Healing Homes A Search for a Future Home that Fosters Wholistic Wellbeing

Healing Homes

The home of today is faced with concurrent problems like not being ageing friendly 1 2 3 4 5, associated with poor wellbeing 6 7 8, pollution 13, poor effects of the environment 9, poor accessibility and safety(fig1), and the design of our homes are a major contributing factor. For an elderly who spends about 72% or more of his time at home 11, with declining physical abilities and frailties, the negative impacts of the home are even more important. On the other hand, Europe’s population is ageing rapidly 12, and even though some solutions are underway, such as multigenerational co- housing, retirement facilities and care homes, they have already proven not to be enough in quantity to support an exponentially increasing ageing population 3 and some of these solutions present the idea of segregating the older population with purpose-built facilities which do not go hand in hand with the ageing in place concept. Another option is the pragmatic solutions for adapting existing homes which address mostly physical wellbeing like enlarging corridors to accommodate stretchers and wheelchairs, placing accessible handrails or adding ramps to accommodate the ageing which although imminent, does not present an outright solution. The role of architecture and design of our homes not only lies in what we design (the product) but also how we design it (the process) because in the end, it determines how we live, play, work, rest and ultimately our wellbeing. Perhaps, instead of designing different homes for different ages/abilities, we could design and plan to host everyone, in a way that combats issues like ageing, stress, isolation, solitude, pollution etc? As Emily Chmielewski and David Hoglund discuss in Healthy places and healing environments, when designing for ageing we should consider broader systems to embrace the concurrent challenges because ‘everything is connected to everything else’ 1.

So then how do we design our homes in a way that tackles the multi-faceted nature of challenges to be suitable for all inhabitants? What should the future home be like, and how can design help? The position taken in the development of the research is that we should design future homes centred on an all-round wellbeing ; one that is suitable for ageing in place and healthy living, so that it takes into consideration the suitability for everyone irrespective of health status and age , exactly what the research refers to as - A healing home. The focus is on merging all three aspects of wellbeing: physical, mental, and social instead on focusing on singular or dual aspects because designing for aspects has proven to be incomplete and retranslates into poor wellbeing overall. In searching for possible solutions, It poses these dire questions;

“How do we design buildings that foster holistic wellbeing?”

“How can these be replicated in the design of the future home?”

To answer these questions, the research evolves in making hypothesis to delve deeper into the issue, highlighting especially the translations of all three aspects of wellbeing in architecture – that is: How architecture design relates, represents, and tackles wellbeing on all three fronts: social, mental, and physical.

Hypothesis 1: The theory of Healing and therapeutic Architecture

Healing and therapeutic architecture is an integrated approach of designing that uses theoretical concept of evidence based design to evoke senses of cohesion of mind, body and spirit, promote physical , mental and social wellbeing and support the health of the planet 15 16 17 18 19 . Although the architecture itself does not heal, the design of these spaces creates ambiences that influences the behaviour of the occupant such that he is able to have an interrelationship with his built environment, nature and people. Whats more, they are sustainable and protect the environment as an added effect. It appears to be the very definition of what Terri Peters refers to as “super architecture” - one that offers positive benefits for both human wellbeing and his environment 20. However, they have a trend of being designed for the frail, the sick and the ‘unhealthy’. It is almost as though these designs are deliberately considered when health fails, just as Charles Jencks mentions in an interview,“... The lower down the scale you feel ... If you are deprived.. in a hospital...then the more architecture really matters” 21. Although the very connotation of the word ‘healing’ or ‘therapeutic’ coincides with the imagination of a healthcare facility or something of its sort, for designers and architects instead, it leaves in its wake the possibility of a building to be super: To be able to integrate all aspects of wellbeing: physical, mental and social and be sustainable at the same time. This kind of architecture in itself becomes evidence that indeed the built environment could aim higher to be better for all people - irrespective of health status, age or gender.

In light of these, the first hypothesis of the research is introduced; It is based on the theory of replicating the design characteristics and theories of healing and therapeutic architecture in the home design as a test for a future home that is resilient and suitable for everyone. (Fig 2)

Hypothesis 2: The wellbeing design process – A parametric index

At the onset of the research, an initial survey was carried out on twenty-five young architects from different geographical locations through phone interviews. When I inquired about designing for wellbeing, about 90% of the participants responded that to them such designs were considered when they did clinics, hospitals, laboratories etc, and when asked about the considerations made in the design phase of their residential projects it wasn’t uncommon to hear ‘direction of the wind, daylight, aesthetics, structure etc’. Although it was in no way an exhaustive response to represent all designers or architects, it was a point of reflection on my personal projects, both built and unbuilt. The question I asked myself was “what could have been different if from the onset in the design process, questions on wellbeing were reflected upon?”, and what will be the outcome of our home designs today if each architect during the design phase asked: “How does this design decision contribute to health and wellbeing” or “How should we design or modify with respect to wellbeing?”. The second hypothesis of the research was introduced through this reflection.

As an initial elaboration on the matter, I developed an index by dividing the project into the sub sections of design; interior design (micro scale), the architecture design(building scale) and the urban design (neighbourhood scale). The goal of this index is to deliberate on the best solution possible of the inhabitants wellbeing. The analysis is done in terms of vulnerability - how susceptible it is to hinder wellbeing, and potentiality - in what way design can be used to promote, avoid, prevent or reduce to a minimum poor health effects.

Methodology:

The main focus of the research is in two main parts; the reflective phase and the design phase. The reflective phase is based on the 2 hypotheses of the research and will both be used as guides in the design phase. The reflective phase entails the study of theories, design principles and characteristics of healing and therapeutic spaces which would be assembled, articulated, and analysed to give a framework to the second part- the design phase. The deduced results would be tested in possible test beds to make design proposals based on knowledge developed in the first phase. The second hypothesis of the research; the parametric index of designing for wellbeing would also be used in the design phase to deliberate on the design choices and decisions in the process.

Thus the research started with a careful examination of the ensemble of ideas, concepts and design characteristics from literature; books, articles and reports on the theme which have resulted in a typology of five healing and therapeutic architecture logics explaining how various researchers have approached the theme.(table 1) They are not absolute approaches by themselves due to the complexities, but many collide, co-habit or merge in their explanation of design characteristics of what constitutes a healing space. In exploring the interpretation of the framework, it guides the unpacking of case studies so that different methodologies of achieving the goal could be compared not focusing on one in particular, but to help frame the thinking process. This is done vis a vis a selection and redrawing of selected case studies of healing and therapeutic architecture by some pioneering architects.

Case studies

Even though the history of healing spaces can be traced to Epidaurus in Ancient Greece, Ancient Roman baths and Florence Nightingale’s influence in hospital design, the research turns to relatively recent cases from 20th -21st century. It analyses the design approaches and characteristics of how architects have designed healing architecture and how they presumably addressed holistic wellbeing while protecting the environment(Fig 3). Other case studies cited from literature as being ‘healing architecture’ are analysed to draw out the healing characteristics (table 2).

Research by Design : Possible testbeds

After deducing the results from the analytical and reflective phase, the research envisions a test on possible test beds; a new housing typology, an adaptive typology and a hybrid building. This is to be done in Italy which is the 2nd most ageing country in the world after Japan. Possible areas where the research could be located are cities like Salerno, Cagliari, Taranto or Siracusa which continue to shrink and have a very high old age dependency ratio.