LAUREN DI PIETRO MArch Architecture 2017 14033056 Design Portfolio
contents
3
THE SOLUTION Solution development Quality of life Public space Social and architectural difficulties Proposal
52 54 56 58 60 64
PRECEDENT STUDY
66
20 22 24 26
PROGRAMME DEVELOPMENT Activity Schedule of accommodation
94 96 100
THEORETICAL PERSPECTIVE Kitwood Changing attitudes Dementia friends
28 30 32 34
SITE SELECTION
102
BRIEF DEVELOPMENT
122
SITE RESPONSE
126
THE PROBLEM Contemporary care Problems with care Care home analysis Care in the community Care in the community analysis Family care Family care analysis
36 38 40 42 44 46 48 50
PROGRAMME DEVELOPMENT
172
DESIGN DEVELOPMENT
182
FINAL DESIGN
204
BRIEF AND SYNOPSIS Authors motivation Contemporary issue
5 6 8
BACKGROUND Understanding dementia Symptoms and types Stages
12 14 16 18
HISTORICAL PERSPECTIVE Timeline of dementia care through history Historical asylums Auguste D
Brief and synopsis authors motivation
01_Brief and Synopsis
Authors motivation
6
I am half Italian and find that this plays a huge
It has always been an ambition of mine to create
Through an exploration of the models of care
role throughout my every day. Being brought up
architecture that aims to solve problems, both
employed in the UK, it was found that the current
in such a family orientated and strong cultural
structurally and socially.
systems, care homes, care in the community and
background has enabled me to reflect this
Dementia is a neurological disease which
family care, do not work as intended. As part of a
personality into my professional life. This meant
ultimately causes atrophy of the brain. The
family which cares for somebody with dementia,
that when my grandmother was diagnosed with
erosion of cognitive abilities causes problems
I have experienced the challenges of family care
Alzheimer’s Disease in 2010, it was important
with memory, communication, language, motor
first hand and would like to use this design thesis
to me to help her in any way that I could. At
function and social skills.
to explore a possible solution which could ease
this time I was just beginning my undergraduate
While dementia has pathological consequences -
these pressures.
studies in architecture and my focus therefore
we experience it as loss; loss of connections; loss
This proposal investigates a dementia respite
became exploring architectural solutions that
of self; loss of place.
facility which aims to promote activity for people
could improve her quality of life, as well as
Dementia is a growing epidemic which poses
with dementia to improve their quality of life,
others diagnosed with this disease.
problems for everyday independent living.
whilst easing the burdens of family care.
01_Brief and Synopsis
7
Figure 1. Photograph of my ‘family carers’
Contemporary issue
8
01_Brief and Synopsis
Figure 2. Diagram of ageing population
Aging is often feared; with growing old comes
As a result of an increasingly aged population,
In 1901 life expectancy was 45 years for men
the fear of death as one comes to the end of
which continues to rise (Qiu, Kivipelto and
and 49 years for women (The Kings Fund, 2015).
their life (Daruwalla and Darcy, 2005). The fear
von Strauss, 2009; Sauer et al., 2014; Wang, Xu
By 2012 this had increased to 79.2 years for men
of aging originates from the assets that one
and Pei, 2012; Sheehan, 2006), it is important
and 83.3 years for women, and this is expected
thinks that they will lose through old age and
to include the needs of the older generation
to rise further by 2032 to 83.3 years for men
death; friends, family, memories and connections
through the built environment.
and to 86.8 years for women (The Kings Fund,
(Genova, 2009). The ailments and health of the
2015).
elderly fuels these fears as culture sees growing
The overall aim of this design thesis is to
old as a sign of a deterioration of one’s mental
explore how architecture can aid people with
and physical capacities. Dementia has replaced
dementia to live independently and maintain the
heart diseases as the leading cause of death in
best quality of life that they can.
England and Wales, accounting for 11.6% of all deaths registered in 2015 (Patel, 2016).
Figure 4. Diagram of global ageing population
01_Brief and Synopsis
9
Contempoary issue
10
The Free Radical theory suggests that we all
There are cases of early onset dementia;
With an increasing ageing population, it is
harbour agents within our bodies that cause
however it is found that there are about 1/688
estimated that by 2025 there will be one million
damage and eventually destroy it through old
people under the age of 65 diagnosed with
people with dementia in the UK by 2025 (Prince
age (Wickens, 2001). This theory attempts to
dementia; 1/14 people aged between 65-80
et al., 2014).
explain the frailties of the elderly and the ever
years old; and 1/6 people over 80 years old are
declining health that sets in through senescence.
diagnosed with dementia (Prince et al., 2014).
Dementia is just one of many ailments of the
01_Brief and Synopsis
elderly and in particular one of mental illness which Rosenhahn (1973) explains carry a greater social stigmatism than physical disabilities.
11
Figure 6. Diagram of risk of dementia increasing with age
Figure 7. Diagram of showing how dementia is a contemporary issue
01_Brief and Synopsis
Figure 5. Diagram of Free Radical Theory
Background understanding dementia
02_Background
dementia
Understanding
14
Figure 8. Diagram explaining key facts about dementia
Dementia can often be mistaken for
There are currently 850,000 people diagnosed
Dementia affects individuals differently, but
forgetfulness in elderly people, and often goes
with dementia in the UK (Prince et al., 2014),
some symptoms tend to be generic, as dementia
undiagnosed for years (Prince et al., 2014).
with many cases undiagnosed. This is set to rise
diseases kill cells within the brain, taking with
It is estimated that only 44% of people with
to 1 million people by 2025 (Prince et al., 2014).
them the ability to perform everyday skills
dementia in England, Wales and Northern
Dementia greatly influences personal, social,
and memories which shape an individual’s
Ireland receive a diagnosis (Prince et al., 2014).
health and economic factors and considerably
identity (Sandilyan and Dening, 2015). Common
Dementia is a debilitating neurological disease
impacts quality of life for those diagnosed
symptoms include difficulties in language
that presents escalating social and health
(Stewart-Archer et al., 2015).
and communication, the inability to perform
problems (Marshall and Hutchinson, 2001). It
There are over 100 different types of dementia;
purposeful movements and the ability to
is the most feared of modern disease (Bond,
most commonly Alzheimer’s disease which
orientate in time and place.
1992) with little understanding of the causes and
affects 62% of people diagnosed with dementia
currently no cure.
(Prince et al., 2014).
15
A person with Alzheimer’s disease may experience a gradual decline in cognitive function over time as it is a progressive disease; they may also become confused and frequently forget the names of people and places; experience mood swings as they become frustrated about their memory loss; become more withdrawn due to a loss of confidence and challenges with communication; and become less
early stages of the disease (Prince et al., 2014)
Figure 9. Diagram showing diagnosis rates in England and Northern Ireland
02_Background
self-aware of the difficulties experienced in the
Symptoms and types
16
02_Background
Figure 10. Diagram explaining symptoms of dementia
A person with Vascular dementia may experience
A person with Dementia with Lewy Bodies
Although memory is affected, it is typically
a more stepped decline in cognitive function
may experience a gradual decline in cognitive
less so than in Alzheimer’s disease; develop
with symptoms remaining at a constant level and
function over time; experience problems
the symptoms of Parkinson’s disease, including
then suddenly deteriorating, and may experience
with attention and alertness; have spatial
slowness, muscle stiffness, trembling of the
problems concentrating and communicating;
disorientation and experience difficulty with
limbs, a tendency to shuffle when walking, loss
experience depression which is a risk in the early
executive function, which includes planning
of facial expression, and changes in the strength
stages due to an increased awareness of the
ahead and co-ordinating mental activities.
and tone of voice; and experience genuine visual
difficulties experienced; experience symptoms of
hallucinations, often of people or animals (Prince
a stroke such as physical weakness or paralysis;
et al., 2014).
have memory problems; and experience
This is one of the few types of dementia where a
fluctuation in the ability to function as some
person is likely to experience real hallucinations
people may find that they can complete tasks at
as with other types of dementia the symptoms
certain times of day, but not at others (Prince et
are more likely to be a visual perception error.
al., 2014).
02_Background
17
Figure 11. Diagram showing types of dementia
Stages
18
The symptoms of dementia are progressive,
One of the most commonly used staging scales
which means that they will get worse over time
is the Global Deterioration Scale for Assessment
(Prince et al., 2014). This means that there are
of Primary Degenerative Dementia (GDS),
different stages of dementia, and it is important
which divides the disease process into seven
to recognise that how the disease is progressing
stages based on the amount of cognitive decline
in each individual will determine their symptoms
(Reisberg et al., 1982).
and their capabilities. The stages refer to how far a person’s dementia has progressed at that moment in time.
Stage 1:
Stage 2:
No Cognitive Decline
Very
Mild
Cognitive
Decline In this stage the person
functions
This stage is used to describe
normally,
has
no memory loss, and is
normal
mentally
People
associated with aging; for
with NO dementia would
example, forgetfulness of
be considered to be in Stage
names and where familiar
1.
objects were left. Symptoms
healthy.
forgetfulness
02_Background
are not evident to loved ones or the physician.
Figure 13. Diagram showing stages of dementia
19
Stage 3:
Stage 4:
Mild Cognitive Decline
Moderate
Stage 5: Cognitive
Moderately
Severe
Stage 6:
Stage 7:
Severe Cognitive Decline
Very Severe Cognitive
Decline
Cognitive Decline
(Middle Dementia)
Decline (Late Dementia)
forgetfulness, slight difficulty
People may be in denial
People in this stage have
People start to forget names
People in this stage have
concentrating,
decreased
about their symptoms. They
major memory deficiencies
of close family members
essentially
work performance. People
may also start withdrawing
and
to
and have little memory of
speak
may get lost more often or
from
complete
activities.
recent events. Ability to
They require assistance with
have difficulty finding the
because socialising becomes
People start to forget their
speak declines. Personality
most activities (e.g., using
right words. At this stage,
difficult. At this stage a
address and may not know
changes, such as delusions,
the toilet, eating).They often
a person’s loved ones will
physician can detect clear
the time or day or where
compulsions or anxiety and
lose psychomotor skills, for
begin to notice a cognitive
cognitive problems during a
they are. Average duration:
agitation may occur. Average
example, the ability to walk.
decline. Average duration: 7
patient interview and exam.
1.5 years
duration: 2.5 years
Average duration: 2.5 years
years
Average duration: 2 years
This stage includes increased
or
friends,
assistance daily
or
ability
to
communicate.
02_Background
family
need
no
Historical perspective
03_Historical Perspective
care
Timeline of dementia
22
Figure 14. Diagram of timeline of dementia care through history
03_Historical Perspective
23
03_Historical Perspective
Historical asylums
24
Case Study - High Royds Mental Asylum
Patients often spent decades in the asylum,
The asylum first opened in 1818 as a means of
forgotten about by loved ones and left to live
treating "paupers" suffering from mental illness.
out their days imprisoned. The vast majority of
It was one of the Victorian era's largest and most
patients from the early 20th century eventually
famous institutions in England, housing hundreds
died in the asylum, and were buried in the
of mentally ill patients. In 1958 the hospital
adjoining cemetery. Life in the asylum was
achieved a population of 2500.
often empty and repetitive, leaving the patients
The main purpose of the asylum upon its
wondering aimlessly with very little care.
opening was to contain and restrain patients.
Security was paramount in High Royds, along
There was no known treatment for insanity, and
with many other British asylums in the late 19th
so the asylum functioned more like a warehouse
century, and high walls were built to separate
than a hospital.
the mad from the sane. Asylums were built on
Identities were lost and patients became
the outskirts of cities and towns to reiterate this
anonymous within the asylums.
separation.
Figure 15. Image of High Royds Mental Asylum
03_Historical Perspective
25
Figure 16,17,18&19. Images of High Royds Mental Asylum
03_Historical Perspective
Auguste D
26
However, in 1901, a German psychiatrist and
With this increased understanding of the
neurologist called Alois Alzheimer met a patient,
medical symptoms of the disease, it was
Auguste Deter, in an asylum in Frankfurt. She
hoped that the face of dementia care would
was losing her memory, and was confused. After
dramatically improve. However, even with the
she died in 1906, he examined her brain, finding
introduction of the NHS and the Alzheimer’s
lesions which he identified as neurofibrillary
Society over the next few years, it wasn’t
plaques and tangles – the pathological hallmarks
until the research of Tom Kitwood and the
of the disease which would later bear his name.
Bradford Dementia group in 1990s that asylums
In 1910, the term ‘Alzheimer’s disease’ appeared
were finally closed and replaced with private
for the first time.
residential care homes which aimed to improve dementia care.
Figure 20. Image of Auguste D
03_Historical Perspective
27
Figure 21. Diagram showing the progression from asylums to Kitwoods new thoughts about modern care homes
Theoretical perspective tom kitwood
04_Theoretical Perspective
Kitwood
30
The media portrayal of dementia tends to be
Malignant social psychology is a theory
Kitwood’s (1997) philosophy is to abolish this
negative which causes negative societal stigmas
introduced by Kitwood (1997, p.46-47)
malignant social psychology aims to maintain
about people with dementia. The societal
that defines the collective impact of certain
the personhood of each individual by focusing
stigmatism of dementia is often coupled with the
behaviours and traits in societal responses
on the positive rather than the negative. For
fears of being old (Daruwalla and Darcy, 2005).
which leads to an overall pervasion and erosion
people with dementia, the biggest dangers are
The way in which one views ageing and the
of care, usually a result of the aforementioned
from how people without dementia treat them
perceptions of the elderly, has a huge impact on
stigmatism.
and make them feel (Daruwalla and Darcy, 2005).
how we view the disease of dementia.
The terms refer to the way in which people with
Kitwood (1997) seeks to view the person living
dementia are treated within society and the care
with dementia as an individual, rather than as the
environment.
medical impairment for which they possess.
Figure 22, 23&24. Diagrams of person-centred approach and modern newspaper headlines about dementia
Figure 25. Diagram showing the theory of malignant social psychology
04_Theoretical Perspective
31
Changing attitudes
32
04_Theoretical Perspective
Figure 28. Diagram of dementia friends
Although societal stigmas are still apparent in
The dementia friends initiative seeks to improve
Living well means different things for different
contemporary society, Information Integration
awareness within the community about dementia
people, but despite the challenges that people
Theory states that the attitudes of society can be
in the hope to ensure that by changing peoples’
with dementia face, it is still possible to live well
changed by the introduction of new information
perceptions of dementia, society can be more
with dementia.
that builds upon the existing information that one
inclusive to people with dementia (“Dementia
The initiative hopes to remove social barriers
already knows and believes (Anderson, n.d).
Friends”, 2015).
that people with dementia may feel may restrict
Oliver (1996) also states that societal responses
The dementia friends initiative, introduced by the
them from living their everyday lives as active
to the contemporary understanding of disability
Alzheimer’s Society, aims to create dementia
members of the community, through informing
can be changed through the introduction of
friendly communities by abolishing stigma and
people about the disease and change the way
information. These theories underlie the ideas of
educating members of society about dementia
that people think and talk about it, and to act on
the dementia friend’s initiative.
awareness.
ideas that can help to improve the lives of people living with dementia.
Figure 26. Diagram of information integration theory Figure 27. Image of a group of dementia friends
04_Theoretical Perspective
33
Dementia friends
34
Throughout the dementia friend’s session,
Dementia is not just about losing your
There is more to the person than the
five key messages were repeated to increase
memory.
dementia.
dementia awareness within society (“Dementia
Any function of the brain can be affected by
This relates to Kitwood’s (1997) theories of person
Friends”, 2015).
dementia, such as communication, motor skills,
centred approach; understanding that recognising
sequencing, changes in inhibition, perception and
the value of life experience contributes to the
vision.
uniqueness of one’s personality.
Dementia is not a natural part of ageing.
04_Theoretical Perspective
Not everyone who grows old will develop dementia and not everyone who has dementia is
It is possible to live well with dementia.
old.
People with dementia may still be able to work, drive and have relationships.
Dementia is caused by diseases of the brain.
04_Theoretical Perspective
35
Figure 29. Diagram of how dementia friends works
The problem
Contemporary care
38
The main strategy of care for dementia is to relocate people to care homes. However, it is found that existing care homes do not work to the ideals that Kitwood had originally hoped. This has led to more and more people with dementia living at home and receiving care in the community. However when this strategy also fails, the duty
05_The Problem
of care is being overtaken by family and friends. These issues were further explored in order to
There are striking similarities between current care homes and the old fashioned asylums. The ‘new’ design of care homes seems to act as a mask to the old asylum strategy for dementia care.
create a solution as the purpose of this design thesis.
Care homes Figure 30. Diagram showing contemporary care strategies
39
Care in the community
This means that families and friends are picking up the slack of home care to ensure that people with dementia can remain living at home. This has its own issues with financial, support and guilt burdens, meaning that this strategy of care is also decreasing the quality of life of people with dementia.
Family care
05_The Problem
This means that people with dementia are remaining at home and receiving care in the community. However, home care workers are overworked and under supported. Due to time and financial restrictions they spread themselves too thin, and thus people with dementia are not receiving the care that they should whilst living independently.
05_The Problem
Problems with care
40
The problems for care homes are rooted in the
59% of people thought the quality of life of the
It is also found that institutional care is more
gap between the costs of care and the amounts
person with
expensive than care in the community (Lecovich,
local authorities are paying for residents. There
dementia living in the care home was poor
2014; Lepp et al., 2003) which leads more people
are staggering variations in fees across the
(Ruddick, 2015).
to remain at home.
country, ranging from £350 a week to as high as
Excellent quality care exists, but pessimism
£750 (Ruddick, 2015).
about life in care homes is leading to people
70% of the general public would be worried
settling for less. Three quarters of relatives
about going into a care home and two thirds
would recommend their loved one’s care home
(64%) don’t think the sector is doing enough to
despite less than half saying their relative has a
tackle abuse (Ruddick, 2015).
good quality of life (Ruddick, 2015).
Figure 31. Diagram showing problems with care homes
05_The Problem
41
Care home analysis
42
05_The Problem
Figure 32&33. Photographs of asylums (left) compared to care homes (right)
Care homes were found to have striking
A lack of activity was something that was also
Even
similarities with the old fashioned asylums.
apparent in both asylums and in modern-day
have progressed over the past century, as
They are similar in both external appearances as
care homes. This is found to be dehumanising
aforementioned, there are still striking and
well as internal layout and architectural features.
as participation in activity was found through
scary comparisons between the old asylums and
Long corridors with multiple doors is a similar
research to improve the quality of life for people
dementia care homes today.
design feature between the asylums and modern
with dementia Marshall and Hutchinson, 2001;
Asylums were often built on the outskirts of
day care homes.
Vernooij-Dassen, 2007).
cities and areas to house the ‘mad’ and ‘insane’
Although activity programmes are implemented
away from civilisation. Care homes are deemed as
in some care homes across the country, there
a dumping ground for the elderly or dependent.
is no set space for people with dementia to go
This leads to a low quality of care.
and undertake activities while retaining their independence and living at home. This leads to a loss in quality of life and an increase for the need to be institutionalised.
though
Dementia
care
seems
to
05_The Problem
43
Figure 34. Diagram of asylum and care home comparisons
05_The Problem
community
Care in the
44
As a result of the avoidance of residential care
It is estimated that 80% of people with dementia
homes, care in the community was deemed as
live in the community rather than in care homes
the alternative strategy to enable people with
(Blackman et al., 2007), making this an already
dementia to remain living at home independently.
contemporary issue for the care of people with
However, as with care homes, care in the
dementia.
community also has its own problems.
The costs of caring for people with dementia
There is a two fold problem with care in the
also put a huge strain on the quality of care
community; people with dementia do not feel
and ultimately the quality of life for people with
that they are living well and carers feel that they
dementia who remain living at home.
are over worked and under supported.
Figure 35. Diagram of problems with care in the community
45
Home care workers are overworked and under supported. Due to time and financial restrictions they spread themselves too thin, and thus people with dementia are not receiving the care that they should whilst living independently.
Care in the community
05_The Problem
Care homes
Care in the
community analysis
46
Care in the community costs, and it is clear that an informal strategy of care is employed as an alternative which sees family and friends picking up the burdens of care for people with dementia. However, the World Alzheimer Report 2013 ‘Journey of Caring: An analysis of long-term care for dementia’, reveals that, as the world
05_The Problem
population ages, the traditional system of “informal” care by family, friends, and community will require much greater support as the current system is not working (Prince, Prina, & Guerchet, 2013). Figure 37. Diagram showing how the financial burdens of care in the community makes it unfeasible for some
Figure 36. Diagram of costs of care in the community
05_The Problem
47
05_The Problem
Family care
48
Figure 38. Diagram showing the many roles of family carers
According to a recent review of current family
Caring for ageing relatives can put a huge strain
There are both emotional and financial
care practices, privatisation and informalisation
on families, particularly those people who may
implications to try and negotiate, and if the
of family care is on the rise across Europe (Della,
also be looking after young children at the same
parent or parents being looked after have a
Giusta and Jewell, 2015). More than 80% of the
time.
degenerative condition, such as Alzheimer’s,
disabled older people receiving informal care
those caring for them can feel overwhelmed by
and living in private homes are being cared for
the responsibility and unsure how best to meet
either by adult children or by spouses or by
the needs of their parent and their own family at
both of them.
the same time (Della, Giusta and Jewell, 2015).
49
Family care
05_The Problem
Care in the community
Families and friends often pick up the slack of home care to ensure that people with dementia can remain living at home. This has its own issues with financial, support and guilt burdens, meaning that this strategy of care is also decreasing the quality of life of people with dementia.
05_The Problem
analysis
Family care
50
The annual care costs of dementia in the UK
Informal carers are 2.5 times more likely to
The onset of dementia is often associated with
amount to £26.3 billion – of which £11.6 billion
experience psychological distress than non-
negative emotions about the unpredictable
are met by informal carers (Prince et al., 2014).
carers, and working carers are two to three
burden of dependence (Thompson et al.,
Caring for someone else can often be
times more likely to suffer poor health than
2007). As the illness progresses, the caregiver’s
demanding and overwhelming. Over time, this
those without caregiving responsibilities (Della,
relationship with the care recipient becomes
can lead to mental health problems. The strain
Giusta and Jewell, 2015).
more and more strained and the caregiving
of family caring could be dramatically improved
One of the greatest challenges of family care is
burden grows.
if people with dementia were supported better
caregiving for someone suffering from dementia.
A detrimental result of the stresses and strains
whilst living independently. If the family know
Dementia is one of the main causes of disability
of family care are often that people with
that the person with dementia can safely
in later life (Thompson et al., 2007).
dementia become increasingly lonely as the
participate in activities and can remain living
family who care for them have jobs/children
safely within the community, this automatically
to look after and therefore the person with
reduces the feelings of stress and guilt.
dementia often gets left behind, or left in their house all day alone.
51
? The background work poses the question of how to ease the pressures of family carers whilst maintaining the quality of life for people with dementia
Figure 39. Diagram showing the problems with family care
There is no alternative...
05_The Problem
Family care
The solution
06_The Solution
Solution
development
54
Figure 40. Diagram showing solution mind mapping
06_The Solution
55
06_The Solution
Quality of life
56
The solution is to ease the pressures of family
It is often assumed that living with a chronic
It is proven though research that activity
care whilst maximising the independence and
condition of any form will correspondingly mean
improves quality of life and well-being for
quality of life of people with dementia.
a reduced quality of life.
everyone, not just people with dementia
Functional disability is the lack of ability to carry
However it is possible to live well with dementia
(Phinney, Chaudhury and O’Connor, 2007;
out everyday activities as normal (Prince et al.,
(“Dementia Friends”, 2015) and thus it is
Edvardsson et al., 2013; Torrington, 2006).
2014). This increases as dementia progresses
important to maintain the quality of life for
Increased activity is especially beneficial to
because functional abilities are directly related
people with dementia through every means
people with dementia as it improves mood,
to cognitive and thinking abilities. It was found
possible, especially through the care that they
reduces disruptive behaviours, and provides
through exploration of the historical and
receive.
feelings of success and accomplishment (Teri
social contexts of dementia that current care
For the elderly, satisfaction with leisure activities
and Logsdon, 1991). Phinney, Chaudhury and
strategies add to this disability.
is one of the best predictors of quality of life
O’Connor (2007) talk about how people with
(Marshall and Hutchinson, 2001) as well as social
dementia miss being able to take part in activity
integration (Koldrack et al., 2013).
as they lose the ability to perform activities that are rewarding and enjoyable.
Figure 41. Diagram showing the indicators of quality of life for people with dementia
Figure 42. Diagram showing the purpose of activity
06_The Solution
57
06_The Solution
Public space
58
Well-being and behaviour is largely influenced
Architecture can provide a safe and comfortable
As a person’s capacity decreases, they demand
by the environment (Marquardt and Schmieg,
environment that allows people with dementia
more from the environment (Brorsson, et al.,
2009), and promoting and maintaining the health
to maintain good quality of life and retain a sense
2011; Nahemow and Lawton, 1973), therefore
and wellbeing of older people is one of the most
of independence (Mitchell and Burton, 2006).
people with dementia lose the ability to
pressing priorities of our time (Skingley and
Public space is also defined as a platform
manipulate their environments (Mehendiran and
Vella-Burrows, 2010).
for activity (Carmona, 2003), and the ability
Dodd, 2009; Sixsmith et al., 2007) and therefore
We are all affected by the environment
to utilize the environment is found to be
need extra support to be able to participate
- controlled, enabled and disabled by it
essential for performance in activity (Mitchell
in activities. It is proven that building design
(Mehendiran and Dodd, 2009).
et al., 2003). The physical environment should
can therefore improve the lives of people with
Environments should and can have a positive
therefore support activity, especially for people
dementia (Joy, 2008).
effect on people (Mehendiran and Dodd,
with dementia who struggle to utilize their
2009; Blackman et al., 2003) facilitating social
environments (Torrington, 2009).
interaction (Campo and Chaudhury, 2011).
06_The Solution
59
Figure 43. Diagram showing activity in the public space
Social and
architectural
60
Social Difficulties
Difficulty in recognising faces and people who are family or friends causes a loss of connections. People with dementia feel that they might offend family or friends if they do not recognise them. This creates a barrier for interaction and results in a diminished quality of life as people with dementia avoid interactions (Campo and Chaudhury, 2011). Difficulty in orientation of time results in difficulty sleeping with a lack of concept of the time, inability to know the time or often the day which could result in missed appointments or meetings/gatherings (Sandilyan and Dening, 2015). A loss of the ability to communicate effectively is at the root cause of almost all social challenges of dementia as people with dementia often remove themselves from social situations when they do not feel as though they can communicate well with other people.They often cannot find the right words, or use different words that do not have the same meaning, which can also result in embarrassment (Sandilyan and Dening, 2015) and thus avoidance of these situations. If people with dementia lose the ability to navigate and find their way, this can often result in them not using the built environment anymore as they become lost and distressed when navigating around public space. This means that they no longer participate in social events or interactions which happen in public space (Carmona, 2003).
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Physical abilities may be reduced by sensory impairment (Marquardt, 2011) as dementia exacerbates the effects of physical impairments (Blackman et al., 2003) meaning that the ability to travel for social interactions becomes increasingly more difficult. A loss of memory links with other symptoms causing problems remembering names of people and events that may also be important to attend or remember (Koldrack et al., 2013).
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Architectural Difficulties Difficulty recognising usually familiar spaces resulting in getting lost often. This also means that public space is often avoided by people with dementia, as public space is often seen as inaccessible (Brorsson et al., 2011) due to this unfamiliarity. Difficulty in orientating in space, meaning that spatial awareness is decreased and could result in spaces and objects feeling out of scale or a misjudgment of spaces (Sandilyan and Dening, 2015). As a person’s capacity decreases, they demand more from the environment (Brorsson et al., 2011; Nahemow and Lawton, 1973) without the ability to ask for it as people with dementia lose the ability to manipulate their environments on their own through other symptoms too (Mehendiran and Dodd, 2009; Sixsmith et al., 2007). People with dementia are dependent on their external environment to provide cues for navigation around as they cannot adapt themselves (Marquardt and Schmieg, 2009; Nahemow and Lawton, 1973) resulting in them getting lost easily. The environment restricts autonomy through spatial disorientation and wayfinding (Blackman et al., 2003).
Humans have an innate awareness of their environment and seek environments with qualities to satisfy safety, security, physical, psychological and comfort needs (Stewart-Archer et al., 2015). Short term memory loss could mean that a person with dementia doesn’t actually know what they need. It is therefore important that the environment can be adaptive to the changing needs of its users, especially people with dementia.
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It is clear from the existing knowledge that the physical and social environment is currently designed for the mobile and functionally independent people (Lecovich, 2014). Where the environment is designed for the disabled, this focuses on physical impairments, not necessarily cognitive ones.
Social and
architectural
62
Social Difficulties
Impaired judgement may lead to inappropriate behaviour with people and thus cause embarrassment or humiliation (Sandilyan and Dening, 2015).
People with dementia may not be able to see properly to undertake everyday or leisure activities, or they may not see people and things that they need in order to carry out tasks (Sandilyan and Dening, 2015).
Confusion could lead to the inability to recognise people, or getting them mixed up and confused with other people (Sandilyan and Dening, 2015). This could lead to hostile relationships which cause negative effects for people with dementia.
Changes in mood means that people with dementia may act differently than they did before diagnosis. Without the understanding of this, friends and family may not want to spend time with the person with dementia, resulting in a lack of social interaction and positive emotions that would contribute to quality of life (Sandilyan and Dening, 2015).
The symptoms of dementia can often cause a loss of social connections and people with dementia feel like they can no longer do the things that they used to do as the
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symptoms pose too many challenges (Marshal and Hutchinson, 2001). Dementia threatens one’s ability to connect with others (Vernooij-Dassen, 2007).
People with dementia lose the ability to perform activities that are rewarding and enjoyable (Teri and Logsdon, 1991) resulting in a termination of such tasks and activities, exacerbating social isolation and diminishing quality of life (Blackman et al., 2007).
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Architectural Difficulties
Impaired judgement can often lead to decreased spatial awareness with leads to problems with orientation and navigating (Blackman et al., 2003). Visual perceptions problems means that architectural interventions, with the aim to aid movement around the built environment, may not be sufficient, such as signage and lighting (The Kings Fund, 2015). Confusion can cause disorientation and exacerbate other symptoms of dementia too (Sandilyan and Dening, 2015). The environment can influence non-cognitive symptoms of dementia (Sandilyan and Dening, 2015). The environment can therefore become a toolkit for care (Habell, 2013) as a supportive environment can increase mood and improve quality of life. Community connections are essential for the creation of dementia friendly environments (Davis et al., 2009) and maintaining community connections in long term care for people with dementia is being increasingly explored - trips out etc., therefore creating dementia friendly public buildings can also aid people with dementia in care homes as well as living independently
Buildings can influence the enjoyment of activities (Torrington, 2006) and thus the physical environment should support activity (Torrington, 2009).The ability to utilize the environment is essential for performance in activity (Mitchell et al., 2003) and thus architecture goes hand in hand with the ability to perform activity.
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(Davis et al., 2009).
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Proposal
64
It is clear that the symptoms of dementia can
Although there are activities arranged through
There are currently a variety of strategies to
present problems for independent living (Duggan
the Alzheimer’s Society, there is currently no
enable respite care in the UK, including;
et al., 2008) and as most people with dementia
set space where people with dementia can go
• Day centres
remain living at home their lives include
for a short break where they will be given the
• Care at home
activities in public space (Brorsson et al., 2011;
specialist support and care that they require,
• A short stay in a care home
Mitchell and Burton, 2010; Mitchell et al., 2003;
whilst also having the opportunity to participate
• Shared Lives
Mitchell and Burton, 2006; Blackman et al., 2003;
in activity.
• Holidays or short breaks
Torrington, 2009; Shanley, 2014).
Replacement care, also commonly known as
• Carers’ emergency replacement care schemes.
This proposal aims to eradicate these
respite care, is any care arrangement designed
issues whilst implementing the ideas, as
to give rest or relief to unpaid carers. It aims to
aforementioned, of activity, architecture and
support carers to have a break from their caring
reducing the burdens of family care.
responsibilities.
Figure 44. Diagram showing the current respite strategy
Figure 45. Concept image showing activity for people with dementia
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65
Precedent study
guidelines
Dementia friendly
68
Dementia friendly guidelines have been
Health building note (HBN) 08-02 also sets out
providing a safe environment; providing optimum
produced in order to help design architecture
design guidance for dementia-friendly healthcare
levels of stimulation; providing optimum lighting
which aids people with dementia through
buildings (Department of Health, 2015).
and contrast; providing a noninstitutional scale
orientation and wayfinding in buildings. The
The guidance covers both new and existing
and environment; supporting orientation;
symptoms of dementia have been studied and
refurbishment of healthcare buildings, and states
supporting way-finding and navigation; providing
explored in order to create design guidelines
that ‘colour and the layout of the buildings, can
access to nature and the outdoors; promoting
which accommodate for these through the
make an enormous improvement in people's
engagement with friends, relatives and staff;
design of buildings. Although some people with
quality of life’ (Department of Health, 2015).
providing good visibility and visual access;
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dementia do move to care homes, as presented
promoting privacy, dignity and independence;
earlier the majority of people live at home and
The notes explore twelve principles of
promoting physical and meaningful activities;
in the community, where these guidelines are
design with an underlying focus on creating
and supporting diet, nutrition and hydration
not implemented.
secure, supportive and non-institutionalised
(Department of Health, 2015).
environments;
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Figure 46. Diagram showing the HBN design guidelines
The Kings Fund (2015) guidelines for designing for dementia were constructed after collaborating with carers and people living with dementia about what they believe would help them through the built environment. They set out general policy principles for the design of care environments for people living with dementia. These guidelines and based upon 07_Precedent Study
five key themes which, in turn, incorporate a further set of design principles that can be used to aid each of these five categories of design; way finding; familiarity; maintaining activity; orientation; and legibility. Figure 47. Diagram showing the Kings Fund guidelines
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Implementation
70
These dementia friendly design guidelines from
Even though these guidelines have been created
As aforementioned, the public space is currently
the Kings Fund have been implemented in
to aid the design of buildings for people with
inaccessible to people with dementia and would
participating healthcare organisations across
dementia, they are currently only implemented
therefore benefit from the implementation of
England, but have not been implemented into
in healthcare settings. It has been proven
these guidelines in these settings too. Dementia
public buildings or purpose built dementia care
through the Kings Fund Enhancing the Healing
friendly environments can enhance and extend
facilities as of yet.
Environment study that these guidelines are
the active participation of older people in local
The diagram shows the initial twenty-
proven to aid navigation and other difficulties
communities (Mitchell and Burton, 2006). The
three participating organisations of the EHE
for people with dementia when using the built
ultimate aim would be to implement these
programme 2008 to improve their environments
environment.
guidelines in any public building or setting,
of care for people with dementia (The Kings
however for the purposes of this design thesis
Fund, 2015).
these guidelines will be used in the design of the proposed respite centre, and precedents mentioned here will be further explored as the design advances.
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01 Berkshire Healthcare NHS Foundation Trust 02 Bradford Teaching Hospitals NHS Foundation Trust 03 Cheshire and Wirral Partnership NHS Foundation Trust 04 Cornwall Partnership NHS Foundation Trust 05 Cumbria Partnership NHS Foundation Trust 06 Derbyshire Community Health Services 07 Devon Partnership NHS Trust 08 Dorset Health Care University NHS Foundation Trust 09 Hertfordshire Partnership NHS Foundation Trust 10 Humber NHS Foundation Trust 11 Ipswich Hospital NHS Trust 12 King’s College Hospital NHS Foundation Trust 13 Leeds and York Partnerships NHS Foundation Trust 14 Leicester Partnership NHS Trust 15 Lincolnshire Partnership NHS Foundation Trust 16 Mersey Care NHS Trust 17 Poole Hospital NHS Foundation Trust
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18 Rotherham, Doncaster and South Humber NHS Foundation Trust 19 Royal Wolverhampton Hospitals NHS Trust 20 Sheffield Teaching Hospitals NHS Foundation Trust 21 South Warwickshire NHS Foundation Trust 22 Taunton and Somerset NHS Foundation Trust 23 University Hospitals Coventry and Warwickshire NHS Trust
Figure 48. Diagram showing the location of the trusts which have implemented the Kings Fund guidelines
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cities uk
Dementia friendly
72
A dementia-friendly community is a city, town
There are 50 cities in England, but only 22 of
or village where people with dementia are
these are currently implementing strategies
understood, respected, supported, and confident
to help them become dementia friendly. It is
they can contribute to community life. This is
important to note that there are no dementia
achieved through the dementia friends initiative
friendly cities in the North.
which was explored earlier. An economic analysis
The concept of dementia friendly communities
commissioned by the charity in September 2013
has been explored through this precedent study
showed that Dementia Friendly Communities
as an initial indication to dementia friendly public
could save ÂŁ11,000 per person per year by
spaces, however it is apparent that the concept
helping people with dementia to remain
currently only focuses on eradicating the societal
independent, stay out of care for longer and have
stigmas of dementia, rather than the design of
a better quality of life.
the physical environment to enable dementia friendly public space. Figure 49. Diagram showing the concept of dementia friendly cities in the UK
Figure 50. Diagram showing the location of dementia friendly cities in England (the black dot represents dementia friendly, whereas the white dot represents not dementia friendly)
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Hodgeways
74
Hodgeways is a dementia friendly village
This uses the idea of familiarity, explored by the
Each resident fills out a questionnaire on
designed in Holland. It offers its residents
Kings Fund guidance (The Kings Fund, 2015), to
arrival which helps carers to better understand
maximum privacy and independence. In the
improve the quality of life of people living with
each individual’s personality and match them
design of its streets, are squares, courtyards
dementia. Unfortunately the model of dementia
to a suitable house within the village (Jenkins
and a park where people can walk freely and
care in the UK does not yet implement the
and Smythe, 2013). Each house is designed
safely. Hodgeways has various facilities including
strategies as seen in Hodgeways. This begs the
in a different way, from working class homes
restaurants, cafes and theatres.
question as to whether this model, or aspects of
to modern townhouses, and each resident is
There are 7 lifestyles: urban, Beverly Hills,
this model could be adapted in the UK, and will
matched to a similar style of house to what
domestic, Christian, traditional, Indian and
be further explored through this design thesis.
they have lived in throughout their lives, which
cultural. Together with a team of employees, the
There are 23 specially designed residential
evidently matches them to suitable ‘roommates’
residents conduct their own household. Meals
homes where 152 elderly people with dementia
(Jenkins and Smythe, 2013).
are cooked in each household and shopping for
live.
Residents can go out freely, but remain in a
food is done at Hodgeways own supermarket.
Hodgeways is designed so that the residents can
protected environment.
move freely through the neighbourhood.
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75
Figure 51. Images of models of Hodgeways
Figure 52. Drawing of the plan of Hodegways
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care
Cuban model of
76
Cuba has a number of interesting projects for
Activities are planned everyday with the option
The system works well in this Cuban model of
the elderly, such as the University for Senior
to attend or not; morning exercises, choir
care, as family members can still maintain jobs
Citizens, where pensioners can study, participate
practice, dominos playing, etc.
and their own lives, whilst knowing that their
in Tai Chi exercise sessions and the Casas del
These centres are located in the city centre to
elderly relatives are being well looked after and
Abuelo (“Grandparent Homes”), where the
ensure easy accessibility for elderly people to
enjoying themselves with the opportunities for
elderly can spend the day while their sons and
use them.
activities if they wish with other like-minded
daughters work.
Although the architecture isn’t glamorous in
people.
Instead of referring to the elderly community
the Cuban senior homes, the atmosphere is
The concept ensures that children can be
as ‘elders’, they were instead referred to as
described as different to the typical care home.
dropped off at school, while elders are dropped
‘abuelos’ and ‘abuelas’, meaning grandpas and
Elders were there by choice, and not made to
off at the ‘Grandpa’s House’ whilst family carers
grandmas.
go as the rest of the built environment was
go to work. They can then both be picked up
no longer sufficient to accommodate for their
before returning home to create a sustainable
needs.
solution to family care.
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77
Figure 53-76. Images of activities for the elderly
Niall mclaughlin
78
The challenge in designing a care environment
McLaughlin’s practice worked with dementia sufferers from 1999
for people Alzheimer sufferers is to produce
to 2014 while collaborating with the Alzheimer’s Society of Ireland
calm, coherent spaces which reduce enervating
on the organisation’s first new building – a respite centre in Dublin.
distraction, aid orientation and encourage
Niall McLaughlin Architects represented Ireland at the 2016 Venice
mobility (McLaughlin, 2016).
Biennale based on this project.
The centre responds to these demands by
“Occasionally we get lost in our physical surroundings. Occasionally
creating a protected precinct of courts, gardens,
we get lost emotionally and lose the ability to find routes through
interconnected social spaces, and private 07_Precedent Study
individual rooms all of which connect with the walled garden outside. A labyrinth of pale yellow stock brick lows walls and buildings is broken up with timber pavilions conjugated with beams, panels, transoms and roofs, all adjusted to the human scale.
our lives or to think straight and decipher problems. What we have probably all experienced is a state of confusion that brings angst and fear. Imagine this as a permanent or progressive state, and one that is terminal. It is a frightening thought, being out of control and unable to recall. This is what a person with dementia experiences daily”. (McLaughlin, 2016)
79
External space Internal space
392sqm
940m2 30% 70%
Architect: Niall McLaughlin Architects Client: Alzheimer’s Society Ireland Begun: June 2006 Completed: September 2009
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Floor area: 1,392m2 Sector: Healthcare Total cost: £2.7M Address: The Orchard Centre, Temple Road, Blackrock, Co. Dublin, Ireland
Figure 77-80. Images of the Alzheimer’s Respite Centre Figure 81. Diagram showing the proportion of internal to external space
Figure 82. Image of the biennale exhibition concept
Niall mclaughlin
80
4. 50sqm
This respite centre provides accommodation for 11 clients, including private bedroom and en-suite facilities and shared living / dining facilities.
11. 100sqm
The bedrooms are single rather than double, and thus I would like to incorporate some couple bedrooms in my proposal to ensure that couples have the opportunity to stay together while other family carers have a break. 07_Precedent Study
The total internal floor area for this respite
10. 25sqm 12. 200sqm
3. 25sqm 13. 50sqm 7. 20sqm
5. 75sqm 6. 60sqm
7. 140sqm
8. 40sqm
12. 100sqm 9. 5sqm
centre including accommodation is 940sqm, however this figure include 300sqm of external office space, which my programme is not looking to include, making the internal size of this respite centre approximately 640sqm.
Figure 84. Spatial strategy diagram showing the approximate sizes of spaces in the Alzheimer’s Respite Centre
81
NATIONAL OFFICES ENTRANCE
1
RESPITE CENTRE ENTRANCE
2
KITCHEN 3 DINING ROOM 4 ACTIVITY ROOM 5 CENTRAL SPACE 6 SITTING ROOMS 7 CONTEMPLATION ROOM
8
BEDROOMS 9 HAIRDRESSING 10 RESPITE CENTRE STAFF OFFICES
11
ALZHEIMER’S SOCIETY OFFICES
12
THERAPEUTIC REMEDIES
13
MORNING TERRACE 14 AFTERNOON TERRACE
16
MAGNOLIA TERRACE
17
EVENING TERRACE 18 HERB AND SCENT GARDEN
19
ORCHARD 20 WORKERS GARDEN 21
Figure 83. Plan of Alzheimer’s Respite Centre
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UPPER TERRACE 15
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Firhill respite centre
82
The plan is arranged around a double height
The mono pitched roof is clad in standing seam
The expressed building form accentuates
social space, which opens onto the verandah at
zinc with a concealed gutter and the roof to
the primary importance of the spaces whilst
the front of the building. Bedrooms are arranged
the rear of the building is finished with a single
providing a well-lit, airy space that is a distinct
along the length to the rear and one side of the
ply membrane incorporating roof lights and
move away from the cramped domestic
building. The building is constructed from a steel
concealed gutters. Access to and from the
architecture the respite users were used to in
frame with insulated timber framing infill and is
building is barrier free, as is the access onto the
their previous centre. Provides accommodation
clad with vertical Siberian larch boarding with
timber verandahs to the front and rear of the
for 8 respite clients, including private bedroom
elements of zinc. Externally all detail is removed,
building. The project creates a new facility that
and en-suite facilities and shared living / dining
rainwater pipes are hidden, only rain chains
is based on a typology of pavilion and garden
facilities. The plan is straightforward; a double
are visible to the recessed entrance and rear
architecture and it is intended to be subsidiary
height social space to the front is viewed as
verandah.
to the existing Day Centre opposite whilst
the heart of the building with the bedrooms
forming its own frame of reference against the
arranged along its length to the rear. The
landscape.
interiors are thoughtfully designed to ensure maximisation of views to the landscape beyond.
83
The expressed form creates a civic presence on a human scale as an attempt to create an opposite to the standard form of residential architecture associated with respite centres. The respite centre acts as a subsidiary to the existing day centre opposite. Access to and from the
Architect: JM Architects
building is barrier free. Internally, all corridors,
Edinburgh Council
Client: City of
doors and lobbies have been designed to aid
Begun: December 2008
unimpeded movement around the building.
Floor area: 575m2
Although this respite isn’t specifically for people
Sector: Healthcare
with dementia, it still implements strategies
Address: Colinton
Total cost: £1.1M Road, Edinburgh,
which aids wayfinding ‘creating unimpeded
EH14 1DW, UK
movement around the building.’ Figure 85-92. Images of the Firrhill Respite Centre Figure 93. Plan showing the types of spaces within Firrhill respite centre
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Completed: April 2010
Maggie centres
84
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Figure 94-105. Images of Maggie Centres (from left to right: Aberdeen, Airdrie, Edinburgh, Edinburgh phase 2, Inverness, Kirkcaldy, Liverpool, Manchester, Oxford, Newcastle, Nottingham, Swansea.)
Although the Maggie Centres are designed
Although dementia is an incurable degenerative
In 1995 Maggie Keswick Jencks, wrote this about
primarily for cancer patients, it was deemed
disease, the ideas employed in the Maggie Centres,
her experience of cancer:
that the architectural interventions employed
about wayfinding, visibility, security and activity
“A diagnosis of cancer hits you like a punch in
through their brief would also be well received
would also be hugely beneficial to people with
the stomach…No road. No compass. No map.
by patients with dementia.
dementia as a respite centre, as I am proposing
No training…At one time, I could not sit, or lie,
The concept of healing spaces and places
through this design thesis.
or stand, listen or speak coherently because my
specifically designed to aid the recovery for
Some Maggie centres were looked at in further
shattered mind vibrated so violently through my
people diagnosed with cancer is a beautiful
detail as they were found to employ good specific
body I felt I might disintegrate.”
concept of how architecture can really influence
techniques that I would want to take forward
(Keswick Jencks, 1995).
the quality of life for people who are suffering
through this design thesis.
Over the course of seven years, Maggie
from illnesses (Martin & Hurst, 2017).
experienced
cancer
diagnosis,
remission and recurrence.
treatment,
85
Among Maggie’s beliefs about cancer treatment was the importance of environment to a person dealing with cancer. She talked about the need for “thoughtful lighting, a view out to trees, birds and sky,” and the opportunity “to relax and talk away from home cares”. She talked about the need for a welcoming, reassuring space, as well as a place for privacy, where someone can take 07_Precedent Study
in information at their own pace. Although the concept of the Maggie’s Centres are based around a cancer diagnosis, the ideas of healing spaces can still be evident through the design of dementia care facilities. Figure 106. Location of Maggie Centres in the UK
86
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Dundee
Figure 107-114. Images of Maggie Centre Dundee
Two-storey white rendered masonry structure
The building is particularly well designed in that
It helps to orientate the building within its
with elliptical tower and timber pitched roof at
every destination can be viewed from the main
context, as well as just employing orientation
multiple angles, clad in stainless steel. This was
entrance to the building. This would promote
aids through the internal design of the building.
the first new-build Maggie’s Centre. Maggie’s
wayfinding and orientation. The design was also
The other noticeable design aspect to this
Dundee was inspired by the design of historic
inspired by the historic highland dwellings. This
building was the idea that every destination
simple Highland dwellings known as Brochs.
relates the building to a familiar typology to the
could be seen from the entrance to the building.
A cylindrical form ‘borrowed’ from that house
area, which also aids with orientation of the
This would be important to aid the wayfinding
type became the ideal space for the Centre’s
location. This Maggie centre was deemed a good
of a person with dementia as they would be able
library with the addition of small sitting room
precedent for a dementia respite centre as the
to see their destination as soon as they entered,
above it. Except for this sitting room, the rest of
form was based upon the local area and context.
and reduce the ideas of getting lost or not
the building is on one level with an open-plan
It would be beneficial to employ this same
knowing how to reach destinations within the
kitchen and dining area, a large sitting room, and
technique through the design of a space for
building.
smaller rooms for one-to-one sessions (Martin
people with dementia.
& Hurst, 2017).
87
Architect: Gehry and Partners Client: Maggie’s Centre Begun: April 2002 Completed: 2003 Floor area: 214m2 Total cost: £932,000 Address: Maggie’s Dundee, Ninewells Hospital, Tom McDonald Avenue, Dundee, DD2 1NH, United Kingdom Figure 115&116. Floor plan of Maggie Centre Dundee and wayfinding strategy Figure 117. Image of model of Maggie Centre Dundee
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Sector: Healthcare
Cheltenham
88
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Figure 118-125. Images of Maggie Centre Cheltenham
One of the principles of the design of the
The intention is that the building, with its
This adds an aspect of security to the design
communal spaces is that people feel more
combination of openness and intimacy and its
as people are deemed to be more comfortable
secure if they have their back against the wall.
secluded gardens, can provide a sanctuary away
if they have their backs against a wall, rather
The building provides a series of distinct and
from the busy hospital which complements the
than being unsure of what may be behind
reassuring spaces. The scale of both the existing
emotional and psychological support provided
them. Security is deemed to be an important
lodge and the new extension offer a domestic
by the Maggie’s Centre staff (Martin & Hurst,
factor when designing for dementia as well as
context distinct from the institutional character
2017). There are two secluded pods within the
it can help to put people at ease and reduce
of the hospital itself. The centre is entered
internal building layout which have windows
agitated behaviour. The internal layout of the
through an enclosed and highly landscaped
facing onto the outside world. This aspect
building also enables a closed loop circulation
garden in which there are several discrete sitting
of allowing privacy also creates the sense of
around the whole building, which is a good tool
areas.
inclusion as users of the building still have a link
for wayfinding as it enables people to wander
This plan offered many solutions for looped
with the outside world.
without meeting any dead ends as they can
circulation as well which would aid with
All seating in the interior of this Maggie centre is
always loop to the other spaces.
wayfinding.
situated on the perimeters of the rooms.
89
Architect: MJP Architects Client: Maggie’s Centre Begun: September 2009 Completed: September 2010 Sector: Healthcare Total cost: £1.2M Address: The Lodge, College Baths Rd, Cheltenham, GL53 7QB, United Kingdom Figure 126. Floor plan with wayfinding strategy
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Floor area: 100m2
Newcastle
90
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Figure 127. Sketch of Maggie Centre Newcastle
A central library incorporates stairs up to a
The walled garden also allows for full closed
The entire plot is surrounded by a walled
mezzanine level, covered by an angled roof
loop circulation around the building - always
garden which gives a sense of privacy for the
covered in photovoltaic panels. The mezzanine
ensuring that the user returns ‘home’ again even
whole building and allows people to feel safe
leads out onto the flat landscaped roof, screened
if they get lost.
and secure. This is an interesting aspect to also
by planting. A courtyard occupies the fourth
The centre has two wings - one for counselling
incorporate into a dementia respite centre.
quadrant, which visitors can see and walk out
rooms with a large living room space, the other
The design of the building uses local materials
into from the kitchen and large meeting room.
leads to the kitchen table. This enables privacy
such as steel and timber, which can give a sense
The energy efficient building incorporates solar
for the counselling rooms and separates the
of familiarity and orientation. This will also be
panels on the roof and has thick insulation
homely aspect of the building with the medical
something which I will incorporate into my
(Martin & Hurst, 2017).
aspect. Each wing also has access to the external
proposal in order to orientate the design on a
The links between the internal and external
space and keeps the links between internal and
city scale too by using materials familiar to the
spaces really make this building unique as it
external.
area.
allows secure access between each space and promotes outdoor activity.
Figure 128-130. Images of Maggie Centre Newcastle
91
Architect: Cullinan Studio Client: Maggie’s Centre Begun: June 2012 Completed: June 2013 Floor area: 285m2 Total cost: £1.6M Address: Freeman Hospital, Melville Grove, Newcastle Upon Tyne, NE7 7NU, United Kingdom Figure 132-135. Floor plans with wayfinding strategy and links between internal and external spaces
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Sector: Healthcare
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Oxford
92
The timber and glass building, whose base is
The site is in a calming and tranquil setting
lifted 3m above the ground, is situated on a
located in a woodland. This provides beautiful
small, partly wooded parcel of land designated
links between the internal and the external area.
as a Site of Special Scientific Interest (SSSI), with
The location of the Maggie centres in the vicinity
a stream running along one of its edges. The
of local hospitals is important for the medical
building is entered by crossing a wooden bridge,
nature of cancer; and could also be similar for
with the glazed admin office on the right, with a
dementia. I will aim to look at the location of my
small library and the large group activity room
respite centre in relation to the hospitals in the
on the left arranged around the central kitchen.
vicinity.
The consulting rooms are in the third arm of the building (Martin & Hurst, 2017).
Figure 136-143. Images of Maggie Centre Oxford
93
Architect: Wilkinson Eyre Architects Client: Maggie’s Centre Begun: October 2013 Floor area: 225m2 Sector: Healthcare Address: The Churchill Hospital, Old Road, Oxford, OX3 7LE, United Kingdom Figure 144. Axonometric working drawing of Maggie Centre Oxford
07_Precedent Study
Completed: June 2014
Programme development
08_Programme Development
Activity
96
The need to engage in activity is intrinsic to
Watching television programmes showed a
Enjoyment seems to be measure of meaningful
human beings (Wenborn et al., 2013) as it
protective effect for dementia (Qiu, Kivipelto
activity (Harmer and Orrell, 2008) and a range
enhances well-being (Torrington, 2009). People
and von Strauss, 2009). The top leisure activity
of activity is needed for people with dementia
with dementia rank social and community
rated by Chiu et al (2013) was also watching TV.
with enjoyment as the main aim (Pulsford, 1997).
participation as highest for activity that they
It was also found by Witzke (2008) that music
My hope is that with a supporting physical
want to undertake (Torrington, 2009) with
interventions can also improve the quality of life
environment this will ease the pressures on care
leisure identified as a strategy to the social
for people with dementia. Outdoor activity can
staff and therefore attitudes towards people
disability of dementia (Innes, Page and Cutler,
extend the period of good quality living (Duggan
with dementia and people with dementia can
2015). Leisure activities have also been proven
et al., 2008) so garden spaces and excursions
remain independent. Even if factual memory
to have a positive impact on cognitive function
will be incorporated into the building. The types
declines, emotional memory remains, and
and dementia (Wang et al., 2012). Arts based
of activities researched were grouped into
therefore the need to participate in enjoyable
interventions - music, storytelling, singing, drama
categories in which spaces could be created
activity is crucial for people with dementia.
and dancing all found to have a positive influence
through an initial programme development in
on people with dementia (Lepp et al., 2003).
order to undertake these activities.
Figure 145. Diagram of activity types and ranges
Figure 146. Word image relating to types of activity
08_Programme Development
97
08_Programme Development
Activity
98
There were a range of activities found to be
More active activities were also explored, such
Music therapy, involving both making and
enjoyable to elderly people and people with
as ping pong, yoga and other exercise. These
listening, will be incorporated into the
dementia. These were grouped into categories in
would also be included in the programme of the
programme of the respite centre.
order to understand what types of spaces would
building, as well as the possibility of a swimming
The idea of everyday as well as leisure activities
be needed in order to carry out these activities.
pool and hydrotherapy initiatives.
was also thoroughly explored through literature.
Seated activities were deemed of great
Outdoor space is important as gardening is a
It is therefore important to include kitchen and
importance especially for people with physical
key activity that people with dementia value.
dining facilities to enable people with dementia
impairments. These included bingo, cards, board
to still be able to cook as they would whilst
games, arts and crafts. An activity room would be
living independently.
designed to meet these types of activities.
08_Programme Development
99
Figure 147-154. Concept images of types of activities
Schedule of
accommodation
100
I will be looking to accommodate 10 residents within the respite centre giving a rough total internal floor area of 766sqm with 3 couple
08_Programme Development
bedrooms and 7 single rooms.
Couple bedroom Bedroom Ensuite bathroom with bath Kitchen Living room/dining room Total Single bedroom Bedroom Ensuite bathroom with bath Kitchen Living room/dining room Total Communal areas Kitchen Living room Dining room Small cinema room Swimming/hydrotherapy Disabled WCs Assisted bath Reception/staff offices Games room Activity room Music room Therapy room Total communal internal floor space
16sqm 8sqm 5sqm 15sqm 44sqm 12sqm 8sqm 5sqm 15sqm 40sqm 12sqm 50sqm 50sqm 50sqm 140sqm 4sqm 8sqm 40sqm 50sqm 50sqm 40sqm 20sqm 514sqm
08_Programme Development
101
Figure 155. Diagram of initial programme strategy
Site selection
Site criteria
104
09_Site Selection
Figure 157. Global prevalence of dementia
Based upon the dementia friendly design
As previously explored, there are also no
It is evident from the data that an ageing
guidelines by the Kings Fund and the HBN
dementia friendly communities in the North
population is a global pandemic, with Europe
guidance, as well as the precedent studies as
of England, leaving a gap in the market to be
and in particular the UK containing the largest
previously mentioned, I set a criteria for what I
explored by this design thesis.
numbers of the elderly population, leading to
wanted from my site in order to find the place
As the idea of accessibility is prevalent, I chose
more cases of dementia (Qiu, Kivipelto and von
to situate this respite centre for people with
to look specifically at the city centres within the
Strauss, 2009; Sauer et al., 2014; Wang, Xu and
dementia.
North East in order to determine my site.
Pei, 2012; Sheehan, 2006).
I began by setting this criteria, and then I
It is found that Europe has the largest
explored the prevalence of dementia on a global
percentage of people with dementia to
scale in order to narrow down where a respite
population than any other continent in the
centre might be needed.
world, and these figures are continuing to rise
This led me to the UK; and specifically the
(Qiu, Kivipelto and von Strauss, 2009; Sauer
North East.
et al., 2014; Wang, Xu and Pei, 2012; Sheehan, 2006).
09_Site Selection
105
Figure 156. Diagram of site criteria
European statistics
106
After further exploration it is also found that the UK has one of the highest rates of dementia in Europe. Within the UK, England homes the most elderly people per population (Qiu, Kivipelto and von Strauss, 2009; Sauer et al., 2014; Wang, Xu and
09_Site Selection
Pei, 2012; Sheehan, 2006).
Figure 158. Diagram of European prevalence of dementia
09_Site Selection
107
Figure 159. Diagram of UK prevalence of dementia
09_Site Selection
Breakdown of UK
108
In 2014 an estimated 34,000 people in the
In 2012/13 the prevalence of recorded dementia
North East of England are living with a form of
in North East England was higher than the
dementia (Smith and Otter, 2014).
national rate of 569 people per 100,000 (Smith
It is predicted that between 2014 and 2020 the
and Otter, 2014). The regional rate increased
overall number of people living with dementia in
by 35% since 2008/09, marginally ahead of the
the North East will increase by 17% to 39,800
national rate of 33% (Smith and Otter, 2014).
(Smith and Otter, 2014). Between 2008/09 and
In 2013 the North East had a diagnosis rate of
2012/13 recorded prevalence in the North East
54%, which was higher than the 48% rate for the
increased by 35% from 496 people per 100,000
whole of England (Smith and Otter, 2014).
to 669 (Smith and Otter, 2014).
Figure 160. Diagram of the North East
09_Site Selection
109
09_Site Selection
City centre
110
Accessibility leads me to the idea of choosing a
Although each of these cities provides an
site within a city centre, as aforementioned. This
appropriate setting for a dementia respite
ensures that it is easily accessed by people with
centre, the idea of using landmarks within the
dementia, and also begins to create dementia
city in order to orientate the building within the
friendly cities. This is also where most landmarks
context was an important design driver.
are situated to provide orientation on a city
It was found that Newcastle city had the most
scale which was also found to be important
landmarks that provide good opportunities for
through the site selection.
site selection. Newcastle city centre also has the
Although the North east is split into 9 key areas,
lowest recorded prevalence of dementia in the
there are only 3 cities within this; Newcastle;
North East as it is not dementia friendly, and
Sunderland; and Durham.
thus people with dementia don’t feel that they can live there. This gives great justification for selecting a site in Newcastle. Figure 161. Diagram of cities in the North East
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111
Figure 162. Concept image of landmarks in Newcastle
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Landmarks
112
Figure 163. Diagram of the location of Newcastle Landmarks
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113
Potential sites
114
Town Moor & Exhibition Park
1.39km2
Pros
Cons
•
Exhibition Park has a rich
•
On the outskirts of the city
history
•
Area possibly to big to justify
•
Large open space with beautiful views
•
specific location •
Park - tranquil and calming
No landmarks to reference nearby or that can be seen from the site
Leazes Park
315,000m2
Pros
Cons
•
Near
lake
which
gives
•
reference to water and links
09_Site Selection
with Newcastle and the Tyne
proposal •
Park used by dog walkers/
•
Beautiful views
joggers etc - would a building
•
Event spaces in the park
impede these uses?
•
Children’s
playground
family picnic area
Figure 164. Map of Town Moor and Exhibition Park Figure 165. Map of Leazes Park
Lots of trees to consider in the
•
Reference to St James Park
•
Next to hospital RVI
•
Residential surrounding
and
•
Noise from football stadium
•
Noise from ambulances from nearby hospital
115
Quayside
4670m2
Pros
Cons
•
Beautiful views
•
•
Bridges and Tyne as landmark references
•
Car
park
nearby
for
Possibly too far away from centre
•
Safety being so close to water
•
Security issues
accessibility
Nuns Moor North
1km2
Pros
Cons
•
•
Large open space with beautiful
Outskirts of city
views Park - tranquil and calming
•
Golf club nearby
09_Site Selection
•
Figure 166. Map of Quayside Figure 167. Map of Nuns Moor North
09_Site Selection
Potential sites
116
Figure 168. Map of the Angel of the North Figure 169. Map of Nuns Moor Central and South
Angel
83,000m2
Pros
Cons
•
Open space suitable for a
•
On the outskirts of the city
respite centre
•
Angel is a relatively new
•
Council plans to develop area
landmark (25 years old) and
around the angel
thus may not be as relevant to
•
Easily accessible from A1
the current elderly generation
•
Surrounding residential
•
Angel as landmark
Nuns Moor Central and South
383,000m2
Pros
Cons
•
Large open space with beautiful
•
Outskirts of city
views
•
Land too big could make it
•
Park - tranquil and calming
•
Golf club nearby
inaccessible
117
St Michaels
0.04km2
Pros
Cons
•
Best views of the Tyne
•
•
Surrounded by residential
•
Landmarks of the bridges and
Possibly too far away from centre
•
the Tyne
Accessibility issues for public transport or on foot due to topography of site
Hunters Moor
180,000m2
Pros
Cons
•
Large open space with beautiful
•
Outskirts of city
views
•
Land too big could make it
Park - tranquil and calming
•
Closer to centre than other moors
Figure 170. Map of St Michaels, Biker Figure 171. Map of Hunters Moor
inaccessible
09_Site Selection
•
Leazes park
118
Leazes park is the only site identified earlier as
The main challenges that I expect to face
The noise from the football stadium will be
fulfilling all of the criteria, and is also located
with the Leazes Park site are the trees and
concealed throughout most of the building,
within a 10 minute walk of Newcastle city
the noise from the ambulances and St James
however it would be an interesting design aspect
centre. The centre was defined as Central
football stadium. The proposal will incorporate
to try and exploit this through certain areas of
Station to ensure that the site would be
a high level of acoustic properties in order to
the building as the noise from the stadium could
accessible to as many people as possible.
accommodate for this.
provoke memories for people with dementia, and could therefore be beneficial to the purpose
09_Site Selection
of the respite centre.
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119
Figure 173. Photograph of signpost in Leazes Park Figure 174. Photograph of playground in Leazes Park
Figure 172. Map location of city centre and distances
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120
Figure 175. Photograph of Leazes Park
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121
Brief development what’s next?..
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What’s next?..
124
Figure 177. Concept image of activity
The next stages of the project will involve a
The site within Leazes Park that I am looking
The aim of this is to enable the respite centre to
more comprehensive site response analysis in
at provides 360 views around the proposed
feel secluded, but also remain an active part of
order to understand the area of Leazes park
building; with views of the lake, St James’ Park, as
the community and encourage intergenerational
further. This will also include drawing up a
well as views of activity within the park as I am
interactions with the people with dementia.
levels survey and a tree survey - both of which
looking to place the building next to the existing
Whilst undertaking a comprehensive site
have already been conducted by myself (see
children’s playground and family picnic area too.
response I will also be exploring the types and
Appendix). A site model will also be made,
It will be a useful exercise to write up the pros
ranges of activities identified earlier in the initial
both physically and digitally to aid with the
and cons of the specific sites within Leazes park,
programme development in order to understand
site response. This will aid me positioning the
similar to the site selection exercise previously
the requirements that these activities may
proposal within the urban park setting. Further
in order to determine the most suitable location
need spatially in order to further develop the
exploration into urban parks and urban park
for the building.
programme of the proposal.
precedents will also be a useful exercise.
A
125
R D
S O
N R O A
D 42. horse chestnut
43. sycamore
45. common box
47. common box
44. osier willow
48. whitebeam
46. common box
52. sycamore
51. field maple
64. alder buckthorn
49. aspen 54. ash
55. field maple 57. ash
50. aspen 62. ash 66. midland hawthorn 65. field maple
63. aspen
61. sycamore
60. european silver fir 59. copper beech
R
R
D
The first of these has been exploring the
C
V I C T OR IA
I
everyday activity of making a cup of tea. This
H
A
R
D S
will also be further developed in order to
O N O
Q U E E N
R
understand the spatial strategy for this process.
A
D
It is hoped that by doing this activity exploration
R
T
R
E
S
T
A
S E
S R
E Z A R
L
E
K
O
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L E D
A Z E S
A
S T R E E T
C
E
PL
A
RR
TE
L A
D E R B Y
AC
CE
E S A Z L E
function.
H
S
A
located in the best places suitable for the
T
L
R
development on the site so that they can be
T
C
EA
A
activity rooms etc. through the programme
S
R
Z
E
E
B
create an understanding of the placement of
C
alongside the site response, this will begin to
NE
P
A
R
K
L
R
Y
L
A
C
E
O
E
P
R
W
Figure 176. Site Plan of Leazes Park
L
Site response
Walking tour of Leazes park A walking tour was undertaken throughout Leazes Park in order to establish possible sites within the park to place the proposed dementia
11_Site Response
respite facility.
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Walking tour of Leazes park
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Walking tour of Leazes park
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Walking tour of Leazes park
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Walking tour of Leazes park
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Site 1 - 2340m2 Pros
Cons
• Good location next to
• Would
children’s playground • RVI close by
children’s
block
the
playground
and make it unsafe
• Family picnic area
Site 2 - 9720m2 Pros
Cons
• Close to a main road -
• Close to a main road -
access
noise • Lack of parking facilities
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along the East side of the park
Site 3 - 35,750m2 Cons
Pros • Surrounded
by
residential
• Might
overlook
residences
• Close to RVI
• Furthest away from St James Park to use as a landmark • Vast area
Site 4 - 1550m2 Pros • By
Cons stand
• Might be quite a busy
great
music
area of Leazes Park -
connections
and
-
the
band
too busy?
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events
Site 5 - 25,750m2 Pros
Cons
• RVI close by
• Cattle graze on this
• Near
to
children’s
site March - November
playground and family
- safety? - For users
picnic area, although
of building as well as
blocked by trees and
cattle.
shrubs Site 6 - 3800m2 Cons
Pros • Immediate
links
with
children’s playground,
cause
RVI and family picnic
removal
constraints
• Springbank
area
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• A lot of trees on site or
Pavilion
• Can see St James Park
currently on site - needs
• Close
to be removed
Road
to
Richardson -
available here
parking
Site 7 - 22,700m2 Pros
Cons
• Immediate links to St
• Close to Listed buildings
• Close to lake
in
the
conservation
area - stricter rules • Noise pollution
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James
Justification 11_Site Response
Within Leazes Park there is also a family picnic
Although I do not want to exploit the views of
area, boating lake and children’s playground, all
the RVI in the respite centre, as hospitals can
of which already provide activity within the park,
provoke distressing memories which is not the
further reiterating the function of the respite
intention, it is important the there are close links
centre.
with the RVI to the respite centre as dementia is
This makes the site located on the old
still a medical condition.
Springbank pavilion site the most appropriate for
This makes Leazes Park a relevant and
the proposal.
appropriate site for the location of a dementia
There are also tennis courts and a bowls club
respite centre in Newcastle.
located to the south of the park.
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Site conditions
144
VIEWS
ACCESS
The main views from the site would be towards
Central station is a 10 minute walk from the
the cattle grazing field to the north of the site,
site. The nearest metro stations are Haymarket
the children’s playground to the west and the
and St James. Buses 15, 16, 32 and 50 all stop on
family picnic area to the south. There is also ST
Richardson Road. The park has a public car park
James Park to the far south.
at the South-East of the site which has 3 disabled
GREEN SPACE
parking bays for Blue Badge Holders. There is
It is an important design imperative to keep
also on street parking along Richardson road.
all of the trees on site as remaining as to be
The main access to the site is from Richardson
sensitive to the context as well as integrating the
road (denoted by the larger dotted line), with
nature into the proposal.
secondary access along the public footpaths around Leazes park (denoted by smaller dotted lines).
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145
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Site criteria
152
In 1984, a researcher named Roger Ulrich
Trees are an efficient and cost-effective way for a
noticed a curious pattern among patients who
community to improve its air quality and reduce
were recovering from gallbladder surgery at a
pollution. A mature tree absorbs between 120-
suburban hospital in Pennsylvania. Those who
240 pounds per year of small particles and gases,
had been given rooms overlooking a small
like carbon-dioxide, which are released into
stand of deciduous trees were being discharged
the air by automobiles and industrial facilities.
almost a day sooner, on average, than those in
In addition, a single tree produces nearly three-
otherwise identical rooms whose windows faced
quarters of the oxygen required for one person;
a wall.
and a canopy of trees in an urban environment can slash smog levels up to six percent.
153
WAYFINDING FAMILIARITY
ORIENTATION Nodes Pounts of reference Internal and external
FAMILIARITY Making memories Sparking memories Objects which provoke or are associated with memories St James Park Types of tree - horse chestnut (conkers), fir (christmas).
ACCESSIBILITY
CALMING ENVIRONMENT
ACCESSIBILITY Level access Easy vertical navigation
WAYFINDING No corridors Closed loop circulation
CALMING ENVIRONMENT Nature Sensory gardens
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ORIENTATION
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Site model
154
Trees help anchor soil and reduce storm water
Trees have demonstrated the ability to reduce
Noise pollution is an often overlooked problem.
runoff, saving the high costs of drainage ditches,
heating and cooling costs and counteract the
Excessive or unwanted sound has negative
storm sewers, and other "engineered solutions"
“heat island� effect in urban environments.
physical and psychological effects. Noise can
to storm water management. A street lined with
Urban areas with little vegetation can
come from many sources, especially roads and
32-foot tall trees can reduce runoff by almost
experience temperatures of up to seven degrees
highways. Trees can play an important role in
327 gallons, allowing cities to install smaller
higher than those with tree cover. This translates
deadening unwanted noise. Sound waves are
and less expensive water management systems.
into significantly higher energy costs to cool
absorbed by a tree's leaves, branches, and twigs.
Reducing runoff also decreases topsoil erosion
buildings. Properly planted trees can cut heating
Studies suggest that belts of trees 100 feet wide
and the amount of silt and other pollutants
and cooling costs by as much as 12 percent and
and 45 feet long can cut highway noise in half.
washed into streams, rivers, and lakes.
reduce overall power demand.
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155
Casa vogue
156
Casa Vogue is a residential project designed by
The project was designed for a dentist and
There is another tree in the garage and the
the architect Alessandro Sartore to integrate
art collector who wanted a house that had
glass walls with the skylight for the tree ensured
into the natural landscape of Rio de Janeiro,
some of the characteristics of a showroom
sufficient natural ventilation even for the warm
Brazil with the plants allowed to pass through
but with the warmth of a family retreat instead
climate of the region.
the structure and thus bring more texture into
of the magazine cover look that is sometimes
the living areas.
too impersonal.The tree in the middle of the living room is a large mango called Bethany and it passes through a hole in the floor slab
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with a diameter of three meters. The tree was the inspirational element that determined the entire layout of the house with its shading and ventilation.
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157
Hopetoun avenue
158
Hopetoun Avenue is a renovation and extension
With a sensitivity to the site’s inherent strengths,
The covered outdoor spaces are literally built
to a period home in the Sydney suburb of
the design embraces the preservation and
around the tree, encapsulating and framing the
Vaucluse, a tree house with harbour views.
integration of the established tree allowing it to
trunk. The timber-clad columns recede into the
Offering an intentional point of difference to the
remain the dominant feature on the property.
background and a fine line of glazing opens to
solidity of the existing modern sandstone house,
the densely planted side yard for continuous
the new addition is a gentle intervention that
access to the natural environment from within
emerges quietly from the canopy of a beautiful,
the interior spaces.
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mature lemon-scented gum tree.
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159
Barnaby gunning
160
Bringing the outside in was the key idea, so that
The pod, designed by architect Barnaby
we could feel we were sitting in the garden 24
Gunning, is made from green glass to blend
hours a day, all year round. The tree is like a
into the natural surroundings. It’s dramatic in all
sculpture, full of character.
weathers, sun, snow or storms.
The concept of this dining room design in Janjri Trivedi’s house. In her new dining room, the tree is cased in a glass pod and there is a hole in the
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roof for it to grow through.
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161
Israel museum
162
Architects Ifat Finkelman and Deborah
“As a tribute to the childhood collective
Warschawski have built a slatted wooden
memory of a treehouse, we positioned a small
structure around an old pine tree to update
roofed structure where children can hide and
a courtyard space at the Israel Museum in
overlook at high up a tilted trunk raised above
Jerusalem.
the meticulous surroundings of the museum,”
Situated at the entrance of the Israel Museum’s
said the architects.
Youth Wing for Art Education, the IMJ Tree House provides a gathering point for both adult
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and children visitors.
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163
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Kook eating house
164
The young firm Noses Architects completed
To strengthen the relationship between
their 'mission architecture' for the Kook eating
innovation and tradition, between granny’s
house project in Rome:it meant creating a place
recipes and the chef’s specialities, an olive
that enhanced the perception of the senses
tree, the symbol of wisdom, longevity and
without going overboard.
Mediterranean essence, embedded in the glass.A
“The project trusted in cold concrete, heated
‘green aquarium’ that holds one of the true
by the warm wood and custom furnishing full
symbols of the local culture and cuisine, but
of memories and, perhaps, until recently, bearing
making it a free catalyst of light that spreads
witness to intimate family scenes.
throughout the premises.
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165
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Bounding edges 166
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167
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Bounding edges 168
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169
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pavillion
Springbank
170
Public spaces play a vital role in the social and
Generally, government owned spaces, such as
Although it is still regarded as public space, there
economic life of communities. Public space
parks or public buildings, are considered public
are a series of derelict pavilions within the park
can be an important social resource. Public
spaces, however there is a need to reclaim this
that could be more accessible to the public.
spaces (including parks, and playgrounds) play
public space. Reclaiming public space
The Springbank pavilion, for example, is one of
a vital role in the social life of communities.
Shared space is a key aspect of
these derelict pavilions within the park. It was
They act as a ‘self-organising public service’, a
social sustainability. This proposal therefore
the former changing rooms for the bowls club,
shared resource in which experiences and value
looks at creating Leazes Park as a social
until they got relocated to the south of the park,
are created. Places can provide opportunities
inclusion space once more, for all generations.
and now it sits empty. This is the perfect location
for social interaction, social mixing and social
Leazes park is owned by the freemen of
for a public facility and thus reiterates the
inclusion, and can facilitate the development of
Newcastle, but is also partially owned by the
importance of the public cafe part of my scheme,
community ties. This is important particularly
governement.
to both integrate people with dementia with the
to people with dementia as they often feel that
public, but also to integrate the public more with
they loose connections through their diagnosis.
Leazes Park.
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171
Programme development
174
The quality of this project must be of
Design quality is the principle objective of this
exceptionally high standard in order to
project with cost and time following this.
incorporate designing for dementia guidelines
The building must reflect the values of the
in order to ease the use of the building by all,
Alzheimer’s Society throughout every aspect of
through the use of colour, light, texture and
the design. The spaces need to relate to each
architectural features to enrich the environment.
other to ensure ease of use of the building as well
The internal environment should be comfortable
as creating individual safe and secure spaces.
in relation to lighting, heating, air quality and acoustics, as well as allowing physical comfort in the furnishings. It is important that individual users can also control the internal quality of their environment.
175
176
As a result of the need for high design quality, a
The project will also need full demolition and
traditional procurement route is sought for the
planning permission to remove the disused
realisation of the project. Although there are
Springbank pavilion which is currently on site.
cost benefits with design and build contracts,
Although a sustainable strategy could argue that
the traditional route is preferred for this project
the existing structure would be better retained
as it is considered to be a low risk method of
than a new build, it was deemed that the pavilion
contracting for the client, as the contractor takes
was disused and was insufficient for the new
the financial risk for construction.
proposed use.
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Outline Specification
Substructure - Pad foundations Superstructure - Timber frame construction with beam and block flooring Cladding (including external windows and doors) - Timber cladding and natural sandstone with timber vertical sliding sash windows and timber door. Roofing - 35 degree pitched roof with natural welsh slate Internal walls and partitions - Timber stud walls and internal glazed partitions with manifestations for user safety Internal doors - Timber internal doors with coloured frames Ceilings - Skim on plasterboard Flooring - Beam and block construction with carpet, vinyl and wood floor finishes Finishes - Paint on skim on plasterboard wall finishes Building services (including lighting, heating, ventilation and air conditioning, water supply and drainage and other special installations). Fixtures and fittings (such as sanitary fittings). Landscape.
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The entrance and reception area should be clear
It will be implemented where possible to use
to occupants as well as accessible and welcoming.
locally sourced materials in order to improve
The building should have minimal impact of
the sustainability of materials, as well as using
the surrounding environment, whilst providing
renewable, reused or recycled materials.
good quality views and overlooking the natural
The building materials will also be to a high quality
landscape of the park.
standard to ensure that they have a long life span
The internal layout of the building will provide a
to enable the design to be durable.
flexible layout for future planning.
Energy consumption and pollution, both in
The building aims to enhance the local community
construction and in use will be kept as minimal as
and enriching the lives of people with dementia.
possible.
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Design development
Stage 2 184
185
The concept design of the building is based up the idea that all of the existing trees that are in good condition should remain on site and thus the development should happen in the vacant spaces within the trees and between the root protection areas. After the critique of existing care homes as well (see DP3 Report) it was also important to reduce the conventional ‘corridor’. This has been explored in great detail through the concept design by making corridors within the plan multifunctional, or given the ability to open up so that they are not just a transition point from A to B. Closed loop circulation has also been explored in depth, using the spaces around the trees as circulation space and creating loops around the trees.
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Technology
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Technological strategy
Pad foundations are deemed the most appropriate
Site clearance and demolition works will be
as they will have minimal impact on the existing
carried out first (demolishing the existing pavilion
ground. Micro piles can also be considered,
and clearing the site of shrubbery).
however access for machinery will be limited due
Root protection areas can then be marked and
to root protection areas.
fenced off in accordance with the Tree Protection Method Statement. The building is proposed to be built in timber frame to create a lightweight structure. Trusses will be used to support the 35 degree pitched roof.
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Materiality
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The management plan sets out key materials that should be used within Leazes Park Conservation Area for any development. Materials must be traditional and sympathetic to the history of Leazes Conservation Area. The original pattern of gardens and the presence of trees greatly contributes to the character of Leazes Conservation Area and should be retained.
Walls Natural Sandstone - colour to remain unchanged Brick Stucco - colour BS 08 B17 Windows Timber frame vertical sliding sash windows Roofs Natural Welsh Slate Rainwater Goods Cast iron with gutters on brackets Boundary Treatments to remain unchanged Advertisements should be sympathetic to the historic character of the area Rooflights should be in a ‘conservation’ style in design, materials and size
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Parti diagrams
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An extensive research study was undertaken to
closed loop circulation and nodal points to aid
closed loop circulation and nodal points to aid
understand the difficulties faced by the symptoms
with orientation;
with orientation;
of dementia in which strategies have then been
the
explored to mitigate these, and a series of design
enjoyment as the main aim;
enjoyment as the main aim;
criteria was established in order to provide the
legibility and familiarity on both building and city
legibility and familiarity on both building and city
best possible solution;
scale to aid with navigation;
scale to aid with navigation;
the abolishment of corridors which cause
the abolishment of corridors which cause
confusion in people with dementia.
confusion in people with dementia.
provision
of
meaningful
activity
with
the
provision
of
meaningful
activity
with
The use of colour is important for people with dementia to be able to navigate easily. The pods that I will design will therefore reflect different colours according to their function to utilize this design aspect.
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RED Passionate, Aggressive, Important As a dominating colour, red adds gravity and heightened awareness – quite literally, as the colour increases blood circulation, breathing rates, and metabolism. Red can take on a variety of meaning, associated with both love and war, but the unifying factor in all meanings is a sense of importance. Think of the red carpet. Red is a colour best used cautiously. Its knack for attracting attention makes it a priceless tool for designers, but excessively it will inhibit relaxation. Lighter shades emphasize the energetic aspects of red – including youthfulness – while darker shades emphasize power, and even durability, such as a brick wall. Red will be used in the couple residential pods as it reflects romance love and passion.
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ORANGE ORANGE Playful,Energetic, Energetic, Cheap Playful, Cheap Sharingred's red'senergizing energizing aspects, but to a degree, safer degree, Sharing aspects, but to a safer orange orange a good way to add excitement to a site without is a goodisway to add excitement to a site without severity. It severity. It isplayful, generally playful, and some claim it creates is generally and some claim it creates haste and plays haste and Itplays on impulse. It can even signify on impulse. can even signify health, suggesting vitalityhealth, and suggesting vitality and vibrance. vibrance.
Orange will be used in the activity spaces to promote the playful and energetic nature.
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YELLOW Happy, Friendly, Warning Yellow is a strange colour: it is often associated with happiness, but also activates the anxiety center of the brain. Like red and orange, it's able to stimulate and vitalize – it's the colour of warning signs and taxis – but use bright yellow sparingly because of the potential negative connotations. Lighter shades play on the happiness aspects, reminding users of summer and the sun. Darker shades, including gold, add more weight and give a sense of antiquity. Yellow will be used in the entrance and staff pod and cluster as this reflects security.
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BLUE BLUE Serene,Trustworthy, Trustworthy,Inviting Inviting Serene, we first first described describedinin Web Design Human Eye, As we Web Design for for thethe Human Eye, blue blue thepopular most popular colours in web design is oneisofone the of most colours in web design – and for – and for good reason. good reason.
Blue is the colour of calm and serenity, and as such inspires Blue is the calm However and serenity, and effects as such security and acolour feeling of of safety. the calming inspires and aand feeling safety. However the also makesecurity blue a friendly invitingofcolour. calming effects reason also make blue a friendly As if that weren't enough to use it, blue isand also inviting colour. versatile; its vibrancy has more drastic effects incredibly
than other colours. Light blue is the colour of water and the As ifsothat weren'thas reason enough use it, blue is also sky, it generally a refreshing andto free feeling – even incrediblyifversatile; its vibrancy morethat drastic effects energizing bright enough, but still has retaining reliable than other colours. Light blue is the colour of water and calm. the sky, it generally has a pod refreshing and to free feeling Blue will so be used in the therapy and cluster reflect the – even energizing if bright calming aspects of the colour.enough, but still retaining that reliable calm.
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GREEN Natural, Stable, Prosperous Green mostly represents the environment and outdoors, for obvious reasons, making it the clear choice to suggest nature and an organic quality. As the bridge between stimulating warm colours (red, orange, yellow) and calming cool colours (blue, purple), it is the most balanced of colours, lending it an air of stability. It's also a popular choice as an accent or for calls-to-action because it stands out, but more softly than the warmer colours. In Western Culture, it also represents money and financial safety. Green will be used with brown in the external areas to integrate the inside with the outside and reflect the nature of the park.
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PURPLE PURPLE Mysterious,Romantic Romantic Luxurious, Mysterious, Long associated associated with royalty, purple air of Long with royalty, purple createscreates an air ofan luxury, luxury, even decadence. a purple dominantly even decadence. Using a purpleUsing dominantly is a quick way to is a quick way createorahigh-end sense of elegance highcreate a sense of to elegance appeal, even if or your end appeal, even if your(an product is budget-minded (an product is budget-minded “expensive” effect that's quite “expensive” effect that's quite the opposite of orange). the opposite of orange).
Lighter shades of purple bring to mind spring and romance, Lighter shades purple bring to mind spring and especially lavender.of Darker shades of purple add more romance, lavender.creativity. Darker Darkening shades ofthe purple mystery, andespecially can even symbolize add more mystery, can even symbolize creativity. shade will also turn theand romantic elements more sensual. Darkening the shade willsingle also turn the romantic elements Purple will be used in the accommodation areas to give more sensual. the sense of luxury and royalty to those staying at the respite
centre.
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PINK Feminine,Young, Innocent Pink is a specialized colour that won't work for a lot of sites, but will work perfectly with the right audience. Because most people interpret people as feminine, the colour is quite popular for targeting female users. The connotations with childhood and with sugary treats gives it a sweet, sometimes innocent appeal (not surprisingly a selfperpetuating cycle). It is also traditionally used with love and romantic themes, alongside red and light purple. Pink will be used in the cafe to connect with the childrens playground and stimulate a childhood innocence within the public integration.
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BROWN BROWN Earthy,Sturdy, Sturdy,Rustic Rustic Earthy, popular choice in web design, can, While not aapopular choice in web design, brownbrown can, under under the right circumstances, benonetheless. effective nonetheless. the right circumstances, be effective As the As the associated colour associated with the trees, colour with the earth andearth trees, and brown can brown add an can add an a pairing with outdoorsy feel,outdoorsy maximizedfeel, by amaximized pairing withby green. The tree green. The tree connotations give a sturdy and connotations also give a sturdy andalso reliable feeling. reliable feeling. In web design, brown is most often used in conjunction with
wood texturing, giving the same old-fashioned and rustic In web design, brown iscabin. most often used in conjunction atmosphere of a wooden with wood texturing, giving the same old-fashioned and Brown will be used in the external areas with green. rustic atmosphere of a wooden cabin.
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BLACK Powerful, Sophisticated, Edgy As the strongest of all colours, black is often used only sparingly – such as for text – but it works quite well as a primary colour element (like for backgrounds). Much like purple, it adds an air of sophistication and elegance, and also mystery, though with much bolder confidence.
WHITE Clean,Virtuous, Healthy Its association with “good” and “holiness” give it a virtuous and pious feeling as well, while its association with hospitals and medical staff give it a healthy feeling.
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GREY Neutral, Formal, Formal,Gloomy Gloomy Neutral, the intermediary intermediarybetween between black and white, gray As the black and white, gray exudes exudes neutrality, lack of any sensation. particularHowever, sensation. neutrality, or a lack or of aany particular in However, in an theexpert, handsthis of intermediary an expert, this intermediary the hands of position can be a position can powerful tool.be a powerful tool.
varyingthe thevibrancy, vibrancy, onproperties the properties of By varying graygray takestakes on the of either eitheror black – attention black whiteor– white attention grabbing grabbing or repellingor–repelling to specific– to specific if black isfor too powerful degrees. Thatdegrees. means if That blackmeans is too powerful your design, for your try dark gray. If white is too bland, try light try dark design, gray. If white is too bland, try light gray. gray.
BEIGE BEIGE Accentuates surrounding colours Accentuates It takes on the surrounding characteristicscolours of the colours around it. It takes on the characteristics of the colours around it.
Final design proposal
plan
Upper ground floor 206
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Final renders 208
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Title 210
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Title 212
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Title 214
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Title 216
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