“Real functional architecture must be functional mainly from the human point of view”, claimed Alvar Aalto, the Finnish architect and designer, one of the most important figures in the architecture of the 20th century. He was one of the first architects to put patients first with his design of the Paimio Sanatorium, meant for tuberculosis patients. The structure was not the only thing that mattered; he also considered the colours, the furnishings, the materials and the lighting. However, it was just from the ‘70s that hospitals and healthcare spaces started to be seen as a potential cause of stress for their users due to the distressing noise, the disorienting routes and the impersonality of their inpatient rooms. In the following pages we will discuss examples of how healthcare spaces, tailored to the patient, can be built: from elderly homes encased in natural landscapes to the first village created for those suffering with Alzheimer’s, all the way to a new children’s Hospital in Parma that looks after the needs of its young patients.
Paimio Sanatorium, Finland
Built by Alvar Aalto between 1929 and 1933 for tuberculosis patients, the Paimio Sanatorium is located at the centre of a large area of morainic hills covered by thick woods, far from villages and farms. The idea of the design emerges clearly from the architect’s own words: “Protecting as much as possible and serving – through the means of art and building work – the little man, in this case even an unhappy and sick one”. It’s exactly for this reason that the fundamental unit the whole complex is modelled on is the patients’ room, with only two beds. Aalto designs it keeping in mind that the patient will rest lying down horizontally: the colour of the ceiling is chosen for quietness, the heating spreads from the ceiling to the footing of the bed, the airflow does not create currents of air and the water runs soundlessly from the taps. Alvar Aalto wrote, “The main purpose of the building is to function as a medical instrument. One of the basic prerequisites for healing is to provide complete peace: the walls are light and the ceilings are darker, and from the point of view of a patient lying down that creates a more peaceful atmosphere. The general lighting source of the room comes from a point above the patient’s head so that it is out of the patient’s field of vision, given he is lying down”. The lounges and the balconies are positioned in such a way as to always offer a different view and to let the patient choose between the shade and the sun. Alvar Aalto’s project did not stop at the definition of the external aspects of the building but also ventured to design all the furnishings, offering in this regard a lesson on how to improve the patients’ quality of life. One of the most iconic pieces of furniture is the Paimio armchair, the backrest of which was designed to aid the patient’s respiration.
Elderly home, Switzerland
“I like to imagine I am designing and building constructions which, when they have been completed, I shall leave, as the architect, ready to be inhabited, a structure that belongs to the world of things, capable of doing without my own personal rhetoric”. Peter Zumthor’s words clearly show his intent to create an architecture meant to satisfy – with essentiality and accuracy – the human needs. The elderly home in Coira, Switzerland, is a symbolic example. The building was constructed between 1989 and 1993, encased in an orchard, and comprises 21 apartments and a personal lounge for the staff, all connected by external corridors. As Zumthor stated, “We want the building to seem relaxed and informal, like a ‘big rock’ in the open expanses of a mountain landscape, expertly worked with precise, careful, perhaps even old-fashioned craftsmanship”. Since many residents grew up in the nearby mountain villages it was decided to utilize traditional materials: wooden floors that seem empty when you walk on them, wooden panels covering tuff walls and an integrated veranda protected from the wind. The organization of the apartments is very refined, even in the interiors. A sliding door between the lounge and the bedroom allows the conversion of the studio apartment into two separate bedrooms, depending on what’s needed and the time of the day.
Opened in December 2009, the first village for Alzheimer’s patients is called Hogewey and it is in Holland, fifteen minutes away from Amsterdam, among rural areas and navigable canals. It is a type of “nursing home” intended for those suffering with a severe form of Alzheimer, where 150 guests live in small groups, under the constant supervision of qualified health workers that play the role of shopkeepers, gardeners or normal citizens of the village. Each elderly has a spacious bedroom but also shares a kitchen lounge, a living room and an equipped laundry room with the other residents. Under every aspect Hogewey is an elderly home but it’s organised as a small town so that patients can lead an almost normal life and feel at home while they receive the appropriate care as well. The philosophy of the village is to encourage an active life and every day the staff organises a range of workshops – from gardening to painting – that the elderly residents can choose from. Additionally, everyone has the right to move freely within the village, where they can find a supermarket, a cinema, a theatre, a church, bars and restaurants, and even a beauty salon. The one checkpoint present is the reception that controls the only entrance to the village. The doors are also open to friends and family as well as the citizens of Weesp – the borough that the village is part of – in order to stop isolation and promote the integration with the community.
Children’s Hospital in Parma, Italy
When you enter the “Pietro Barilla” children’s Hospital in Parma one of the first things you will see is a giant plastic model with unstoppable running trains, chairlifts, mills and playgrounds. On the side, there is also a rainbow coloured child-sized welcome desk. It opened in 2013 thanks to the collaboration between the public and private sectors, that sought to coordinate the efficacy of medical practices with healthcare humanization concepts, so that the environment could have an active role in the care of the patients. Aside from the functional aspects, attention was also placed on aspects linked with the psychological perception of the space: the orientation, the lighting, the mobility, the relational trust, the reassurance, the privacy and the socialisation. The inpatient room is then considered an important space where the daily life of the paediatric patient takes place. The ambient inside the room is personalised through the mild and relaxing colours of the surfaces (floors, walls and ceilings) that define more private spaces around the child, recreating everything tailored to his or her size. However, that’s not all, because the magnetic walls allow drawings to be hanged easily; the windows touch the floor so the view from the small beds allows patients to see what’s happening outside and to look out without having to be picked up by an adult; the bathroom doors open in both directions with a simple rotation; there is no neon lighting and the lights can be regulated with a sun/moon effect; the televisions have six channels with animated cartoons. Finally, during the functional allocation of spaces particular attention was placed on the positioning of and the relationship between the bed and the relevant small couch, in order to favour the vicinity and continuous contact between the child and the parent, preserved even during visits or medical treatments.
A healthcare space has to be an open space. Interview with Gianluca Darvo, architect, University of Florence
The first step is listening. Interview with Sergio Beccarelli, architect, project manager of the new “Pietro Barilla” children’s Hospital in Parma