happy conversation is the main focus of activity in third places, although it is not required to be the only activity. The tone of conversation is usually light hearted and humorous; wit and good natured playfulness are highly valued.

Accessibility and accommodation アクセスしやすさと設備 Third places must be open and readily accessible to those who occupy them. They must also be accommodating, meaning they provide the wants of their inhabitants, and all occupants feel their needs have been fulfilled.

The regulars 常連・会員 Third places harbor a number of regulars that help give the space its tone, and help set the mood and characteristics of the area. Regulars to third places also attract newcomers, and are there to help someone new to the space feel welcome and accommodated.

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A low profile 控えめな態度・姿勢 Third places are characteristically wholesome. The inside of a third place is without extravagance or grandiosity, and has a homely feel. Third places are never snobby or pretentious, and are accepting of all types of individuals, from several different walks of life.

The mood is playful 機嫌がよくなる The tone of conversation in third places are never marked with tension or hostility. Instead, they have a playful nature, where witty conversation and frivolous banter are not only common, but highly valued.

A home away from home 第2の家 Occupants of third places will often have the same feelings of warmth, possession, and belonging as they would in their own homes. They feel a piece of themselves is rooted in the space, and gain spiritual regeneration by spending time there.

2-4. Summary of Third place Concluding the third place and summarize it how exist in our situation. Under the understanding of the characteristics and the definition of Third place, it show a certain image of it. Hans, Third place is a informal meeting space. Perhaps it is a functional space in a city such as a amenity of the area( Barbershop, Cafeteria, Station, Small shops. etc….) or it is a besides a street, park or a space ( front of the church, nice view point, etc.. ) . And it could be a space as your home.

Perhaps it has common kitchen, common living, common garden or comfortable space etc…

Those a exist softly and standing with real life. And when we applicant a third place in a project we need a survey in the area what the surround of the site has.

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2-5. Some examples of Third place in a city.

Church Image : Bern ; Switzerland Kosuke Osawa

The Church is used to use as a meeting point and also some reunions. And ceremony and celebrations . Actually the church has lot of function in it.

The front of a station Image : Bern ; Switzerland Kosuke Osawa

Today the station has lot of programs.

And to do something in a city, the activity always start from the station. The picture show a people always gather front of the station.

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Master Thesis Preparation

The front of a beach Image : Brazil ; Switzerland Kosuke Osawa

The picture is taken in Brazil. And people go to this place to enjoy. This place is very comfortable. There are wind, wind, view, green, water, small cafeteria, and people.

Cafeteria or Bar Image : Bern ; Switzerland Kosuke Osawa

According to Oldenburg, the program of the cafeteria in a city could have many characters of third place.

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Master Thesis Preparation

Bibliotheque Image : Lausanne ; Switzerland Kosuke Osawa

According to Oldenburg, the program of the Biblioteque is a good program for the Third place. It is a Neutral ground, and L e ve l e r p l a c e. T h e r e i s a g o o d accommodation such as books, internet, space for study , and meeting.

Gym Image : Lausanne ; Switzerland Kosuke Osawa

Gymnasia is a place where people gather to play something. It is a just a big space with equipment and sometimes people in a club. This program offer to have contact with people.

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A game on the street Image : Bern ; Switzerland Kosuke Osawa

In a public plaza people can play something with another people who does not know each other. On the street we could talk with them .

Chess club on the street Image : Bern ; Switzerland Kosuke Osawa

The picture show a people playing the chess in a plaza. Always people enjoy to play with another people. And the scene that people are playing it makes a good atmosphere for the place.

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Master Thesis Preparation

A piazza Image : Bern ; Switzerland Kosuke Osawa

The piazza has multi functions. people could meet with someone and also can do something in there.

A common kitchen Image : Bern ; Switzerland Kosuke Osawa

A common kitchen could have a chance to keep contact with a small community.

To share a dinner and relax time with people is create a relationship.

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Master Thesis Preparation

Park Image : Lausanne ; Switzerland Kosuke Osawa

The park can offer a place of Leveler, neutral ground and conversation. sometimes relax, to enjoying the sun , nature. That can create a relationship community .

Barbershop

Image : Brazil ;http://www.agenciabrasil.gov.br/media/imagens/ 2006/10/24/1802FP03.jpg/view

The barbershop is a place where you can go regularly. Hans this place is a kind of club in a community. Perhaps you can meet your fiends and you can talk something while waning in the shop.

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Master Thesis Preparation

III. AGING SOCIETY 3-1. A situation behind Swiss aging society (スイスの高齢化社会) Let's look around the situation of Switzerland. As a general tendency of today, Switzerland also is a country which is increasing the population of elderly people (more than 65 years) . And the number of births plays in the national level is decreasing. It influenced to the demographic shift tend to an aging country. Moreover the birth ratio since 1970 that is called baby boom births indicates a necessary to produce a demographic reproduction. The ratio of the elderly people is getting increased since this year. And also the situation of the life expectancy is getting longer be cause of the medical development could succeeded to decries the people who will die prematurely.

It has a social back ground that is supported economical environmental effect as another developed country which has good social support and economical base. Those situation of development has influenced above the genetically the process of aging6.

According to the Scenario of Swiss population development7, the amount of the demographic transition of the people more than 65 years is expected that will quickly increase for the next several decades. It will increase that according to the graph (Fig ; SA 01) from 1.5 million in 2015 to 2.17 million in 2030 and to next 2.69 million in 2045. The rate will transit for the same years is 18% in 2015 to 22.8 % in 2030, and to next is 26.4 % in 2045. The population age is especially marked between 2020 and 2035 , when the baby boom births are retired.

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The Swiss Healthcare System : Giulia Alessio , Benedetta Ghisalberti , Sophie Haßlacher , Kirill

Kudryavtsev : 2008 7

: Szenarien zur Bevölkerungsentwicklung der Schweiz 2015‒2045 : Bundesamt für Statistik (BFS) :

2015

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Fig; SA 01 ; Annual growth of the 65-year-old and older population.

Source: Bundesamt für Statistik (BFS), 2015

Fig; SA 02; Development of the permanent population in the main age groups

Source: Bundesamt für Statistik (BFS), 2015

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Master Thesis Preparation

In such a situation the research expects a weakening of the population growth once the next decades due to the leading of the increase of the death, stabilization of the number of the birth and slightly less migratory movements. However from the year around 2025, the number of the age under 19 and the age over 65 will change the position that age over 65 will get a position which is lager number than age under 19 (Fig; SA 02).

So, we look from the population pyramid and check those pyramids against the categories of the definitions, that it could show the tendency of the population development in Switzerland. 1st population pyramid is the data from the 1970 (Fig; SA 03) that it has from as a gradual corn. It is show us the majority of young people in the demographics. Under the age 30s are occupy the rate of the population. Around 1970, there are baby booms in Switzerland. So, the age between 5 to 9 is 4 % and 0 to 4 also 4 % of the population. Moreover the age between 20 to 24 has 4.2% and 25 to 29 is 4% too. When we compare with another ages of the percentage, to reach to 4% is mean that they are lot of people in the demographic. This data show us that there is another baby booms when the age between 20 to 29 horned.

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Fig; SA 03

Switzerland 1970 Population: 6,169,357

Source: Population Pyramids of the World from 1950 to 2100: https://www.populationpyramid.net/switzerland/1970/2015

Fig; SA 04

Switzerland 2017 Population: 8,454,082

Source: Population Pyramids of the World from 1950 to 2100: https://www.populationpyramid.net/switzerland/1970/2015

Fig; SA 05

Switzerland 2037 Population: 9,541,279

Source: Population Pyramids of the World from 1950 to 2100: https://www.populationpyramid.net/switzerland/1970/2015

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Master Thesis Preparation

Second population pyramid is from today that is the 2017 (Fig; SA 04). The population is still growing from 6,169,367 in the 1970 to 8,545,082 ion the 2017. And the age between 0 to 9 in the 1970 moved to the age 45 to 54 in the 2017. After the baby booms in 70s, there did not happen another baby booms. As the shrink of birth rate after the 1970s. The form. Of the population pyramid became the type of “Constrictive”. This population pyramid show us a kind of big change of the social idea that young couple refused to have a child or a family. Moreover, the important things is that there was not many parentage of the category of the age over 80 in the 19709. However in the 2017, the categories of the age over 80 has increased more that it became 5.8% in the population. In the 1970, the age over 80 was total only 1.7%. This data also show a fact that people got a long life.

Fig; SA 06 ; Development of the total population

Source: Bundesamt für Statistik (BFS), 2015

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Master Thesis Preparation

The population in Switzerland is going to grow gradually. Third population pyramid is showed a expectation in the 2037 that according to “PopulationPyramid.net” (Fig; SA 05). As the same expiation by Bundesamt für Statistik (Fig; SA 06). The PopulationPyramid.net has expected 9,541,279. According to the scenario B-00-2015, the population will reach as same like the “PopulationPyramid.net”. The from of the population pyramid is more close to the type of “Constructive” The number of the birth play will not develop and have more stability.

In conclusion, those graphs and data show us a aspect that to change to a “aging society” and a phenomenon what happening in Switzerland is following as another developed county. so that if we continue this transition as another developed country , Switzerland also the rate od the elderly people will increase more, and change to “Aged society. The tendency of demographic transition what we have it is difficult to change. Thus to think from the society and community we need to think more about the elderly people how to include with the society and how to integrate with it.

But before how we live with old people? Why we have to dived the life place or community?

Before a social might been able to help each other with out social service as a care families. We might have a knowledge from old society.

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3-2. A situation in the world. (世界の高齢化社会) 世界保健機関では65歳以上の人が人口の7%をしまえた場合高齢化社会と定義してい る。

According to the WHO, the proportion of a society’s population that is comprised of persons age 65 or older is called the “aging rate”. If a society’s aging rate exceeds 7%, it is an “aging society”.

If the rate surpasses 14%, it is an “aged society”; if over 21%, it is a “super-aged society”.8

OECD announce the percentage of age over 65 people.(Fig; ASW 01) Japan is the country which has highest percentage of elderly people that is 25.06% of whole population. And Italy marks second of the rate in th world that has 21.25%. Switzerlands still has 18%. And Europe average is 19.3%. So as a definition of WHO, Switzerland and Europe is "Aged Society”. Japan is categorized as a super-aged society. Now in japan is developing a lot of care facilities.

8 Statement by H.E. Mr. Yoshifumi Okamura; Ambassador and Deputy Representative of Japan to the United Nations ;

13 July 2016

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Fig; ASW 01: Elderly population: Source: OECD Data: https://data.oecd.org/pop/elderly-population.htm

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When a society has large number of the old people, social system needs more medical expense, care costs. Moreover supporting to those system are financed by tax. So if there are more young people as a worker and paying tax to the society, the social circulation could define "healthy" 9However in the tendency of developed country, young couple due to some reason of financial and changing of the life style they tend to refuse to have a child and family or to make a single family. And in all developed countries had a baby booms. In japan there were twice baby booms in the end of 1940's and 1970. Moreover the development of medical technology succeed to have more long life to the people So, what happing in Japan they are influence of baby booms and development of medical technology.

Fig; ASW 02: PopulationPyramid.net: World population pyramid: Source: United Nations, Department of Economic and Social Affairs

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Aged population and social security 人口高齢化と社会保障 ; Yasushi Iwamoto ; 2004 ;

Hitotsubashi University

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To Check the aging society we could use the population pyramid (Fig; ASW 02). The population pyramid that is divided by ages and sex. According to the Population Education10 broadly dividing them, currently there are three types of population pyramid (Fig; ASW 03). 1st is named " Expansive" it is used to describe populations that are young and growing. 2nd one is named "Constrictive"(Fig; ASW 04). The type of constrictive population pyramid is used to explain that aew elderly and shrinking. 3rd one is named “Stationary"(Fig; ASW 05). It is used to explain the population that is not growing.

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Population Education: https://www.populationeducation.org/content/what-are-different-

types-population-pyramids

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3-3. Definitions about the population pyramids Fig ASW 03,04,05

Fig; ASW 03: What are the different types of population pyramids?: Lauren Boucher: Population Education: https://www.populationeducation.org/content/what-are-different-types-populationpyramids

“Expansive population pyramids are used to describe populations that are young and growing. They are often characterized by their typical ‘pyramid’ shape, which has a broad base and narrow top. Expansive population pyramids show a larger percentage of the population in the younger age cohorts, usually with each age cohort smaller in size than the one below it. These types of populations are typically representative of developing nations, whose populations often have high fertility rates and lower than average life expectancies.”

Fig; ASW 04: What are the different types of population pyramids?: Lauren Boucher: Population Education: https://www.populationeducation.org/content/what-are-different-types-populationpyramids

“Constrictive population pyramids are used to describe populations that are elderly and shrinking. Constrictive pyramids can often look like beehives and typically have an inverted shape with the graph tapering in at the bottom. Constrictive pyramids have smaller percentages of people in the younger age cohorts and are typically characteristic of countries with higher levels of social and economic development, where access to quality education and health care is available to a large portion of the population.”

Fig; ASW 05: What are the different types of population pyramids?: Lauren Boucher: Population Education: https://www.populationeducation.org/content/what-are-different-types-populationpyramids

“Stationary, or near stationary, population pyramids are used to describe populations that are not growing. They are characterized by their rectangular shape, displaying somewhat equal percentages across age cohorts that taper off toward the top. These pyramids are often characteristic of developed nations, where birth rates are low and overall quality of life is high.”

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IV. AGING The necessity of care facility. (介護施設の必要性) Defining the aging and to determine the changing from adult to elderly. The border cut off 65 which is a chronological measurement that is related with ability is not practical to measure the capacity of human.11 Of course, when a human get more age, we will change as gray hair or wrinkles that it may show a appearance of age visually. According to the Encyclopedia Nipponica 12 the aging phenomena of a human is a general term which is complexed observations with several aspects observing to the human body.

According to Joseph K, the developing of aging is a slowly process which is difficult to realize consciously by ourself.

“ Physiological appearance is a deception.”

“It will not act as am accurate predictor of capability” “ The problem is that heath is not a constant which suddenly evaporates at the onset of death. Everyone tends to change or develop both physiologically and in other ways throughout the life span and especially in advanced years” Source: World Health Organization (2012), “Fact Sheet Number 362. Dementia”, www.who.int/mediacentre/ factsheets/fs362/en/.

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11

DESIGNING THE OPEN NURSING HOME : Joseph A. Koncelik : 1976 : Dowden, Hutchinson & Ross , Inc.

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Encyclopedia Nipponica (日本大百科全書) ; Shogakukan, Inc. : 2001

Master Thesis Preparation

Thus to get age is a dally process which is progress day by day and gradually. He describe a real aging is measurement by losing the reserves or declining the ability in the human body that to keep the function of homeostasis.

“Hemostats refers to the equilibrium of interaction among organs, glands, muscles, bone, and tissue in the human system.”

Source: World Health Organization (2012), “Fact Sheet Number 362. Dementia”, www.who.int/mediacentre/ factsheets/fs362/en/.

When the body woks as young people, energy, muscle tissue, the lungs and other parts of the human body will require more oxygen and nutrients. The body try to supply those requirement to organize equilibrium. When the human is youth, it has strength, suppleness and expansive development that the reserve is high. And when it advanced the age, it has less strength , a lessening of supply of oxygen and nutrients through the respiration and circulation systems, therefor the body has either a harder job or in some cases, an impossible task in re-organization homeostasis . It is indeed an oversimplification which is describing about the concept of the aging.

So that loss of the reorganization of homeostasis and decline of the biological function in human body , it occurs the declines effects to endocrine system, the nervous system related with the brain, Musculoskeletal system, The major organs of heart, lungs, kidneys and lungs, and the sensor organs.

When people get age, we will get several problems under effects of the declines of reorganization of homeostasis and biological functions. For example the hypertension of blood, rheumatism, cerebral infarction, diabetes or cataract etc… And very important disability is dementia.

Dementia is a wards with has several symptoms regarding to decline brain function or damage of it that according to the WHO.

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“Dementia is a syndrome – usually of a chronic or progressive nature – in which there is deterioration in cognitive function (i.e. the ability to process thought) beyond what might be expected from normal ageing. It affects memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement. Consciousness is not affected. The impairment in cognitive function is commonly accompanied, and occasionally preceded, by deterioration in emotional control, social behaviors, or motivation. Dementia is caused by a variety of diseases and injuries that primarily or secondarily affect the brain, such as Alzheimer’s disease or stroke.”

Source: World Health Organization (2012), “Fact Sheet Number 362. Dementia”, www.who.int/mediacentre/ factsheets/fs362/en/.

Dementia is the second largest cause of disability in those age over 70. 44 million people have dementia in the world. From the point of financial burden the global cost of dementia is like half trillion US dollars every year. This cost more less as well as the GDP of Switzerland. However still social service and health system are not enough and are in the progress with dementia. The cost of dementia with the growing of elderly people is continuing to escalate. In the 2030, it is expected the percentage of the dementia that in high-income countries will have 50% and in low -income countries will have 80%. Dementia affect to memory, thought, behavior, and daily capacity of performance. Dementia has big affection to patient but also to family and care giver that is the one of the most important cause of the elderly people who needs the primary nursing care and has a damage in all over the world. All most all countries has many obstacles to care and diagnose about the patient due to the prejudice and miss understanding. Because of that there are big affection to family, care giver and social physically, physiologically and economically.13

13 OECD (2015), Addressing Dementia: The OECD Response, OECD Health Policy Studies, OECD Publishing, Paris.

http://dx.doi.org/10.1787/9789264231726-en

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As has been noted, when we get age, the human body and ability will decline with declines of homeostasis and it will have another troubles and sicks with those changes. Depend on the people, aged human will need a existence of care giver, family or friends to care about them because of the difficulty of daily capacity of performance, activity of the normal life. Additionally depends on the levels of the symptoms or care levels, people are difficult to live alone or lives in them house. because some times they need call a doctor or help to special care giver, so that they need to live a place where the doctor stay or care specialists and the place or institution where there are well equipment for care.

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V. TYPES OF CARE FACILITIES (介護施設の種類 ) 5-1. A definition in Joseph A. Koncelik Learning from Joseph A. Koncelik; “Designing the open nursing home” Around end of 60s to 70s, In United States of America, under the changing of a society to Aging society, there was a pressure to develop more about the care facilities. In that time Joseph K investigate and propose some strategy and design criteria.

According to Joseph, he divided the care facilities into 9 kind of types that it is depended on the symptom of the elderly people that those are existed for the level of the care facilities.

“1: Managed public housing .

Public housing is not considered a housing type providing services to the elderly. However , the time is near when the needs of those elderly living in public housing must be met either by internal service or through outreach programs of agencies or health facilities in the same catchment area.

2: Apartment for the elderly.

Independent living units created and financed by a variety of federal funds and programs. These units would not necessarily have public spaces such as lounges or conglomerate dining facilities , although in later building project these amenities have been provide.

3: “Domiciliary” Housing units.

This designation refers to independent living units where social services, programs , and conglomerate dining facilities are provide.

4: Health-related facility (HRF) .

A step below that of the 24-hours nursing service found in the next level of care. The concept behind the HRF is that it would serve those elderly who have been rehabilitated in nursing homes.

Ideally, it should be open to those who find a need for health care services , enter from a private

38

Master Thesis Preparation

dwelling units or from apartments or domiciliary units. This area of facility development is quite new.

5: 24-hour skilled nursing home.

A health care facility providing round the clock nursing observation and care , meals , social services , physiotherapy , and other programs. This is the true nursing home.

6: Extended care facility(ECF) .

A designation created though Medicare legislation and funding. A recuperative setting having the amenities of the 24-hour skilled nursing home , but the potential for more intensive rehabilitation - theoretically. Entrance is allowed after treatment in acute care hospital when recuperation may be extended , but intensive care space is unwarranted. Extended care facilities were created as an idealistic alternative to the nursing home. The idealism which promoted this conception was that if the elderly could be rehabilitated they would not need long term care in a nursing home.

Statistical evidence shows that very few of the elderly population entering ECF’s are actually rehabilitated and sent home. Many are then forced to pay high fees to remain or become wards of the state in the ECF’s administrative , monetary , heath service system.

7: Geriatric hospital.

An “ acute “ care setting where the elderly who have been struck down with an affection or have suffered an accident can be treated by specialist in geriatric medicine in surrounds conducive to their special needs and recovery rate. Although 50 percent of the patients in U.S. hospitals are over 65, there are partially no geriatric hospitals in the United States.

8: Retirement community .

A long affiliative organization providing housing and social services in an age-segregated community. The emphasis is on leisure activities and a protected environment. They are often expensive and utilize a variety of financial devices to encourage participation.

9: Geriatric canter .

A long-term contractual organization providing housing and health care services , as well as social programs. The emphasis is health care. The central triumvirate facilities are usually a 24-hour skilled nursing home , health- related facility , and domiciliary housing.”

Source ; DESIGNING THE OPEN NURSING HOME : Joseph A. Koncelik : 1976 : Dowden, Hutchinson & Ross , Inc.

39

Master Thesis Preparation

As has been described by Joseph A. K, there are many care facilities for dependency of the care levels and levels of symptoms. Those are very important to define the character of facilities and to adapt the needs and facilities. Moreover nowadays under the needs of elderly peoples those facilities could divide into more types and to give the names to them. Meanwhile we cloud unify those types into the four groups. the first is the “Home care” where the own house there are people can help to them or a elderly people does not need care. It is a care in one's own home.

And if a family can support or help to a elderly people in a family, elderly people dose not need special care or they have good equipment they do not need to live in another place. This group could be covered the “Managed public housing” in the types by Joseph A. K. And second is the “Assisted Living”. This group could cover “Apartment for the elderly”, “Domiciliary Housing units” and “Health-related facility”. In short, the assisted living is a place where elderly people can live alone or with your partner, but there are care supports for them. To live in the assisted living is protected own privacy or life styles. Third is the “Nursing Home”. This grope cover “24-hour skilled nursing home”, “Extended care facility” and “Geriatric hospital”. This care facility is a place where elderly people needs 24 hours care or has a problem to live alone because of the levels of the care and the levels of symptoms of sick. The fourth one is the Care service” that is covered “Retirement community” and “Geriatric canter”. That has some care services or activities to elderly people who live in the house alone, people want to do something or still do not need a special care from someone. So that this group could be community, organization, public service or private services.

40

Master Thesis Preparation

5-2, Swiss care facilities To identify and categorize the care facilities of Joseph K to Swiss care systems. Switzerland also there are lot of care facilities and they are some semi-public company which are working by the giving the fond from some foundation or Swiss taxes. The diagram is shown the category of care facility of Joseph K , Swiss care facilities and the names of groups (Fig; SF01). One of the care investigation service which is named "Avlir" 14 , did identify about the care facilities of the groups of assisted living. (Fig; SF02) According to the "Avlir" , “Le Logement Adapté” is Adapted Housing. Next is the “Le Logement Protégé” is Protected Housing. And So, the definitions of Joseph K which are Apartment for elderly could adapt to this category . And next is “Le Logement Médicalisés” which could be named Medicated Housing in english. It can cover “Health-related facility (HRF)” and “24-hour skilled nursing home” of definition of Joseph K. And There is a one more category which is named EMS(Etablissements Medico-sociaux)15 could cover about Extended care facility and Centric hospital of the definitions of Joseph K. 1: Managed public housing.

Home care

2: Apartment for the elderly.

Adapted Housing

3: “Domiciliary” Housing units.

Protected Housing

Le logement adapté

Le logement protégé

4: Health-related facility (HRF) .

5: 24-hour skilled nursing home.

Assisted living

Medicated Housing

FigSCF01; A diagram about the relationships of the category of care facility of Joseph K , Swiss care facilities and the names of groups : Kosuke Osawa

Le logement médicalisés

6: Extended care facility(ECF) .

EMS 7: Geriatric hospital.

Nursing homes.

Etablissements Medico-Sociaux

8: Retirement community.

Service 9: Geriatric canter.

14 Swiss care facilities organization . Lausssane.

15

42

Etablissements et pensions pour personnes âgées (EMS): http://www.guidesocial.ch/fr/fiche/570/

Master Thesis Preparation

%>F$/+&;%6?%>F;%6#76?;%>F @9;'>F$%>F%B937/? 6?>F$%F>/?%F%?F$%>F9;7)%>>/766%3>F$%F> 6?& F67@>F 5'6%6?F F9%6>%;F:@ /3F%>?F/597<? 6? F97@;F3 F"766%F#759;&.%6>/76F$%F?!@> F$%FDF$&)/6/;FEF3%>F?%;5%>F@?/3/>(> F @%33%>F6@ 6#%>F* />76> 67@>F%6?;%F 7-%5%6?F $ 9?& F 7-%5%6?F ;7?&-& F 7-%5%6?F &$/# 3/>& F

7-%5%6?F ;#./?%#?@; 4%5%6?F $ 9?(F#759;%6 6?F $%>F%>9 #%>F $%F A/%F >9&#/ 3%5%6?F #76 @F 97@;F $%>F 9%;>766%>F ); -/3/>&%>F 9 ;F 3 -%F 7@F 3%F . 6$/# 9 F > 6>F " ;;/';%>F ;#./?%#?@; 3%> F 7-%5%6?F $76?F 3 F 37# 3/> ?/76F) A7;/>%F3 FA/%F>7#/ 3%F$@F37# ? /;%F%6F3/%6 F>/F6&#%>> /;% F A%#F$%>F9;%>? ? /;%>F $%F>%=A/#%F 3%B/"/3/?&F F

6F 93@>F $%>F :@ 3/?&>F ;#./?%#?@; 3%>F %?F $%F 37# 3/> ?/76F $%>F 99 ;?%5%6?>F $ 9?&> F /3>F /6#3@%6?F @6F %6>%5"3%F $%F 9;%>? ?/76> F &? "3/%>F 3 A 6#%F %?F ) #?@;&%>F )7=) /? /;%5%6? F /6>/F :@%F $%>F 9;%>? ?/76>F 79?0766%33%> F )8@;61%>F>@;F$%5 6$% F %>F9;%>? ? /<%>F$ 5%6?F/$%6?/)/&>F >>@;%6?F3 F $&3/A; 6#%F$%F#%>F 9;%>? ?/76>F$%F5 6/';%F7;- 6/>&%F%?F#76?/6@% F %F#76?; ?F$%F9;%>? ?/76>F9%@?F) /;%F9 ;?/%F/6?&-; 6?%F$@F " /3F 3!C%; F

7-%5%6?F ;#./?%#?@; 4%5%6?F $ 9?& F/6#3@ 6?F@6F%6>%5"4%F$%F9;%>? ?/76>F7"3/- ?7/;%>F7@F79?/766%33%>F %?F"&6&)/#/ 6?F$ @6%F>?;@#?@;%F$%F>7/6>F%?F$ @6F%6# $;%5%6?F>&#@;/? /;%F>@;F>/?% F F%>?F $/,&;%6#/%;F$@F 47-%5%6?F9;7?(-&F9 ;F3 F9;&>%6#%F$%F#%>F$2>97>/?/)>F:@/F 99 ;%6?%6?F>76F)86#?/766%5%6?F @6%F@6/?&F$%F >7/6> F FigSCF02; Liste cantonale des logements adaptes/proteges du Canton de Vaud; Association Avril; 2010;Sante Publique (SSP) et du Service des Assurances Sociales et de l'Hebergement (SASH)

43

Master Thesis Preparation

Translating the definition of Adapted Housing, Protected Housing and Medicated Housing by association Avril which is used in canton Vadud.

“3.1 Adapted Housing: Architecturally adapted housing including living spaces specially designed for people fragile by age or handicap, without architectural barriers. Housing whose location favors the social life of the tenant in connection, if necessary, with service providers (Flexibility +++) 3.2 Protege Housing: In addition to the architectural qualities and the location of the adapted apartments, they include a set of services, established in advance and invoiced flat rate, as well as optional services, provided on request. Duly identified providers ensure the delivery of these services in an organized and continuous manner. The benefit contract may form an integral part of the lease.

3.3 Medicated Housing: Architecturally adapted housing, including a set of mandatory or optional services and benefiting from a structure of care and a framing on site security. It is necessary to differentiate between the protected housing by the presence of these devices which relate its operation to a unit of care.”

And also Canton Vaud propose the guide lines about the Adaptede housing and Protected Housing which has a technical definition of them. According to the Canton Vaud, protected housing is Architecturally suitable housing, fully compliant with the standards set out by the State of Vaud (in this brochure) and the applicable regulations (SIA 500: Building without obstacles). They include living spaces without architectural barriers, specially designed for people fragile by age. The location of sheltered housing, close to the service providers, favors the social life of the tenants. They include a set of pre-defined and billed services as well as optional services provided on request. The latter are issued in an organized and continuous manner, they can form an integral part of the lease contract and be insured by duly identified providers. A legal declaration, linked to the granting of individual financial aid, is contained in Article 16 of the Act to assist persons using medico-social action (LAPRAMS). Only protected units can benefit from a loan within the meaning of the Housing Loan Regulations (RPL). And Adapted housing is Structures whose architecture and environment are designed, adapted and adaptable (as defined above) to tenants in situations of fragility. Unlike protected housing, no ancillary services are proposed. (Fig:SCF03) This report is attached a regulation about the Adaptede housing and Protected Housing of Canton Vaud. It could compare and use as a strategy to design a third place. (page104-)

44

Master Thesis Preparation

} 1.1 définitions

}1

Les logements protégés ou adaptés répondent aux difficultés que peuvent rencontrer des personnes fragilisées, le plus souvent âgées, et offrent la sécurité recherchée. Ils constituent, à côté des EMS et des services à domicile, le 3ème pilier de la politique médico-sociale vaudoise. Ils satisfont aux besoins des personnes fragilisées désirant conserver leur « chez soi » tout en bénéficiant d’un encadrement sécurisant. Ils contribuent au maintien de l’autonomie et constituent également une réponse à l’isolement social de certaines personnes.

Logements protégés :

Logements architecturalement appropriés, pleinement conformes aux normes définies par l’Etat de Vaud (dans la présente brochure) et aux prescriptions en vigueur (norme SIA 500 : Constructions sans obstacles). Ils comprennent des espaces de vie sans barrières architecturales, spécialement conçus pour des personnes fragilisées par l’âge. La localisation des logements protégés, proche des prestataires de services, favorise la vie sociale des locataires.

Ils incluent un ensemble de prestations définies à l’avance et facturées forfaitairement ainsi que des services optionnels fournis sur demande.

Ces derniers sont délivrés de manière organisée et continue, ils peuvent faire partie intégrante du contrat de bail à loyer et être assurés par des prestataires dûment identifiés. Une définition légale, liée à l’octroi des aides financières individuelles, figure à l’article 16 de la loi d’aide aux personnes recourant à l’action médico-sociale (LAPRAMS). Seuls les logements protégés peuvent bénéficier d’un prêt au sens du règlement sur les prêts au logement (RPL).

}1

Logements adaptés :

Structures dont l’architecture et l’environnement sont conçus, adaptés et adaptables (selon définition ci-dessus) à des locataires en situation de fragilité. À la différence des logements protégés, aucune prestation annexe n’est proposée.

Fig:SCF03: Source: le logement protégé ou adapté: 2011: canton de Vaud : 4 http://www.vd.ch/themes/social/vivre-a-domicile/logements-proteges/:

45

Master Thesis Preparation

This graph is shown a relation cost with types of care facilities (FigSCF04). According to “The essence of home” , To care elderly people in your house can realize a low cost care but the quality of the services will be low quality. However the environment is close to the home. It is mean that home care could keep a own life which is used to live and they do not need to go to another place where is people who does not know each other. Besides, to care in the nursing home is offered high care service and the quality of the place is more close to the hospital. Moreover the cost is high. The good things of caring in nursing home is that they are well equipments. so that if a elderly people has problem, they organize a equipment for their levels of sick or symptoms and when it happen some problems, they can cope for it as soon as possible. However this place in the environment levels is far from the home. Put simple, the nursing home dose not have a kind of quality of home, so that a elderly people has to live a new place and there are many people how has some kind of sick or symptoms of the levels of cares. Moreover it needs to pay a lot for the service. Between the nursing home and home, we could bring a type of group that is “Assisted living”. In fact between them , there are many possibilities. A elderly people can chose it by their needs.

High

Cost Hospital Nursing home

Low

Home Institution

Low

Enviroment

Services

High

Home

FigSCF04; THE ESSENCE OF HOME , Design Solutions For Assisted-Living Housing : William J. Brummett : 1997 : Van Nostrand Reinhold.

46

Master Thesis Preparation

As it's is described about types of the care facilities, the situation of today, depended on the levels we could find a facilities which adapt to elderly care levels and needs. Nevertheless the problems is that if a elderly people need a care of 24 hours and dose not like to live in the nursing home, in the situation of today, there is no place for this needs. When we follow this graph, if elderly people wants to live a place which has well equipment, they need to live in the nursing home or another place close to the nursing home in the graph. So that the environment is not comfortable as a home. But is it better to have a facilities dose not need to pay a lot? How we could realize a place which has a environment close to the home? Is it going to be interesting to realize a place which is a nursing home but it has a environment as an home? Because if you are living in your house, perhaps there are family, friend, or neighbors . When we think about our environment, normally we have those situation. But when we have to move to somewhere in a hospital, the relationships and environment totally will change. But also some elderly people needs a specific environment for the care. Hans still we need to create to have a another option of the place which has several kind of environments which are integrated in to the one. Little is know about the needs of elderly people.

47

Master Thesis Preparation

VI. NEEDS Needs from the elderly people about the city.

This paragraph will show the needs from elderly people that we could use as a design strategy and motivation for the designing the “third place” in a care facility. The report of “Urban planing for an aging society” by NRP 541 has reported the needs of elderly people of city life. The report did the research “UrbAging- Planing and designing the urban space for an aging society” that focused on the existing public space and urban design through various needs from elderly people by the discussion.

“Conviviality; Places that encourage meeting and socialization result attractive and encourage people of all ages to attend them.”

CRITERIA FOR THE ELDERLY PEOPLE CITY? SIMPLIFY THE COMPLEXITY TO ACT IN CONCRETE TERMS Marcello Martinoni 1, Alma Sartoris 2:Designing urban space for an ageing society: 2011: Institute for Contemporary Urban Project Academy of Architecture:

One of the main needs of elderly people according to the research of “UrbAging- Planing and designing the urban space for an aging society”, we need a place where you can meet with another people to keep the contact with all kind of people that will be attractive and encourage people of all generation. Moreover there are many factor that to make a public space and a city due to the needs of elderly people that having a adequate offer of housing, goods and services of daily use in the neighborhoods, access to treatments, suitable places for meeting outdoor and

1

48

The national research programme "sustainable development of the built environment" (NRP 54)

Master Thesis Preparation

indoor, ability to move independently and in particular a solid social network2. And the research clam that to strengthen the social network as helps and socialization.3 The report presented a criteria and a recommendation for the city and the elderly based on the analysis of the two existing projects with involvement of elderly people that could have needs from them. The name of this criteria is “The chart of age-friendly public space”. It has three categories that are “Management”, “Context” and “Space quality”. In the category of Management has three key wards that are : Governance, Participation and Transversality which are calming about the soft-wear (Fig:N01).

The chart of age-friendly public space2 MANAGEMENT Governance The city for the elderly is a city for all.

Considering the diversity of needs of older people brings benefits to all other people (children, young people, families, workers, entrepreneurs, ...).

A renewed governance improve the quality of life and prevent ghettos and exclusions.

Participations The city for the elderly is built with the elderly.

Elders are an active part of the definition of priorities and projects.

Being old means living in very heterogeneous way, actively involving elderly we can avoid using stereotypes and simplifications.

Transversality The sectorial coordinated interventions give coherence to the public action.

The actors of urban management (construction, planning, services) consider the needs of older people in the application of sector policies (health services, public green management, public transport, construction, ...).

The quality of life of elders results from personal circumstances, combined with public policies and private initiatives.

CONTEXT Fig:N01: CRITERIA FOR THE ELDERLY PEOPLE CITY? SIMPLIFY THE COMPLEXITY TO ACT IN Accessibility CONCRETE TERMS: Marcello Martinoni 1, Alma Sartoris 2:Designing urban space for an ageing society:2011: Institute for Contemporary Urban Project Academy of Architecture The different parts of the city are easily accessible through public transport and safe pedestrian ways.

2 CRITERIA FOR THE ELDERLY PEOPLE CITY? SIMPLIFY THE COMPLEXITY TO ACT IN CONCRETE TERMS: Marcello The accessibility of public spaces is given by the absence of architectural barriers and the Martinoni 1,presence Alma Sartoris 2:Designing urbancrossings. space for an ageing society:2011: Institute for Contemporary Urban of facilitated pedestrian Project Academy of Architecture Interventions for the construction or renovation of public spaces, buildings or roads must consider the needs of persons with reduced mobility (pavements, slopes, ramps, signs for the 3 NRP 54 Sustainable Development of the Built Environment : Urbaging: Designing urban space for an ageing visually impaired, flooring, handrails, pedestrian crossings, obstacles, ...). society »: 2009: Prof. Acebillo Josep Clear information allows people with reduced mobility to make up with their own resources or the aid of others persons (family, volunteers, public agencies, ...) to face foreseeable difficulties.

Connectivity A good connectivity between public spaces can give an added value to the single components of the urban system.

49

Master

The city for the elderly is a city for all.

Considering the diversity of needs of older people brings benefits to all other people (children, young people, families, workers, entrepreneurs, ...).

Thesis PreparationA renewed governance improve the quality of life and prevent ghettos and exclusions.

Participations The city for the elderly is built with the elderly.

Elders are an active part of the definition of priorities and projects.

The category of means Context has three key are : Accessibility, Connectivity and Being old living(Fig:N02) in very heterogeneous way,wards activelythat involving elderly we can avoid using stereotypes and simplifications.

Intensity which are calming about the way of localization. In the last, it is a category of Space quality Transversality (Fig:N03) that has four key wards that are : Conviviality, Flexibility Security and Comfort The sectorial coordinated interventions give coherence to the public action. which are calming about requirements for the space. Those are showed a possibility to applicate The actors of urban management (construction, planning, services) consider the needs of older for the designing the care of facilities. people in theofapplication sector policies (health services, public green management, public transport, construction, ...).

The quality of life of elders results from personal circumstances, combined with public policies and private initiatives.

CONTEXT Accessibility The different parts of the city are easily accessible through public transport and safe pedestrian ways.

The accessibility of public spaces is given by the absence of architectural barriers and the presence of facilitated pedestrian crossings.

Interventions for the construction or renovation of public spaces, buildings or roads must consider the needs of persons with reduced mobility (pavements, slopes, ramps, signs for the visually impaired, flooring, handrails, pedestrian crossings, obstacles, ...).

Clear information allows people with reduced mobility to make up with their own resources or the aid of others persons (family, volunteers, public agencies, ...) to face foreseeable difficulties.

Connectivity A good connectivity between public spaces can give an added value to the single components of the urban system.

A dense and qualities network of routes promotes pedestrian mobility and leisure.

The routes are attractive if they are safe and scattered with pleasant spaces (benches, water, green, shadow, cleaning, ...) suitable for a break and/or a meeting.

Intensity The desirable intensity of a public space depends on the diversity of its functions and its position in the urban context.

The intensity degree of use of a public space can be stimulated according to its characteristics (context, type, ...).

2The intense use of space, in a virtuous process, motivate further attendance.

For other versions of the chart (italian, french, german) see www.urbaging.ch SPACE QUALITY Fig:N02: CRITERIA FOR THE ELDERLY PEOPLE CITY? SIMPLIFY THE COMPLEXITY TO ACT IN

Conviviality CONCRETE TERMS: Marcello Martinoni 1, Alma Sartoris 2:Designing urban space for an ageing society:2011: Institute for Contemporary Urban Project Academy of Architecture Places that encourage meeting and socialization result attractive and encourage people of all ages to attend them.

A friendly space presents high security conditions.

Flexibility Public spaces and their furnishings are designed to allow the realization of temporary events (market, concert, show).

50

Security The perceived sense of security in an area depends on structural conditions (promiscuity among means of transport, cars or bicycles, dark and narrow alleys, hidden corners, safe

Master Thesis Preparation

The intensity degree of use of a public space can be stimulated according to its characteristics (context, type, ...).

The intense use of space, in a virtuous process, motivate further attendance.

SPACE QUALITY Conviviality Places that encourage meeting and socialization result attractive and encourage people of all ages to attend them.

A friendly space presents high security conditions.

Flexibility Public spaces and their furnishings are designed to allow the realization of temporary events (market, concert, show).

Security The perceived sense of security in an area depends on structural conditions (promiscuity among means of transport, cars or bicycles, dark and narrow alleys, hidden corners, safe pedestrian crossings, ...), on the individual experiences (perceived number of criminal acts) and on the presence of preventive measures (video surveillance, patrols, objective information, ...).

Comfort The adequate furnishing of a public spaces allows an appropriate, safe and pleasant use of it.

The number and quality of the benches are sufficient and their exposure takes in consideration weather variations (sun, wind, ...) and their context.

The organization of public space takes in consideration the impact of environmental pollution (noise, air quality).

Drinkable water and the possibility of using it as a tool for the game is enhanced.

Toilets of quality and free of charge are available.

Fig:N03: CRITERIA FOR THE ELDERLY PEOPLE CITY? SIMPLIFY THE COMPLEXITY TO ACT IN CONCRETE TERMS: Marcello Martinoni 1, Alma Sartoris 2:Designing urban space for an ageing society:2011: Institute for Contemporary Urban Project Academy of Architecture

Strategic recommendations for age friendly public space

Following the structure of the Chart we describe with more details the different criteria.

Management Governance: the city for the elderly is a city for all UrbAging focuses on the needs and requirements of elderly people in public space, but the city for the elderly should remain a city for all. Consider the specific needs of older people in their diversity, taking particularly into consideration the range of needs of the weakest, benefits at the same time many

51

Master Thesis Preparation

VII. CASE STUDIES IN SWITZERLAND Evaluation to the situation of today (介護施設 現状況への評価)

Today we have lot of care facilities deadens on your symptom and needs. These are very useful to adapt to the situation of elderly people. However do we miss something ? The case study will focus on the existing projects in Switzerland that will show a matter of the isolated and integration with the society. It is mean that those projects suggest a possibility of the design to have good contact with your family , friends and a chance to know new friends such as a society. Under the needs of the elderly people they are many types of care facility. Their good point is that you can choose a place for your care levels and perhaps you can live with your family or live in a place where has well equipment. But is there place which is integrated with whole this point of needs?

For the future, we have to improve exiting project and next new project. The case study will analyze positive point and negative point that we could use as a knowledge for the project.

This case study will chose four kind of Assisted livings in Switzerland that are related a definitions of Avril. First one is Protected housing in Canton Vaud which is in the list of Protected housing of canton Vaud.The sound one is named Net Age where is located in suburb of Lausanne, Third case study is Adapted Housing where is located in close to the Lausanne station, the last one is the medicated housing in Basel. The last of case study, it will reach to the summary that will explain the character of the design aspect and the location of the projects. All of the pictures of case studies were taken by Kosuke Osawa. Using the explanation from the architect or the foundation of the care facilities. Moreover, we did some interview and visiting the site and entered into the project.

52

Master Thesis Preparation

7-1. Case Study 01 : Net Age: Lausanne • • • • • • • •

Project Name Project type Architect Location

Project year sqm Programs

3rd Place candidate

: NetAge : Protected Housing : Thibaud et Zingg : Lausanne : 2011 : 5’788 m2 : Barbershop, Meeting Space ( Apero, workshop, cooking ,,etc) : Camping place, Pool, Big kitchen, Three and park, Outside sport place.

First Case study is named Net Age that is located in canton de Vaud(Fig CS 01) . This facility is a “Logements protégés” Protected housing in english. The location of the project is quite far from the center of Lausanne. Around the project there are good nature and environment. And there is a commercial space where has camping place, pool , small restaurant for the people ho use this camping place. The project has 8 building.(Fig; CS02) In a first building next to the entrance of the site, there is a multi use space and a barbershop. In the middle of the project has promenade which can connect with all buildings. The concept of this project is that to combine comfort, safety, sustainable environment and user-friendliness into the building.

Good points of this projects is that it is located in a wealthy nature. The project is considered about the sustainable, safety and user-friendliness. However the real project did not succeed the concept of the project. And the location could to be safety. In other hand, the site is quite isolated from the society. There is a common space, But in fact it does not active for everyone.

The barbershop does not open every day. It just open 2 days for a week. Actuary there is missing to think about third place. People who living in the building can communicate with only people from there.

53

Master Thesis Preparation

Ground Floor plan.

NetAge Longment de Protege

Under Ground Floor plan

Environment

Project

Lausanne Center

© swisstopo

0

Density

© swisstopo

20

40

60m

0

Topography

Scale 1: 2,500 Printed on 24.05.2017 18:13 https://s.geo.admin.ch/736696999b

20

40

54

Project Name

: NetAge

Project type

: logements protégés pour seniors

Architect

: Thibaud et Zingg

Location

: Lausanne

Project year

: 2011

sqm

: 5’788 m2

Proglams

: Barbershop, Meeting Space ( Apero, workshop, cooking ,,etc)

3rd Place candidate

: Camping place, Pool, Big kitchen, Three and park, Outside sport place.

60m

Scale 1: 2,500 Printed on 24.05.2017 18:13 https://s.geo.admin.ch/736697406e

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Conection with the city

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Fig CS 01 Source: https://map.geo.admin.ch/?topic=swisstopo&lang=en&bgLayer=ch. swisstopo.pixelkarte-farbe : Swisstopo

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Master Thesis Preparation

The project there are two kinds of dwellings (Fig CS 03) . Both of them, they has considered about the efficient way which is less windows less common space. The dwelling is for elderly couple or single family. Each rooms has rational design that could became simple, In a way , it did not design how to communicate with another residents. Each buildings of 1st floors there are common space which you can relax in there. Every rooms has terrace.

Remarkable points of the room design is that each rooms has small windows that you can save the energy. But in this part as well, there is no consider about how to communicate with another people. The less windows affect to the contact to outside, The common space which is a kind of corridor can not use a place to relax or communicate. Because it is too small if you want to use with some people. This place could be better to design more bing space.

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Case sutudy 01

criticizing and analysing the exsting proje LES MAISONS DE PRA ROMAN LAUSANNE 26 / VD Logements protégés/Domicile Housing unit.

“Le Concept NetAge s’inscrit donc dans ce qu’il est convenu d’appeler une structure de lo environnement durable et convivialité. Cette réalisation figure dans la liste des logements sur le marché libre.” : THIBAUD ZINGG ARCHITECTES URBANISTES

Ground Floor plan.

Entrance Building

View to out side

Commune space Comercial space Privte space Corridor

Under Ground Floor plan.

Commune space Functional space Privte room Corridor Out side Corridor

Fig CS 02: Source: http://www.lausanne.ch/lausanne-officielle/administration/logement-enviAnother Buildings ronnement-et-architecture/service-du-logement-et-des-gerances/projets-constructions/projets-et-chantiers/projets-habites/immeubles-pra-roman/mainArea/04/text_files/file/document/plans-praroman.pdf:

Project View to out side

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g the exsting project.

View to out side Terrace

N LAUSANNE 26 / VD /NetAge

convenu d’appeler une structure de logements adaptés, adaptables, groupés, alliant confort, sécurité, Commune space ion figure dans la liste des logements protégés, reconnus par le Département de la santé du canton, mais Commune space Comercial space Privte space Corridor

Functional space Privte room Corridor Out side Corridor

Another Buildings Commune Wall

View to out side

View to out side View to out side

View to out side

Commune Wall

NISTES

View to out side Terrace Commune Wall

View to out side Terrace

Commune space Functional space Privte room Corridor Out side Corridor

Commune space Functional space Privte room Corridor Out side Corridor

View to out side

Fig CS 03: Source: http://www.lausanne.ch/lausanne-officielle/administration/logement-environnement-et-architecture/service-du-logement-et-des-gerances/projets-constructions/projets-et-chantiers/projets-habites/immeubles-pra-roman/mainArea/04/text_files/file/document/ plans-pra-roman.pdf:

View toF-04 out side

F-05 Title

View to out side

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Fig CS 04: Photo:Kosuke Osawa

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As you can check the first picture of the projects (Fig CS 04), there is a multi use space for every building. Next to this space there is a barbershop. The promenade has some benches , you can take a rest and talk with another people. But there is no any magnetic design such as third place in this area. And there is any activity out side, So that people easily understand that to stay in his rooms. Monopoly design of the buildings and planing of the landscape design occurs a kind of tedious are in this country side.

This project exactly does not have a third place. And it need to have or design a third place. If people come to the countryside, they would like to see more nature or related with nature.

So that, perhaps it could be better to combine with a camping place, pool or shopping space to make a third place.

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7-2. Case Study 02 : Maison Mivelaz: Lausanne • • • • • • • •

Project Name Project type Architect Location

Project year sqm Programs 3rd Place

candidate

: MAISON MIVELAZ : Adapted Housing : M. Marco Ceccaroli : Lausanne : 2008 : 1601 m2, : Maison, common cafeteria. meeting place. : Chess Club, Park, Public Library, Common kitchen,

The project is located in a quietly housing area of Lausanne(Fig CS10). It is in the south from the Lausanne train station. There are no many commercial places. However at the same time the project is not in a isolated area, it is even more integrated with the city. That is mean that it is in the city. The total surface of the projects is 2,190m2. It has a small park in the north side.

The west side has a entrance, from the entrance there is corridor to north and south. In fact the project has three building which is connected by corridor.(Fig CS11) And more, Due to a street of westside, a building is planed as diagonal. Two building of them are planed as 90 degrees. By this reason the form of the corridor between two buildings and diagonal one is not strait. It is more about organic form. This from could occurs a space for standing chasing with neighborhood.

Master Thesis Preparation

1st Floor plan.

Site plan. familial room Single Room Corridor

MAISON MIVELAZ Adapted Housing

Environment

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Lausanne Center

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Conection with the city

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Project Name

: MAISON MIVELAZ

Project type

: Adapted Housing

Architect

: M. Marco Ceccaroli

Location

: Lausanne

Project year

: 2008

sqm

: 1601 m2,

Proglams

: Maison, comun cafeteria. meetig place.

3rd Place candidate

: Ches Club, Park, Public Library, Commun kitchen,

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Adapted Housing

“Aujourd’hui trente-neuf logements à loyers modérés e cent les voeux de la testatrice. L’ensemble per met aux qui gère déjà des structures similaires à Lausanne, en

1st Floor plan.

Site plan. familial room Single Room Corridor

Fig CS 11: Source: http://www.ceccaroli-architecte.ch/Download/Typologies_de_ logements.pdf: Marco Ceccaroli, Architecte SIA 40

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Fig CS 12: Photo:Kosuke Osawa

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And unique points of the project are a facilitator, common cafeteria and the system of the habitants and rooms.(Fig;CS12) There are 39 completed apartments. And 29 of them are 2 rooms , 5 of them are 3 rooms and another 5 of them are 4 rooms. Obviously The apartments is designed to focus for elderly people who does not need intent care. However this apartment is considered that to live with different generation. For this purpose 10 apartments which has 3 rooms and 4 rooms could live with family or another generations. The common cafeteria could offer a meal with another people and meet with neighborhoods. Moreover this place a meeting point with CMS and a facilitator. The system of multi generation habitants and existence of facilitator could generate good contact with another people.

But If the cafeteria has more open to another neighborhood such as public cafeteria library or chess club could be more interesting to think about the third place in this care facility.

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7-3. Case Study 03 : Sudpark: Basel • • • • • • • •

Project Name Project type Architect Location

Project year sqm Programs

3rd Place candidate

: Südpark : Medicated Housing : Herzorg de Meuron : Basel : 2012 : 6’195m2 , : Shops, Office, Care facilities. : Public Library, Public Park, Public Gym,

Third Case study is named “Sudpark” that is located in the next to the main station of Basel (Fig CS 05) where is the most densely populated area in all of Switzerland. The project was designed by Herzog de Meuron that is for a care facility with multi functional programs.

“The Südpark ensemble plays an important role in this process of renewal; it is a multi-functional project with challenging specifications and uses.” Herzog de Meuron This facility is a “Mediculise Longment ” which is a Medicated Housing in english. The project is really connected with the city (Fig CS 06). The facility arrowed to live for people who need 24 hours care service and people has more light symptom. Projects has not only care facility but also shops, and office. The most strong positive points is that it has a potential to became a hub for this area. Unfortunately this project has good situation but it does not use this good point.

The first of all, project is located in next to the station, but there is no direct access to from the station. And the entrance is behind the main street. So that it is very difficult to find it. In addiction, there are some another programs but, there is no any connection each other. It is just combine some programs into a building.

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Site plan.

Sudpark Mediculise Longment

Environment

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Fig CS 05: Source: https://map.geo.admin.ch/?topic=swisstopo&lang=en&bgLayer=ch.swisstopo.pixelkarte-farbe : Swisstopo www.geo.admin.ch is a portal provided by the Federal Authorities of the Swiss Confederation to gain insight on publicly accessible geographical information, data and services Limitation of liability. Although every care has been taken by the Federal Authorities to ensure the accuracy of the information published, no warranty can be given in respect of the accuracy, reliability, up-to-dateness or completeness of this information.

Copyright, Swiss federal authorities. http://www.disclaimer.admin.ch/terms_and_conditions.html

www.geo.admin.ch is a portal provided by the Federal Authorities of the Swiss Confederation to gain insight on publicly accessible geographical information, data and services Limitation of liability. Although every care has been taken by the Federal Authorities to ensure the accuracy of the information published, no warranty can be given in respect of the accuracy, reliability, up-to-dateness or completeness of this information. Copyright, Swiss federal authorities. http://www.disclaimer.admin.ch/terms_and_conditions.html

Project Name

: Südpark

Project type

: Mediculise Longment

Architect

: Herzorg de Meuron

Location

: Basel

Project year

: 2012

sqm

: 6’195m2 ,

Proglams

: Shops, Oddice, Care facilities.

3rd Place candidate

: Public Library, Public Park, Public Gym,

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Site plan.

Entrance

Fig; CS 06 Source: DETAIL 4/2015 - Vorfertigung/Prefabrication

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Commune space Activity space Privte space Entrance

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Fig; CS 07 Source: DETAIL 4/2015 - Vorfertigung/Prefabrication

The project has big courtyard (Fig CS 07) and a big restaurant and there is a Gym and cafeteria. Most important part of this argument is the size of the entrance. It is very hiding. there is a big courtyard but there is no people sitting in the area.

This mean that every rooms and function has strong separations. It has to be more connective between the function and space. there is no easy access to the second floor. it could generate to dive the each floor strongly.

Master Thesis Preparation

2 st Floor plan.

Privte space Office

Fig; CS 08 Source: DETAIL 4/2015 - Vorfertigung/Prefabrication

This is the second floor plan. (Fig CS 08) There are two kind of space.

One of them is the office and other is dwellings for elderly people. In fact this project arrowed only people who need care, so it has good location, but inside there is no connection to out side. In addiction , in the second floor, there is no common space. so that if you do not go to the 1st floor, there is no any contact with another people.

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The project is surrounded by many square of windows. (Fig CS 09) “The façade of the Südpark seeks to render the historical character of the differently shaped windows in the Gundeldinger Quarter in a contemporary architectural idiom.” :Herzorg de Meuron

Those windows are considered to have connection with old context of this area and new project.

That are crated to combine with some kind of old windows pattern in to a same layer. It could became this facade.

Criticizing the facade design with connection and about the third place, they has some missing points. first one is about the commercial place which does not connected to the people living in this project. The design of the facade does not open to the neighborhood. Its very closed . And there are some programs which are not public.

So that, If it could have some public programs in the project, we could make a third place. And It is interesting to live with another generations . Perhaps we could combine with public gymnasia and we could change the floor design. In addiction , we could connect with the station.

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Fig CS 09: Photo:Kosuke Osawa

Photo: http://www.residenz-suedpark.ch/die-residenz/bildergalerie/

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6-4. Case Study 04 : Résidence La Cité Project Name : Résidence La Cité Program : Logement protégé/ Protected Housing Country : Switzerland Canton : Vaud Address : Rue du Simplon 26,1800 , Vevey sqm : 915m2

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Fourth project is named “Residence La Cite” that is located in the city of Vevey and the program of this facility is the Protected Housing. It has easy access to the station, city and the lake. The project is built on the Coop. Around the apartment has lot of small shops and informal public space such as coffeeshop, barbershop, or local markets …etc The project does not have such as cafeteria or barbershop as a program. However around project there are lots of small local community space such as “third place” . So that elderly people who are living in this facility can access to “Society” easily. The strong point of this project is the location. The location could succeed to invite a good accessibility, a convenience life for shop and to keep contact with neighbor.

Inside of the apartment has a wide corridor that can unify the each rooms and makes a connection with nature. Next to the apartment has kindergarten and a park.

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https://fondationbeausejour.ch/index.php/ informations-pratiques-residence-la-cite

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7-5. Summary of case studies Finally it will write a summary and comments about the evaluation of each case studies. it will talk from two points. First point is about building design and the location of the projects. And the end Third point will use to check about the third place.

Firs point To discuss about the building design and the location, it would like to propose a diagram to check the quality of the building design and the location. In the diagram there are two kind of key wards(Fig; SM 01). The horizontal part has “Isolation - Integration” which can check the integrity with another programs and connection to another programs or city. So that if a project is located in a city but planing does not connect to other program, it will be “isolated”. But if a project located in a countryside but has many contact with environment or surround, it would be integrated. The vertical part has “Transparency - Privacy” which can check the levels how open to out side or neighborhood. So that if the building less windows and small entrance, it will be a “privacy”. And if a project has many windows or many entrance to enter to inside, it would be a “transparency”

Case study 01 of Net Age is really far form the center of the city and the design of the building does not have enough windows. In addiction , it is missing to make a open space for everyone. so that Net Age is mapped level 4 and level 4 of privacy. Case study 02 of Maison Mivelaz is located in a city and have a open cafeteria. But the design of each rooms and floor are very dark and there is no communication between outside and inside rooms. For this reason, it is mapped at the level 3 of integration and the level 1 of transparency. Case study 03 of Sudpark is located in a city and has design another programs with care facility. But there is no connection to another programs and there is small entrance. Moreover the design of facade is protect a chance which could connect to outside and environment. For this reason, this project is mapped at the level 4 of the integration and the level 3 of privacy.

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Transparency Transparency

Maison Mivelaz

Maison Mivelaz

Isolation Isolation

Résidence La Cité

Integration Integration

Sudpark

Sudpark

Net Age

Net Age

Privacy Privacy

Fig; SM01 ; Image ; Kosuke Osawa Fig; SM01 ; Image ; Kosuke Osawa

Second point Low Cost High Low High This part will check about the third place. InCost fact those case studies show us a result which care facility do not consider to design a third place in the care facility. The most important project is Maison Mivelaz. It has a challenges to create a kind of third place in to the care facility. But still it can use only people living there, so that if there is public space such a kind of library, cafeteria for local community, it will be more active. In contrast, Sudpark has lot of programs and located in a city, moreover it is close to the station. But there is no connection from inside to out side and out side to inside. Perhaps we could propose another kind of program such as a Gymnasia for the

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local community and another people. Last one is Net Age. It does not any magnetic space such as a third place. it is very dangerous to live in this care facility. It is very isolated. And there is no connection with new people and friends.

Still we do not design a part of transparency and integrity. There is a lot go potential to realize a open and friendly care facility. And another area which is between transparency and isolation, there is a huge blank. when we got another case study, we could investigate about this possibility and negative point.

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VIII. CONCLUSION As we analyzed he demographic tendency of Switzerland and development of the care families, it will show us a necessary of more quantities of care facilities for elderly people in Switzerland.

This investigation did take a case studies of Assisted living in Switzerland. At the moment the project of Net Age and Südpark have not designed to crate a space such as a third place in the project. However Le Cite has a advantage to have a third place out side of the project that is have good point of the location and could connect to the society easily. Maison Milavez is a unique project and has good points of multigenerational habitants and a semipublic cafeteria where people living around the project can use it. This project is located in a good place too. As a result Two of them the facilities have good equipment and also good life quality. However it does not have enough contact with a society, neighbor or local community. And another two of them have third place effecting from the advantage of location. Furthermore some times care facility need to close from out side because of the security. However because of the security demands and to realize a quiet situation occurs a place where is difficult to have a relationship with this place. In conclusion to try to realize a third place in an assisted living could be a active place it is not for elderly people but also for another kind of generation and people. When it could realize that, we could have lot of benefit for our future of our society.

For the next step is going to design a assisted living with third place in a real situation. And to adapt to this knowledge into the project. It is going to have lot of potential.

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IX. FOR THE THESIS PROJECT 9-1. Introduction

Looking to the demographic changing point around 2020 by BFS 201516 and concerning the existing project and the research of the urban design for elderly people, we are standing at the point of the necessary to reconstruct social system of the elderly people and the strategy of the designing the care facility how to integrate into the society more. That is because, today we have many care facility. However those are still have not developed about the adaptation with the society.

For the master thesis project, it will focus on the transformation in the three existing project in Switzerland. Resolving the problems due to the isolation problems of the care facility that we analyzed above. In addiction, the project will focus the existing care facilities where does not have such as a “third place”. Moreover, the project try to add a “third place” into the site based on the knowledge by Ray Oldenburg of The Great Good Place and will use the research of NRP54 for the knowledge to resolve and to evaluate the project. The project will be pushed by a motivation which are the problem of the isolation about the care facility and the needs from the elderly people. The aim of this project is to create a space which can connect a people who living in the care facility and society.

Selecting the candidates site, it will propose three existing projects of care facilities and various area. First one is in Fribourg which is named “Residence des Chenes” where is working as EMS and Protected housing. The site is adjoined by apartment building and there are meany nature.

Second one is also in Fribourg which is named “Diablo Menthe” that is working under the association of “Pro Senectute”. It is working as Protected housing. The site is designed with 16

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Master Thesis Preparation

normal apartment and kindergarten. It is located close to the main station of Fribourg. Third existing project is also in Lausanne which is named “Fondation Simone Pegurri”. It is working as Protected housing. The site is adjoined with EMS building and there is a big garden in the site. It is located 20 mints from the main station of Lausanne. To categorize the care facility, it will use the definition of association Avril17 and Canton Vadud18

9-2. Objective Perspective beyond the next.

The projects sets out to analyze the environment of the program or function to which developed public space and associated amenity are able to resolve the problem of the existing projects of my thesis work as “third place”. And to make a new quality of a space above a keyword of “comfortable” by the characteristic of “third place” by Ray Oldenburg. The findings from the project be used to develop a prototype and the strategy aimed at the new development of care facility and necessary of the demographic changing of the 2020.

17 Liste des Appartements Protégés/Adaptés dans le Canton de Vaud ; Avoir association; 2014; Canton Vaud 18

Etablissements et pensions pour personnes âgées (EMS): http://www.guidesocial.ch/fr/fiche/570/

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9-3. Strategy of the project A method how to work for the project.

The project will focus on three existing project in Switzerland. Two of them are in Fribourg, one of them is in Canton Vaud Lausanne. The first step will analyze about the existing building. And next it will analyze the site which program have and how is the surround environment of the associated amenity and public space. To test those analysis into the project that is used the criteria of the research of NRP54 and the definition of the “Third place” by Ray Oldenburg.

A comparison will them be made, for the three locations with the environment geographical amenity and public space data on the architectural project, program and user of the project.

Proposing the architectural space with programs associated with the needs of the exiting projects regarding to the situation of the amenity and public space as “Third place” that will be presented by the models, plans and some graphical images. Finally it will have a discussion with elderly people such as user of the project.

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9-4, Project Site01, Fribourg Existing project Program Country Canton Address sqm

: Résidence des Chênes : Logement protégé/ Protected Housing, EMS : Switzerland : Fribourg : Route de la Singine 2, 1700 : 3700m2

Project Site01

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Progrm of the Existing project / Résidence des Chênes La Résidence des Chênes

“Située sur les hauts de Fribourg, l’institution offre de la ville une vue privilégiée et en restitue les ambiances au gré des saisons. La Résidence des Chênes a été reconnue en tant qu’ Établissement Médico-Social (EMS) dans la planification cantonale. Ce titre n’a cependant pas modifié la philosophie de l’enseigne, laquelle se définit avant tout comme un lieu de vie.” : https://www.chenes.ch

Criteria

The site is located on the hill of the North area of the city. The institution is working as EMS( établissement médico-social). The institution is using a 70s apartment building. Around the project there are apartment buildings. The front of the project has a garden and back side, there is a parking. The project has common cafeteria, and multi use room where you can use for physical trainings. If there is a area to connect to environment the project could unify with environment and local community.

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Project Site01

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Site situation

Project Site01

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9-5, Project Site02, Fribourg Existing project Program Country Canton Address sqm

: Diablo Menthe : Logement protégé/ Protected Housing : Switzerland : Fribourg : Passage du Cardinal 18, 1700 : 8100m2

Project Site02

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Progrm of the Existing project / Diablo Menthe Diablo Menthe

“La personne de référence encadre les habitants, provoque et anime les rencontres et organise des activités. La philosophie est de lutter contre l’isolement social. Il n’y a pas de prestations médicales au sens « blouse blanche ». La personne de référence ne loge pas dans l’immeuble, mais elle est présente tous les jours ouvrables du lundi au vendredi aux heures de bureau.” : http://www.bern.ch/en

Criteria

he project is next to the Bluefactory and close to the station. The concept of the project is “La philosophie est de lutter contre l’isolement social.” It is mean that to fight with a isolation. So that, the project has some challenges which are some activity by some concierges from the institution and the program of the architectural planning which is to be combined with kindergarten and normal apartment into the same area. But, a building of the elderly people in the area is isolated from another building. So that it is inserting to have a intermediate space for it.

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Scale 1: 1,000 Printed on 22.06.2017 17:04 https://s.geo.admin.ch/73fbafd8ab www.geo.admin.ch is a portal provided by the Federal Authorities of the Swiss Confederation to gain insight on publicly accessible geographical information, data and services Limitation of liability. Although every care has been taken by the Federal Authorities to ensure the accuracy of the information published, no warranty can be given in respect of the accuracy, reliability, up-to-dateness or completeness of this information. Copyright, Swiss federal authorities. http://www.disclaimer.admin.ch/terms_and_conditions.html

Project Site02

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Site situation

Project Site02

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9-6, Project Site03, Lausanne Existing project Program Country Canton Address sqm

: Fondation Simone Pegurri : Logement protégé/ Protected Housing/ EMS / Assited Living : Switzerland : Vaud : Avenue de Morges 64C, 1004 : 13,000m2

Project Site03

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Progrm of the Existing project / Fondation Simone Pegurri City of Fribourg

“Un soin particulier a été apporté à l’architecture et à l’ergonomie. Un coin salon et une buanderie sont disponibles à chaque étage.

Pour tout complément d’information ou souhait d’inscription, Merci de vous adresser à la direction de la Fondation Clémence.” : http://www.fondation-clemence.ch/#appartement

Criteria

The project is in Lausanne. It is not a down town area of the city, but it is combined with the Lausanne city. you can have easy access to the project. The place is in the same area of the “Fondation Clémence” which is organizing EMS service in this area. There are big spaces in the area, and the project is surrounded walls and abandoned spaces. So that it needs a place where you can have contact with surround or environment which is included with society.

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Project Site03

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Site situation

Project Site03

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9-7, References of the project 01 This paragraph will been explained about a project in a hospital of Spain which had been created by Alain Fidenza and Josep Maria Martin. The project name is “Prototipo para gestionar emociones en el hospital” That is a project to manage emotions of the people in the hospital. The space was conceived as a place of the transition between the hospital and the house. The hospital has many patients and also visitor that they have needs to manage about their emotions some times. Authors did a challenge to create a kind of third place in a hospital. The project could connect with hospital and people visit to there.

The project has five types of space. 1st space is a main part of the project, which is named Programmed space where can allow to stay 8 persons. It is equipped some furniture, projector, Audio system and kitchen. In addiction in a book lack there are magazines and movies. Some freezes iglidients in the refrigerator. 2nd space for coffee where has coffee machine. 3rd space is for the internet where you can have internet connection. 4th space is the coexistence space where is situated inner garden of the hospital and it is connected with space before. And a device to listen to the music and wi-fi. 5th space is named the urban connection space where is a complaint for the exterior.

Source: http://www.josep-mariamartin.org/es/index.php

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Source: http://www.josep-mariamartin.org/es/index.php

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9-8, References of the project 02 Architects: Manuel Ocaña Project name: Santa Rita Geriatri Location: Ciutadella de Menorca, Balearic Islands, Spain Total Area: 5.990 sqm building + 6.200 sqm gardens Project Year: 2003 http://www.manuelocana.com A example of the project where is located in Spain. The architect though the project that to be a optimistic appealing to live or visit.

The idea is to try to create a vital space in a uniq environment where elderly people can spend the last year or month of their life. In the result it could succeed to built a generic center that does not look like a hospital, with neither corridor nor architectural barriers and on on a single floor, in which all the rooms have direct access from a garden that, as a sort of ‘lobby’, acts also as direct access towards (and from) the collective spaces. The project would like to make sure total accessibility, physical autonomy, psychical security and protect to individual privacy, facilitating access to visitors.

Source: http://www.manuelocana.com

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Source: http://www.manuelocana.com

Source: http://www.manuelocana.com

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9-9, References of the project 03 Architects: Aprdelesp Project name: El café Wi-Fi CAFÉ ZENA Location: CDMX, Mexico Total Area: 30 sqm Project Year: 2013 This project is located in a residential area of Mexico City where where you can have easy access to Chapltepec park. The program of the project is quite small and narrow. Moreover the cafeteria in which serve not only coffer bout also lunch and dinner. The architect would like to realize a community hub in this area, so that he invented to have a table in a shop which is mean that you can have coffee and lunch with another people each other.

This table instated as a form of the space that has cored out of a building to inside garden. Owenr and architect alway organize some events regarding to foods. In the result this cafeteria offering a people as a kitchen or dining room for neighbor.

Source: http://coolhuntermx.com/cafe-zena/

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Source: http://arquitecturapanamericana.com/?p=51640

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9-10. Refarences of the third place in public space

Plaza

Street game

Park

Meeting point

?

Gym

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BIBLIOGRAPGY

1. DESIGNING THE OPEN NURSING HOME : Joseph A. Koncelik : 1976 : Dowden, Hutchinson & Ross , Inc. 2. THE ESSENCE OF HOME , Design Solutions For Assisted-Living Housing : William J. Brummett : 1997 : Van Nostrand Reinhold.

3. A DESIGN MANUAL LIVING FOR THE ELDERLY : Eckhard Feddersen , Insa Lüdtke : 2011 : Birkhäuser Verlag AG .

4. Les coûts des soins de longue durée d’ici à 2030 en Suisse : France Weaver, Hélène Jaccard Ruedin, Sonia Pellegrini, Claude Jeanrenaud : 2008 : Institut de recherches économiques, Université de Neuchâtel.

5. The Swiss Healthcare System : Giulia Alessio , Benedetta Ghisalberti , Sophie Haßlacher , Kirill Kudryavtsev : 2008 : Università degli studi di Bergamo, Italy , Università degli studi di Bergamo, Italy , Johannes Kepler Universität Linz, Austria , Higher School of Economics, Nizhny Novgorod, Russia.

6. The Great Good Place: Cafes, Coffee Shops, Bookstores, Bars, Hair Salons, and Other Hangouts at the Heart of a Community : Ray Oldenburg: 1999: Da Capo Press 7. OECD Health Policy Studies, Addressing dementia; THE OECD RESPONSE;2015;OECD PUBLISHING 8. Young-Old Urban, Utopias of an Aging Society; Deane Simpson; 2016; Lars Müller Publishers 9. THE FUTURE OF EMPLOYMENT, HOW SUSCEPTIBLE ARE JOBS TO COMPUTERISATION? ; Carl Benedikt Frey and Michael A. Osborne; 2013; Oxford University Engineering Sciences Department 10. Santé des personnes âgées vivant en établissement médico-social ; 2012; Office Federal de la statistique OFS.

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11. 人口高齢化と社会保障; 岩本康志 ; 2004; 一橋大学院経済学研究科 12. Les coûts des soins de longue durée d’ici à 2030 en Suisse ; France Weaver ; 2008 ; Office fédéral de la statistique 13. Global Health and Aging; National Institute on Aging, National Institutes of Health, U.S. Department of Health and Human Services; 2011; WHO 14. Liste des Appartements Protégés/Adaptés dans le Canton de Vaud ; Avoir association; 2014; Canton Vaud 15. Dementia, A public health priority; WHO; 2012; WHO Library Cataloguing-in-Publication 16. Addressing Dementia ,THE OECD RESPONSE; OECD; 2015; OECD Health Policy Studies, OECD Publishing 17. La dépendance des personnes âgéesn et les soins de longue durée; François Höpflinger, Lucy Bayer-Oglesby, Andrea Zumbrunn; 2011; Verlag Hans Huber, Hogrefe AG, Bern 18. Liste cantonale des logements adaptes/proteges du Canton de Vaud; Association Avril; 2010;Sante Publique (SSP) et du Service des Assurances Sociales et de l'Hebergement (SASH) 19. Le logement protégé ou adapté: Brochure destinée aux constructeurs et exploitants; 2011: canton de Vaud 20. CRITERIA FOR THE ELDERLY PEOPLE CITY? SIMPLIFY THE COMPLEXITY TO ACT IN CONCRETE TERMS: Marcello Martinoni 1, Alma Sartoris 2:Designing urban space for an ageing society:2011: Institute for Contemporary Urban Project Academy of Architecture 21. NRP 54 “Sustainable Development of the Built Environment” : Urbaging: Designing urban space for an ageing society »: 2009: Prof. Acebillo Josep

22. Integrated Service Areas; http://www.isa-platform.eu/nc/national-contexts/ switzerland.html?cid=418&did=63&sechash=a0af1355、https://www.google.ch/ ; www.isaplatform.eu

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23. Soins à domicile ; http://www.vd.ch/themes/sante/organisation/donnees-de-reference/ indicateurs-synthetiques-du-systeme-sanitaire-vaudois/soins-a-domicile/ 24. Suisse ; PANORAMA DES PENSIONS 2013 : DESCRIPTIFS PAYS – SUISSE ; 2013 ; OECD :l https://www.oecd.org/fr/els/pensions-publiques/PAG2013-profil-Suisse.pdf 25. http://www.guidesocial.ch/fr/fiche/785/ 26. http://www.guidesocial.ch/fr/fiche/570/ 27. http://www.association-avril.ch/index.php? option=com_dropfiles&format=&task=frontfile.download&catid=9&id=3&Itemid=10000000 00000, http://www.association-avril.ch/index.php/documentation

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XI, INFORMATIONS

}1 introduction L’objectif du canton est de fournir à chacune et chacun l’opportunité de rester chez soi dans de bonnes conditions aussi longtemps que possible. Dans ce cadre, le Conseil d’Etat vaudois a souhaité favoriser le développement d’alternatives à l’hébergement médico-social telles que les logements protégés ou adaptés. Il en a fait l’une de ses priorités.

Le Grand Conseil a également soutenu cette orientation en adoptant en janvier 2006 la loi d’aide aux personnes recourant à l’action médico-sociale (LAPRAMS) qui introduit le principe d’une aide financière individuelle aux personnes vivant à domicile ou dans un logement protégé (art. 17).

Les logements protégés ou adaptés sont des logements autonomes assimilés à un domicile. Ce ne sont pas des structures de soins et ne sont ainsi pas soumis à une planification socio-sanitaire.

Sur demande du Département de la santé et de l’action sociale (DSAS), l’Association Avril, Conseils et gestion en habitats adaptés, a répertorié l’ensemble des logements protégés ou adaptés présents sur le territoire vaudois.

L’emplacement et les caractéristiques de chaque site sont présentés sur des fiches disponibles sur Internet. A partir de cet inventaire, l’Association Avril a également rédigé un rapport contenant des critères, conseils et recommandations sur l’habitat protégé ou adapté. Cette brochure a été élaborée sur la base de ce rapport, elle est destinée principalement aux futurs constructeurs et exploitants.

Les fiches et le rapport sont consultables sur www.vd.ch/logements-proteges.

Source: le logement protégé ou adapté: 2011: canton de Vaud : 3 http://www.vd.ch/themes/social/vivre-a-domicile/logements-proteges/:

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}2 conception des projets Recommandations prépondérantes pour un projet de logements protégés ou adaptés pour des personnes fragilisées.

} 2.1 l’environnement Les logements protégés ou adaptés sont situés de préférence dans une zone urbaine ou villageoise et bénéficient des infrastructures qui s’y rattachent : magasins, transports publics et autres services (moins de 15 minutes à pied pour une personne à mobilité réduite ou 5 minutes en transport en commun). Ils peuvent faire partie d’une structure mixte de logements de manière à favoriser le maintien et la qualité de l’intégration sociale. Le canton est favorable à l’exploitation d’une Unité d’Accueil Temporaire dans les bâtiments proposant des logements protégés. La proximité d’un EMS ou d’un centre médico-social (CMS) peut être un avantage en raison de synergies possibles.

} 2.2 l’immeuble Aménagements extérieurs

L’aménagement d’espaces extérieurs communs et adaptés aux locataires doit être favorisé notamment par : - des cheminements donnant accès à l’immeuble, correctement éclairés et offrant les meilleures facilités pour une utilisation avec un moyen auxiliaire ; - des pentes de 4% maximum, même si la norme SIA 500 définit la déclivité maximale admissible à 6% ; - l’accès aux containers à ordures ménagères possible pour une personne se déplaçant avec un moyen auxiliaire ; - l’accès aux boîtes aux lettres et à l’interphone, protégé des intempéries et accessible ; - la distinction entre la circulation des piétons et des véhicules motorisés, visant à offrir un maximum de sécurité aux piétons ; - la conception des places de parc devra respecter les normes de l’Union suisse des professionnels de la route. Leur nombre à prévoir est en principe dicté par le règlement communal du lieu où le projet verra le jour.

Source: le9logement protégé ou adapté: 2011: canton de Vaud : http://www.vd.ch/themes/social/vivre-a-domicile/logements-proteges/:

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Selon le rapport de l’Association Avril, moins de 20% des locataires ont un véhicule. Les porteurs de projets évalueront la possibilité de demander à déroger auprès des communes par rapport à l’application du règlement, sachant que le besoin en places de parc est moindre pour ce type de locataires.

En revanche, il est indispensable de prévoir une place de dépôt (taxi) et des places visiteurs plus larges que les 2m50 habituels. Le nombre de places de parc pour « handicapés » doit être équivalent au 1/6 du nombre total des logements. Les places doivent respecter une largeur de 350cm. En cas de réversibilité, les dispositions légales seront appliquées.

Parties communes

- Les dimensions des couloirs doivent être conformes à la norme SIA 500 ; - les ascenseurs seront dimensionnés afin de permettre l’accessibilité aux personnes utilisant un moyen auxiliaire selon la norme SIA 500-SN 521’500 (dimensions minimales de la cabine : 110 x140cm) ; - chaque logement doit bénéficier d’une cave ou d’un local de rangement (surface de 6m2) accessible aux personnes avec moyen auxiliaire.

Il peut être situé dans les étages, sa largeur est au minimum de 150cm ; la porte s’ouvrira vers l’extérieur ; - un local de conciergerie doit être prévu en fonction de la taille de l’immeuble ; - la buanderie sera située de préférence sur le palier d’étage mais devra, dans tous les cas, favoriser les relations sociales et : • •

•

être accessible aux personnes avec moyen auxiliaire ; facilement utilisable par les locataires (socle de 30cm pour surélévation des machines + accès au monnayeur) ; située dans un espace propice aux relations sociales.

Espace communautaire : un espace de rencontre

- La surface mise à disposition doit correspondre à 3.5% de la surface totale nette habitable des logements protégés ou adaptés (20m2 au minimum) ; - il doit se référer au concept défini par les porteurs de projets et doit favoriser les échanges et les manifestations diverses ; - le local peut être modulable et polyvalent.

Dans les cas où le bâtiment intègre une Unité d’Accueil Temporaire, la dimension de l’espace communautaire sera étudiée de cas en cas.

Source: le logement protégé ou adapté: 2011: canton de Vaud : 10 http://www.vd.ch/themes/social/vivre-a-domicile/logements-proteges/:

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} 2.3 le logement

- le loc un lav le tab Par ai être g du loc perdra

En règle générale, les logements protégés ou adaptés comprennent des appartements de deux, voire trois pièces. D’autres modèles de logements, comme les logements communautaires par exemple, sont également possibles et seront étudiés de cas en cas.

- L’entrée du logement doit comprendre une penderie ou une armoire, dont la dimension est en relation avec l’importance du logement et l’accessibilité garantie pour les personnes utilisant un moyen auxiliaire ;

- les loc le cas

- un réduit ou espace doit être prévu à l’intérieur du logement pour le rangement des moyens auxiliaires ; - l’espace devant tout agencement doit être suffisant pour permettre une bonne liberté de mouvement (rayon de giration d’un moyen auxiliaire = 140cm) ; - l’accès à un espace extérieur depuis le séjour ou la salle à manger doit être favorisé. Les seuils devront être réduits au minimum (inférieurs à 2,5cm) pour être aisément franchis avec un moyen auxiliaire ;

Afin que les loye les surfaces nette

Surfaces nettes

(sans balcon/terras

- chaque chambre doit avoir une largeur minimale de 320cm, de manière à permettre les soins au lit. Une armoire de dimensions convenables et en relation avec le nombre d’occupants doit pouvoir être placée en tenant compte des mouvements d’une personne se déplaçant avec un moyen auxiliaire. La fenêtre doit être accessible par toute personne avec moyen auxiliaire ;

Partie “nuit”

- l’emplacement de la cuisine doit, par sa convivialité, inciter les locataires à préparer leurs repas. Le nombre d’éléments requis pour l’agencement de la cuisine, y compris les appareils, est précisé dans le tableau ci-dessous. La cuisine devra être adaptée au concept général afin de permettre son utilisation par une personne avec moyen auxiliaire (article 10.3 de la norme SIA 500). L’agencement privilégiera des équipements de cuisine en hauteur, évitera de disposer les fours, frigos et lave-vaisselle en partie basse et veillera à ce que la majorité des placards soient accessibles à toute personne en fauteuil roulant ;

séjour

(m2

chambre 1 chambre 2

Partie “jour”

cuisine réduit circulations

Local sanitaire

Total des m 2 ne

12

Source: le logement protégé ou adapté: 2011: canton de Vaud : http://www.vd.ch/themes/social/vivre-a-domicile/logements-proteges/:

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- le local sanitaire répondant au concept retenu comprendra : un WC, un lavabo et une douche sans seuil. Les surfaces mentionnées dans le tableau suivant ont été définies afin de faciliter l’aide par un tiers.

Par ailleurs, un accès latéral au WC avec un moyen auxiliaire doit être garanti ; l’ouverture de la porte doit se faire vers l’extérieur du local afin de garantir l’accessibilité au cas où le ou la locataire perdrait connaissance ;

ent des gements, nt possibles

une armoire, ogement oyen auxiliaire ;

- les locaux sanitaires seront de préférence ventilés naturellement, le cas échéant, de façon mécanique.

ment pour

r permettre n moyen

e à manger mum (inférieurs uxiliaire ;

cm, de manière convenables être placée éplaçant e par toute

Afin que les loyers ne soient pas trop éloignés des normes fédérales reconnues, les surfaces nettes habitables minimales à respecter, sont les suivantes :

Surfaces nettes en m2 des logements (sans balcon/terrasse)

logement de 2 pièces

logement de 3 pièces

Partie “nuit”

14 m2

28 m2

35 m2

42 m2

4.5 éléments

5.5 éléments

6 m2

6 m2

55 à 58 m2

76 à 81 m2

(m2 des chambres intra muros) :

chambre 1

minimum 14 m2

chambre 2

minimum 14 m2

Partie “jour”

er les locataires r l’agencement s le tableau général afin en auxiliaire légiera oser les fours, ue la majorité auteuil roulant ;

séjour cuisine

minimum d’éléments

réduit circulations

Local sanitaire

minimum 6 m2

Total des m 2 nets habitables

13

Source: le logement protégé ou adapté: 2011: canton de Vaud : http://www.vd.ch/themes/social/vivre-a-domicile/logements-proteges/:

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2.4 l’organisation Le futur exploitant doit définir un concept d’encadrement sécurisé qui comprend au minimum : - une commission d’attribution intégrant l’exploitant et les partenaires significatifs du réseau socio-sanitaire comme les centres médico-sociaux, les Bureaux régionaux d’information et d’orientation (BRIO) des réseaux de soins ; - une liste de critères d’attribution et de limites de prise en charge ; - un cahier des charges de la personne référente de maison.

2.5 les prestations Des prestations d’aide et de soins à domicile, de soutien, de réadaptation et d’intégration sociale, de même que des mesures de prévention et de promotion de la santé peuvent être proposées, sur la base d’une évaluation menée par les professionnels des centres médico-sociaux (CMS). Les modalités de financement de ces prestations sont identiques dans tous les CMS du canton et relèvent de la LAMal (loi fédérale sur l’assurance-maladie), du financement privé et individuel ou des Prestations Complémentaires (PC/PCG), suivant la situation de chaque personne.

D’autres prestataires de soins, en particulier les organisations de soins à domicile (OSAD) reconnues par l’Etat, sont habilités à répondre à des demandes de soins.

2.5.1 la sécurité Un concept d’encadrement sécurisé doit comprendre au minimum : - un ou une référent·e de maison avec un cahier des charges spécifique pour assurer un accueil et favoriser les relations sociales entre les locataires ; - la présence d’un interphone à l’entrée de l’immeuble ; - la mise à disposition d’un système Secutel.

2.5.2 les activités sociales et culturelles En lien avec l’espace communautaire et le cahier des charges de la personne référente de maison, des propositions d’activités sociales et culturelles doivent être mises à disposition des locataires. Les prestations spécifiques à ce type de logement (encadrement sécurisé, animation, gestion des bénévoles) sont facturées directement aux locataires, le cas échéant, aux régimes sociaux dont ces derniers bénéficient (PC, LAPRAMS), pour autant que l’organisation qui les fournit ait passé une convention avec le Service des assurances sociales et de l’hébergement (SASH).

Source: le15 logement protégé ou adapté: 2011: canton de Vaud : http://www.vd.ch/themes/social/vivre-a-domicile/logements-proteges/:

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if the marriage is ended by divorce.

The sum of the two individual pensions may not exceed 150 per cent of the maximum single pension (i.e. CHF 3,525). If this maximum is exceeded, then the two individual pensions are reduced accordingly.

Do I have to wait until I reach OASI retirement age before I can retire?

In Switzerland, women receive an OASI pension from the age of 64 and men from the age of 65. Under the OASI and occupational pension schemes, it is however possible to take early retirement, starting from the age of 58. If you take early retirement though, your pension will of course be lower.

You can also postpone your retirement. There are numerous possible ways of doing this, each of which have a different impact on your income. Ideally, you should seek advice from your pension fund.

What can I expect to receive?

You can obtain an estimate of your own old-age pension online. Or you can ask for an estimate free of charge from your compensation office. In both cases, you will receive a provisional calculation. No binding calculation can be made before you reach retirement age.

AHV pension estimate tool Display information now

Request for the calculation of your future pension Display information now

2nd Pillar: Occupational pension An occupational pension scheme is mandatory for all employees. It starts when you first get a job, from the age of 17 onwards. However, you have to be earning at least CHF 21,150 a year. Both employees and their employers are required to pay contributions. These are deducted directly from your salary.

The level of the pension depends on the contributions you make throughout your working life. Each pension fund has its own rules. All your contributions are combined to make up your retirement savings. The benefits can be paid as a pension or as a lump sum.

The pension is calculated using a conversion rate. The minimum rate is laid down by law. Currently it amounts to 6.8 per cent (for men and women who have reached the normal state retirement age).

Example If you have accumulated retirement savings of CHF 400,000 during your working life and the conversion rate is 6.8%, your annuity will amount to CHF 27,200 a year, or CHF 2,267 a month.

3rd Pillar: Private pension The 3rd Pillar comprises savings made with a view to retirement. Subject to certain limits, payments made into 3rd Pillar funds are tax exempt. There is no obligation to make payments to a 3rd Pillar scheme.

ch.ch also provides information about:

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www.isa-platform.eu

National context: Switzerland

2

Table 1: Demographic development in Switzerland 2008–2050 Population 2008*

Absolute

Change within

Absolute prognosis 2050**

change

the age group

in thousands

in thousands

Absolute in

Population

Age groups

thousands

percentage

Absolute progno-

Population

sis in thousands

Total

7701.9

100.0%

+358.8

percentage

+4.7%

8060.7

40 to 64

2728.9

35.43%

100.0%

-142.8

-5.2%

2586.2

65+

1276.4

32.1%

16.6%

+972.4

+76.2%%

2248.8

65 to 79

27.9%

913.7

11.9%

+393.3

+43.0%

1307

80+

16.2%

362.7

4.7%

+579.0

+159.6%

941.7

11.7%

Source: BfS 2006, ‘Scenarios on the development of the population in Switzerland 2050’, Page 6 (middle scenario )

1.2.

Services and administration structure: Who decides how social services are financed?

Financing and decision making Pension insurance In Switzerland, pensions are reliant on three sources. The most important of these is ‘Age Insurance’ - AHV (‘Alters- und Hinterbliebenenversicherung’). With few exceptions, this is compulsory for residents aged 20 and over. It is also compulsory for all employers to contribute to the second insurance scheme:a pension fund (Pensionskasse). This money is set aside in pension funds and goes toward upholding the standard of living post retirement. The third pension source is organised privately and is not compulsory.

Health Insurance Nursing care costs are partly covered by Health Insurance – KV (‘Krankenversicheung/Krankenkassen’). In accordance with the ‘Health Care Law’ - KVG (‘Krankenversicherungsgesetz’), paying Health Insurance is compulsory for all Swiss residents. This insurance covers basic medical and care services (basic care, treatment care, geriatric psychiatry). There is no state Health Insurance.

Throughout Switzerland, this basic insurance is offered by state-recognised, private insurance funds. Insurance funds are obliged to offer basic insurance to everyone on equal terms, throughout Switzerland. This includes the sick and elderly, even though these groups will obviously be more costly for them. Premiums are neither graded according to the risk factor of the insured person, nor by income. For people with low income, premiums are subsidised at federal and local (canton) level.

Provisions covered by Health Insurance are listed in a benefit catalogue by the Federal Assembly (‘Bundesrat’). A revision of the nursing care financing structure (‘Gesetz über Die Neuordnung der Pflegefinanzierung’) came into effect on the 1st January 2010. Now the Federal Assembly has placed an upper cap on the amount of money Health Insurance is allowed to provide in the case of long term care, namely a maximum sum of CHF 108/day throughout the whole of Switzerland. The exact figure given is calculated according to care costs (as directed by physicians) and graded according to time required.

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Soins à ...

Soins à domicile Nombre d'heures facturées par les organisations de soins à domicile et les infirmiers à domicile, par personne de 65 ans et plus, Vaud et Suisse, 2008 et 2015

Cliquer sur l'image pour l'agrandir Les données pour les soins de l'année 2008 ne sont pas disponibles.

Source: Statistiques Fédérales des Soins à domicile SPITEX

Taux de recours aux soins à domicile, pour 1'000 habitants de la classe d'âge, Vaud et Suisse, 2008-2015

Cliquer sur l'image pour l'agrandir Source: Statistiques Fédérales des Soins à domicile SPITEX

Taux de recours à l'aide à domicile, pour 1'000 habitants de la classe d'âge, Vaud et Suisse, 2008-2015

Cliquer sur l'image pour l'agrandir Source: Statistiques Fédérales des Soins à domicile SPITEX

Nombre d'employés et EPT des organisations et infirmiers de soins à domicile, pour 1'000 personnes de 65 ans et plus, Vaud et Suisse, 2008-2015

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Cliquer sur l'image pour l'agrandir Source: Statistiques Fédérales des Soins à domicile SPITEX Plus d'information:

Office Fédéral de la Statistique (OFS), statistiques de l'aide et soins à domicile

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9.

PANORAMA DES PENSIONS 2013 : DESCRIPTIFS PAYS – SUISSE

Suisse Indicateurs essentiels

Suisse : le système de retraite en 2012 Le système de retraite suisse comporte trois composantes.Le régime public est lié à la rémunération, mais selon une formule progressive.Il existe également des retraites professionnelles obligatoires et une p re s t at i o n co m p l é m e n t ai re s o u m i s e à conditions de ressources.La pension professionnelle peut être complétée à titre facultatif.

Suisse

OCDE

Rémunération CHF du salarié moyen (SM)

86 900

39 100

USD

94 900

42 700

6.3

7.8

Dépenses publiques au titre des retraites

En % du PIB

Espérance de vie

À la naissance

82.5

79.9

À 65 ans

20.7

19.1

En % de la population d’âge actif

28.1

25.5

Population de plus de 65 ans

1 2 http://dx.doi.org/10.1787/888932909732

Conditions d’ouverture des droits L’âge d’ouverture des droits à retraite dans le régime public et dans les dispositifs professionnels obligatoires est actuellement de 65 ans pour les hommes et 64 ans pour les femmes. Pour bénéficier d’une retraite à taux plein, 44 années de cotisation sont nécessaires pour les hommes et 43 pour les femmes.

Calcul des prestations Régime lié à la rémunération La retraite du régime public est calculée sur la base de la rémunération moyenne perçue sur l’ensemble de la carrière.Cette rémunération dépend du nombre d’années de cotisation et du salaire moyen perçu entre 20 ans et l’âge de la retraite. Les prestations sont encadrées par un plancher et un plafond. Entre ces deux limites, la formule de calcul « reposant sur deux piliers » est favorable aux revenus moyens. Elle permet une redistribution du sommet vers le bas de l’échelle des revenus. La pension est comprise entre 13 920 CHF et 27 840 CHF pour une carrière d’assurance complète, soit entre 16 % et 32 % du salaire moyen. La prestation maximum est atteinte lorsque la rémunération moyenne perçue sur l’ensemble de la carrière s’élève à 83 520 CHF, ce qui correspond à 96 % du salaire moyen à l’échelle nationale. La pension servie à un couple marié ne peut pas être supérieure à 150 % de la pension maximum.

Les prestations sont revalorisées tous les deux ans. Les pensions mises en paiement sont indexées à 50 % sur les prix et à 50 % sur le salaire nominal.

Régimes professionnels obligatoires Un régime de prévoyance professionnelle obligatoire a été introduit en 1985. Il repose sur des « bonifications » créditées sur un compte de retraite individuel et s’adresse aux personnes dont la rémunération annuelle s’élève à 20 880 CHF au moins. Ces bonifications diffèrent selon l’âge : La valeur de l’avoir accumulé au moment du départ à la retraite dépend du taux d’intérêt appliqué aux cotisations des années antérieures. Ce taux d’intérêt s’établit

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9.

PANORAMA DES PENSIONS 2013 : DESCRIPTIFS PAYS – SUISSE

Résultats de la modélisation des retraites : Suisse Professionnel

Selon le revenu

Niveau brut relatif des pensions

2.5

Taux brut de remplacement

1.25

2.0

1.00

1.5

0.75

1.0

0.50

0.5

0.25

0

0

0.25

0.50 0.75 1.00 1.25 1.50 1.75 2.00 Salaire individuel, en proportion du gain moyen

0

0.25

Net

Brut

Niveau relatif des pensions, brut et net

2.5

0 0.50 0.75 1.00 1.25 1.50 1.75 2.00 Salaire individuel, en proportion du gain moyen

Taux de remplacement, brut et net

1.25

2.0

1.00

1.5

0.75

1.0

0.50

0.5

0.25

0

0

0.25

0.50 0.75 1.00 1.25 1.50 1.75 2.00 Salaire individuel, en proportion du gain moyen

Hommes Femmes (si différent)

Salarié à revenu médian

0

0.25

0 0.50 0.75 1.00 1.25 1.50 1.75 2.00 Salaire individuel, en proportion du gain moyen

Salaire individuel, en multiple de la moyenne 0.5

0.75

1

1.5

2

Niveau relatif brut des pensions

49.6

32.1

44.6

55.2

55.2

55.2

(en% du salaire moyen brut)

48.9

31.9

44.1

54.3

54.3

54.3

Niveau relatif net des pensions

66.6

41.8

60.1

74.7

74.7

74.7

(en% du salaire moyen net)

65.5

41.4

59.2

73.5

73.5

73.5

Taux de remplacement brut

58.4

64.3

59.5

55.2

36.8

27.6

(en % du salaire individuel brut)

57.6

63.7

58.7

54.3

36.2

27.2

Taux de remplacement net

77.8

78.4

78.8

74.7

49.1

37.3

(en % du salaire individuel net)

76.6

77.7

77.6

73.5

48.3

36.7

Patrimoine retraite brut

11.1

12.4

11.4

10.5

7.0

5.2

(en multiple du salaire individuel brut)

12.9

14.6

13.2

12.1

8.1

6.1

9.9

10.7

10.2

9.4

6.3

4.7

11.5

12.5

11.8

10.9

7.3

5.4

Patrimoine retraite net (en multiple du salaire individuel brut)

1 2 http://dx.doi.org/10.1787/888932909751

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