Designing for the Sacred in Living & Dying: A Comprehensive Environment for Palliative Care

N U H S - N U S / S D E D E S I G N C O L L A B O R AT I O N P R O G R A M M E 2 0 1 6

COMMUNITY & HOUSING DESIGNING FOR THE SACRED IN LIVING & DYING: A COMPREHENSIVE ENVIRONMENT FOR PALLIATIVE CARE C o m m u n i t y & H o u s i n g D e s i g n S e c t i o n | B . A . ( A r c h ) Ye a r 3 S e m e s t e r 2 | A c a d e m i c Ye a r 2 0 1 5 - 2 0 1 6 | 1 1 J a n - 1 5 A p r 2 0 1 6

N U H S - N U S / S D E D E S I G N C O L L A B O R AT I O N P R O G R A M M E 2 0 1 6

COMMUNITY & HOUSING DESIGNING FOR THE SACRED IN LIVING & DYING: A COMPREHENSIVE ENVIRONMENT FOR PALLIATIVE CARE C o m m u n i t y & H o u s i n g D e s i g n S e c t i o n | B . A . ( A r c h ) Ye a r 3 S e m e s t e r 2 | A c a d e m i c Ye a r 2 0 1 5 - 2 0 1 6 | 1 1 J a n - 1 5 A p r 2 0 1 6

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Lin Derong presenting his project at the Round-up Crit Session

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CONTENTS

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Background

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Project Preamble

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Studio Chin Kean Kok

20 24 28 32 36 40 44 48 52

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Studio Chu Lik Ren

60 64 68 72 76 80 84 88 92

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Studio Ruzica Bozovic-Stamenovic

102 106 110 114 118 122 126 130 134

Visuals - [ by Lee Jo Hee ] A Hospice Community - [ Leong Hui Fang ] Alveolus - [ Liu Meilan ] Connecting Communities - [ Pan Bin ] Hamlet - A Village Hospice - [ Ting Hao ] Reminiscence - [ Ye Baogen Josiah ] Beyond The Green - [ Ye Luman ] The Commune - [ Yin Aiwei ] Into the Woods - [ Yu Yiying ]

LAPUTA - [ Bryan Ng Shi En ] The Green Wave - [ Goh Jin Ping, Joshua ] The Porch - [ Hung Yu-Shan ] harvest HOSPICE! - [ Lee Jing Han Jireh ] Vision 2036 - Hospice of the Future - [ Melcas Lim Zhi Ming ] Experiencing Nature in Hospice - [ Seri Binte Sapari ] The Community Hospice - [ Shawn Tan Lip Song ] Sunshine Forest Hospice - [ Tu Wen ] The Hospice : Grief & Healing - [ Zoe Lim Kai Ee ]

Healing - [ Amanda Dwiyani Widodo ] BEYOND - [ Bernard Heng Jia Chuin ] N A T U R A L E . - [ Chin Yi Hui Clarabelle ] Behind The Screen 卷帘 - [ Han Rui ] Connecting Spaces - [ Khairulanwar B Abdul Rahim ] Everyday - [ Lim Yan Yee Joie ] Symbiosis - [ Pan Guan Shen ] Healing In Nature - [ Peh Wei Keong ] Transit - [ Sim Wei Yih ]

ls - St udio Chin Kean Kok Studio Fung John Chye

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142 146 150 154 158 162 166 170 174

雨晴: Closure to Life - [ Chia Ming Kuang ] Conversation Places - Meanders and Niches - [ Koh Jie Zhi ] RÉN: An Open Dialogue & Reflection - [ Carleen Lee Sin Ying ] Hospice for Solitude - [ Li Zhengyao ] The Rail Corridor - [ Liew Chee Chuen ] House of Celebration - [ Joseph Lim Boon Kian ] Between the Walls: Air | Light | Privacy - [ Lin Derong ] Expanding Greens - [ Soh Qianyu ] HOMEY: Palliative Care Design - [ Tan Jia Hui Jeanette ]

Studio Zhang Ye

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Home Hospice - [ Agnieszka Bogumila Lewicka ] Sequence@Alexandra - [ Espanol Daniel Aguinalde ] Fruitful Hospice - [ Heng Bang Hao ] Hospice Sanctuary - [ Lee Shang Jie Daniel ] THE QUEENSWAY TERRACE - [ Lin Jingyi Jean ] Green Hospice - [ Liu Jie ] Harmonizing Nature - [ Soh Jia Tong ] in | between - [ Tessa Kok Foong ] Palliative Care Center@Therapeutic Terrace - [ Zhang Hanfei ]

182 186 190 194 198 202 206 210 214

Appendix 1

Reflections Index

220 226

Appendix 2

A. Site Analysis

B. Contextual Studies

C. Demographic Studies

D. Precedent Studies

231 261 278 290

Staff Editor & Photography Assoc Prof Fung John Chye

Published by

Student Editors Lin Derong Pan Bin Soh Jia Tong Khairulanwar B Abdul Rahim Lee Jing Han Jireh Joseph Lim Boon Kian

National University of Singapore

Community + Housing Design Section, Department of Architecture, School of Design and EnvironmenT

© Individual Contributors © 2016 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form by any means, electronic, mechanical, photocopying, recording, or otherwise wihtout prior written permission of the publisher.

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BACKGROUND | Assoc Prof Fung John Chye Year 3 Leader | Community & Housing Design Section Studio Masters Chin Kean Kok Chu Lik Ren Dr. Ruzica Bozovic-Stamenovic Assoc Prof Fung John Chye Dr. Zhang Ye Part-Time Tutors Chang Yong Ter Andrew Lee James Leow Tan Chee Kiang Chan Mun Kit C & S Consultants Ng Cheng Kiat Philip Wang Ronnie Chong M & E Consultants Ho Thim Seng Sean Ying Yee Poh Kin Acknowledgements The students and staff of SDE are extremely grateful to the following persons for their invaluable contributions to this programme: Grace Chiang (NUHS) Christine Low (NUHS) Mervyn Lee (NUHS) Cherie Leong (NUHS) Jim Gu (NUHS) Dr Noreen Chan (Dover Park Hospice/NUS) Sister Halijah (Dover Park Hospice) Ng Kim Hoon (MOHH) Loke Mun Sing (MOHH) Lai Swee Leng (MOHH) Chin Thoe Chong (DP Architects) Ng San Son (DP Architects)

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This book documents the outcome of a semester-long design-based research programme conducted by the Community & Housing (C & H) Design Section of the Department of Architecture in Semester 2 of Academic Year 2015/2016. The programme involved five Design Studios, each directed by a Studio Master, and 45 students in the 3rd Year of their B. A. (Arch) undergraduate studies.

Significantly, this Semester inaugurated a pilot collaborative effort between the National University Health System (NUHS) and the Department of Architecture (DoA) of the National University of Singapore. It builds upon an earlier collaboration between NUHS and the Division of Industrial Design (DID), an allied discipline in the School of Design and Environment (SDE). It is envisaged that such exploratory collaboration will eventually lead to multi-disciplinary designbased research programmes comprising NUHS, SDE (DoA, DID), other academic disciplines as well as industrial collaborators and public stakeholders.

This programme invites imaginative designs for palliative (end-of-life) care through design-based research of the deep complexities intrinsic to this aspect of healthcare, which is increasingly relevant to an ageing population like Singapore. In order for our architecture students to build empathy for real world issues, this programme is appropriately grounded in a high degree of realism as the design brief was written in consultation with NUHS, who is currently master-planning a new medical campus that will include a special-built facility for palliative care. As an active collaborator in this programme, NUHS was deeply involved in various stages of the students’ design process. First, a clinical expert and a senior nursing staff from Dover Park Hospice was invited to give insightful talks at the beginning of the Semester. This was followed by a study visit to the Hospice. Second, NUHS and the Hospice participated in an Interim Crit and provided useful feedback for the students. Lastly, upon completion of the Department’s usual Final Crit, a special Round-up Crit Session was held with NUHS, who invited representatives from Dover Park Hospice, MOH Holdings and DP Architects (the masterplanner) to select and participate in reviewing 5 students’ projects with insightful discussion and closing comments. The session was attended by most of the students in C&H Design Section, except for a handful who were sitting for other examinations. NUHS and all the invited guest critics were impressed by the overall outcome of this programme, and awarded prizes to students of the selected schemes to reward them for their dedicated

efforts in exploring this difficult topic. The benefits of such a collaborative effort is evident from the mutual learning of all participating parties.

Despite some initial concerns regarding the complexity of the design programme, the Year 3 students of C&H Design Section did well to produce imaginative solutions that advance our knowledge of designing for end-oflife care. More importantly, this programme engendered opportunities for the students to cultivate deep empathy for people who are facing the final journey of their lives, family and friends who cared for them, healthcare workers, and the importance for design to support various psychosocial needs besides fulfilling the mundane functional requirements.

Finally, an acknowledgement of deep gratitude to our collaborators and all who shared their knowledge and experiences with our students, just so that they understand the true value and raison d’être of architecture in serving humanity.

The guest critics with students selected for the Round-up Crit Session

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PROJECT PREAMBLE | Assoc Prof Fung John Chye Since time immemorial, the unceasing human quest for immortality to avert death invariably ends in vain. Nature itself appears to favour life—its raison d’être—being a construct that exists only if there are living organisms. This phenomenon bears out in evolutionary natural selection processes; the species that survive strengthen their positions in the overall scheme of things, while losers face an inevitable extinction. Against this existential milieu, it is unsurprising that most human societies prevail upon a negative stigmatization of death. Euphemism in our languages offer ample evidence of this aversion to death, which is referred to variously as “demise”, “deceased”, “passing” and “deliverance”, among others. Throughout history, the utopian ideal of eternal life manifests in diverse endeavours ranging from ancient Egyptian’s mummification and Qin Shi Huang’s terracotta army for afterlife to ancient alchemy for an elixir of life, esoteric Taoist rituals, and even the contemporary sciences of anti-ageing and cryogenics invented to extend our physiological functioning. Still, our struggle to prolong life cannot defeat the ultimate truth that impermanence is the only absolute certainty. Impermanence and change are defining characteristics intrinsic to nature and reality, as we know them.

Thus, death as an inescapable outcome is to be accepted by man. That we will pass on eventually is an acknowledged fact of life; but so is the uncertainty in the timing and manner of our death.

The deep question lies in how the sacredness of living and dying affects what we value in life as a human being. Consequently, we need to ask how our environments can sustain this sacred experience by mitigating the impact of suffering for those in death’s throes. Our uniqueness as individuals with distinct identities exacerbates the complexity of such a question. Does this imply that there is not a set of universal values of what constitutes living, which we cherish as a human collective? Alternatively, is there in the spiritual—albeit, not necessarily in a religious sense—the sacredness of life that we all hold in common?

From a medical perspective, palliative care is a relatively recent area of modern medicine that addresses the needs of people facing the end of life. Its primary aim is to relieve pain and suffering so that patients live out their final moments in a way that they wish, as a form of catharsis. Significantly, this represents a paradigm shift from the primary purpose of medicine in seeking a cure,

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Functional environment

Psychosocial environment 9

to one of providing soothing care. It is a rare threshold in medicine where science surrenders, and humanity takes over. Here, the mandate is about sustaining a quality of living rather than prolongation of life. It is when deep human emotions take precedence over cold logical reasoning. It is treating the individual in a person rather than the disease in a patient.

The deep human concerns encountered in palliative care include: a) Autonomy (identity); b) Comfort (relief of pain, suffering, anxiety, anger); c) Reminiscence (treasured memory, life story); d) Social Engagement (kinship, friendship, human bond); e) Fear (dying, the unknown); f) Spirituality (transcendence of self); and g) Closure (avoidance of burdening others).

These are but only some of the extensive range of human emotions and conditions that accompany living on the final journey; and by no means are they exhaustive nor listed according to priority because each individual values various aspects of life differently. Yet, one thing is certain, every person on palliative care treasures each grain of the hourglass; and will relish just being present for the moment.

Ultimately, palliative care is about living life, and less so of dying and death as the latter will come, regardless. Herein lies the deep challenge to architecture, and the crux of this design investigation. What constitutes living for people whose physical and mental functions are diminished? What is the quintessential environment for living out such moments?

In addressing this design challenge, we may refer to precedents in human history. From the death houses in Chinatown’s Sago Lane of early Singapore to the practice of some indigenous cultures of leaving their dying members to live out their last days in isolated forests or caves, and various ancient rituals that accompany dying and death; the focus is almost always phenomenological rather than rational. Of these beliefs, one notable instance is the Buddhist notion that a person’s state of mind at death is most crucial to a good rebirth—a practice that the Tibetans developed to near perfection as exemplified by the well-known “Tibetan Book of the Dead.” Ancient Egyptians also had such a record of funerary practices.

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Prevailing practices for palliative care mainly assume the institutional typology of a hospice, although the home hospice concept is rapidly gaining traction. Even here, there is no prescribed formula defining exactly what is an ideal hospice or how it fits within the entire care continuum from acute to intermediate to long-term and eventually to end-of-life care. If this linear transition in care continuum echoes an inverse but heightened gradient in sacredness of living and dying, then the possibilities and repercussions for design must be revealed.

Regardless of ancient beliefs and practices or contemporary palliative care, there is a significant role for the environment where profound human-tohuman relationship occurs. It is arguably correct to say that the environment plays an active role in such events, and is not a mere backdrop or container.

The purpose of this programme is to explore through design, the subtleties of this relationship between the environment and sacredness of living and dying.

In the process, generate deep, imaginative but humane design responses befitting the final acts of life. Of interest are the series of Maggie Centres designed by renowned architects for cancer care and support. Although not exactly a direct typology for palliative care, the philosophy underlying these centres is worthy of study by the serious designer.

If we accept that the raison d’être of design is to serve humanity, then we can reasonably suggest that there is no greater need for imagination and innovation than in the area of palliative care. For students and teachers alike, it is a meaningful opportunity to explore a programme that embodies this profound purpose.

Responding to the challenge expressed in the preamble, each student is to design a comprehensive environment for palliative or end-of-life care.

Students are encouraged to explore creative designs integrating healthcare, environmental behaviour, psychosocial, technological and environmental aspects. Ideas in passive design strategies as well as active solutions are encouraged, with sustainability as an objective. Universal design is an important aspect of this programme especially for areas meant to be accessible by the patients.

The site is a long stretch of land adjoining the Rail Corridor at the former Alexandra Hospital. This linear parcel of land is identified by the NUHS masterplan for a palliative care facility, which is clustered with other long-term and rehabilitation care facilities. Students were given the freedom to select a

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project site of approximately 5,000 m2 to develop a facility of approximately 6,000 m2 GFA. Access to the project site is assumed to be via an internal road system as part of the overall masterplan.

Space programming is deliberately provided in detail to immerse students in the complex functional relationships between spaces. However, students had the flexibility of re-interpreting the schedule of accommodation, and many of them reviewed the prevailing bedroom provisions to investigate newer typologies. At the early stage, a group exercise was conducted to help students understand the functional proximity relationships, zoning, servicing and other salient planning issues.

Overall, the programme posed a challenge for the students, as it demands good site planning, functional planning and vertical stacking strategies; the learning of which would contribute to immensely as they embark on projects that are even more complex in their senior years.

Picture: Location of project site

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SPACE PROGRAMMING GUIDANCE FOR NUS SDE AY2015-­‐2016 SEMESTER 2 AR3102 DESIGN PROGRAMME

Suggested References

Disclaimer The room schedule and their respective areas listed below are intended for the purpose of an academic design programme of an exploratory nature, which involves the design of a healthcare facility for long-­‐term care and end-­‐of-­‐life care, as part of the NUS SDE academic curriculum. This schedule is for NUS SDE information and internal circulation only, and does not have regard to the specific design objectives, spatial requirements and the particular needs of any specific person.

Gawande, A. Being Mortal: Medicine and What Matters in the End .

New York: Metropolitan Books.

The information contained herein shall not be construed, in any form, to represent or warrant as to its adequacy, completeness, accuracy or timeliness for any particular purpose.

PALLIATIVE CARE TYPICAL SPACE PROVISIONS S/N Description

Unit Area (m2)

(A) 1 2 3 4 5 6 7 8 9 10 11 12

In-­‐Patient facilities Bedroom 1-­‐bed including ensuite bathroom Bedroom 2-­‐bed including ensuite bathroom Bedroom 4-­‐bed including ensuite bathroom Isolation room Nurses' station Family/caregiver lounge Grieving/farewell room Assisted bathroom Dirty utility room (with sluice) Clean utility room General store Common toilets

32 64 64 36 20 25 25 10 12 25 10 10

(B) 1 2 3 4 5 6 7 8 9 10

Out-­‐Patient facilities Reception & Registration Day care centre Dental clinic Consult rooms Treatment rooms Caregiver's support centre Resuscitation room Podiatry/chiropody clinic Social medical worker office Counseling rooms

100 400 20 12 12 50 25 15 30 12

(C) 1 2 3 4 5 6 7

Shared-­‐Patient facilities Dining room Multi-­‐purpose room Quiet/Prayer rooms Physiotherapy room Music/Art/Light therapy rooms Hydrotherapy room "White Space"

200 200 20 50 25 30 100

(D) 1 2 3

Staff facilities Volunteers room Admin office Staff lounge

50 150 80

(E) 1 2 3

Public amenities Cafeteria Hairdresser/barber Training room

100 15 50

(F) 1 2 3 4 5 6

Centralised Support Services Central kitchen Central laundry & sterile support Central equipment store General store Mortuary Common toilets

200 150 50 200 50 20 NETT GFA

(G) 1 2 3 4 5 6 7 8 9

Ancilliary Spaces Circulation Consumer switch room Emergency generator room Air-­‐conditioning equipment room Telecomms/data room Security & emergencey response centre Boiler/heater room Pump room Bin centre TOTAL GFA

(H) 1 2 3 4 5

Outdoor Spaces/Activities Landscape & water features Patio, balconies, sky terraces Community garden/farm Car parking Ambulance parking

Quantum Remarks 2,135 m2 approx. 35% of total GFA 10 units with en-­‐suite bathroom 5 units with en-­‐suite bathroom 10 units with en-­‐suite bathroom 3 units with en-­‐suite bathroom 6 units 6 units 3 units 6 units 6 units 6 units 6 units 6 units 736 m2 approx. 12% of total GFA

4 units 2 units

2 units 715 m2 approx. 11.5% of total GFA

Channel NewsAsia. (2015). Facing Death (Episodes 1 to 5). Singapore.

Rasmussen, B.H., & Edvardsson, D. (2007). The influence of environment in palliative care: Supporting or hindering experiences of ‘at-homeness’. Contemporary Nurse , 27:1, 119-131.

Timmermann, C., Uhrenfeldt, L., Høybye, M.T., & Birkelund, R. (2013). A palliative environment: Caring for seriously ill hospitalized patients. Palliative and Supportive Care (2015), 13: 201-209.

Gardiner, C., Brereton, L., Gott, M., Ingleton, C., & Barnes, S. (2011).

Exploring health professionals’ views regarding the optimum physical environment for palliative and end of life care in the acute hospital setting: a qualitative study. BMJ Supportive & Palliative Care 2011, 1:162-166.

3 units 3 units special function determined by design intent 280 m2 approx. 4.5% of total GFA

165 m2 approx. 3% of total GFA

730 m2 approx. 12% of total GFA

4 units 4,761 m2

1049 20 40 80 30 30 30 30 30

1,339 m2 approx. 22% of total GFA

6100 m2

Table: Schedule of Accommodation

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DESIGN

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PROPOSALS Studio Chin Kean Kok Studio Chu Lik Ren Studio Ruzica Bozovic Stamenovic Studio Fung John Chye Studio Zhang Ye

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STUDIO CHIN KEAN KOK

Yu Yiying presenting her project at the Round-up Crit Session

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STUDIO MASTER STATEMENT | Chin Kean Kok Students Lee Jo Hee Leong Hui Fang Liu Meilan Pan Bin Ting Hao Ye Baogen Josiah Ye Luman Yin Aiwei Yu Yiying

ISSUES The project brief proved challenging for the 3rd year students who just began to grapple with the relationship between programmatic issues, function and form.

As Studio Master, I had chosen to focus on a few pertinent issues, namely: - Building response to a naturally wooded and sloping site adjacent to the rail corridor - The role of the building in relation to adjacent communities and users of the rail corridor - The quality and type of spaces required for the users’ (patients and their family) emotional and interaction needs - Programming and overall layout synthesized from the student’s conceptual notion of a Palliative Centre - An appropriate architectural language which deliberately avoids the typical institutional outlook of medical buildings PEDAGOGY Within the 12 weeks, I had decided to introduce the various complex issues progressively so the students could address them in manageable bite sizes. The progression was approximately as follows: 1. Site Analysis 2. Precedent Study of similar building typologies 3. Conceptual Notion of a Palliative Centre 4. Spatial relationships and layout leading to the resolution of plans. This included the incorporation of services and support spaces 5. The sculpting of legible architectural forms in relation to the various building blocks 6. The development of an appropriate architectural language and subsequently material selection and application

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CHALLENGES This project’s programmatic requirements were indeed complex, even for professional architects. The sloping site, adjacent rail corridor and communities helped to inform the overall massing of the architecture. However, these parameters also posed additional challenges such as patients’ mobility to negotiate different floor levels and the privacy of live-in patients and their family.

The main struggle for the students was to understand the programmatic requirements so as to translate the spaces into a meaningful and positive architectural response while fulfilling the functional requirements.

REFLECTIONS At many points, the students did not produce any works when they hit a mental block. I felt that the lack of understanding of the subject matter was an immense obstacle. To an extent, the visit to the Dover Hospice helped the students to answer many of their questions.

Most of the students responded with “safe” designs for this project. On hindsight, I would have encouraged the students to use their naivety to their advantage; to explore unexpected and even controversial spatial relationship and push the boundaries of what a palliative centre can be. Overall, I am proud of the students’ effort.

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Visuals Lee Jo Hee: Visuals is a community-based hospice located within proximity of Alexandra hospital and the rail corridor. Designed with visually interconnected spaces, the proposal intends to address both the negative public perception of hospices as a dead/dying area and the lonely/isolated sentiments patients who face death may have.

Firstly, to address this negative public perception, the design creates moments and opportunities for the public to visually relate to the hospice activities and interact with hospice members in dedicated shared courtyard spaces. This interaction is not one of a mere passerby experience but an intimate engagement via entering the hospice grounds from the rail corridor.

Secondly, to tend to the isolatory and despairing emotions hospice patients may face, the proposed design likewise creates opportunities for patients to view the public and it’s activities everyday.

Considering the largely natural environment of the site, rehabilitative and health benefits attributed to being exposed to this lush greenery were taken advantage of through the integration of internal courtyards and the orientation of in-patients wards. However, maintaining a need of balance between privacy for patients of the hospice and an integrative community aspect, the actual public attractions/ programs (Cafe & Bike rental stop) are kept on the rail corridor level.

Apart from being a designated pit/rest-stop along the rail corridor commute, the hospice also serves as a linkage facilitating pedestrian movement between the rail corridor and the inner Alexandra Hospital. In doing so, the hospice serves more than just the immediate hospice users and rail-corridor but the hospital users as well.

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1. Internal courtyard 2. Rail corridor plan 3. 2nd storey plan 4. In-patient ward 5. Longitudinal section A-A 6. Rail corridor perspective

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Community + Housing | Proposals - Studio Chin Kean Kok

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Community + Housing | Proposals - Studio Chin Kean Kok

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A Hospice Community Leong Hui Fang: The design aims to cultivate a community in a hospice. According to research, terminally ill patients tend to embrace kinship, friendship, and the various form of human interaction towards the last moments of their life. Hence, the design of the hospice is user-centred, targeted at the need of the terminally ill patients. The architecture is focused on the celebration of life within the hospice.

The communal spaces and sub-interaction spaces are ‘enlarged’ in the views of the users eyes in a deliberate attempt to celebration the dynamism of the human bonds in the hospice. On the other hand, the design of the hospice attempts to overthrow stereotypical impression of a lifeless hospice. The design aims to promote the different kind of ‘life’ and community that is possible in the hospice. It reflects how terminally ill patients treasure the last moments of the life and live it to their fullest in the various platforms of interaction for the patients.

Next Page 1. 1st Floor Plan 2. Mezzanine Floor Plan 3. Interior Perspective I (Overlooking Atrium) 4. Typical Floor Plan 5. Interior Perspective II (Inpatient Ward’s Corridor) 6. Front Elevation 7. Short Section

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Community + Housing | Proposals - Studio Chin Kean Kok

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Community + Housing | Proposals - Studio Chin Kean Kok

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Alveolus Liu Meilan: Although a hospice provides necessary medical treatment, patients spend most of their time on non-medical related rituals. The aim of this project is to make these non-medical related rituals more enjoyable experience for the patients.

Equipped with the knowledge that most patients are either bed-bounded or wheelchair-bounded, the concept of this project is to increase the patients’ autonomy through shortening the distance that they need to travel from one space of activity to another.

Spaces in the hospice are thus divided and categorised as: 1. core space that provides the most basic services in hospice including inpatient bedroom and outpatient clinic and day care, as well as treatment rooms for both groups of patients. And 2. interactional space, which are subdivided into many, in terms of the level of interaction involved and parties involved in such interactions.

1:1000

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Community + Housing | Proposals - Studio Chin Kean Kok

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1. Section across existing site 2. Massing & Spatial distribution in response to site and landscape 3. Convert “interactional space” into small pockets around “core space” 4. Shortening distance amongst programmes 5. Convert “core space” into small pockets and mix with “interactional space” 6. Two typical floor plans in inpatient block

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Basement

Level 2

Level 4

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Community + Housing | Proposals - Studio Chin Kean Kok

Level 1

Level 3

Level 5

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1. Exterior view of ALveolus from rail corridor 2. Interior space - meditation corner 3. Interior space - patient lounge 4. Interior space - atrium and amphitheatre 5. Interior space - family lounge 6~7. Photo of model

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Connecting Communities Pan Bin: The proposed design aims to connect the public along the railway corridor to a private end-of-life palliative care facility. The design stems from initial research pointing towards evidence that terminally ill patients increasingly want to spend their last days and pass on within the comforts of their own home, surrounded by family in a familiar environment.

Upon further reading up on relevant topics and surveys, there seems to be common negative perceptions that Singaporeans have of a hospice or palliative care facility. Generally, it can be inferred from research that a hospice located within the local context is very isolated from society. There is a lack of understanding and public awareness that prevents the healthier citizens in Singapore from having comprehensive knowledge about what is going on in a hospice, which therefore leads to 82% people in a particular survey expressing their desires to know more about hospice palliative care.

Taking the needs of the two distinct demographics into consideration, the next step was to re-attach patients to society and their everyday lives before contracting these terminal illnesses, to allow them to heal or spend their final days in a comfortable environment that encourages engagements with different groups of people involved in caregiving.

These groups of people are no other than their family and friends, social workers, fellow patients and caregivers; and these engagements are envisioned to be forged while the community of healthy citizens are being brought into this picture to raise awareness about palliative care. Hence, this project would be focusing on how various communities are being brought together within a public space but yet a private facility.

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Community + Housing | Proposals - Studio Chin Kean Kok

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1. Design Strategy Diagrams 2. Design Development Diagrams 3. Materials & Finishes - Part Plan 4. Section A-A

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Community + Housing | Proposals - Studio Chin Kean Kok

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Hamlet - A Village Hospice Ting Hao: Hamlet is a hospice based on the workings of a village. The architecture is made up of 4 floors of inpatients spaces and a separate administrative block.

The inpatient spaces houses the living quaters, storage, gardens and common living rooms. The outpatient facilities, shared facilities, offices, storage and other amentities are located in the administrative block. Hamlet aims to emulate a sense of neighbourhood-ness and harmony with nature, which could be seen in villages.

The hospital is usually made up of homogenous and dull double-loaded rows of wards. There is also a lack of appropriate spaces for patients to interact with family, friends and even the public. Greenery can also be an essential healing tool during their time in the hospice. The village is found to be an appropriate example that can be associated as an effective typology that encourages the friendly interaction between people.

The social framework of a village can broken up into three scales: the ‘home’, the ‘cluster’ and the ‘neighbourhood’. This is likewise translated into the hospice.

The ‘home’ is a two-person room with its own toliet and a verandah, which acts as a semi-private living room. The ‘cluster’ is made up of 4-5 inpatient ‘homes’.

2 ‘clusters’ forms a neighbourhood’, each with its own garden and communal spaces for daily activities. On the ground floor is the village square, comprising of three internal courtyards, which is accessible by the public.

The hospice adopts a curvilinear form, with single loaded rows of rooms. The winding configuration breaks monotonous atmosphere of the conventional hospital and opens out to either the nature outside or the internal courtyards.

Cladded with wood, the hospice is built to create a sense of homely-ness and blend in with nature.

Through social spaces such as the verandah, gardens and village square, Hamlet is designed on multiple scales to encourages interaction between people, not just with family and friends but also other patients and the public. Using the model of a village, Hamlet aims to allow patients to spend their last days with a good quality of life.

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1. Analysis of Conventional Hospital and d Proposal

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Community + Housing | Proposals - Studio Chin Kean Kok

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6 1. Site Anlysis 2. Natural Ventilation 3. Natural Daylighting 4. Construction Isometry 5. Furniture Design 6..Operatable Walls

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Reminiscence Ye Baogen Josiah: Research has shown amongst the many issues faced by the terminally ill, two of the most prevalent ones are that of autonomy and privacy - Autonomy being defined as the continuity of self; and how a terminal illness robs you of being able to do things that make you who you are. Privacy on the other hand, defined as the right to pass on without being disturbed by others.

This project attempts to tackle these two issue.

The vision was to create an environment where residents are given a choice to continue to be part of the community until they are no longer physically able to.

However, since autonomy values the idea of choice, this project should also, on the flip side, offer them a private haven where they can retreat to if they wish.

The strategy behind this project involves creating a community square that allows residents a visual and mental connection to some semblance of an everyday life, allowing residents the opportunity to reminisce upon the life they’ve led and to reaffirm the residents that they are still part of the community, which is a merely an elevator ride down.

On that note, this community square would also double as pit stop for the commuters of the rail corridor, providing a link way through the facility from the rail corridor to future developments for both cyclists and walkers, offering food and social/activity spaces for families and commuters.

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1. Location & Site Plans 2. Design Process 3. Community Square Floor Plan 4. East-West Section Cut

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BEYOND THE GREEN Ye Luman: The proposed design utilizes the special site condition where it brings public from rail corridor to the other side of the road. The proposed project acts not only as a palliative care centre but also a public facility where the patients have the chance to interact with the public. This helps general public to have more awareness of what palliative care centre concept.

The project is orientated in the way that most of the inpatients’ wards are facing rail corridor to enjoy the optimal views. In order to avoid the direct sunlight from the west, the whole building is hence positioned 45 degrees towards the north.

The project also follows the general slopes from the site to creat a more natural fitting into the surrounding.

The project utilizes the “buffer concept� to seperate private space from public space. Patients can enjoy their private space at the their private balcony outside the wards while walk through the buffer zone to interact with their families and general public.

Art Exhibition space and central garden area is created for the patients to showcase their art work from their art therapy sessions.

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The Commune Yin Aiwei: View The site is located at the end of a small valley. The terrain is gently sloped and the railway corridor (green corridor) sits right at the base of the valley. Beyond the bottle neck it reveals a large patch of flat land with dense forest. As the railway corridor is expected to be transformed by the URA into a recreational area, the levelled forest with natural vegetation is ideal to be transformed into a nature reserve or natural park.

Therefore the view to the forest beyond is one of the key elements in this design.

The basic module is derived with this in mind using a staggering method both horizontally and vertically. This also creates opportunity for the second element (food) to be celebrated and viewed.

Food The second concept that drives this design is food. This derived from the site analysis in early design stages in which we have found the amount of food court within comfortable walking distance around site is insufficient to the amount of residences located in the residential area. Therefore it is proposed to create a food court to encourage the public to engage with the hospice.

Dining is a very social and intimate activity. To allow the public to dine with the patients at the hospice is the best way to encourage the public to accept the hospice rather than a taboo. More importantly, it engages the patients to feel part of the society or community. The modular design also creates private dinning opportunity for patients to connect with their family alone.

This food valley creates a visual connection between different parties and different levels. It is also a gate way to the natural forest beyond. Therefore, food and view, these two elements work hand in hand in this design.

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Into the Woods Yu Yiying: For the patients who have been diagonosed with incurable disease, the hardest thing is to accept the fact that they are dying. It is not only hard for these patients but also for other people to face their irresistable destiny as human beings.

The rapid advancement of technology in medical field has made people live much longer than before, however, the optimism created by the technology has made it more difficult for people to accept the truth that human still have limits no matter how far technology has gone. Nature plays an important role for people to help them face themselves and the truth, and with the aid of natural elements, patients could find the peace for their souls. Therefore, the care centre would be a builidng with natural elements inside which could give patients a chance to appreciate the natural view of the site as well.

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Lee Jing Han presenting his project at the Round-up Crit Session

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STUDIO MASTER STATEMENT | Chu Lik Ren Students Bryan Ng Shi En Goh Jin Ping, Joshua Hung Yu-Shan Lee Jing Han Jireh Melcas Lim Zhi Ming Seri Binte Sapari Shawn Tan Lip Song Tu Wen Zoe Lim Kai Ee

The semester’s brief represented a quantum step-up in scale to what the students have hitherto been exposed to and introduced well-defined parameters that closely followed real-world situations. The topic of end-of-life chronic care is also one that was not easily grasped by students in the peak of youth and health. The first weeks of the semester were utilised to ask the broader questions. Do the dying seek isolation or engagement with a closed circle of people? Given a choice, would patients prefer to die at home or in an institution? How can an institution be less institutional? Should corridors be shortened to ease supervision and travel, or extended to gain more privacy.

Would the general public visit a hospice if encouraged to? Would patients prefer a single-bed room or a shared bedroom? Through precedent studies, videos and talks by healthcare professionals and a guided visit to a hospice, the students were able to come to terms with the given brief and formulate some overriding concept for their designs. These were then tested and adjusted to suit the particular site that they were at liberty to shape and define for themselves.

Technicalities aside, the concept of a design is an idealised vision that drives the design of a scheme. A very brief summary of the variety of concepts the students in this studio took up are attempted as follows. Tu Wen’s thesis asked if the hospice can be built around and blended with the surrounding trees such that it will enjoy some privacy and seclusion, and offer natural views for the patients living or visiting there. Many students sought to capitalise on the view across the Green Corridor that verges the site. Schemes by Bryan, Zoe and Shawn were largely designed to give each in-patient rooms the best vantage points through their site-planning, although they were also guided by other benefits at the more micro levels, such as therapy kiosks or the comforts of intimate courtyards. Seri proposed air-wells to be introduced in the heart of the shared bedrooms such that no bed-ridden patient need ever be unaware of the

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weather outside. Yu Shan wanted to incorporate spaces that contained a notion of spirituality into her design, and an edifice for remembrance of departed friends. For Melcas and Joshua, a projection of 20 years into the future was taken, and the notion of a high-rise ‘sky’ hospice which afforded distant views and sits on ample open grounds were explored. And finally, the scheme by Jing Han introduced terraced roofs that could support a farming activity by the entire community of the hospice.

Given the plot ratio imposed to the designs, all the schemes were multiplestorey buildings and the students were guided through the semester by a practitioner architect as well as Structural and Mechanical engineers to resolve technical matters related to higher density structures. A fair amount of the final presentation panels was also devoted to the construction details of each scheme.

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LAPUTA Bryan Ng Shi En: Death, an inevitability for those that breathe and live; This project has tasked us to create a Hospice for those who are ready to accept the reality of their passing. The challenges of the project were apparent for me, firstly, how do you dignify the death of an terminally ill person and secondly, how does one enrich and ease this transition from ability to disability and finally death.

Laputa was first conceived through the idea of views. Most patients in Hospices are bed bound. This translation of time was indicative of a design opportunity.

The rooms and wards of Laputa have views that are orientated at least 2 ways – when bed is propped up and toward either side of bed. This allows patients to be able to enjoy views regardless lying down or sat up when conducting various activities about their bed. The views outward essentially harnesses the regenerative abilities of nature.

The second generative element was finding ways to deinstitutionalise the facility.

I explored the typology of various Hotels and attempted to create a new typology through the amalgamation of a Hospice and luxurious Hotel living. When an individual first enters Laputa, he is brought into a central atrium that spreads out towards the day care centre. The verticality of Laputa is brought together by the central atrium that leads out into an open skylight. The programs about the central atrium became places of gathering, from the common living areas to the day care centre.

From a patient’s perspective, moving out from the rooms, they enter a common living area that is shared by 2 wards. These common living spaces are shared amongst 6 patients from its wing. Beyond this, one finds the main nurse’s station and storage facilities that services the floor. This delineation of spaces, creates a hierarchy of programs that ranges first from semi-private to private spaces of the wards and the service area. By using the semi-private space of the common living area, essentially pulls the service area further away from the wards, as an attempt to create the idea much like a hotel. In addition, this segmentation of spaces allowed the patients the autonomy of interaction – where privacy is appreciated, they stay in their rooms, when they wish to interact with other, the common spaces are used.

Laputa essentially seeks to create an environment rather then a facility, which dignifies and empowers the transition of death. This is achieved through the introduction of various elements, like hierarchy of spaces, views towards nature, exclusivity and privacy. Despite their ailments and disabilities, these individuals in their final moments are more then ever deserving of their own exclusivity and autonomy of choice, Laputa, is thus their fortress in the sky. vestibulum mollis

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Iteration 1 In-patient wing 1:400

LAPUTA - CONCEPT

Light is introduced into the space by pushing out the wings parrallel to itself

Iteration 2 In-patient wing 1:400 The rooms are compacted, the idea of views is kept, each patient is able to enjoy views both seated up and while lying down. This design intended to house 20 patients a floor. Which would give rise to 3 floors of inpatient wards. However, it is obvious the corridors on each wing becomes elongated.

Wings -1 bed-2 bed- 4beds/ 1:300

Light was added to the central atrium by oushing out the wings.

The original 4 bedder was worked up to create rooms of the same form, but varyign functions, of 1,2 and 4 beds respectively.

The further compaction created this module. That allowed a spread from public to semi public to private spaces in a radiating manner.

Iteration 3 In Patient Wing 1:400

The elongated layout was dealt away and a more compact design was explored using squares. Its symmetry / asymmetry and how they react to one another.

The design started from the simple notion of offering Views Hospital beds were explored and precedence taken from Ng Teng Fong Hospital.

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LAPUTA

4 Bed Room 1:50

SIngle Bed Room 1:50

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Detail B

LAPUTA - CONSTRUCTION DETAILS

150mm Precast RC Slab Component Waterproof membrane Drainage/ Protective Sheet Soil

Geotextile Filter Layer Drainage Pipe

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Hanger Wire Main Runner Channels 19mm cross furring channels tied to the main runners Metal lath tied to furring Metal lath and Plaster

Detail A - 1:20 / Planter Box & False Celining

Silicone Sealant on highside Snap On cover Condensate gutter Purlin Double safety glazing

Butyl Weatherseal Aluminium Retaining Cap Stainless Steel Fasteners Weep Holes at corners for drainage Treated 2x Plate Condensate Gutter

Detail B - 1:5/ Skylight

Section A-A - 1:100

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The Green Wave Goh Jin Ping, Joshua: While research has shown that the provision of wide, open areas and a variety of private spaces can be extremely beneficial to a palliative care patient’s well-being in a hospice setting, it is often seen as an unattainable luxury in land scare and densely built Singapore. Yet, palliative care is an increasingly important issue to be addressed in our community as we deal with an ageing population. The Green Wave is a hospice that challenges the conventional model of a low-rise, sprawling institution by introducing a high-rise, high density design that is suited to Singapore’s context and is still able to offer patients and sense of exclusivity and privacy, Wards are spread out vertically along the main 10-storey tower, with each floor accommodating a maximum of 10 patients. The main intention is to reduce corridor lengths, thereby improving patients’ mobility and ability to access facilities. The excellent views afforded by a high-rise typology is taken advantage of by providing each ward with its own balcony and each bed with its own view. The shared facilities and outpatient services are housed in an adjacent 3-storey podium block, which is conveniently linked to the main tower via two bridges. As a way to encourage patients, caregivers and staff to experience nature as a form of therapy, a tree-shaded courtyard with a koi pond is carved out in between the tower and podium blocks, which also leads to the nearby green corridor. A passive design strategy has been adopted for the hospice with the use of timber screen facades facing east and west, as well as “green walls” made with planter boxes in the tower that shield the building from direct sunlight and allows for natural ventilation.

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The Porch Hung Yu-Shan: The concept of my project is to design a hospice as an embodiment of spiritual journey. I have observed that some hospice focus their design base on the daily routine. This sometimes results in neglecting the spiritual needs of a patient. There’s a misconception that spirituality is limited to the realm of religion, it is instead about reaching a balance in all kinds of relationship you will have in life. With yourself, your family, with nature and religion. For someone reaching their death, It is very common for patients rely on religion and spirituality to help them cope with terminal illnesses. Providing spiritual care can help a patient regain a sense of purpose so spiritual healing can occur before death.

A circular plan is employed to reflect the spiritual journey that a patient would take, beginning at the entrance and ending at the prayer hall, which houses the closure room and mortuary room. As soon as one comes into the entrance, one will see straight through the building where everything is. I would like to reflect the transparency of the patient care process. This unobstructed visual expanse welcomes and encourages people to think that the whole ethos of the place is open and supportive. Each in-patient module comes with 1/2/4 bedders wards and its related services. To provide a spiritual care, I attempt to use architecture to promote better relationships of users with others within the hospice such as different level of social interactions, geometrically different space to indicate areas for religious needs, special private space (prayer hall) to treat deceased patients with dignity and a memorial garden in remembrance of the deceased patients. Lastly, to created a visually soothing living environment, white plaster walls with timber cladded columns that are soft and comfortable for the eyes are adopted.

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harvest HOSPICE! Lee Jing Han Jireh: The idea of a hospice as we understand today is not the end of life. The idea of a hospice is essentially creating an inclusive community where the residents are able to dwell in a healing environment, at the same time, establish social relationships with the public.

Harvest Hospice is a proposal that speculates a new typology of hospice where it uses the act of production as a palliative care treatment. Hence, the proposal is a system of production of processes: grow, cook and eat. An urban farm would be the lynchpin of this idea. The idea is through participatory farming, to allow the residents to attain a sense of independence and fulfilment of creating and have control of one’ environment, then harvesting to cook with the staffs and ultimately coming together to dine in a grand hall.

In essence, it is not just about harvesting crops, but a community and environment, that is well-informed and well-aware of palliative care and end-of-life users.

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accessibility

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1st. floor plan

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Vision 2036: Hospice of the Future Melcas Lim Zhi Ming: The project is an experimentation of a prototypical small building footprint hospice in a best possible environment in view of future increase in ageing population and decrease supply of land. The prototype seeks to enhance and improve current hospice typology that tackles the hierarchy of social relationship between programmes at different scales, embedding and inlay of private - public programmes to achieve interfacing and synergy between patients and public.

The prototype is also an experimentation of the manipulation of private and shared space in a vertical environment so that they are perceived less as polar opposites, and more as overlapping layers that merge into one another that would result in an interactive hospice environment.

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Site area 5000m2

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Maximise Views

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Experiencing Nature in Hospice Seri Binte Sapari: My proposed design is about giving each patient their own garden/nature as well as privacy at the comfort of their own beds as most of the patients/residents are immobilized. Taking into consideration the condition of majority of the patients, the hospice is designed in a way to allow them to still being able to enjoy nature and being aware of what is happening on the outside such as whether rain or shine without the need to move around or even stepping out of the compound. Integration of nature in the hospice can be experience at every facet of the hospice even at the convenience of the patient’s bed. Examples would be the mini garden, voids near their beds to let rain or daylighting to penetrate and to add on, a terrace garden for interactivity amongst patients, caregivers, doctors and so on. Patients or residents will have a pleasant time in their last few moments of life in a calm and comfortable environment the proposed hospice could provide due to the healing element that nature has as well.

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1. Form Exploration - Shared 2. Form Exploration - Inpatient 3. Floor Plans 4. Structural Diagram 5. Circulation Diagram

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The Community Hospice Shawn Tan Lip Song: The project started off with a comprehensive study of the report The Hospitable Hospice by the Lien Foundation documenting the current problems with palliative care in Singapore. Three key areas where identified to be the basis for the design. 1. That the hospice was isolated from society. 2. Interactions within the Hospice were based on formal structures (Doctor - Patient, Doctor Nurse etc..). 3. There was a lack of autonomy and ownership for the patient. The design for the hospice revolved around a large central courtyard with the main mass raised on stilts allowing a seamless connection between the nearby green corridor and the central courtyard of the Hospice. More private functions such as the wards and treatment rooms were raised to the second and third storeys whilst the more public shared patient facilities were left to the ground floor. In patient wards were then divided into clusters and arranged around a sunken family lounge and small atrium thus providing opportunity to foster closer bonds within a smaller community. The room layout was adjusted in sucha a way that 2 units share a toilet and are connected by a foldable screen allowing the rooms to operate as single rooms when closed or double when drawn thus giving each patient more autonomy, flexibility and ownerhsip of their own space. Greenroofs were chosen to preserve the greenery of the site as well as provide a pleasing sight for residents to look upon.

In essence the design aims to create a vibrant and comfortable envrionment for both patients and staff by providing spaces to foster community at 3 different and overlapping scales centered around visual connectiong and greenery.

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1. Initial Approach 2. Concept Sketch 3. Initial GFA Calculation & Ward Layout 4. Initial Ward Cluster maximising views and engagement with rail corridor 5. Final Ward layout

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Sunshine Forest Hospice Tu Wen: Since the over population of elderly has become a serious issue, as the need for palliative care grows, so does the need for design of accompanying pallitive architecture. Palliative architecture is compassionate. It aims at relieve pain and stress as much as possible for patients at the end of life.

According to the data collection from several hospices, most of patients prefer to have thier own spaces to share with family members and familiar people if they have to stay at another place instead of home. Thus, as an attempt at improving the system of hospice care, this project emphasizes the issue of privacy at the first place.

In order to provide enough privary and comfort environment for patients without bringing too much pressure, instead of creating enclose building blocks with solid walls, the existing tropical trees actually act as great buffer between each block and public human flow on the rail corridor nearby in the future. Additionally, since the site, which is next to the Alexandra Hospital, is abundant in tropical trees, the conserved natural scenery is also helpful for the process of psychotherapy.

Moreover, by peeling off functional progrmas layer by layer from public to private, inpatient wards could be hidden into the woods with joyful views. Family lounges are settled in front of inpatient rooms for the convenience of gathering and communication.

Sickness and old age make the struggle hard enough. The professionals and institutions we turn to should not make it worse.

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1. Site Analysis (population) 2. Precedent Study 3. Process Model 4. Inpatient Unit Analysis 5. Flow Analysis

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1. Sectional Perspective 2. View of Main Entrance 3. View of Open Therapy 4. View of Farewell Room 5. View of Dinning Hall 6. Sectional Detail 1:25

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The Hospice : Grief & Healing |” Death isn’t scary, Dying is “ | Zoe Lim Kai Ee: The project objective is to design a comprehensive environment for palliative or end-of-life care and to explore creative designs integrating healthcare, environmental behavior, psychosocial, technological and environmental aspects.

Based on the current Hospice and propose a new hospice concept that improves the different aspects of the hospice that give the user a comprehensive environment in their final journey in Hospice.

My proposed design is supposed to create a healing and therapeutic environment for the patients and caregiver. Healing does not mean fully recovered but to know that “death isn’t scary, dying is” and give them the pride to live during the last journey of their life. Therapeutic help to improve their well-being, giving them quality living. My design provides a space for them to ease their mentally suffering after all the tough journey and relieve their physical pain.

My design intention is to separate in-patients and out-patients facilities into two wings where the ward section allows patients to have a view of the green corridor.

It also allows the center courtyard as a therapeutic courtyard garden for the users.

Therapeutic courtyard garden creates intimate communal spaces between both wings. The users engage with the nature while during their therapy session creates a sense of healing for them.

Based on the design proposal, new hospice concept creates a therapeutic experience and environment for the patients, caregivers and staffs. By having healing and therapeutic environment in the hospice, it set up a comprehensive experience for them during their final journey in their life.

SITE RESPONSE

SITE AREA

COURTYARD

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( VIEWING TOWARDS GREEN CORRIDOR )

VOLUME

( EXTUDING UP FOR MORE LEVELS )

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( COMMON SPACE FOR THERAPY FACILITIES )

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CONNECTION

EXTENDING

( EXTENDING FOR WARD SECTION )

( LINKWAY FROM BUILDING TO BUILDING )

LAYERING

( CANTILEVER OUTWARDS FOR EACH LEVEL IN DIFFERENT LENGTH )

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STUDIO RUZICA BOZOVIC-STAMENOVIC

Han Rui presenting her project at the Interim Crit Session

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STUDIO MASTER STATEMENT | Dr. Ruzica Bozovic Stamenovic Students Amanda Dwiyani Widodo Bernard Heng Jia Chuin Chin Yi Hui Clarabelle Han Rui Khairulanwar B Abdul Rahim Lim Yan Yee Joie Pan Guan Shen Peh Wei Keong Sim Wei Yih

Hospice, the contemporary institutional model of palliative care, is the offspring of the ancient Hospitium (in Roman culture) or Xenia (in Greek culture) that hosted all those who were in need of a shelter and security. The word is derived from the Latin hospes meaning both the guest and the host and implying the divine rules of hospitality that put ahead the wellbeing of the guest. The modern hospice, however, retained the historic word but lost its meaning and values.

The general focus in our Design studio was on finding and restoring the original humanistic values of the hospice. The task inevitably triggered a number of issues pertinent to the theme. Lingering above all of them, however, was the perception of “end life” by young people. Would they have objective views on the needs of dying patients, families and care-providers and on related issues of the intrinsic fear, spirituality, values, social status, fatigue, stress, and many more? A number of other questions emerged too, starting with: is it possible for a young and healthy person to have an objective stand regarding death? The theme and the complex design brief together with the choice of site close to the future iconic rail corridor added on to the complexities of this endeavor.

It was clear right from the beginning that the hospice project demanded an elaborate design teaching method and approach. In the weeks dedicated to the analysis our students embarked on interviewing elderly people, both known to them and the unfamiliar ones. The topics covered in these interviews were proposed and selected by students in the pre-interview process. The subjectivity of these young designers was thus very early questioned, exposed to other opinions and tested. The outcome was a more profound understanding of the sentiments and needs at the end of life. The bases for design decisions was thus established and rooted in this in-between zone, the edge that demarcated life from death.

In discussions regarding this thin line we addressed not necessarily its boundaries but its elusiveness. The sense of operating ”in-between” spread to other issues too. The hospice was to be built in lush greenery and thus the juxtaposition of the architectural coherence with the more complex chaotic order of nature was inevitable. Interference of the two systems was often recognized as a powerful tool for creating the supportive healing environments.

Other dichotomies that emerged from the design concepts covered the issues

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of privateness and publicness, stigma and social acceptance, profaneness and spirituality, denotation and connotation, activities and contemplation, etc.

Driven by basic conceptual statements our students positioned their design ideas somewhere between the programmatic pragmatism and its creative interpretations.

At this stage when the design decisions became very precise, the teaching method also had to follow. The brief hands-on design experiment addressed the Studio edge, the thin 90 cm wide area demarcating the Studio space from the corridor. Students had to rethink it as a respite place, an area where some relief from stressful work could happen. They had to be creative in spite of the constraints of the stiff, given circumstances, a few minutes of time for the experiment and personal disbelief in the outcome. In the discussion that followed the value of the ideas was not as relevant as the revelation that restrains might not necessarily limit the design creativeness. With this relieving sense of empowerment the students embarked on questioning the typical layout of the hospice rooms, the possibilities of the corridor spaces to be resolved as both functional and healing, the role of nature in balconies and verandahs, on establishing connections with the public in spite of demands for security and privateness, etc. The hospice edge and its elusive boundaries were thus recognized as valuable for making choices and being in control of ones decisions in space, the luxury usually denied to those at the end of life.

The range of students’ diverse interpretation of the hospice edges was in the core of their design concepts. The most interesting outcome, however, was their confidence to actually question the common hospice paradigm and build their own, coherent new interpretations.

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Studio Collective Peamble The elusive edge - Negotiating the connectivity between the home and hospice

In the beginning of the semester, there were a few design exercises done in studio to help students start on their scheme was to explore how a space of 500mm in width can be designed to add value to the surrounding spaces. It was a quick sketch exercise that in 5 minutes, students were to come up with drawings to elaborate the idea. Here are some of the drawings These set of design exercise would become the studio guiding principles during the design process that is to come. The explorations of the limit of healthcare institution and a home environment made the in-between spaces increasingly harder compromise. Hence the ever-elusive edge became the aim of the process of connecting the functional aspects of a hospice and the qualities of a home.

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Community + Housing | Proposals - Studio Ruzica Bozovic Stamenovic

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Healing Amanda Dwiyani Widodo: This project aims to integrate the benefits of nature into the design.

The concept of ‘healing’ goes beyond physical healing alone, it also involves psychological, social, and spiritual aspects of a person. It involves a peace of mind, a safe environment, and an optimistic atmosphere. Tying the concept with the given site, nature is important for the healing process, as it provides an opportunity for people to gather and interact, and also offers a chance for them to have some alone time. I started with trying to make the building less ‘compact’.

Then, I tried to orientate the rooms according to the existing rows of trees. After that, I adjusted the orientation according to the contour of the site.

There is one big tree in the middle of the chosen site which can be a good opportunity to be a focal point. The building thus has this curving glass wall overlooking that big tree. The spaces overlooking that tree at the entry level is for public, such as daycare centre and dining room. The in-patient rooms have access to private balcony outside via sliding glass door, the balcony is actually partially the roof of the rooms below, so in profile it will have a staggering form.

All 3 levels will have the in-patient rooms, 20 patients in each level (not including isolation rooms), and 2 nurses’ stations. The services such as laundry, pump room etc can be found at the basement. The entry level will consist of the out-patient services, such as daycare centre and consultation rooms. The therapy rooms, multi-purpose hall, and administration offices will be found at the top level.

Some public spaces such as the dining room and multi-purpose hall, is equipped with folding doors which are openable. The therapy rooms at the top also have access to an outdoor deck.

Internal courtyard -> Strips with nature in between

Orientating towards rows of trees

Adjusting according to site context and contour

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BEYOND Bernard Heng: The project calls for increased sensitivity to the patients due to the nature of palliative care. Beyond (the room) is a concept inspired by an experience at local Dover Park Hospice. While the staff has done well in encouraging a positive experience for the patients at the hospice, most of the patients ultimately remained enclosed within their rooms for their remaining days (for a number of reasons including immobility). Hence the design proposes to extend the experiences of the patient to beyond just a room, but to make use of the potentials around the site.

THE NATURAL ENVIRONMENT: - VENTILATION - NATURE - DAYLIGHTING & SOCIAL INTERACTION Concept

AS BASIC NECESSITIES FOR PATIENT’S WELL-BEING, PROVIDED AT MAXIMAL

THE PATIENTS ARE EMPOWERED TO CRAFT THEIR EXPERIENCE AT THE HOSPICE, THROUGH PROVISION OF CHOICES

EMPOWERMENT/ DIGNITY

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THE VARYING NECESSITIES ARE ADJUSTED TO THE PATIENTS’ WANTS

CHOICE OF EXPERIENCE

BEYOND THE STATIC 4 WALLS

PATIENTS IN A HOSPICE ARE FREQUENTLY SWEPT ALONG, UNCONTROLLABLY, BY THEIR MEDICAL SCHEDULES AND REQUIREMENTS. HENCE DIGNITY AND DEINSTITUTIONALISATION BECOMES AN IMPORTANT KEYWORD IN GUIDING THE DESIGN PROCESS, IN AN ATTEMPT TO DESIGN A HOMELIKE ENVIRONMENT.

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PERSONAL LAYER

ADJACENT BREAKOUT SPACE

VARIETY OF CONNECTED SPACES

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- FUNDAMENTALLY PRIVATE SPACE - LARGER ROOM TO ACCOMODATE CLOSE ONES

PUBLIC SPACE COMPLIMENTARY TO PRIVATE ROOMS ENCOURAGES FORMATION OF COMMUNITIES AMONGST DIFFERENT GROUPS -

TWO-BEDDER

- BEST OF BOTH WORLDS - IN-BETWEEN THE TWO TYPOLOGIES

ACCESSIBLE TO BOTH PUBLICNESS & PRIVATENESS DEPENDING ON THE NEEDS & WANTS OF PATIENTS -

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- FUNDAMENTALLY A PUBLIC SPACE - PROVISION OF PRIVACY WITHIN ROOMS

LARGER BALCONY AS PRIVATE SPACE FOR PATIENT & CLOSE ONES ISOLATED FROM THE HECTIC PUBLICNESS OUTSIDE OF THE ROOMS -

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NATURALE. Clarabelle Chin: This project aims to create an environment to fascilitate interaction between the users of the space and between the users and nature.

Working with nature included in the following ways: In-Patient rooms focuses on allowing each patient having their own personal window, a sense of privacy, access to nature and a common balcony shared between patients of the same room. The balcony could potentially be a space for caretakers to rest and enjoy the surrounding nature.

Blocks were dissociated which allowed users on both corridors (functional & terraces) to have access to nature. Penetration of nature took place. Internal Gardens were then integrated .Each garden had its own characteristic of engaging with different human senses. (i.e sight, smell, hearing) Also, Nature is penetrated vertically through the space where small accessible gardens are placed at upper levels. This allows in-patients , especially to those who have restricted mobility, to have access to nature.

Corridors are lined with Vertical Shades to allow a sense of privacy for patients and users walking around the vicinity while having a visual connection to the gardens and nature. Duality is integrated into this vertical language where seats and tables are present. Along the corridor, Protrustion of Spaces into the larger internal gardens (i.e seats and balconies) permits opportunites for users to have a more intimate experience and interaction with nature.

Nature bridges allows a more intimate, refreshing and healing interaction with the existing surrounding nature. As users travel around these bridge, it creates opportunities to bask in the healing environment of nature.

Treehouses are also presented to bring In-patients from upper levels down which connects them to these nature bridges while appreciating and enjoying and engaging with the tree. Moreover, within these treehouse, protrusion of spaces following an organic form consist of seatings for users to rest and enjoy the engaging environment as well. Social spaces are present at every level that focuses on fascilitating an environment for users to interact, between one another while enjoying the nature ambience, Private Social Spaces are present at the end of each block to allow more private conversations and discussion to occur while also allowing them to engage with the surrounding nature.

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MASSING

WORKING WITH NATURE

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Behind The Screen ĺ?ˇĺ¸˜ Han Rui: This project aims to deinstitutionalize hospice by increasing the dynamics of the space and create a rhythm of changes in the circulation. According to one of my studio mate who had volunteered in hospice before, most of the patients she met, despite having difficulties walking, still wish to escape from the bedroom and move around on wheelchair or with assistance. Thus, it is important to create a playful space for the patients to move around and enjoy a changing scenery, since the site is gifted with an abundance of greenery. In order to achieve this dynamics of space, I started to disegement the volumn into 3 masses, and adjust the different mass according to the site condition, for example, tilting the blocks to avoid killing the existing trees. The programs were layered according to privacy and experience along the 3 blocks. While connecting the different volumes, pocket space and courtyards were created in between the blocks which contains different programs.

The out-patient, in-patient the staff and the visitors may all have different circulation and requirement for privacy, as a result, there will always be one circulation which is more public, which might eventually become welcoming for the public who visit the railway corridor. There are a few programs such as cafeteria and ourdoor green space which can be shared between the hospice and the public. To reduce the sense of loneliness, I do believe that a buffer zone can be provided for the public and the patients to share.

The dynamics is further achieved through the materiality of this building. The horizontal language of the red bricks and the vertical language of aluminum fins both contribute to the dynamic flow. The red bricks were chosen for its warm color, which create a positive atmosphere with homely feel. The aluminum fins forms a screen between the public and people inside the hospice. It allows view connection and privacy at the same time. Besides that, the screen which wraps around the hospice is a climatical approach. It can be closed when it is sunny or rainy, and opened for sunlight and natural ventilation.

Process Massing Bedroom Distribution

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Connecting spaces Khairulanwar Bin Abdul Rahim: The starting point for the process was a article from The Straits Times titled “Old and home alone in Singapore” publish Aug 17,2015. Even though the article does not mention about the dying in Singapore, it raises a serious issue of elderly Singaporeans who live in isolation away from their families. The articles talks about how these elderly citizens become depressed and often pass away without anyone’s knowledge. However, this can be avoided by encouraging interactions between them and the community.

This led to the idea of connectivity and creating such interactions in hope that it will allow the hospice user to live better in their final days. This idea would then become the concept that would guide my process in designing my scheme.

The concept was to explore spaces that encourage interactivity in the hospice in three aspect. Firstly was to connect the hospice as part of the community to remove that sense of isolation and the stigma of a hospice. Next is to encourage connectivity between the patients and their family by created spaces that will allow quality interactivity between each other. Lastly the third aspect is the individual where spaces will be created to allow them to connect with themselves and find peace.

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Everyday Lim Yan Yee Joie: This project focuses on celebrating the everyday and aims to do this through providing many spaces where the patients can gather just outside their rooms. They can spend time with family or other patients in these spaces that look out to or lead to more public areas like the cafeteria and act as a buffer between these spaces and their rooms.

Each of these areas as well as each room also extend out onto timber decks and have views to either the surrounding landscape or a courtyard. These balconies and access to greenery allow the patients and caregivers to have a place to escape to and relax no matter where they are in the hospice. The staff lounge also extends onto a deck with a view to the courtyard.

Each courtyard acts as a point of public activity relating to the multipurpose hall, cafeteria and main entrance and the main corridor of the hospice links all these spaces as well as the lifts and stairs. This corridor also cuts through the hospice, allowing a straight view and leading one towards the rail corridor.

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Symbiosis Pan Guan Shen: The design seeks to harmonise the dichotomic nature of life and death within the physical and spatial constraints of a hospice. There is a need to translate these 2 greatly differing concept into a wholesome space for the patients to reside in, and for these spaces to come together to create a unifying whole, one half supporting the other half.

Thus symbiosis, the coming together and mutual support of either half is granted to the other, life in death, to create a harmonious whole where a patient is given the choice of interaction - privately with nature, or publicly with the other users of the hospice.

The hospice is separated into two distinct cores to reflect the different nature of life and death, the out-patient core being more hermetically sealed and inward looking to encourage interaction within the hospice community, and the in-patient core being more fragmented and porous, generating private nooks where patients are able to interact with the penetrating nature without being disturbed.

Large, open spaces abound in the out-patient core, encouraging user interactions with the other patients, staff, family members or volunteers. These spaces surround a central courtyard where the dining hall is located, providing a visual connection to the rest of the users within the core.

In contrast, the in-patient core is much more fragmented, creating pockets of private spaces such as balconies overlooking the exterior nature landscape and allowing them to get within close proximity of the flora.

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Healing In Nature Peh Wei Keong: The concept of this design aims to create an oasis-like environment, through the use of nature and eco-therapy, where terminally ill patients can, even for just a moment, forget their harsh reality. As these patients have reached their physical limit, naturally the focus falls on their mental well-being. By employing eco-therapy, which includes views of lush greenery, ample daylight, and activities among these natural elements, this scheme hopes to help alleviate the patients’ anxieties as they face their own mortality.

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Transit: Architectural connections that redefines a hospice in the community Sim Wei Yih: The hospice has always come under social stigma relating to a place of death. Rather then death, it should be a celebration of life. This architectural proposal sough to challenge the stigma and redefines a hospice as a CONNECTOR. Both in the macro and micro scale, the building acts as a network to link up the patients with the residential and the healthcare workers. Because in doing so, hospice and their patients will not be isolated. It aims to foster relationship and pass on legacies that will allow the public to see hospice in a different light.

The design process started on questioning the method of integration between the different user groups - patient, family members and lastly the public. There should be a common ground between these groups so as to encourage certain dynamics and interactions. Such interactions are important to redefine the hospice as by reshuffling certain programs and also designing the corridors, the hospice starts to depart from the dreaded insituitionalized compund. The design of the architecture will create the hospice environment to be more user friendly, more interactive, more green and relaxing, more intimate for the patient and their family. Although it is still a hospice, the spaces aims to provide comfort and opportunities to customize according to the user’s needs. The patient themselves are constantly engaged with the lush greenery and are given a choice whether they want to interact with other patients or just seclude to the private space. In each rooms there will also be space allocated to family and care support groups so that they are always around and comfortable to the duration of care.

The hospice will be primarily a place that allows the patient to feel less bothered with their illness by engaging themselves with the lush greenery and activites surrounding them. In times of pain or lonliness, the architecture aims to provide the comfort both physically and mentally.

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STUDIO FUNG JOHN CHYE

Joseph Lim presenting his project at the Round-up Crit Session

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STUDIO MASTER STATEMENT | Assoc Prof Fung John Chye Students Chia Ming Kuang Koh Jie Zhi Carleen Lee Sin Ying Li Zhengyao Liew Chee Chuen Joseph Lim Boon Kian Lin Derong Soh Qianyu Tan Jia Hui Jeanette

Given the programme’s complexity and wide ranging issues that might be explored through design as an intervention, this studio responded to the salient needs of end-of-life care: namely, to facilitate closure between the dying person and his/her family and friends by providing a range of spaces that are conducive for close interaction. The designs were driven by a higher objective of creating health-supportive, therapeutic spaces that are appropriate for such intimate human contact and bonding. Privacy is an overarching concern in designing the spaces, including those for collective use, to support the differing needs of patients at different stage of their end-of-life process. Opportunities for solitude, intimate group gathering and larger inter-group support are evident in the different plan-form typology adopted by each student.

Another enduring concern is the desire to provide ample contact with nature— the all-important outdoor connection with the sky and landscape that helps in restorative functioning for ailing patients. This manifests in a multitude of design strategies, starting simply with offering direct viewing of the outside world for bed-bound patients, to individualised balconies, common skyterraces, and inviting the site’s natural setting into the building. All the schemes engaged the lush greenery that is a unique character of the site, many resulting in spatial porosity at ground level.

Functional zoning further reinforces this attempt to integrate public engagement, albeit of different degree, particularly from the Rail Corridor. Most of the students were keenly aware of the need to segregate people and service movements. Much thought went into ensuring a good site planning outcome so that user experience and functional expediency are considered holistically. The gently sloping site and presence of mature trees become both a challenge and an opportunity, which many schemes responded to with great considerations.

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Creative innovations were also evident in rethinking the residential floor for in-patients. All the projects attempt to re-interpret the space provision and bed allocation of the bedrooms. This resulted in new typologies of bedrooms and residential floor layout. Efforts were made to imbue the residential spaces with a home-like character as a direct manifestation of the desired ambience and character of place that is suited to end-of-life care. Patients and caregivers were treated with well-intentioned designs that engender stress relief and evoke a sense of human-scaled comfort.

Supplementary programmatic activities were introduced to augment the primary functions of the facility. Many of these additional programmes target the ailing patients with therapeutic outcome as the underlying intent. Music, art, light and horticultural therapies were incorporated to create a purposeful engagement of the human psyche at a deeper level.

Notwithstanding, all projects share the two fundamental objectives stated above; the design approach, planning strategy and imaginative outcome demonstrate a diversity of ideas, spatial experiences and forms. It is evident in the work of this studio that there are a lot of possibilities in designing for this highly challenging programme, despite the abiding imperative to resolve functional requirements as is typically expected of a healthcare project.

The variety of designs from the studio attest to this unhindered creativity in innovating spaces for healthcare and healing environments.

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雨 晴: Closure to Life Chia Ming Kuang: Inspired by the Chinese idiom of ‘雨过天晴’ which means a calm after a storm, the design hopes to bring about comfort and closure to the cancer patients that resides. 2 distinct components are required in order to achieve that, the use of natural elements and spending their last few moments with their family members and love ones.

According to research, being in nature, or even viewing scenes of nature, reduces anger, fear, and stress, and create pleasant feelings. Exposure to nature not only makes you feel better emotionally, it also contributes to your physical wellbeing, such as, reducing blood pressure, heart rate, muscle tension, and the production of stress hormones. It may even reduce mortality such as improving the patient’s immune system and increases pain tolerance. Being in nature not only benefits the patients but the staffs and caretakers as well.

Family members assist the patients in finding closure. They play a health and emotional role by relieving patient’s physical symptoms such as pain, fatigue, lack of appetite, nausea and vomiting, or shortness of breath. It has been demonstrated that when people are seen by the supportive care team, they feel better. Important decisions and intimate conversation are crucial for the patients and family members and the design hopes to create spaces that caters to these needs.

Since majority of the patients are bed-ridden, the design started from a patient centric approach, starting from the bedrooms. The bedrooms are designed according to 2 guiding principle. (Refer to Image 1) 1 ) The design should allow patients to interact with natural elements.

2) There should be privacy between caregiver and the patients at all times.

The rooms are merged together to form a configuration of 12 patients per level.

And then they are stacked and displaced vertically. Giving opportunity to create new private and open space. After which, different functions starts coming together to integrate into the architecture. (Ref to image 2)

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Conversation Places: Meanders and Niches Koh Jie Zhi: Conversation spaces explores the notion of the niche as a means of creating small pockets of semi-public to private spaces that allows people to have private conversations. Imagined as three meandering routes , it creates a public street for out-patients, a street for day-care centre patients as well as a street for in-patients.

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BREATHE RELAX WANDER TOUCH LISTEN HEAL

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10. Elevation of Out-patient Block 11. Elevation of Day-care and Shared Patient Street 12. Elevation of In-patient Block 13. Interior View of Entrance 14. Exterior View of Rooms 15. Dining Hall View 16. Overall Parti 17. Circulation Meander 18. Ground Floor Plan

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RÉN: An Open Dialogue & Reflection Carleen Lee Sin Ying: RÉN; is an end-of-life and palliative care facility that attempts to create awareness, encourage reflection and provoke conversations around end-of-life issues among patients, healthcare-personnels and the general public. With this approach, “Both Sides Now” by LIEN Foundation serves as a programme intervention that work in-sync with the functions and programmes of the end-of-life and palliative care facility; in encouraging dialogues, interactions and reflection amongst the community/public and patients.

+ PROGRAMME An Immersive Arts Experience Sponsors: LIEN FOUNDATION, ANG CHIN MOH FOUNDATION Produced By: Artswork, Dramabox In Collaboration: Alexandra Health Support: National Arts Council, a.r.t.s.fund Time: (10AM - 10PM) Participating Years: 2013, 2014, 2015

Programmes such as community conversation, dialogues, installations and theatric plays, informed interesting and unique users-centric spatial design and spatial qualities. Located in between the main access road of the health-care zone and green corridor; the facility serves not only the main users (patients and healthcare personals) but it also brings the general public through the buildings.

With this, a trigonometric form is derived, serving as the basic massing of the design — a ‘nexus’ of activities that promotes interaction between the general public and patients is envisioned in between the In-Patient block, Out-Patient block and public thoroughfare. Lastly, the context of the site with its abundance of greenery, also played an important role in informing the placement of the different blocks; in providing comfort and privacy while encouraging close interactions between patients and public.

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Images courtesy of “Both SIdes Now” from http://www.bothsidesnow.sg/experience.php

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1. “Both Sides Now” Programmes 2. Diagrammatic Analysis, Massing & Study 3. “Both Sides Now” Users & Programmes 4. Green Corridor + Public Thoroughfare 5. Public + Patients Communal Area 4.

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Hospice for Solitude Li Zhengyao: This palliative care project aims to solve the dilemma between keeping patients’ privacy and give them a sense of autonomy of space as much as possible, and creating opportunities of communication and interaction between different groups of people. According to the visit to Dover Park Hospice, most in-patients are in the condition of assisted-walk, so it is very important to create connection between their bedrooms and communal spaces in many senses.

Another problem is that patients in current multi-bed hospital rooms are often disturbed by visitors as they usually share bedroom. Thus, this solution is to group semi-closed private bedrooms in clusters and control the vision angle so that patients could have daily communication from bed to avoid loneliness. In this way, the cluster of bedrooms can also be considered as multi-bedded wards.

Enjoying quality time with family inside the room will not be too disturbing to other patients as well. Small stacked greenery in between the bedrooms for less mobile patients to enjoy outdoor fresh air without travelling too far to a large communal area. These are also in a more intimate scale for patients who enjoy a solitude lifestyle.

In the larger scale, the further end of the site is chosen because of the more serene atmosphere for the patients to stay. The proximity to the green corridor suggests a very positive attitude towards life which is very beneficial for the inpatient to sense. Thus, the two in-patient blocks are located closer to the west.

And the two inpatient blocks are directly making use of the several palm trees in the middle as a garden open to the west.

The entrance is open to the major road in the east behind the feature tree. The very large canopy provides a natural shade over the porch. The central hall is transparent to connect greenery on both sides. A cafeteria and the dining hall are located in the central block as they are unavoidable in the routes for all user groups to become the communal area to encourage interaction.

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Social medical office Day care ·consult rooms -treatment rooms -resuscitation room -clinic

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Day care ·consult rooms -treatment rooms -resuscitation room -clinic

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This hospice design aims to provide a living space that give the patient sense of privacy and space autonomy as well a communication opportunities, such as eye contact and othe passing by, especially for the majority of in-patient who a having difficulty to move independently and are constraine in bed. The main circulation spine ties all blocks together encourage interaction without disrupting the activities inside eac block. The room layout not only achieves the two goals b also integrates green features and outdoor spaces for upp floors. More landscape elements are introduced to respond the sloping topography, for instance the water feature. Sunlig and wind direction are also taken into consideration in th overall site plan. Thus, patients should be able to enjoy normal and comfortable life and feel like home in the hospice 4.

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6 Transformer room 7 Switch room 7 Switch room collection 8 Rainwater 8 Rainwater collection 9 Elevator shaft 9 Elevator shaftcore to run ducts and wires 10 Service 10 Service core to run ducts and wires

Steel frame structure is used to achieve large span and long cantilever to Steel frame structure is used to achieve large span and long cantilever to support the roof in the central block. support the roof in the central block.

A combined use of frame structure and shear walls is adopted for the day A combined use of frame structure and shear walls is adopted for the day care center due to the irregular shape of parallelogram. care center due to the irregular shape of parallelogram.

Frame structure with steel columns and beams is adopted for in-patient Frame structure with steel columns and beams is adopted for in-patient block accoding to the regular grid of walls. Beams are cantilevered at corner block accoding to the regular grid of walls. Beams are cantilevered at corner window to avoide the use of column.

Ground floor plan window to avoide the use of column.

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Steel frame structure is used to achieve large span and long cantilever to support the roof in the central block.

A combined use of frame structure and shear walls is adopted for the day care center due to the irregular shape of parallelogram.

Frame structure with steel columns and beams is adopted for in-patient block accoding to the regular grid of walls. Beams are cantilevered at corner Ground floor plan

window to avoide the use of column.

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The Rail Corridor Liew Chee Chuen: There are extensive range of human emotions and conditions that accompany patients when living on the final journey. In most cases, it would be a painful and exhaustive experience for both the patients and care givers.

Therefore it is important to provide an experience that helps relieve the mental and physical stress during their stay. Research has shown that nature has a therapeutic effect on human’s emotion, enable tense feelings to be calm. Hence the design explore nature as a means to create a unique experience for the users.

Responding to the site topography and the surrounding views, the design connects the users with greenery on the site. The design taps on the big tree on site as an anchoring point to allow visual connection towards it. Situating right next to the rail corridor has allow for serene views and also inspired the architecture to explore public access to the common public facilities which in turn the building act as a nodal point to the 24km stretch of the rail corridor.

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House of Celebration Joseph Lim Book Kian: The project began with the personal need to identify how people looked at death, and their perspective towards living their last days.

Unfortunately, even despite the lack of negativity in response, the prevalence of mortality and finality stood out in their answers. Interestingly so, 3 participants within the survey had a more positive outlook. Their answers were as such: “Living life to the fullest”, “Appreciating a life that has been lived, and the people part of it.”, and “Enjoying life to the very end.” This is where the design concern stemmed from, and I found the need to conceive of a palliative care centre that would result in its participants thinking and feeling the same way these 3 surveyees did.

Charles Jencks, co-founder of the Maggie’s Centres, in his book called “Architecture for Hope”, wrote “‘Well how long have I got...‘ The aim of the centres is to transform such questions into ‘the will to live or to live better.’ Self transformation is at their hearts.”

This is where the concept of Celebration is adopted, where the architecture intends to bring about this self-transformation at the heart, where particpants of this palliative care centre - patients, staff, family and friends - adopt an appreciative and almost ‘celebratory’ perspective towards life even amidst impending death. The design, in similar hope, seeks to realign the patients’ inner thoughts and emotions towards one that is almost joyous in character, appreciating and celebrating life through the relationships experienced within, and the sensual experience of spirituality.

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1. Conceptual Diagram and Sketches 2. L1 Floor Plan 3. L2 Floor Plan 4. L3 Floor Plan 5. Roof Floor Plan 6. Exploded Axonometric 7. Model Photos

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8. External Perspective (In-Patient Ward) 9. Twin Bed Room Interior 10. Entrance Lobby 11. 2nd Floor Corridor

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Between The Walls: Air | Light | Privacy Lin Derong: The design process started off with questioning the institutional nature of a hospice. From precedent studies, privacy and family spaces is of paramount. However these are often compromised in institutions. The design challenge for me was to look into the in-betweens: Between the private and the community, between the nature outside and the interiority and between the sterility of a hospital and the domesticity of a home. The design intention to deinstitutionalize the hospice is to bring forth the notion of domesticity – it is not to replicate a home but to return spatial autonomy to the residents. By giving them a choice of engaging with the community and to be able to retreat to their individual realm with their families this design proposal aims to address directly to the resident’s spatial needs.

Design process began with an assumed single unit with ancillary facilities serving a 4,2 and single bedder. The strategy is to borrow the concept of kitchenism from Maggie’s center and to expound on the performative aspect of its pin-wheel system. The design exploration seek to requestion the brief of having a 4 bedded, 2 bedded and 1 bedded – which I felt was the reason why it is so institutional. I thus delved deep into its spatial layout. Instead of beds, I treated them as spaces.

How do I create these identical spaces in an open plan but yet make them feel like a single room with different experiences.

The abstraction process was to synthesize the pin-wheel and the centrality of the kitchen and to use the performative aspect of the pin-wheel to promote privacy, circulation and direct light carved out from the walls within the living spaces.

Started out with a square, a series of experimentation and geometric resolution result in 2 pinwheels which revolves around a larger square – a nurse station disguised as a communal central kitchen. Furthermore, the second level iteration involves a twisting of the individual room geometrically governed by wall arms which creates pockets of balconies for families to gather. I have also proposed using furniture or in this case, partition wardrobes, to delineate the bedrooms from the communal spaces.

With these modules, they proliferate on site in response to existing elements.

The building’s orientation is with the wind direction – from north east to south west. This uses the walls to channel wind into the ground floor clinic and services.

Living spaces are lifted up, creating a void with the ground. This frames the visual connection to the exterior.

The drawings made in this project aim to capture the temporality of the hospice.

Through hand drawings, it challenges the assumed sterility of a hospice and the idiosyncrasy of the domestic realm. The next page depicts identical spaces in the living modules which are negotiated through small scale individual appropriations. This would embody values of comfort, privacy and even taste.

Through these personal objects, no matter how little they have or short their stay, they are traces of bodies left behind by them. I strongly believe that by focusing on the resident’s spatial practices is vital in order to create an environment which frames this last part of their lives.

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1. Drive-In Perspective 2. Entrance Space 3. Rooftop View 4. Ground Level Environment 5. Ground Spatial Sequence 6. Living-Cell Structural System Next Page: Living-Cell Module ALEXANDRA

BETWEEN THE WALLS AIR | LIGHT | PRIVACY ENVIRONMENT FOR PALLIATIVE CARE LIN DERONG | A0111169M SUBMITTED FOR AR3012, AY15/16

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Expanding Greens Soh Qianyu: In challenging the current issue of isolation in hospice care, different degrees of engagement are explored: from providing the patients with visual connections to the greens and common spaces within and out of the hospice, to isolating the lying-in room by designing water features around the space.

Through the engagement of greens, there is the hope of reducing chances of depression in patients by creating spaces that allows them to be as one and a part of the community. In response to the site, a continuous community garden runs through the terraced steps and spaces of the ground floor from the drop off down towards the green corridor and vice versa.

The site is also chosen based on its close proximity to the neighbouring blocks and in using its curve/turn to draw the view of the public into the hospice. Essentially, the breaking open of the hospice allows for expansive spaces that brings in public flow and greens to engage with the patients and the hospice community.

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HOMEY: Palliative Care Design Tan Jia Hui Jeanette: Often, palliative care came across as institutional to most people. The objective of this project is to propose a healthcare living space that is homely -to create a tranquil and relaxing environment for the patients, having private pockets of spaces to spent with their loved ones, and create spaces that fits the programme of the staff and public users.

My first design strategy is to create a low rise modular massing. I felt that at two to three storeys high, the building mass is of a comfortable height, as the patients get to enjoy views in and out of the building, without being too detached from the greeneries on the first storey. Secondly, courtyards and outdoor decks will be punctured through each module. The courtyards will weave through the whole site as a linkage of the building mass, and it provide opportunities for users to gather, as well as activities to be held at. As it is located on the ground floor, it will be convenient for the patients to venture outdoor if they do not wish to stay indoor. Thirdly, the building will be situated at the corner of the site as it’s the quietest area away from the expressway.

The building mass then cascade down together with the topography, and majority of the facade faces the green corridor to enjoy the greeneries. Each In-patient module houses 20 beds plus 2 isolation wards and nurse station as the core.

Therefore 3 of them make up 60 beds, 6-isolation room and 6 nurse stations in total.

Passive design strategy is adopted in the modules so as to maximise and capitalise on the nature, floral and fauna in the site right beside the railway corridor and be one with the nature in this home like setting atmosphere.

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Jean Lin presenting her project at the Round-up Crit Session

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STUDIO MASTER STATEMENT | Dr. Zhang Ye Students Agnieszka Bogumila Lewicka Espanol Daniel Aguinalde Heng Bang Hao Lee Shang Jie Daniel Lin Jingyi Jean Liu Jie Soh Jia Tong Tessa Kok Foong Zhang Hanfei

Year 3 studio, especially the one for the second semester, is of paramount importance to the entire five years architectural education. At this stage, students should have already been able to synthesise and apply all the basics of architectural design and are expected to start on thinking more critically about the process and methods of design. This means that in-depth study of a particular building typology, though imperative for teaching and learning of design, should not be taken as the primary objective but instead a vehicle for studying design process. It is precisely in view of such a strategic role that this studio should play that the following approach to studio teaching was deployed with a particular focus on design methodology.

At the onset of the studio, a short lecture on design methodology was provided, introducing and comparing different models of design thinking based on a couple of well known case studies. The objective here is twofold. First, it aims to let student gain some general knowledge about what epistemological assumptions are used in defining design problems and framing design goals and what kinds of reasoning are employed in formulating design ideas and developing design solutions. Second, on this basis, students are expected to apply this abstract analytical framework to conducting precedent studies and later evaluating and improving their own design proposal. This lecture set the tone for the studio that design would be approached as argumentation, whereby design ideas and proposals need to be solidly justified and supported by systematic and sound reasoning.

Following the introductory lecture, the first two and a half weeks were completely devoted to discussions about the cutting-edge issues on palliative care in the local context. The more conventional activities prior to design exploration such as site analysis and precedents study were intentionally suspended. This was to encourage students to focus on and think deeply and carefully about the problems with which they are going to deal in their design exploration, while being screened off from possible prejudices and/or biases.

In this process, the tutor constantly challenged students in their logic and

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reasoning used for understanding design problems and formulating design objectives. The ultimate goal is to help students to build a concrete foundation for their design investigations, and which were repeatedly taken as the reference for evaluating design proposals at a later stage. The discussions were conducted particularly in groups to enable peer learning.

Underpinned by the aforementioned view that design is argumentation, the main part of the studio was taught with an emphasis on self-reflection. In other words, for every studio session, instead of introducing and/or imposing design concepts and solutions, the tutor worked together with the students as collaborators to scrutinise in details the their design argumentations, evaluate design proposals, identify deficiencies in logic and reasoning and develop correspondent solutions. It is hoped that through this process a critical and selfreflective approach to design can be cultivated and internalised by the students such that they would be able to take this approach with them to their future studies, regardless of specific building typologies.

Reflecting on the process and outcomes of the studio, the following two issues probably can be better tackled in the future. First, despite the explicit focus on design methodology, the high level of complexity of this project, which arguably exceeded the general ability of year 3 students, largely hindered the above-mentioned objectives of studio teaching to be fully achieved. A slightly simpler project can be much more helpful and meaningful. Second, definition of design problems and framing of design goals need to be further emphasised in teaching to formulate a more concrete basis for design. For instance, deinstitutionalising hospices was proposed by quite a few students as the main design objective, but a clear definition and explanation of it was largely missing even at the end of the studio.

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Home Hospice Agnieszka Bogumiła Lewicka : According to patients confessions in the book “Being Mortal: Medicine and What Matters in the End”: most of them prefer to stay at home as long as it is possible instead of moving in to any kind of health care institution. Resigning from that, usually is associated with big family effort or even lack of special equipment or qualified personnel care. We want to keep our loved ones close, in safe, comfortable environment. This image does not bring to our minds health care institution, which are mainly associated with raw, anonymous, institutional spaces full of pain and despair.

By diversifying, introducing new solutions and modyfing the from of hospice, we can let the patients spend their last moments in cosy, calm atmosphere with family and other patients, by creating good environment, providing privacy and and the facilities, which encourage to engage them in not only medical activities but social, artistic, relaxing activities as well.

The main aim of the project is making “hospice more like-home”, be reducing the scale of in-patient part and deviding it to smaller cluster with individual staff focusing on small group of patients,which help them build friendly atmosphere and separating them from the rest medical facilites. Every each of them is linked with main public part, which is contain public space (cafe and library) allowing local community to interact with patients whenever they want and keeping the privacy and letting familly be still big part of patients life in the same time.

The project is shaped to respond to surrounding it vegetation, flower gardens and ponds connectined directly with patient’s rooms, to let them enjoy the beauty of the nature. Environmetaly responsive

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Sequence@Alexandra Espanol Daniel Aguinalde: The Project dwelves upon the notions of familiarity; not being dejected the everyday norm of society as they pass. Through a series of scales being divided into three different tiers, the residents could experience interaction with however they wanted based upon incentives. The public tier allows visual interaction from the patients to the public through spaces that would cater to them (cafe/rest-stop). The second focuses on the in/out patient interaction and this is where most out patient facilities are located. The third with two levels is exclusively for the in-patients, where they would enjoy the most amount of privacy.

Through a series of voids capped out with a large bamboo roof structure and green roof, the users would hence experience a controlled amount of visual and natural connection with accordance to their preferences.

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Patient/Staff/Family Between Other Patients On a Cluster level Out/In Patient Interaction Public Accessed Spaces

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Fruitful Hospice Heng Bang Hao: The vision guiding the design of the hospice is to enpower fruitful living through an all encompassing effort from patients, families, staff and the community. 3 main deisgn objectives were derived from this, namely comfort in the body, mind and soul, purpose in life, as well as hope,. To help fulfil these aims, 4 design strategies were utilised. Firstly, the overall design form adopts a u shape symbolising the embracement of the public and the non-exclusion of hospice and patients from their surroundings. Secondly, the dining room was chosen as the main sequential space based upon studies of the daily routines of all users. Next, the accomodation was designed with privacy and views for patients, as well as nursing efficiency for nurses. Finally, 2 types of green spaces are incorporated throughout the hospice facility, namely the active engaging and passive restorative to allow users to benefit from the green spaces.

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Hospice Sanctuary Lee Shang Jie Daniel: The intent of my design is to create a hospice environment that caters to all the end-users of the hospice; including in-patients, out-patients, friends and family of the patients, staff and the public. This is done through several design strategies such as utilization of nature, natural elements and existing site, prioritizing wayfinding and ease of access, and finally protecting patients’ privacy and dignity through their time of stay in the hospice.

The design inspiration of this hospice was from the Pavilion Hospital typology (1) which emphasized natural ventilation, sunlight and segregation of patient rooms; as well as the existing Alexandra Hospital (2) which seamlessly integrated Hospital within Nature.

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THE QUEENSWAY TERRACE Lin Jingyi Jean: The design of a palliative care centre calls for an innovative and revolutionary architecture that aims to provide a peaceful and comfortable environment for the patients and their families. In the stigmatised and complicated setting of a hospice, solutions to improve patient comfort and medical staff welfare became the key focus in creating a cohesive and rehabilitative community within the hospice.

With unique site topography and surrounding green features, the strategy of reacting to site context while keeping in mind micro spatial considerations of bedrooms and facilities were utilised. This ensures the design was well-suited to the Queentown precinct and Rail Corridor while fulfiling practical and functional aspects of the project brief. The intent focus on familial relationships between patients, their families and hospice staff were conceptualised to provide an interesting cluster design that is observed throughout the compound. Design features like landscaping, voids to allow in light to deeper levels and terracing of cluster units were further conceived to augment the design.

The considerations of materiality and structural expression was used to further contrast between the bedroom clusters and shared spaces as well as enhance the difference between spaces of different hierarchy. Ultimately, the design solution caters to a wide spectrum of private to public spaces that are contrasted but do not appear segregated from each other.

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Green Hospice Liu Jie: The hospice designed to provide a space integrated with nature.In this natural environment, family interactions are encouraged and new form of communities between patients, patients and staffs will form. This creates a new experience in the last stage of people’s life. The building is oriented to funnel in the prevailing wind. It situated on the upper part of the site in order to use the slop on the site and get a better view.The Green Hospice is divided into three parts. The clear separation of the three parts protects patients’ privacy and keep different circulations clean. The shared space is guided by big water body. Going to the two wings of the space are the inpatient’s rooms. The inpatient rooms and the central axis is separated by courtyards. This is to provide a more quiet space for the inpatients.The inpatient rooms are viewed as individual houses attached to the central service core and linked by glass sheltered corridors.This separation is to give people a sense of individuality and provide a sense of privacy to the patients. They will create a “house “feeling instead of a institutional feeling.

Going to the details of the green hospice,beside each bed a wood screening is adopted to prevent patients looking directly at each other. For personal experience, each patients has a view to the green corridor The greenery eats into the room to form a semi private space, It is also a shared urban farming space.

People will look at what their family members do even when they are on the bed.

It is also the space to create a ward identity.Beside the bed each patient has a bacolny with height about 700mm, When their family members come, they can sleep and work beside the patient. If they want some family time ,they can go to the urban farming space where sits are provided.For community bonding ,the central area of the room is reserved for events like music therapy, pet therapy and for them to come together.Between the rooms ,this strip of greenery space is for them to sit and enjoy the landscape. For people stay in the Green Hospice.

They will spend their last stage of life in a place immensed in green and create new experiences with people they love.

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Harmonizing Nature Soh Jia Tong : The project aims to remove the existing social stigma that people have towards palliative care. The main idea is envision the growth of the hospice with its surrounding communitites as well as to instill a sense of home into the patient’s bedrooms. Nature is presented as the key strategy in enriching the private spaces, as well as its incorporation into the hierachy of communal spaces within the hospice.

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in | between Tessa Kok Foong: The purpose of this programme is to explore through design, the subtleties of this relationship between the environment and sacredness of living and dying.

In an age of increasing social fragmentation, rethinking a neighborhood like scenario within a hospice means to address the question of privacy as well as that of shared resources, spaces and time-shifts among its users.

The project adopts a strategy of cohabitation between nature and community, while combining the compacity of built space, the optimization of resources (spatial and environmental) with a sequence of open spaces that claim for informal occupations, leisure activities and, in general, shared spaces for the whole of the community.

The morphology of the development and the relationship between the patient’s bedroom, mediated by the large courtyards and break out spaces for communal interaction and engagement, aim at creating a sense of community.

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Palliative Care Center @Therapeutic Terrace Zhang Hanfei: Keeping a normality of life, the company of family and a natural environment for patients to act upon are treasured most by Palliative Care Patients.

Nowadays, hospices for palliative care are trying to create an atmosphere of “athomeness�. Feeling-at-home, not only means a cozy and warm environment but also refers to a state, where the patients have control over his private and social life.

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REFLECTIONS Ye Luman: This project helps me to understand more about the palliative care concept and the importance of creating different spaces for different groups of users. By carefully considering the site conditions, rational and proper design decisions can be made.

Leong Hui Fang: The design aims to explore how to cultivate the sense of community within a hospice environment. according to research, the terminally ill patients tend to embrace kinship, friendship, and the various forms of human interaction towards the last moments of their life. Hence, the design of the hospice is user-centric, targeted at the needs of the terminally ill.

Ting Hao: I love this project. I had alot of fun designing this project. I really did.

I would like to thank my family and friends, especially my fellow studiomates.

Let’s not forget our dearest tutor, Mr Ckk. I really appreciate his guidance and scoldings. He is the best tutor i ever had. I hope i will have the chance to design such an exciting project in future again. I hope you enjoyed my reflections! Have a great day! Peace out, XOXO!

Yu Yiying: The hospice project has given me a chance to think of some heavy and serious issues, like death and life and how the living environment could get involved into people’s lives when we are dealing with the journey of life which might be rarely discussed about by people.

Yin Aiwei: “This is my first project with such complexity which gave me an opportunity to ponder upon my personal beliefs about life and human relationships. The careful balance between spirituality and practicality in programs and spaces is an area that could be further studied upon. A good lesson learnt is to be less of a designer who dictates his design philosophy but more of a sensitive architect who shares his vision with the inhabitants.

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Lee Jo Hee: The Community & Housing hospice project brief has definitely posed a very realistic design challenge with its numerous considerations and implications on both patient and the larger community. I am truly grateful to our tutor KK for his rigid yet unwavering support throughout the semester and studio KK.

Lee Jing Han Jireh: The semester has been a fruitful one with much discussions on what hospices are and what they could be. Many ideas were bounced off tutors and students and I am proud to say we have produced several schemes that challenge existing norms and standards. One thing I learnt is that changing attitudes towards dying does not mean romanticising death and only these changed attitudes can affect our environment, which in turn affect us.

Goh Jin Ping, Joshua: Generally, I found this project particularly challenging due to the the technically complex programme of a medical facility. However, designing a hospice has led me to realise just how much architecture is able to impact people’s lives and the community, this being a setting where many people are at their most physically and emotionally vulnerable. Architects have to be sensitive to the consequences of their design not just in the human scale but also in the human experience.

Hung Yu Shan: “This project has highlighted to me the importance of understanding the intricacies and nuances of the end-user, and how a good scheme should ultimately be able to reach an effective compromise betweeen the end-user as well as the accompanying processes, as opposed to being overly distracted by either. Conceptually and formally speaking, I felt that this scheme could have better brought forth how I felt spirituality should be emphasised throughout the palliative care process. I could have been bolder in making certain design choices, perhaps through showing a stronger contrast between this spatial duality within the hospice. The scale and programmatic requirements of this brief were extremely challenging, but also fulfilling and satisfying to resolve.�

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REFLECTIONS Bryan Ng: The semester has been interesting and enlightening. Prior to the project, the term Hospice has been foreign to me, what little i know seemed morbid, no better than a prisoner on death-roll - awaiting death. As we delved further into the subject of the inevitability of death, questions started to arise.

Why is death hard to accept? Why do we fear it? And ultimately how does one ease this transition, from life to aliment to non-existence? The project exposed us to the nuances and sensitivity of creating such a personal project - as with a patient and his/her family. The scale of the project, also allowed us the opportunity to design something of a greater complexity. Beyond the project, we integrated the design on a larger social scale, with the upcoming green corridor that lies adjacent to the site. The various elements that were present and required to be encompassed in the design of the Hospice proved to be truly challenging, a certain manner of discipline and rigor was definitely required. On hindsight, the rigors and tenacity of the project has certainly made it a fulfilling semester, as we tackled new challenges and explored new design dimensions, moving one step closer to be better practitioners of this highly demanding career called Architecture.

Heng Bang Hao: “The design project on hospice / palliative care facility was a thoroughly challenging one, demanding precise and well balanced thinking between the big and small pictures, and between theory and reality. This project can be seen as being especially relevant to countries like Singapore that are experiencing the issues of having aging populations. It provided us the opportunity to get in touch with the topic of death, one that is usually avoided, and through the process become more aware of and better understand the fragility and preciousness of life. In addition, another important takeaway this semester personally was the refinement of my own design thinking process and learning to see more clearly, the connection between architecture and the real world.�

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Lee Shang Jie Daniel: “This design project to me has been a challenging and fulfilling one. Designing a hospice, to me, was a very real project, which is relevant to Singapore’s context today of an ageing population. I felt that such a programme grounded my design to very real and practical issues, rather than programmes in the past that might have felt rather fanciful and less grounded in reality. I appreciate the learning experience and dare say I have learnt the most in this semester compared to past semesters for design module.”

Lee Jingyi Jean: “The project brief of a palliative care centre with extensive considerations of in-patient and out-patient facilities, shared amenities, services etc, was challenging and requires a thorough understanding of medical spaces and how patients use these spaces to derive comfort at the end-oflife stage. In addition, the active design thinking behind creating a deinstitutionalised and homely hospice was needed. Thus, practical and logical considerations coupled with innovative strategies for a new typology of hospice indeed proves to be a challenging and engaging topic that pushes our boundaries as design students and provides a platform for us to develop a large scale and complex project, which I am grateful for.”

Espanol Daniel Aguinalde: “This project provided us the opportunity to work on such a large and complex scale. The main challenges were to tackle the existing norms, push boundaries whilst maintaining a sense of logic and practicality. Furthermore, this project encouraged us to look past the surface and analysis the scheme thoroughly, from the furniture layout and how it affects patient to patient interaction to the overall urban fragments. This steep learning curve has thus been a pleasure.”

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REFLECTIONS Tessa Kok Foong Yi: “. Designing a hospice was not solely about meeting various specifications of the programme deliverables. The challenge was to create a hospitable hospice, in which it empowers patients, and life’s pleasures are celebrated and spaces are designed for life, not death alone. Our design thinking methodology was challenged and stretched to go beyond physical spatial design, but rather, designing for the dignity of the dying and the scared in the living.�

Amanda Dwiyani Widodo: The design process started with a question to create an overall uplifting atmosphere for the hospice by making use of the site. I thus proceed to explore ways to integrate the benefits of nature into the design.

Han Rui: This design began with the question of how to make a hospice less institutional, and more homely to people who spend their last days there.

With this question in mind, I started to explore how to create a dynamic and playful space which encourage patients to move around and enjoy the different scenery.

Khairulanwar B Abdul Rahim: I questioned myself whether I am capable enough to design a space for people who are facing death, a problem that I would not be able to comprehend or relate to. However this did not stop me from trying to find out more by doing interview and analysis to be able to understand the issues of death in the society.

Lim Yan Yee Joie: What struck me when we started learning more about hospices through the documentaries and visit was how unexpectedly normal it all was, with patients eating together and a nurse sitting by the patients reading.

Along the corridor were tables and seats for visitors and a piano that volunteers would play music on it. I thought that I would like to make spaces that could feel easy to be in and candid like these with the patients, caretakers, staff and visitors interacting a little bit.

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Peh Wei Keong: My first thoughts was a question of how to design a hospice that is therapeutic for the patients’ mental well-being. With that in mind, i explored different space and forms in an attempt to create a soothing, relaxing and meaningful environment.

Sim Wei Yih: The design process started with a question: How can a hospice integrate well into a community and overcome the current stigma. This led to further explorations on the methods to redefine connection spaces. The reason being,connection space is crucial to break away from the institutional character and to seamlessly juxtapose the complexity of different user groups in the hospice.

Lin Derong: After 5 semesters and 9 projects, I have never felt so inadequate in my 10th project. 13 weeks of short but tough training. There were so much to do but so little time. This is our first attempt in responding to a demanding brief and I was only able to grapple its scale late into the tough design process. All the skills we have acquired in the past 5 semesters were utilised and the brief required us to demonstrate our capabilities to handle complex programmes and its implications on both the soft and hard engineering of the edifice. The brief challenges one to rethink the common assumptions about the dying process and the spaces catered for it. It calls for a holistic synthesis of requestioning a social condition, finding creative solutions and resolving building practicalities.

As such, this project thus made us a little tougher, a little smarter, and a little better as aspiring architectural professionals. I would like to thank my tutor Fung John Chye for his patience, his big heart to our studio and who has taught me something else about architecture – to have perseverance and determination.

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1.1

1.2

1.3

1.6

1.7

1.8

2.2

2.3

2.4

2.7

2.8

2.9

3.3

3.4

3.5

3.8

3.9

4.1

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1.4

1.5

LAPUTA

1.9

2.1

4 Bed Room 1:50

SIngle Bed Room 1:50

1.1. Visuals - Lee Jo Hee 1.2. A Hospice Community - Leong Hui Fang 1.3. Alveolus - Liu Meilan 1.4. Connecting Communities - Pan Bin 1.5. Hamlet - A Village Hospice - Ting Hao 1.6. Reminiscence - Ye Baogen Josiah 1.7. Beyond The Green - Ye Luman 1.8. The Commune - Yin Aiwei 1.9. Into the Woods - Yu Yiying

Double Bed Room 1:50

2.5

2.6

3.1

3.2

3.6

3.7

4.2

4.3

2.1 - LAPUTA - Bryan Ng 2.2 - The Green Wave - Joshua Goh Jin Ping 2.3 The Porch - Hung Yu-Shan 2.4 harvest HOSPICE! - Lee Jing Han Jireh 2.5 Vision 2036: Hospice of the Future - Melcas Lim Zhi Ming 2.6 Experiencing Nature in Hospice - Seri Binte Sapari 2.7 - The Community Hospice Shawn Tan Lip Song 2.8 Sunshine Forest Hospice - Tu Wen 2.9 The Hospice : Grief & Healing |” Death isn’t scary, Dying is “ | - Zoe Lim 3.1. Healing - Amanda Dwiyani Widodo 3.2 Beyond - Bernard Heng Jia Chuin 3.3 N A T U R A L E . - Chin Yi Hui Clarabelle 3.4 Behind The Screen 卷帘 - Han Rui 3.5 Connecting Spaces Khairulanwar B Abdul Rahim 5.6 Everyday - Lim Yan Yee Joie 3.7 Symbiosis - Pan Guan Shen 3.8 Healing In Nature - Peh Wei Keong 3.9 Transit - Sim Wei Yih 4.1. 雨晴: Closure to Life - Chia Ming Kuang 4.2. Conversation Places - Meanders and Niches: Koh Jie Zhi 4.3. RÉN: An Open Dialogue & Reflection - Carleen Lee Sin Ying

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4.4

4.5

4.6

4.9

5.1

5.2

5.5

5.6

5.7

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4.7

5.3

5.8

4.8

5.4

5.9

4.4. Hospice for Solitude - Li Zhengyao 4.5. The Rail Corridor - Liew Chee Chuen 4.6. House of Celebration - Joseph Lim Boon Kian 4.7. Between The Walls: Air | Light | Privacy - Lin Derong 4.8. Expanding Greens - Soh Qianyu 4.9. HOMEY: Palliative Care Design Tan Jia Hui Jeanette 5.1. Home Hospice - Agnieszka Bogumila Lewicka 5.2. Sequence@Alexandra - Espanol Daniel Aguinalde 5.3. Fruitful Hospice - Heng Bang Hao 5.4. Hospice Sanctuary - Lee Shang Jie Daniel 5.5 THE QUEENSWAY TERRACE - Lin Jingyi Jean 5.6. Green Hospice - Liu Jie 5.7 Harmonizing Nature - Soh Jia Tong 5.8. in | between - Tessa Kok Foong 5.9. Palliative Care Center@ Therapeutic Terrace - Zhang Hanfei

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Site Analysis Contextual Studies Demographic Studies Precedent Studies

STUDY REPORT

APPENDIX 2A

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Section Line

Scale 1:5000

Site

B

C

A A

C

B

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The site sections reveal that the site located on a spot that separates the green zone from commercial or residential zones. The eventual rail corridor would also be a crowd-generator and a potential tap-on for the site as people across from the main public transport to fr this rail corridor.

Site

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As seen from the aerial view of the site, there is an abundance of vegetation in and around the current Alexandra Hospital Campus. Within the campus, the layout of vegetation tends to follow the layout of internal roads. To the West of the campus is the Rail Corridor and relatively dense forested area. To the North of campus is a relatively open ďŹ eld with sparse vegetation.

Site

235

Big Tree Small Tree Bush Flower Grass Water Body

Not to Scale

Site

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This slide shows a collage of the large trees found within the site.

Some notable ones include the Frangipani Tree, the Jackfruit Tree and the Fig Tree.

Site

237

This slide shows a collage of the medium-sized trees, shrubs and owers found on site; including the Bamboo tree, Papaya tree, mangrove-like tree, Heliconia plant, Ixora plant etc.

Site

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The subsequent layer depicts the views of the rail corridor from within the site looking out, showing the extent of wild grass and tree growth across the fence boundary.

The bottommost layer shows the views of various vegetation from the main hospital building.

This ďŹ nal slide gives an overview of the vegetation found in the site.

The top layer of photographs depict the various gardens and ponds found on site (Not all are active). The next layer shows the vegetation relative to the buildings found on site: si note the relative sparseness as well as the height contrast.

Site

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Allocated Zone 1 Allocated Zone 2 Alexandra Hospital Cat A Cat B Cat C

Scale 1:5000

Site

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Carpark Carpark 200m Range Bus Stop Bus Stop 200m Range

Scale 1:5000

Site

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Human Intensity Allocated Zone 1 Allocated Zone 2 Alexandra Hospital

Scale 1:5000

Site

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Carpark Lots Fire Engine Access Ambulance Parking Lots

Scale 1:2500

Site

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Public Access Roads Private / Restricted Roads Entry Points

Scale 1:2500

Site

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Allocated Zone 2 Rail Corridor VIewports

Scale 1:5000

Site

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The Rail Corridor as it now stands is without most of its tracks, sleepers and railway equipment. It has become a stretch of greenery; a “green corridor�, that stands out as an informal public space in contrast to the dense urban developments in other parts of Singapore. It weaves through diverse landscapes, linking high-density public housing estates with pockets of private housing, business parks, industrial areas, nature reserve, parks and land that have yet to be developed.

The Rail Corridor is a 24-kilometre long former railway line that stretches from the north to the south of Singapore. This train line, known formerly as the Keretapi Tanah Melayu (KTM) Railway Line, connects Singapore to its neighbouring country, Malaya. The southernmost terminal station of the KTM line was located at Tanjong Pagar Railway Station (TPRS) next to the Central Business District.

The last train left TPRS on 30 June 2011 and the land occupied by KTM Line was returned to the Singapore government on 1 July 2011.

Site

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Retaining and recapturing the Rail Corridor’s sense of place and memory

A platform for thoughtful, innovative and sustainable design solutions with surrounding developments to be sensitively integrated

Community-oriented and nurturing a sense of ‘community ownership’

A form of recreation and for commuting: seamless connectivity for both pedestrians and cyclists

A ‘green corridor’ An ecological corridor A leisure corridor

Site

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>80 70 60 50

Scale 1:2500

Site

- Cicada / Bird Sound

- Traffic Noise

Clear Background Noise

- Cicada / Bird Sound

- Faint Traffic Noise

Soft Background Noise

- Soft Cicada / Bird Sound

- Faint Traffic Noise

Quiet

- Very Faint Traffic Noise

Very Quiet

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Allocated Zone 2

Scale 1:2500

Site

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Site Analysis Contextual Studies Demographic Studies Precedent Studies

STUDY REPORT

APPENDIX 2B

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0 - 119.9 119.9 - 337.3 337.3 - 614.4 614.4 - 1228 1228 - 2778.8

Population Density

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Low Medium High

Pedestrian Density

ALEXANDRA HOSPITAL

AIA

QUEENSWAY SHOPPING CENTRE

ALEXANDRA VILLAGE FOOD CENTRE

Zone 2 Zone 1 Alexandra Woodland Rail Corridor Future Residential Other Landmarks

Landmark Networks

F LONG TERM CARE & END O

RE CA E LIF

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Zone 2 Zone 1 Commercial Mixed-Used Commercial Institute Other Landmarks

Landmark Networks

F LONG TERM CARE & END O

RE CA E LIF

alexandra central

alexandra village

queensway shopping center

anchorpoint

Zone 2 Zone 1 Existing Residential Landmark Residential Future Residential Other Landmarks

Landmark Networks

existing residential

future residential

RE CA E F F LI LONG TERM CARE & END O

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the interlace

existing residential

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Site Analysis Contextual Studies Demographic Studies Precedent Studies

STUDY REPORT

APPENDIX 2C

279

Statistics taken from the Lien Foundation Survey

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281

Identifying Patients Wants and Needs - Analysis of patients from CNA Facing Death

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Identifying Patients Wants and Needs - Analysis of patients from CNA Facing Death

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Identifying Patients Wants and Needs - Analysis of patients from CNA Facing Death

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Identifying Patients Wants and Needs - Analysis of patients from CNA Facing Death

285

Interview Transcripts with family members

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Knowing the Medical Healthcare workers better

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Wants and needs with regards to the Environment - Patients

289

290 Community + Housing Definition: - a home providing care for the sick or terminally ill.

- a lodging for travellers, especially one run by a religious order.

- a place for refuge

Origin: Latin, Hospitium.

The ancient Greco-Roman concept of hospitality as a divine right of the guest and a divine duty of the host.

noun

Hospice [ˈhɒspɪs],

Site Analysis Contextual Studies Demographic Studies Precedent Studies

STUDY REPORT

APPENDIX 2D

291

Diagramme above dipicts the continuum of care given to patients. Each care system dedicates to the various types of needs and its corresponding facility. Arrows shows the movement of patients with respect to the seriousness of their illness. For patients diagnosed with terminal illness, they transit from curative to palliative care. Towards the end of life, hospice care, which is an application of palliative care, is provided to patients with less than 6 months of living. The aim at the final stage is to reduce patient’s both physical and emotional pain and sufferings.

The Care Continuum

Understanding Palliative Care

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Mapping Complexity Within Palliative Care

Understanding Palliative Care

293

Caretakers’ needs

Typical Day In Nursing Home

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Typical Day In Hospice (In-Patient)

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Typical Day In Hospice (Out-Patient)

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In this book, Dr. Atul Gawande addresses the difficult topic of palliative care and end of life. With his poignant recounts from his experiences as a surgical oncologist and interviews from the palliative care field, he explores the evolution of elder care, providing a roadmap to skilfully initiate and navigate end of life and palliative care. In dealing with theme of death and ageing, he examines the delicate patientphysician relationship at the end of life. Through this examination he probes right at the heart of the issue: How can we make our last days more meaningful, comfortable and affordable? Communication becomes a tool as important as a scalpel in treating one during his final period of his life.

Gawande, Atul, "Being Mortal." Metropolitan Books, 2014

Literature Review “She visited a nursing home nearby. “It was actually one of the nicer ones,” she said. “It was clean.” But it

power is finite and always will be.”

But again and again, I have seen the damage we in medicine do when we fail to acknowledge that such

and cells and flesh and bone. Medical science has given us remarkable power to push against these limits…

“Being mortal is about the struggle to cope with the constraints of our biology, with the limits set by genes

helplessness, they offer a chance to take care of another being”

even ones with advanced dementia…In place of loneliness, they offer companionship. In place of

Chase Memorial Nursing Home: “how irreplaceable the animals had become in the daily lives of residents,

between him and someone else.”

“He did not want his life reduced to a bed, a dresser, a tiny TV, and half of a room with the curtain

corridors. It was horrible.”It was the sort of place, she said, that her father feared more than anything.

was a nursing home. “You had the people in their wheelchairs all slumped over and lined up in the

297

Through an examination of St Francis hospice, she uncovers how hospice spaces negotiates 3 main themes: 1) Front/Back Regions and the ‘Perceived’ Hospice 2) Prospect/Refuge and ‘Conceived’ Hospice 3) Privacy/Community and ‘lived’ hospice. Central to these themes is the hospice philosophy that it is possible for one to live while dying. Rejecting old social and medical attitudes towards death, it embraces the reality of dying and seeks to help the patient bring proper closure in their lives by easing their discomforts, and caring for them holistically with compassion. Unlike the old hospital philosophy which isolated dying patients on the basis of medical failure, the hospice embraces death, and seeks to readdress some of the attitudes towards death. This is achieved through balancing the seemingly opposite characteristics that are both required in a hospice, as illustrated by the three themes, and finding a spatial balance based on the relationships established between the spaces.

In The Production of Hospice Space , McGann makes an enquiry about the characteristics of space embodied by a hospice. Through tracing the antecedents of the hospice to the crowded bedroom of a dying patient, uncovering its root latin word ‘hospitium’ - ie guesthouse and highlighting the birth of the movement as a reaction to deaths happening in hospitals, she posits that the hospice lies somewhat between the hospital and the home.

Sarah McGann, The Production of Hospice Space: Conceptualising the Space of Caring and Dying (Dorchester: Ashgate Publishing Company, 2013).

Literature Review “The Name hospice, ‘a resting place for traveler or pilgrims,’ was chosen because this will be something

-Munley

intimacy with death heightens one’s potential for discovering the meaning of life.”

“The hospice approach creates a context where it is possible for one to live while dying. In such a context,

- Dame Cicely Saunders, Founder of Modern Hospice

able of the other and the beds without invisible parking meters beside them. “

between a hospital and a home, with the skills of the one and the hospitality, warmth, and the time avail-

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all families following a patient’s death] Grief counselling is begun before a patient’s death

The patient and the family are the unit of care Care is provided in the home and in inpatient facilities Symptom management is the focus of treatment Hospice treats the whole person Services are available 24 hours a day, 7 days a week Hospice care is interdisciplinary - team includes physicians, nurses, social workers and other mental health professionals, chaplains, therapists, and volunteers Hospice care is physician directed Volunteers are an integral part of hospice care Services are provided without regard to ability to pay Bereavement services are provided to families on the basis of need [ie bereavement support

These characteristics are a result of a directed approach towards assisting a person in preparing for death, by helping them to have the time and space needed to say their proper good-byes, allowing them also to bring proper closure to any conflicts that have been left unresolved, as well as for their personal matters.

7.

8.

9.

10. for

1.

2.

3.

4.

5.

6.

In Hospice: Practice, Pitfalls and Promise, Connor highlights some of the key concerns of Hospice care. In it he underlines 10 characteristics which have become an important part of a hospice:

Stephen R. Connor, Hospice: Practice, Pitfalls, and Promise (Washington: Taylor & Francis, 1998).

Literature Review

By expounding on the happenings of a hospice, he reveals the differences in environments between the sterile and impersonal environments of hospitals and nursing homes which often place greater emphasis on safety, and health instructions given by doctors, and fail to treat a person as a unique being with their own like and dislikes. Rather than following the doctor’s wishes to the tee, the hospice is fundamentally about placing the patient at the centre, with the doctor finding out what he can do to help ease the suffering of the person that has been placed under his care. Therefore, the focus is placed on helping the person to live out his last few months and days, as he wishes to, and being a support to him.

Through examples and analysing existing hospices, Connor illustrates the unique and tailored approach of palliative care to the various needs of the patient, highlighting how a person is treated holistically - helping them to live out their last periods with comfort through strategies to relief their pain, as well as caring for their psychosocial and spiritual needs, helping to make the grieving process a bit more comfortable for both the person and his family.

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-Other Overseas Centres

-Maggie’s North East by Cullinan Studio, NewCastle

-Maggie’s Centre Gartnavel by OMA, Glasgow

CASE STUDIES

A network of drop-in centres iwhich aim to help anyone who has been affected by cancer. They are not intended as a replacement for conventional cancer therapy, but as a caring environment that can provide support, information and practical advice

Founder: Charles Jencks, Inspired by Maggie Keswick Jencks

Maggie’s Cancer Caring Centres

"On every visit to recharge her chemo-drip we had to wait in this windowless box and avert our eyes from the other possi­ble victims on death row, sitting opposite, just six feet away. All one could do was hide behind a well-worn copy of Hello!, an­other version of penitential cheer and 'have a nice day"'

"So we sat on these two chairs in the windowless corridor trying to deal with this business, having two to three months to live."

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Architecture plays a crucial role in Maggie’s Centre’s palliative care approach. Believing strongly that the setting and environment is able to influence one’s thoughts. spirit and emotions. Maggie was an advocate for architectural buildings and spaces which deviated from the highly functional and hygienic models of care/ health centres. Her confidence, was not in that architecture could completely alter human behaviour. Rather. it was in the ability of buildings to distract. to uplift. and to give hope. Humanism was central. where each centre were free to concentrate on the individual as well as the society at large.

Guiding Philosophy

Case Study: Maggie’s Centre

- Charles Jencks

Self-transformation is at their heart.”

will to live or live better’.

‘Well how long have I got?’ Or, ‘Will I live?’ The aim of the centres is to transform such questions into ‘the

“When one is faced with this life-threatening disease the first question is often the one that Maggie asked:

301

A recurring theme occurs across most Maggie’s Centres. A term coined by Charles himself. ‘kitchenism’ results in spaces revolving around a central ‘kitchen’. Spatial planning is intentionally ambiguous, with surprising corners and overlapping spaces, amalgamating to a sense of togetherness. Just as this multi-space works to unify the tea, it is the coffee and tea that seeks to draw each person to each other. One is never alone in this ‘war of cancer’.

Kitchenism

Case Study: Maggie’s Centre

- Charles Jencks

and fundraising become less abstract. an integral part of the ‘war on cancer’.”

patients are brought through the same, multi-use space works to unify the tea. Such things as office work

more private spaces for consultation or the offices on the top floor. Again, the way all the staff. carers and

“One enters unobtrusively and turns into the kitchen for a snack and then continues, on a spiral route, to

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Adopting ‘kitchenism’ in spatial planning, each centre explores circulatory patterns. Across projects, hybrids are formed such as the pinwheel spiral model. Despite the differing forms for each building, an emphasis is also seen on landscaping and natural features that accompany the site.

Hybrid: Spatial Form, Circulation, Landscaping

Case Study: Maggie’s Centre

303

DESIGN As opposed to a series of isolated rooms, the building is designed as a sequence of interconnected L-shaped figures in plan that create clearly distinguished areas – an arrangement that minimises the need for corridors and hallways and allows the rooms to flow one to another. The plan has been organised for the spaces to feel casual, almost carefree, allowing one to feel at ease and at home; part of an empathetic community of people.

PURPOSE It aims to provide a first class level of evidence based emotional support and practical advice to people with cancer, their friends and family. People at any stage of their cancer journey will be able to access the professional and peer led support available at Maggie’s, to help them to build a life with, through and beyond cancer.

Maggie’s Gartnavel is a single-level building in the form of a ring of interlocking rooms surrounding an internal landscaped courtyard, which overlooks the hospital site and city from its position atop a hill on the Gartnavel Hospital site.

Maggie’s Centre Gartnavel by OMA, Glasgow

Case Study: Maggie’s Centre

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“The last thing you need as a cancer patient is to be aggressively confronted by architecture,” says Hollington, explaining that the firm wanted to make the building as “background” as possible. Its approach was thus pragmatic: the centre is disaggregated into its constituent rooms, each expressed as individual blocks, arranged in an interlocking circle around a planted courtyard, according to adjacencies of use. The more private spaces, including the three counselling rooms, are to the north, slightly submerged into the sloping site, while the public functions of kitchen, dining room and library lie to the south, open to both sides and flooded with light.

Nestled into a raised, sloping site to the west of the hospital, barely legible among the trees, this little cluster of glass boxes is quite a leap of scale. It looks out upon a jumbled NHS-scape of brutish structures, from the 1970s high-rise fortress of the main hospital, to the beige-clad expanse of the Beatson West of Scotland Cancer Centre, built in 2007 — the second largest such facility in the UK, serving a population of 2.8 million, and the reason for locating the new Maggie’s centre here.

Maggie’s Centre Gartnavel by OMA, Glasgow

Case Study: Maggie’s Centre

-Project Architect, Richard Hollington.

“We were trying to create the antidote to the NHS corridor: something light, open, full of views out.”

305

What only becomes apparent once we have passed inside, however, is the significance of the north-south axis that cuts across the L-shaped plan at precisely 45 degrees. The identically dimensioned wings mirror each other on either side of this line, the symmetry being further enforced by the presence of a doubleheight volume — a library that incorporates a stair leading to the roof terrace — at their meeting.

DESIGN The scheme’s dominant geometry accords with that governing the rest of the campus. It is composed as a pair of perpendicularly disposed wings, laid out on a rigorously maintained 12-foot-by-12-foot grid. These frame two sides of the courtyard, the others being closed by planted bunds.

This latest manifestation of the architect’s lifelong preoccupation with architecture’s relationship to climate has been designed to make optimum use of the sun on such occasions as it deigns to åpresents itself in Tyneside’s far from Californian skies.

AIM Maggie’s Newcastle provides social, emotional and practical support to people with cancer, their families and friends in a calm environment surrounded by nature.

Maggie’s North East by Cullinan Studio, NewCastle

Case Study: Maggie’s Centre

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Above the insulated concrete roof, a series of interlocked precast trays form the upper level perimeter.

The separate roof structure enables the continuous insulating wrapping of the envelope and provides an additional protective layer between roots and waterproofing membrane.

These two elements – earth retaining and earth containing – are designed as two separate structural systems. The base is formed from a 300mm thick reinforced concrete frame, with infill concrete walls cast flush with the frame and left internally with a smooth finish.

Maggie’s Newcastle was conceived as emerging from the ground – so the earth becomes part of the construction. The earth contains the ground floor of the building. The concrete frame and footings combine to resist the inward thrust of the battered banks and support the roof – which in turn provides a container for the earth from which the new garden grows.

CREATIVITY

Like all Maggie’s Centres, the kitchen table is its heart. Here people can gather over a cup of tea, chat to each other or seek advice from the professional staff always on hand.

It is here that people with cancer and their families come to find support and comfort. There is nothing institutional about Maggie’s. Materials such as timber and clay tiles are warm and tactile. Calm, light-filled internal spaces – some communal, some private – open out onto a sheltered, landscaped courtyard.

The much needed Maggie’s Newcastle opened in May 2013. It sits in the grounds of the Freeman Hospital, surrounded by trees and plants – copper beeches, cherry blossom, crocuses, wild flowers and herbs – that change with the seasons.

Maggie’s North East by Cullinan Studio, NewCastle

Case Study: Maggie’s Centre

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In summer, the high thermal mass reduces temperature swings, and windows open for night time cooling. The building is naturally ventilated and windows can be opened manually – so it is easy and simple for people to control their environment.

CLIMATE Sunlight absorbed by the roof is transformed into energy. The orientation of the building maximises winter heat from the low sun. This is soaked up into the heavy concrete mass and kept within the building by the thick insulation and the earth mounds surrounding the building. This reduces demand for heating, while maintaining a constant and comfortable level of heating throughout the day.

The building is arranged around an L-shaped plan. The two wings of accommodation meet at a doubleheight library. A staircase – doubling as bookshelves – leads up to a mezzanine level with access to the roof.

A roof garden – with a bowling green and fixed exercise equipment – is reached from within the building or by steps from the grassy bank. A clipped beech hedge provides privacy.

A new landscape, responding to the changing light, trees and plants of each season, has been created.

Maggie’s is surrounded by earth mounds that form a south-facing courtyard planted with wild flowers and herbs – which visitors can enjoy while feeling protected and enclosed.

CONTEXT In what was a non-descript hospital car park, there is now an elegant, intriguing building nestled into the natural environment.

Maggie’s North East by Cullinan Studio, NewCastle

Case Study: Maggie’s Centre

308 Community + Housing

ARCHITECT’S STATEMENT Geriatric centers should be optimistic places appealing to live in or to visit. The idea is to create a characteristic atmosphere in a vital space where spare time prevails and where residents spend the last years or months of their lives. The fact is that it is possible to build a geriatric center that does not look like a hospital, with neither corridors nor architectural barriers and on a single floor, in which all the rooms have direct access from (and towards) a garden that, as a sort of ‘lobby’, acts also as direct access towards (and from) the collective spaces. The aim is to ensure total accessibility, physical autonomy, psychical security and respect to individual privacy, facilitating access to visitors.

Case Study: Santa Rita Geriatric Center, Spain

309

INDOOR SPACE The centre is single story and attempts to distinguish itself from a hospital like environment by incorporating wide open spaces and interconnected zones. Residents can move fluidly throughout the space without being hindered by architectural barriers or narrow corridors.

In-Patient Bedroom Plan

OUTDOOR SPACE Central courtyard adjacent to the in-patient rooms allow patients to have views towards the greenery while allowing each room to have direct access to the outdoor.

Case Study: Santa Rita Geriatric Center, Spain

310

Community + Housing

The new building is positioned to maximise the views over the south-facing terraced gardens and yet discretely nestles into the contours of the landscape, minimising its visual impact. A hierarchy of spaces is organised into wings and two courtyards.

One courtyard forms a welcoming entrance space and the other a glazed-over space that incorporates specialized play and therapy areas. The two children’s bedroom wings are oriented south to maximise daylight and views, with each culminating in fully glazed spaces housing the library and hydrotherapy pool. The “ribbon roof”, which encloses and defines the foyer and day spaces, is a response to the plan geometry and the desire to maximise daylight, and also to create a unique identity for the build ing.

CONCEPT STATEMENT

Case Study: Scottish Children’s Hospice – Robin House, Scotland

311

The inteior embraces playful sophistication, combining rich materials with undulating forms and unexpected SECTION THROUGH THE ROBIN HOUSE daylighting efforts.

Skylight dominated the corridor, allowing natural daylighting into the interior (top) The lowest part of the splayed roof doubles as the hoist/chair for the hydrotheraphy pool (bottom)

Case Study: Scottish Children’s Hospice – Robin House, Scotland

312

Community + Housing

Singapore Hospice Facilities

- to coordinate/promote hospice care in Singapore - to provide/coordinate training in hospice care - to undertake such activities which are incidental or conducive to the attainment of the above objects including - to act as the representative body for hospice are in Singapore, nationally and internationally - to promote public awareness of hospices in Singapore

OBJECTIVES

It aims to meet all needs... (physical, emotional, psychosocial and spiritual) so as to alleviate suffering and maximise quality of life for patients and their loved ones.

The Singapore Hospice Council (SHC) serves as an umbrella body that incorporates all voluntary organisations that actively provide hospice and palliative care in Singapore.

About Singapore Hospice Council (SHC)

-Patch Adams

Our job is improving the quality of life, not just delaying death.

313

Bright Vision Hospital (BVH)

Singapore Cancer Society Hospice (SCS) HCA Hospice Care (HCA)

| In-Patient Hospice Care: Medical and Nursing Staffs Available Round the Clock | Day Care/ Day Hospice Centre: Operates only Normal Working Hours | Home Nursing and Medical Care: Home Visits + Staffs Covering Calls at Night and on Weekends/Public Holidays; Ready Anytime for Emergency

HOME NURSING AND MEDICAL CARE

DAY CARE/ DAY HOSPICE CENTRE

Assisi Hospice (AH)

Singapore Hospice Council (SHC)

IN - PATIENT HOSPICE CARE

Dover Park Hospice (DPH)

KEY HOSPICE/ PALLIATIVE CARE PROGRAM

St Joseph’s Home & Hospice (SJH)

Singapore Hospice Facilities

Agape Methodist Hospice

Metta Hospice Care (MHC)

314

Community + Housing

Two Wards (37 Beds) Single-Bedded Rooms : 19 Double/Four/Five-Bedded Rooms: 18 Overlook a Beautifully Landscaped Garden - Tranquil Environment.

+ IN-PATIENT HOSPICE CARE

24 HR Support Service (Team: Nurses, Doctors, Social Workers Etc.) Regular Home Visits + Provides Medical Advice/ Attention + Loan of Equipments

+ HOME NURSING AND MEDICAL CARE

Open-Concept Day Room Sits Amidst Luscious Landscape.

Recreational Activities (Music, Art&Craft, Hairdressing, Exercises, Therapies (Physiotherapy, Occupational Etc)

+ DAY CARE/ DAY HOSPICE CARE

Case Study: Assisi Hospice

Singapore Hospice Facilities

Day Care (Artist’s Impression)

In - Patient Ward (Artist’s Impression)

+ NEW ASSISI HOSPICE CARE (DEVELOPMENT)

PATIENT’S PROFILE 2014

Day Care / Day Hospice Centre

Home Nursing and Medical Care

In-Patient Hospice Care

315

Team: On Call round-the-clock, 7 days a week + Home Visits + 4 Satellite Centres Around Island A registered charity and the largest home hospice service provider in Singapore that cares and support patients with life-limiting illnesses and their families, regardless of religion, ethnicity, income level and nationality.

+ HOME NURSING AND MEDICAL CARE

HCA Day Hospice Centre + Kang Le Day Care Centre At the centres, patients interact with others and engage in constructive and therapeutic activities. Programmes are tailored according to the interests and abilities of each patient and include: Pottery, Painting, Music, Relaxation Theraphy and Outings.

+ DAY CARE/ DAY HOSPICE CARE

Case Study: HCA Hospice Care

Singapore Hospice Facilities

· StarPALS for Children · Psychosocial & Bereavement Support · Palliative Caregivers Programme · Youg Caregivers Programme

+ SPECIAL PROGRMMES

PATIENT’S PROFILE 2014

Day Care / Day Hospice Centre

Home Nursing and Medical Care

316

Community + Housing

Temporary relief for distressing physical or psychological symptoms and issues in the last phase of life when care at home is not possible.

Recognising the need for a higher level of sub-acute palliative care, DPH has as part of its philosophy of delivering patient-centric, holistic care for their patients, embarked on renewing its physical facilities and also concurrently developing relevant capabilities to support this higher level of palliative care. This initiative supported by MOH and the Tote Board have committed close to $1 million and allowed for the expansion of its inpatient capacity by 25%, upgrade of equipment and increase in the number of care staff with requisite knowledge and skills.

+ IN-PATIENT HOSPICE CARE

DPH has also started an integrated home palliative care service that ranges from nursing and medical care to caregiver education and psychosocial care. This is in line with the MOH’s home-centric approach to care, where patients are cared for in familiar environments and in the company of their loved ones.

+ HOME NURSING AND MEDICAL CARE

Case Study: Dover Park Hospice

Singapore Hospice Facilities

PATIENT’S PROFILE 2014

Home Nursing and Medical Care

In-Patient Hospice Care

317

Summary of Admissions & Referrals from 2008-2014

Source of Refferals 318

Community + Housing

319

Outcomes of Accepted Patients

Admitted Patients by Age Group

320 Community + Housing

Patients & Length of Stay

L: By Length of Stay / R: By Diagnosis

Patients

Patients by Diagnosis

321

Caregiver’s Aim & Task

Before & After Death

322 Community + Housing

323

Hospice Care: Daily Routine

Community & Housing Design Section, Semester 2, AY 2015-2016 Department of Architecture | School of Design and Environment