Table of Contents

1. SYNOPSIS ........................................................................................................................................ 4

1.1 INTRODUCTION: ........................................................................................................................... 4

1.2 AIM: .............................................................................................................................................. 4

1.3 OBJECTIVE:.................................................................................................................................... 4

1.4 METHODOLOGY:........................................................................................................................... 5

1.5 SCOPE: .......................................................................................................................................... 5

1.6 What is Amelioration? .................................................................................................................. 5

1.7 What is Amelioration architecture: .............................................................................................. 6

1.7.1 Homely atmosphere or hermitage ........................................................................................ 6

1.7.2 Connection to nature; ........................................................................................................... 7

1.7.3 Social structure; ..................................................................................................................... 7

1.8 Historical background ................................................................................................................... 8

1.9 Present and future of amelioration architecture: ........................................................................ 9

1.10 The future user group :............................................................................................................. 10

1.10.1 PEOPLE AFFECTED BY CANCER : ........................................................................................ 10

2. ART: THE ANTIDOTE................................................................................................................. 11

2.1 ARCHITECTURE AS A HEALING ATMOSPHERE: ........................................................................... 12

2.2 ESTEEMED ENVIRONMENT ......................................................................................................... 12

2.3 ADDRESSING THE NORMALCY: ................................................................................................... 14

2.4 FREE AND OPEN ATMOSPHERE : ................................................................................................ 15

2.5 DIRECTLY ACCESSIBLE GREEN: .................................................................................................... 16

2.6 Social relation influence on cancer: .......................................................................................... 16

3. SPACE FOR SOCIAL SUPPORT: ............................................................................................. 17

3.1 INTRODUCTION : ........................................................................................................................ 17

3.2 PATIENTS TO PATIENTS: ............................................................................................................. 18

3.3 PATIENTS AND THEIR FAMILIES: ................................................................................................. 18

3.4 SOCIAL SUPPORT IN FUTURE ONCOLOGY WARD: ...................................................................... 18

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 3.5 PSYCOSOCIALLY SUPPORYIVE DESIGN: ....................................................................................... 18

3.6 THE PUBLIC SPACE ELEMENTS: ................................................................................................... 18

3.6.1 HOW TO ENHANCE SOCIAL ATTRACTION: ........................................................................... 18

3.6.2 PUBLIC SPHERE ENVELOPES THE PERSONAL SPHERE: ......................................................... 18

3.6.3 Call for social contact: .......................................................................................................... 19

3.6.4 ACTIVIES IN THE PUBLIC ZONES: .......................................................................................... 21

3.7 Dayight and Healthl..................................................................................................................... 22

3.8 Detail designing:.......................................................................................................................... 23

4. ELEMENTS OF HEALING:......................................................................................................... 26

4.1 COLOUR:...................................................................................................................................... 26

4.2 LANDSCAPE: ................................................................................................................................ 30

4.3 HEALING GARDEN: ...................................................................................................................... 32

4.4 THERME VALS:............................................................................................................................. 33

4.5 MATERIALS .................................................................................................................................. 33

5. THE LITERATURE STUDIES: ................................................................................................... 34

5.1 CASE 1: LUND UNIVERSITY HOSPITAL: ........................................................................................ 36

5.2.1 KAVA- SURGICAL EMERGENCY DEPARTMENT: .................................................................... 36

5.1.2 FUNCTIONS: ......................................................................................................................... 37

5.1.3 .MATERIALS AND TEXTURES: ............................................................................................... 37

5.1.4 CONCLUSIVE REMARKS: ....................................................................................................... 38

5.2 CASE -2 Shri . Siddhivinayak Ganapati Cancer Hospital ............................................................. 39

5.3 THE HOMELY ATMOSPHERE :...................................................................................................... 40

5.3.1 HOW TO DEVELOP SOCIAL INTERACTION: ........................................................................... 40

5.3.2 Feeling at home: .................................................................................................................. 40

5.3.4 Summary: ............................................................................................................................. 43

6. CONCLUSION ............................................................................................................................... 44

8. BIBLIOGRAPHY ........................................................................................................................... 46

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3
AMELIORATION IN ARCHITECTURE

1. SYNOPSIS
1.1 INTRODUCTION:
The overall aim of this research is to study the life enhancing design in hospital
architecture which increases the healing property of a building through architecture and
planning guidelines .The goal of such healing spaces are they can reduce fear ,stress
,tension and give relief for some time which actually results in healing of the patient. The
study has also been carried out to acknowledge the critical experience of patient ,staff and
visitors in hospital buildings.
For detached spectators it seems obvious that ,when building and planning hospitals ,the
architectural environment surrounding patients ,families and staff, should support the
medical treatment in friendly welcoming and accommodating environments .However,
the majorities of our current hospitals are built on another foundation, and are often
considered the direct cause to stress, anxiety, frustration and generally longer
hospitalization due to the unsuited facilities and environments in today” s health care
system.
1.2 AIM:
Aim is to analysis the existing healing environment systems of techniques and to
create a design guidelines for healthcare architecture.
1.3 OBJECTIVE:
The aim of this research paper is to obtain an in-depth understanding of the physical
aspects in hospital design and how these physical aspects play important roles in creating
a healing environment .
 To acknowledge the critical experience of patients, staff and visitors in hospital
buildings,
 Importance of daylight in hospital architecture,
 To outline the physical aspects in healing environment,
 To investigate the previous and current research available on the subject of health
and environment, design for healing and the effect of daylighting on human
beings,

4
  To examine the elements of physical aspects of existing project brief of public
hospitals,
 To study the need for social support during hospitalization,
 To promote social interactions and support,
 To promote homely atmosphere,
 Study the connection of building and nature.
1.4 METHODOLOGY:
An extraction and assembly of the body of knowledge and on-going research of healing
environment in hospital design is apprehended in this paper .It is intended to identify
potential research areas on the physical aspects of healing environment in future hospital
design .Methodology employed in this research in literature review ,which is followed up
by some architectural functional and planning design ideas. The key findings will focus
on the physical and social aspects affecting the hospital environment which are the most
pronounced influential physical factors affecting bedridden patients.
1.5 SCOPE:
To make the physiologically focus into the life even after knowing their death of life
span.
1.6 What is Amelioration?
Amelioration is the process of re-establishing harmony within the organism, Illness
implies a loss of this balance and the need for reintegration with the bodys natural ability
to heal and regenerate. Amelioration cannot be understood in isolation from the factors
that operate in the dynamic life of an individual. These include the self, the family, the
community, the environmental context within which life is carried forth, and the world of
spirit or essence. Healing is dependent on restablishing successful relationships and
developing reciprocity between these factors. In fact, healing is not a process of curing or
fixing, but rather a return to balance between all these components. Health therefore, is
understood as the presence of this balance ;illness is its lack far from being inert
containers, spaces can be understood to be fully participant in the amelioration
experience. It is possible to conceive and create structures that heal. Although materials ,
structure , and equipment are part of this endeavour , equal footing can be granted to the
land, the natural world, the community , our ancestors, and the spirit in all of this.

5
1.7 What is Amelioration architecture:
Modern hospital + hermitage=future hospital
Hermitage-1. Homely atmosphere
2. Connection to nature
3. Social structure institution
4, daylight factor

As introduction, the project will describe and define some of those terms used
when considering health care architecture , and according to the planning of future
hospitals , the concept healing architecture is introduced. For detached spectators it seems
obvious that , when building and planning hospitals, the architectural environment
surrounding patients, families and staff, should support the medical treatment in friendly
welcoming and accommodating environments. However, the majorities of our current
hospitals are built on another foundation, and are often considered the direct cause to
stress, anxiety , frustration and generally longer hospitalization due to unsuited facilities
and environments in today’s health care system. As a response to the current state of
modern hospitals and as a weighty tool in the discussion of our future health care settings,
the term healing architecture has gain ground. It is best described as a design concept ,
which represents the vision of encouraged human well-being and healing influenced by
well designed architectural surroundings.
Thus we have explained an equation on that says the importance of architecture in
hospitalization which reduces the healing period through its various examples given
below;

1.7.1 Homely atmosphere or hermitage

 Authentic healing modalities
 Individual process
 Spiritual guidance
 Hermitage club spa – anti stress
 Hermitage workshops
 Yoga centre
 Meditations centre in nature
 Architecture of hermitage should be in relation to natural built environment.

6
1.7.2 Connection to nature;
 Nature window views
 Garden accessible to patients
 Nature art : no abstract at
 Daylight factor
 Internal courtyard connected to ward , patient room
 Quiet in the ccu (coronary care unit )
 Music during minor surgery
 Air quality
 Landscaped courtyard
 Floor to ceiling windows
 Therapeutic benefits
 Landscape setback
 Front porch –(overhang may scale down the size of the building)
 Entry garden
 Plaza (include trees, shrubs, overall is not of green image, but of a paved urban
plaza).
 Roof terrace (potentials for expansive views).
 Viewing/ walk in garden
 Sound of water and attraction of birds to the fountain are particularly appreciated (
roof garden).
 Roof garden for mood change
 Wide walkways outside patient rooms provide a buffer from garden activities.
 A covered ratio style coffee shop provide and shelter for an outdoor eating area
within a garden.

1.7.3 Social structure;

 Green lawn for social improvement in structure.
 Imaginative maze for children.
 Covered sitting terrace or patio within a nature surrounding.
 Single occupancy vs multi occupancy patient room study.

7
  Elements in the social dayroom.

1.8 Historical background

 In the 17th and 18th centuries, the dual emergence of scientific medicine and
romantic-cism gortuitously combined to encourage the re-emergence of usable
outdoor spaces in hospitals. The intention behind the concept oh healing
architecture seems immediately obvious and straightforward, and it seems rather
strange that not all hospitals are based on these concepts of integrating the
architectural environment as support for the medical treatment.
 However, the idea of a beneficial effect on patients healing process sup- ported by
well designed surroundings is not a new concept. In fact, these ideas may be
traced back to thoughts and ideas evolved in the 18th century.
 At that time , leading doctors and nurses proposed changes in the layout and
design of hospitals in order to reduce the danger of contamination by designing
smaller wards and increasing ventilation, later these theories are followed by
Florence nightingale, who in notes on hospital from 1859 published her
philosophies and thoughts of the supporting effect of aesthetic environmental
settings for the patients physical and psychological condition .

8
  In Denmark , the first public hospital is planned by request of king Frederik v in
1752. At that time , the medical knowledge was underdeveloped and the
experience of building health care settings were naturally lacking.
 In the 17th and 18th centuries , the dual emergence of scientific medicine and
romanticism fortuitously combined to encourage the re-emergence of usable
outdoor spaces in hospitals. The notion that infections were spread by noxious
vapours spawned design that paid special attention to hygiene, fresh air, and cross-
ventilation .
 The so-called pavilion hospital became the predominant form throughout the 19th
century. Two and three story buildings linked by a continuous colonnade and
ventilated with large windows marked the design of the influential royal naval
hospital at ply-mouth, England ,Recommendations for hospital garden de-sign
written by german horticultural the findings of researchers such as roger unrich at
Texas A and M university, who documented in one study the healing benefits of a
view onto vegetations for patients recovering from surgery.
1.9 Present and future of amelioration architecture:
 The idea behind the concept 0f healing architecture is not a new concept but is
rather a earlier exploration in more advanced techniques that the surrounding
environment, daylight, nature , views and access,.. etc. had a healing effect on
patients. in todays planning at new modern h05pitals has shifted to patient
centered care and the welI - being of the patients and their families, attempting to
balance the building codes , functionality and aesthetic considerations.
 Today we are building upon this rational thinking , however with a broadened
mind. evidence and science is no longer limited to medicine , they are also related
to interior and architecture at hospitals.
 Developed as an extension at evidence-based medicine, research within the field
0! architecture and its effect on patient outcomes is still gaining ground,
documenting the benefits of patents hospitalized in well-designed environmental
settings (Ulrich et al 2008 and Hamilton 2003). today most 0! the hospitals are
build on EBD method for increasing the healing power in our future hospitals.
 Through EBD, various proofs ins been found, tint the sensory perception patients
meet during hospitalization have an impact on their experienced level of stress and

9
 it high, this well reduce the immune system causing higher level 0! infection
disease and delayed wound healing.
 This way, undue noise, interrupted sleep, lack of daylight and generally
dissatisfying environments, will 3! be factors that affect the level of stress
negatively .
1.10 The future user group :
1.10.1 PEOPLE AFFECTED BY CANCER :
 When any patient is diagnosed with cancer, a range of arrangements and
precaution are made, usually the treatment is done immediately after being
diagnosed.
 These treatments are often performed while at home or hospitalized in the relevant
surgical ward.
 suffering severe symptoms then it Is shifted to oncology ward tor treatment.
 The patients in our future hospitals are described as being more sick and weak
than today's patients due to enhancement of ambulant treatments and a general
more effective procedure, resulting in faster discharges.
 According to the extrapolation of the expert panel, patents in future oncology
wards, wilI this way only be hospitalized in 23 days in average typical though
their most critical period of illness. with this elaboration of future patients, and the
relative short period of hospitalization , it may be argued, that the patient
experience in hospital is not much of importance as compared to medicinal
approach .
 As such a logical conclusion that on the other hand would be a direct continuation
of mistaken arrangements of previous hospitals from 1960‘s , With layout and
design not according to human scale, finally resulting in long duration of
hospitalization and hospital environment without sensory elements,
 I believe that this is the time to stop courting patients as number treat them as
humans and patients, like everyone else , having social attraction and basic need
for encouraging social interaction. otherwise, we will simply build the same
hospitals again and again
 The fight against the cancer is not solely doing research in medicinal treatments ,
but it is required that What career does to a human being , its physical am
psychological conditions. Especially through several course of disease it is

10
 essential to have social interaction With their close ness to feel safe and comfort in
hospital environment.

2. ART: THE ANTIDOTE

Art has always been a part of our culture, tradition and society. The human race has
evolved with some form of art within cultural practices since our early beginnings and it
seems inherent in all of us whether it is through praising of the gods, healing or rites of
passage. Yet, as evident as this may be, many disregard the healing qualities that art
possesses and the enhancement of lateral creativity that it can bring to us. To look at art as
a tool for healing we have to transcend thresholds that rigidly bind us to the confinements
of our rational consciousness. We need to understand art beyond the traditional technical
approach of artist and canvas. We need to free the boundaries from the terrestrial rules of
art and explore the therapeutic qualities that it can enhance in all of us.

VISUAL ART AS HEALING MEDIUM MEDITATION AS HEALING MEDIUM

The arts, whether in the performing arts, painting, sculpting, cooking or gardening are a
form of meditation where the creator is in tune with his/her centre. In this sense, art is a
spirit that one unconsciously experiences with a sense of a healing.
For me, art is the creation of what the soul is crying out to express. It is the harmony that
tunes the soul with what is tangible. If we are all architects of our reality, then art is an
expression of how we see ourselves within ourselves in relation to the world around us.
This means that artistic expression is personal and it is a journey of self-discovery -much
like healing. “...If Illness and health are nouns, then healing is a verb. It is movement in a

11
 desired direction- a journey that takes you from illness to health. By this interpretation,
therefore, healing is an action: a decision one makes in search of better well-being.

2.1 ARCHITECTURE AS A HEALING ATMOSPHERE:

 With this in mind, I would like to explore architecture to see how art can be used
as a tool for healing.
 Architecture takes a holographic approach by looking at the effectiveness of art to
promote healing. It is a therapeutic experience aimed at connecting with the inner-
self to bring about change in a person’s lived experience.
 The question that needs to be asked is that, if art does have a healing effect how
can architecture as an artistic science contribute to this? Can our environments
heal or can it make us sick? I would like to explore the architecture which can be
used as a tool for healing.
 Healing in psychology, medicine and even nature involves a process where the
patient or the recipient receives a physically external antidote in order to help
them heal.
 It is then up to the patient to take the inward step of acceptance and observation in
order to progress the
healing.
2.2ESTEEMED
ENVIRONMENT
Frequently, a mentally
ill person has a feeling
ofelimination combined
with a negative self-
image. The patient’s
self-esteem can be
boosted by offering
them dignified
environment with
Explain the balance between environmental and other criteria.
premises signalling:
“OK, so you’re ill and
may not always be on your best behaviour, but help and sympathy are forthcoming from

12
those of us who, for the moment at least, are better off..” Care must be made evident in
details both large and small when designing the premises. It is occasionally argued that
many sick persons come from squalid backgrounds should not be offered anything that
seems exaggeratedly posh, something which, not being significant of the patients’
everyday surroundings, may feel strange and uncomfortable. But shabby surroundings are
probably not freely chosen but are the consequences of a generally disadvantaged
situation. Stefan Lundin’s ideologies are more inclined to believe that it is connected with
the actual care situation, with being looked after and having people around one for
company, people who cater to one’s need of security. Arguments are also presented for
psychiatry buildings being solidly and robustly constructed – hard to wreck and easy to
maintain.
If the environment looks to have been designed for the prevention of damage and
vandalism, then,paradoxically enough, it seems to encourage or indeed provoke inventive
modes of destruction. We human beings behave mostly as others around us expect us to.
This also applies to people who are mentally ill. If the smoking room has pressed-brick
flooring, people will stub out their cigarettes on it. If the room has linoleum flooring,
smokers will use the ash tray. But what impression is the environment to make –
homelike, cosy? Probably professional in the treatment situation and more cosy for caring
and residence, but it can be hard to pin down the qualities making one environment
homelike or cosy. Most often, though, a harmony of perception is not hard to find. We
have also discovered that it is possible, and fruitful, to use character concepts of this kind
in the dialogue between operation and architect.
Maintained the balance between the materials and the environment to emphasise the
relationship with the nature, while de-emphasizing the sense of sight in favour of the
other senses. This way of balancing environment and material to revitalize mental illness
is defined as dignified environment.
• a dignified environment
• carefully designed spaces and attention to details
• people behavioural pattern
• cosy accommodation
• Watch out for day-to-day dilapidation

13
2.3 ADDRESSING THE NORMALCY:
Normalcy should be the main objective if the architecture is aimed for healing. This
attempt should permeate the whole of the design process, from overarching zoning to the
tiniest detail. The normal is what is recognisable and familiar. It is the normal – the
healthy – side of the patients which has to be encouraged and supported. The skills people
have lost or have never had must be developed so that the patient will not relapse into
apathy.
Certain patients have a low functional level and inadequate social skills. This being so, it
is essential to create routines for such everyday occupations as personal hygiene, laundry,
cleaning and cooking and to provide a functional, pleasant solution for them. It seemed
especially important to highlight the sensual qualities and social atmosphere of
mealtimes. For this reason too, staff and patients should eat together – a sometimes
disputed tenet. Maintenance of these everyday routines is most important to persons who
will be staying for a long time and who have got over the most acute stages of illness but,
for some reason, are still
being detained. If
institutionalisation is what
we seek to avoid, then
normalcy is what we have to
look for.
But what exactly is
normalcy? The term can be
framed in a variety of ways.
What we normally mean by
normal is, I suppose,
normally interpreted quite
broadly. Stefan Lundin
characterize normalcy as,
“Often we perceive a wide
span of behaviours or
attitudes as normal. Perhaps
the word “normal” can also

14
express what a psychiatric environment is not to be. It must not be a hospital, a prison or
an institution – to quote the imagery often employed with reference to psychiatric care.9
Pursuing the distinctive atmosphere of the hospital or penitentiary does not feel natural.
But where the hospital is concerned, surely what we want to avoid is not the care situation
itself but its frequently bare and none too cosy physical setting? The concept of nursing
includes the feeling of care and security, which is intrinsically positive if it refers to a
brief period during which one is in need of support. Correspondingly positive associations
are harder to find in the concept of criminal welfare , even though the requirement of
social protection is a valid one. Finally, the term “institution” seems to have various
connotations, not all of them pejorative. Some maintain that the expression conveyed by
the building must in fact be that of the institution – society’s expression of its exercise of
authority.
2.4 FREE AND OPEN ATMOSPHERE :
One of the very foremost challenges the architect has to face is that of “creating a free and
open atmosphere” – which again is a proposal to achieve something which will feel
normal. In some cases the desiderata presented by psychiatry are downright self-
contradictory. The desire for a care unit which will experienced as open is coupled with
the need for a care unit which will be closed and locked. The desire to give the patient an
identity of his / her own and the ability to choose, for example, between seclusion and
sociability, is coupled with the staff’s need to know the patient’s position. Mental care
has elements of coercion – unavoidably so. The patients often spend time in a locked care
unit and temporary coercive measures occur in the form of isolation, medication and
shackle restraint. The safety of society – that is, the safety of citizens – requires certain
patients to be kept under lock and key and escapes to be prevented, because certain
patients can turn violent. Other patients, like the staff, also demand protection from
patients with acting-out behaviour within the care unit itself, added to which, patients
need in certain cases to be protected from their own self-destructive behaviour, the
ultimate consequence of which is attempted suicide. The smuggling in of drugs is another
major problem. Nearly half of all psychiatric patients have a dual diagnosis, i.e. a
substance abuse problem on top of their mental illness.
All the things that have now been listed are realities which cannot be overlooked.
Psychiatric work involves a constant intersection of the care and security perspectives.
The issues which the department has to take a stand on are very complex and complicated
and are a perpetual source of discussion and disagreement, but they occupy a central and

15
quite crucial position in discussions concerning the design of the facilities. If the security
perspective has the last word in everything, we risk ending up with a “prison
environment”, with all the negative associations and provocations this implies. In their
physical form, should be concealed or anonymously designed.
2.5 DIRECTLY ACCESSIBLE GREEN:
Nature has a rehabilitating effect on all of us, included the people with mental illness.
This insight appears to have grown of late, among other things because rehabilitation in a
natural setting has proved highly successful in connection with fatigue depressions. Being
outdoors endows a confined person with many positive benefits. They can go off by
themselves, get away from other patients and achieve the seclusion they want. A patio
also multiplies opportunities of movement. The uneasy “wanderer” can move more freely
so as to experience greater personal liberty and so as to cause less irritation to others by
his / her constant to-and fro. The possibility of moving about, feeling space and breathing
one’s fill of fresh air or having a smoke alleviates the sense of confinement and increases
the possibility of physical activity. The changes of the hours and seasons grow more
palpable.

2.6 Social relation influence on cancer:

Health, and persons in a partnership have this way a generally better health tian singles.
This may result from the positive influence by our close relationships, or may in some
cases directly related to the social and emotional support The human is generally a social
creature, and on relationship with other people our social relations is a central aspect of
on He. The amount of social support that cancer patients is experiencing, and especially
the possibilities to discuss ones disease and treatment with other cancer patients, is
considered very helping in the stressful periods of the disease.
The diagnose of cancer generally cause depression , stress , tension , anxiety among the
cancer patient and their families. the risk of developing a profound depression is
increased due to isolated social spaces and lack of control over the situation. the patients
are experiencing upturn process of adaption in order to accept and understand the disease,
changed prospect, various treatment., etc. at that point oi time social support is much
more oi need to conquer depression and stress.

16
3. SPACE FOR SOCIAL SUPPORT:
3.1 INTRODUCTION :
In chapter two 0f this research. hospitalized patient requirement for social interaction and
social support has been identified. Day by day patients general level of stress and fear
increased not only due to changing pattern in disease. Also struggles to perform normal
activities like low level of visits from family and friends may occur a factor of fear. the
future planned single bedroom hospitals is further more increasing the rate of fear and
stress. loneliness and the need social support in hospitalized is playing a crucical role in
future. spaces for social support interlinked with hospitalized patients is much more
important which will enable knowledge sharing and diverts inspiration among the
patients.
social support in future hospitals is encouraged though social interaction that may vary in
different levels and variations. The social interaction can be done through informal
meeting which we experienced in our daily lives such as, we experienced in train, mall,
parks, gym, city square, etc... and complete social relationships like we experienced in
our homes in safe and physically well being surroundings. Through these measures social
interaction will increase and knowledge and sharing and inspiration with patient of equal
status of potentially responsive. The physical surrounding have potential to have ideal
settings where common areas are constructing both initial contact and developed social
relationships. In this contrary the social space may seen as interaction between a public
space and homely environment. Usually our everyday activities are performed with our
family and friends, while in the hospital these simple familiar activities suddenly are
occurring with unknown people in a semi-public space.
If we improved the social spaces then the healing power will also get increased and may
even considered as an influencial elements in regard to healing in architecture .There are
however, not found any specific EBD research that define detailed aspects in regards to
design and physical planning of the spaces.

17
3.2 PATIENTS TO PATIENTS:
 Cancer is a very difficult disease to handle and it is very much important to
have social support during these situations for comfort and support.
 These is done for the patients to give them hope and belief.
 The solidarity with other patients may range from intense conversation and
social support to inspiration of other patient activities and actions.
 That’s why patients don’t feel left alone with their disease.
3.3 PATIENTS AND THEIR FAMILIES:
 A serious disease cancer not only affect the patients but slowly the entire
family.
 As it is important that families facing same situation gets socially
interacted with each other at equal status.
 Depression, confusion, anger, sadness and other negative feelings and
emotions are often unavoidable consequences for the relatives to a cancer
patient.
3.4 SOCIAL SUPPORT IN FUTURE ONCOLOGY WARD:
 The social support is very much of importance in treatment of cancer in
order to satisfy their mental condition.
 The main focus in designing phase there will be patients themselves and
need of their families will be taken into consideration.
3.5 PSYCOSOCIALLY SUPPORYIVE DESIGN:
The quality and character of the design environment should be considered to be a
powerful instrument capable of improving strengthening health processes.

3.6 THE PUBLIC SPACE ELEMENTS:

3.6.1 HOW TO ENHANCE SOCIAL ATTRACTION:
3.6.2 PUBLIC SPHERE ENVELOPES THE PERSONAL SPHERE:

In this chapter will introduce some of the general theories regarding social interaction and
human behaviour in the public space that architects and designers has used until now
when planning and designing urban Spaces. Giving the possible privacy with some social

18
spaces are necessary and are stated as basic qualification of rapid recovery. But constant
withdrawal and always keeping oneself to oneself so as to be spared social contacts and
confrontations is often one of the symptoms of mental illness, and so care is concerned
with developing the patient's social capacity The social element also has to be gradually
stepped up, but of course depending on individual situations. The design of the physical
environment, accordingly, must support the individual patient's gradual expansion of his
/her personal sphere. from patients own bed to open door to green or entering to another
patient room and sitting down to such social well being corner to talk. Moving out to the
social green area, sit on a bench near green plants having a cup of coffee. Meeting a
relative in cafe. Going on a tour of hospital visit. All these activities get used to patient
daily lives which never make them felt that they are hospitalized or progressively
widening the social context.
There we should shape the rooms, or shape rooms within the room, make small niches or
seating areas of varied character where people
can "take a pew. 14Normally speaking .mentally
ill persons have a larger bubble of personal
territory. But the places created must still make
people feel encompassed and secure In pune
"Mukthangan De-addiction centre " observed that
patient rooms are placed near the amphitheatre
space near the natural elements like trees,
sunlight and gentle wind to heal their agitation. The language of making public activity
inside the private spaces are done also in mukthangan rehabilitation centre with the help
of well lit amphitheatre space in the centre enclosed by rough wall to give those agitated
people a sense of35 protection. social participation and elective seclusion successive expansion
of the personal sphere parts with different degrees of seclusion and publicity Mukthangan De-
addiction centre, Pune by secure and intimate seating areas Sirish Beri, Amphitheatre Space on
the fringes of the public zone.

3.6.3 Call for social contact:

Now I will discuss writings by architect and professor Jan Gehl and anthropologist
Edward T. Hall, in their theories described in Livet Mellem Husene (Gehl 2003), Byer for
Mennesker, and The Hidden Dimension , respectively .The call for social contact between

19
individuals is a concept that covers many different variations, from simple unpretentious
contacts to more complex and emotional conversations and intercourse. Jan Gehl defines
in Livet mellem Husene, the various contacts by their intensity, where close relationships
have great intensity ,and the passive and casual meetings have low intensity. From this
figure , the public space primarily represents the casual and passive kind of contacts,
which compared to the more intense contacts are considered modest. However, they still
possess great quality and worthiness, as autonomous contact, or as the basis for more
developed kinds of contact For instance, as maintenance of existing relationships, and
especially as inspiration of acts and activities, that other people are performing. If this
basic social contact is not obtainable, the boundaries between isolation and social contact
are too pronounced, and
you are ether alone or in binding others. The social contact on the low intensity scale is
therefore an evident and important possibility for persons to interact with others on a
casual level, and perform as transition between various kinds of contact . The
establishment of such common attractive and inviting social spaces are very much
required for day meeting to interact socially patient with equal status for social support
which enhances their knowledge about such situation.

20
3.6.4 ACTIVIES IN THE PUBLIC ZONES:
 In regards to activities in the public space, define the types; essential activities,
optional activities and social activities-all with different demands to the physical
environments.
 The essential activities which are regardless of the physical planning of social
environment, they are not in contact to such areas , this may be the medical
treatment.
 The optional activities are generally those activities which are done when they are
desired and these activities are only seen if the physical environment are in proper
condition in respect to this optional activities are common facilities, relaxing
walk, informal conversations etc. however, if the public or the social space is not
in proper condition then only essential activities will be there. The optional
activities are generally those activities which are done when they are desired and
these activities are only seen if the physical environment are in proper condition in
respect to this optional activities are common facilities, relaxing walk, informal
conversations etc. however, if the public or the social space is not in proper
c
o
n
d
i
t
i
o
n

t
h
e

21
 n only essential activities will be there.

ACTIVITIES IN THE PUBLIC SPACE IS DEPENDING ON THE QUALITY OF THE

PHYSICAL

3.7 Dayight and Healthl

Hosking and Haggard (1999) noted that creating a healing environment is not like
building up a garage workshop, where cars are sent for repairs before continuing their
journey. It is an imperative for a hospital environment however, where ‘repair’ of the body
(i.e. healing) is the concern, to have the optimum level of comfort and care physically,
socially and symbolically. For this the luminous environment plays an importantrole and
an integral part of the hospital’s healing environment. As a matter of the fact, natural
daylight is often regarded as part of the healthy environment. Therefore, daylight is
required in most areas in hospital buildings and is one of the crucial physical aspects to
be considered in the healing environment. In the hospital wards indoor environment,
appropriate window design would allow the potential benefit of daylightto be experienced
by patients and staff. Their physical attributes are intertwined in the healing
environmentof hospital wards .Numerous studies have indicated that daylight has
significant effects on the well being of humans bothphysically and psychologically. In
fact, it has been recognised for many years that light has a significant effect on our
circadian rhythm (i.e. biological cycles that repeat 24 hours). Campbell et al. imply that
light is the most important environmental input in controlling bodily function after food (La
Grace, 2004).Similarly, CABE (2004) clearly indicate that access to natural light is one of the crucial
factors affecting patients’ recovery. The presence of visible light in an indoor environment
does influence the physiological responses, mood as well as visual needs (Schweitzer et al.,
2004). Most psychiatrists generally agree that seasonal affective disorder (SAD) with symptoms
of depression; fatigue and irritability may be triggered by shorter hours of exposure to daylight
due to the seasonal change .Research evidence by means of observations and qualitative analyses has
found that lighting strategies in a controlled environment have a positive impact on managing
behavioural disturbances of the Alzheimer’s type . In this aspect, most physician
stogether with other studies are in agreement in their findings that appropriate balance of
daylight and artificial light may positively affect for Alzheimer’s patients . Therefore,
related issues with regard to good lighting design in the hospital wards

22
3.7 Sociofugal and sociopetal spaces:
The physical environment often performs a very specific character in regards to social
interaction also concerned anthropologist Edward T. Hall . h the writing "The Hidden
Dimension", he refers to a research study performed by doctor Humphry Osmond, who
ascertained that some types of spaces, for instance waiting rooms in train stations had the
ability to keep people apart, while French cafes did the opposite and made people engage
interaction. He defined the arrangements that discouraged social interaction as sociofugal
spaces and the spaces that encourages and enforces the development of interpersonal
relationships as sociopetal. Meanwhile Osmond had observed in his psychiatric ward
apparently patient wee talking less to each other after such change in arrangement of
furniture in such a sociopetal arrangement, the social interaction increases in that same
ward. When designing future hospitals we should keep in mind the statement of Edward
T.Hall and change can be made through such small arrangements which can change
sociofugal spaces to sociopetal spaces. Layout of furniture plays a very crucial role in
enhancing the social interaction suppose if the chairs are placed back to back then the
place automatically turned into sociofugal spaces. however, if the layout of the chairs are
immediately changed they are face to face then the place changes to sociopetal spaces In
some occasions the sociofugal setting would be preferable, for instance when studying or
reading, and what is considered sociofugal in one context might even be sociopetal in
another situation depending on the occurring activity and the people involved. The
challenge for the architect is consequently to design spaces with accordance between the
physical space and intended function and to maintain diversity between the
different spaces in order to give people the choice for social interaction or privacy
depending on the circumstances and their own state of mind.
3.8 Detail designing:
Small detail of furniture arrangement can change the character of the space, if prioritized
by an architect, social spaces of the future hospitals can be improved. In regards to the
human interaction in public spaces, this is best unfolded on the horizontal level, where it
has a rather large area of function. On this level, the social usual field is capable of
intercepting other person's features and mood in distances up till 20 meters, and in shorter
distances , where we normally perform social conversations, our visual senses are
supplemented with other senses in order to form a general impression of the person we
are talking to. Hall defines very precise personal distances, where 0,45 1,30 meter

23
describes the close social contact between family members, for instance around the dining
table. Distances between 1,30-3,70 meter is
defining the more public social distance between friends, colleagues, etc. and is usually
seen in comfortable seating arrangements. These personal distances influence many
details in the planning of social spaces, and for instance this affects the sizes of tables. If
too small, two patents not knowing each other, would most likely not sit at the same table,
as their intimate distance would be violated. Too large tables however, may make it
difficult for patents to talk together across the table. Studies through the design phase are
to consider these aspects in order to develop social spaces where patents find it natural to
meet and engage contact. intimate distance would be violated. Too large tables however,
may make it difficult for patents to talk together across the table. Studies through the
design phase are to consider these aspects in order to develop social spaces where patents
find it natural to meet and engage contact.

Sociopetal spaces are gathering people , while sociofugal spaces are keeping them apart.

24
Social distance as defined by anthropologist Edward T,hall .

Through other studies of human behaviour in public spaces, Gehl argues, that the social
activities has its own self-prevailing effect, where human actions attract attention and
Through other studies of human behaviour in public spaces, Gehl argues, that the social
activities has its own self-prevailing effect, where human actions attract attention and
thereby more people. These studies show an instance that the use of benches are
depending upon their orientation, where those situated where more human activities are
done neither in quite green environment. As well as the sizes of furniture the orientation
and layout also have significant importance in regards to use and social interaction
Finally, the placement of furniture in the room is noticeable, where seating environments
along with the inner facades of common open spaces or in the transition zone between
two areas usually are preferred. In these places ones individual exposure is limited, and it
is easier to create an overview of the surroundings and to feel comfort in these situations.

25
PIAMO SANATORIUM ALVAR AALTO , VIEW OF LOUNGE ROOM WITH
SPECIAL FURNITURE.

4. ELEMENTS OF HEALING:
4.1 COLOUR:
The thoughtful reader must have observed that thus far I have avoided touching on the
department’s vision “Colour and design promoting healing processes”. That statement
greatly perplexed me on the level of principle, and continues to do so. What is it that has
colour and design and promotes healing processes? An appealing exterior, direct
communication routes, small-scale building development, sheltered patios and so on in a
never-ending flood of questions? But, does not everything have a design and colour?
Surely these are properties which all architecture possesses, from detail to entirety, from
door handle to façade? After all, you don’t first design or construct a building and then
tack on the colour and shape of it!
The Eurhythmics room with its pink-stained wooden panelling, the truncated high room
volume, the skylight and the coconut matting on the floor were included in our reference
pictures. The treatment rooms were made to illustrate questions of lighting, bed
positioning and vista. I have wrestled with not learned in its theory but am cautiously
sceptical nonetheless. At the same time the architecture as such has an alluring force in
what I see and experience, and I do not believe my impressions are essentially different
from those gained by the people from the Psychiatry Department. Here is something
which intuitively appeals to us and which I believe the department partly tried to pin
down through its desideratum of colour and design promoting healing processes”. A little
more exactly, this could be put a follows:
• the architecture is different: it has an intrinsic value and is strongly creative of identity,
• it is expressive in details, rooms and exterior alike,
• the materials are sensual – beautiful to see and touch; the intrinsic materiality of the
wood and concrete is palpable,
• the colours are often bright, applied in several coats and stained over; the surfaces make
a shimmering or patinated impressions
• the buildings possess simplicity and austerity, at the same time as great care and
refinement has gone into the detailing,
• use of daylight is primary, resulting in narrow volumes and well-lit rooms,

26
• the care devoted to lighting is unmistakeable: the lighting strengths are low in relation to
present-day medical care; the light is sparing, sometimes verging on darkness,
• only warm filament bulbs are used, never fluorescents,
Colour often has different meanings to different cultures and is an immensely evocative
medium, possessing powers to provoke immediate and marked reactions in the viewer. Its
use in the architectural field dramatically affects everyone’s perception of architectural
space and form. Even in western societies, the meaning of various colours has changed
over the years. One of the biggest issues with colour is that each person reacts differently
based on their culture, gender, and own personal experiences, and it has always been one
of the most unpredictable areas within the built environment. According to Harold Linton
in Colour in Architecture “Almost any generalization that can be made about colour can
be overturned in practice.”19 There is power in colour. Each colour has ability to affect
architectural planes which allows it the power to accentuate shapes and forms. Also it can
contradict the true form and expression the building wants to be. Colour can imply proud
architecture or display the building as abstract art. With the many applications of colour,
it has the power to change our environment to make a connection with our environment,
body, mind, and spirit. Leonardo da Vinci believed that the power of meditation increases
10 times when done in a purple light, as in the purple light of stained glass.
While some colours aid the mind others, green for instance, helps to build muscles, bones
and connective tissue. It even has a cooling, soothing and calming effect on individuals,
both physically and mentally. It does so through the sympathetic nervous system by
relieving tension in blood vessels which then lowers blood pressure. Nonverbal activity is
influenced by the colour violet and is often associated with religious and spiritual issues.
The slightly different colour purple affects the brain and central nervous system. In doing
so it promotes health, creativity, inspiration, mental balance and also supports both
artistry and spirituality.
While some colours aid the mind others, green for instance, helps to build muscles, bones
and connective tissue. It even has a cooling, soothing and calming effect on individuals,
both physically and mentally. It does so through the sympathetic nervous system by
relieving tension in blood vessels which then lowers blood pressure. Nonverbal activity is
influenced by the colour violet and is often associated with religious and spiritual issues.
The slightly different colour purple affects the brain and central nervous system. In doing
so it promotes health, creativity, inspiration, mental balance and also supports both
artistry and spirituality.
27
The importance of water as, “Water is symbol of the vitality in life and is a key to the
sacredness of a healing architecture. Water can be metaphorical of peace, tranquillity and
calm. Conversely, it is also associated with vitality, fertility, abundance, fluidity and
movement. Water opens up the contemplative nature of the soul and helps to elicit

memories and a sense of belonging. Because water is a feminine energy, it is also

associated with the Land and with the genius loci”. Water helps to distribute vital sheng
chi throughout the landscape, both as surface rivers, creeks, and lakes, as well as in
underground streams. This force can be tapped by enhancing naturally occurring water in
site planning of by introducing it into the site or the structure in gardens, water features,
and vistas.

Surface water has the ability to enhance both healing and prosperity, provided it is located
on the proper direction in relation to the building and the site. Geomantic practices the

28
world over refer to ideal locations for water in the landscape. Surface water can be
incorporated into a site in many ways: as a gushing stream in a fountain it is symbolic of
the life force, of surmounting obstacles, and initiating new life. As a slow moving,
meandering stream or creek, water is symbolic of the river of life and our personal life
path, and is also symbol of progress and attainment. As a waterfall, it is symbolic of a
leap into the unknown, of courage, and triumph over fear.
As a still pond, water is symbolic of contemplation, of the soul’s yearning for truth,
renewal and healing. Water that disappears into the earth, a cave, or crevice is allegoric of
the cycles of life and death and can be a reassuring symbol of our ability to overcome
even the direst circumstances.
Adding a bridge over moving water is a powerful symbol of our ability to overcome
obstacles. It also helps to define our journey within the landscape and to create a sense of
natural transition into more pristine environments.
Underground water have the potential to greatly augment the healing power of a site.
These can be reliably located by dowsing. Dowsing is a time-honoured skill which allows
its user to perceive energies such as underground water despite the fact that they cannot
be seen. Experienced dowsers can locate underground water on site or remotely using
maps.
Water that rises towards the surface from below the site is particularly beneficial. If the
water does not break the surface it is called a blind spring. Underground water, like the
energy lines, can also be traumatized; geopathic stress often involves compromised
underground water known as dark streams. In such cases it is necessary to perform earth
acupuncture in order to heal the problem. As with other forms of geopathic stress, it is
important to cure or avoid such areas as they have been implicated with many serious
medical conditions.
The quality of water is of great concern in geomancy. This not only includes the
potability and cleanliness of this valuable resource, but also its energetic integrity. There
is growing evidence that water is capable of carrying spiritual information and that unless
managed consciously, it can loose its power to nourish, regenerate, and heal. The
illustrations at left demonstrate how ordinary water can change its crystalline structure in
response to verbal stimuli.

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4.2 LANDSCAPE:
A healing garden is a link to the divine, to the creative force of the Cosmos. A healing
garden needs to work with Nature and its forms: it should discourage rigidity, conceptual
thinking, and preconceived notions of design. It must recognize the polarities and organic
forms present in nature. Consequently, it needs to avoid straight lines, sheer volumes and
planes, and excessive use of symmetry.
A healing garden is a micro cosmos of the larger world: each feature in the garden has the
power to represent a larger feature in the landscape: mountains, rivers, lakes. It is through
this holistic modelling that a healing garden can stimulate the senses, improve vitality,
and promote recuperation from physical, emotional, mental and spiritual illness.
A successful healing garden is a co-creative process in which humans and Nature are
intimately connected through the bonds of reciprocity and stewardship. A healing garden
is a symbol of the possibilities, obstacles, and hardships that need to be overcome in order
to reach higher levels of consciousness and a sense of our own divinity and
interconnectedness with all that is. This potential allows a successful garden to have a
healing role even in those situations where physical healing is not possible. Consequently,
its users should be a driving force in its design and should be involved in its maintenance.

30
Healing is
achieved through
careful alignment
with the forces of
earth, water, air
and fire. It implies
recognition of
orientation in space in a cosmological sense, and of the anthrop cosmic relationship
between man and the larger body of the planet, its creatures, and the invisible forces
behind material reality. It can also include formal religious allusions as well as
iconographic additions. Its end product is a space where many activities are possible:
stillness / movement, contemplation / interaction, wonder / discovery, mystery / creation,
relaxation / work. Gardens should encourage healing through the interaction of patients
with healers, family and friends, the old with the young, staff and colleagues, and even
the act of being in solitude. The garden also needs to provide subspaces and seating
arrangements that allow gathering in larger groups. It needs natural, spatially enclosed
settings for talk and conversation. In all cases, however, there is also the interaction of
humans and nature: plants, wildlife, and the forces of wind, water, light, and colour.
A healing garden should afford opportunities to make choices: private areas and public
spaces, contemplation and people watching, various walking routes, different kinds of
seating, interaction with humans and nature, participation in the garden’s maintenance. A
healing garden should allow its users to experience a sense of control: users must know it
exists, how to gain access to it, they should be able to use it in ways they prefer. They
should enjoy a sense of physical and psychological security. Design should encourage
clarity of layout and movement. The garden should provide a sense of enclosure and a
special entrance to convey a feeling of structure, permanence and ground. It should avoid
dead end paths and complex formations.
Design needs to create opportunities for movement and exercise; this brings physical and
emotional benefits and helps to combat depression. Create paths for walking, make the
garden visible from corridors that can also be used for exercise, place rehabilitation units
in view of the garden or nature, add a walking or jogging route for staff.

31
4.3 HEALING GARDEN:
The garden is a rooftop courtyard “bounded on three sides by two-story buildings and on
the fourth side by a twelve-story tower, with porthole windows, that looms up in one
corner of the garden.” A water feature is the main focus throughout this garden. The
water feature symbolizes “The Cycle of Life.” The different phases of life from birth to
death are symbolized in various ways by means of quiet pools, as well as flowing
streambeds. Throughout the site water is not only audible and visual but also touchable
throughout the garden. Seating in the garden varies from movable chairs and tables to a
curvilinear seat-wall, allowing for different levels of comfort and positions in sun and
shade. Raised beds contain plants that have low water and maintenance requirements.
Another major element featured in this garden is art. A tile artist was brought into the
project to design colourful tiled columns that actively engage users of the site. The site is
handicap accessible and also has capacity for walkers, gurneys, and wagons. A small
coffee bar is a part of the garden that provides a social aspect for the garden users. “The
garden-courtyard is well used: by visitors and inpatients who come together to enjoy a
coffee or stroll; by visitors waiting for an outpatient who is at an appointment or
undergoing a test; by staff, for breaks, lunch, or small group meetings; by physicians and
hospital chaplains meeting with family members. A fairly large expanse of flat concrete
allows beds to be wheeled out on occasions. Another, less direct form of use, is visual
access. Outpatients attending a cardiac care unit can exercise on the Stair. “Masters while
looking out onto the garden via floor-to-ceiling glass windows. An intriguing monitoring
device secreted in the tree canopies permits telemetry cardiac patients to continue to be
monitored in the garden when exercising outdoors”.26 The authors who observed this
healing garden for the most part praised the design of this space. They did express that a
couple elements about the site needed to be reworked. The extensive amounts of concrete
not only took away from the garden appeal of the space but it also produced high amounts
of glare. The suggestion for decreasing the amount of glare is the use of earth-toned tint
to be added to the concrete. Otherwise the garden was mostly successful, providing the
sound and touch of water, native plants many of which had medicinal uses and reflected
the changing season as well as encouraged wildlife. Seating was varied according to type,
material and location in sun or shade. The garden is open twenty-four hours a day which
is great in a hot climate like Arizona where many garden users may be more inclined to
use it when it is cooler at night and early morning hours. The addition of colourful art
engages the garden visitor and the entry and navigation in the garden are straightforward.

32
Patient rooms include views down onto the healing garden. One of the best things about
this garden is the fact that it is strongly supported by the hospital administration.
4.4 THERME VALS:
The prominent use of material to give user the psychological impact can be observed
from Peter Zumthor’s work. In his design of Therme Vals, the mental impact is created
by the multiplicity of textures, materials and interests to engage the mind in awful
manner. Moving forward with this inspiration, Zumthor found beauty in the simplicity of
material, which along with environment became the major determinants of form of which
the other determinants were a function. He celebrated the idea that the material may not
necessarily be subordinate to the idea, but that it may formulate the idea in its own right.
So, with this notion the design moved forward using a grey-blue stone native to the region
called Valser Quartzite, which was layered to form a monolithic structure nestled within
the mountainside.
covering, cloth, velvet, silk”... “A body that can touch me” . He looks at architecture with
a poetic quality that he exhumes to his work. His work on Therme Vals provides a clear
insight of designing with the senses and how he works sensitively with lighting and
materiality. “The sense that I try to instil into materials is beyond all rules of composition,
and their tangibility, smell and acoustic qualities are merely elements of the language that
we obliged to use. Sense emerges when I succeed in bringing out the specific meanings of
certain materials in my buildings, meanings that can only be perceived in just this way in
this one building.

4.5 MATERIALS
Materiality has a direct influence on the overall sense of the environment. Materials have
the ability to affect the sound environment, circulate movement, increase /decrease
comfort, and various other actions. With this, the form in which the material becomes a
part of will also determine the powers of its placement. The associated dimensions of the
material also will play a factor in the design. For instance, wood is a material that retains
heat, is soft and comforting, and can be associated with the concept of natural
environments. Another material like sand has a therapeutic value to it, soft to touch, and
gentle on feet. However, stone is cool and smooth to touch, but hard on feet. When the
materials become integrated in the program, the quality of the materials will embody the
vision of the space and become another dimension in the healing environment. Other, not

33
usually thought to be materials, like light, sky, water, and vegetation will be manipulated
with the built environment to evoke specific responses in order to stimulate the mind and
its perceptual visioning of a space.
The following perspectives provide a vision for the “garden.” These are intended to be
spaces that integrate all the senses; vision, taste, smell, hearing, and touch. The study is
done through a phenomenological lens, designing with a multiplicity of textures,
materials, and interests to engage the mind in a playful manner of distraction. The
awareness of these physical things in the space and their properties provides the necessary
information for the occupant to draw their own conclusions. This awareness of one’s self
is the beginning to any healing process in the mind.

5. THE LITERATURE STUDIES:

In order to visualize the substance of the parameters , defend in the previous chapter,
three various case studies will in the following chapter be described and evaluated based
on the analysis form stated below. The overall thesis of this project defining the future
spaces for social support as an intersection between the public space and the homely
atmosphere is the overall basis for choosing three individual cases for analysis and
comparison. Secondly, the cases are selected depending on the patent's/person's

34
motivation for attendance, which follow the three guiding needs defined in Maslow's
hierarchy pyramid . The basic needs as exemplified in a hospital , the psychological needs
is exemplified in a cancer caring centre , and finally the self – full fillment needs which is
exemplified in a high-end gourmet restaurant . To summarize the chapter of the wide-
ranging case studies, a concluding compilation will define the common relevant
guidelines for the design phase.

CASE -1 LAND UNIVERSITY HOSPITAL

CASE 2 : Shri siddhi Vinayak Ganapathi cancer hospital

35
5.1 CASE 1: LUND UNIVERSITY HOSPITAL:
5.2.1 KAVA- SURGICAL EMERGENCY DEPARTMENT:
Lund University Hospital is placed in Skaane, Sweden as one of the larger regional
hospital with 980 beds. The basis for this case study is the surgical emergency department
with 24 beds and 4-500 patients per year hospitalized for 48 hours in average Patents in
this ward may be compared to oncology patients in regards to medical/surgical treatment
and their general physical condition and mobilization. The ward consists primarily of
multi bedrooms, where the beds are separated with curtains. When this specific ward is
chosen as hospital case, it is due to the recent modernization and remodelling performed a
few years ago in connection with transferring the ward. Here one of the focal points,
among others, was new arrangements of social spaces. The recent buildings are
constructed in 1968 and is today causing problems with the physical surroundings in
regards to patient treatment and human healing condition. When the ward was chosen to
move to another floor, staff was given the possibility to rethink the interior layout and
organization of the ward without changing the main construction. Nurses and other
members of staff initiated a process, where future requirements, visions and ideas were
discussed and planned for the new settings. The intention of improving the social spaces
was strong, and the fact that it was even a focal point in the nurse's vision for a future
ward shows appreciated awareness of its importance. The base in the new dayroom is the
staff operated ward kitchen, where the meals to the entre ward are finalized . Staff is
consequently always present in the room performing a homely activity , and brings life
and atmosphere to the space. Concurrently, the kitchen offers snacks and drinks directly
from the kitchen counter, and mobilized patients can always get something to drink and
eat directly from the kitchen like in their own home. The general use of materials and
textures indicates a clinical environment with institutional furniture, vinyl flooring and
acoustic ceilings. Complimentary, there are single specific elements like a fruit basket,
freshly brewed coffee, biscuits served in glass jar and blankets in the lounge area hat
attempt to drag the room towards a more homely atmosphere. Along with the kitchen
function these small details actually do support the domestic feeling of the dayroom with
added features that may revive memories from the patients' everyday life. However, the
first impression and the overall experience of the dayroom as clinical and institutional is
still predominantly. The intention of making the social

36
space homely is notice able although it lacks in completion of the commenced ideas, and
a deliberate holistic approach towards creating social spaces in future health care
environments are still needed for perfection.

5.1.2 FUNCTIONS:
What are the options for residence?
The dayroom is considered the primary place for
residence outside the bedroom, although there are
some smaller furniture arrangements in the
hallway itself.
These are not used during the observation, and
they seem to be placed randomly in the busiest
place of the hallway next to the elevator and with
no seclusion from the semi-public corridor space.
What are the optional functions? Besides reading and watching television as
entertainment, the primary activity is relaxation in the lounge area and dining at the
tables. Secondly, the ward kitchen is an integrated part of the dayroom, and it offers self-
provide able snacks at the ward buffet and the
kitchen counter patents have no access to the
kitchen itself. Does the functions in the social
space invite to participation?
At the time of observation there were only a few
people in the room, however occupied for longer
periods.
There was consequently only little social
interaction maybe because of different activities .
As the functions are considerably simply there
seems to be moderate possibilities to join in
occurring activities although it may not be
inviting as such.
5.1.3 .MATERIALS AND TEXTURES:
List and short description of used materials,
textures, furniture? Walls are standard white

37
walls floors are grayish vinyl and the ceiling of white acoustic panels with integrated
lightning the same as the rest of the ward ; The kitchen is closed off for patients due to
hygienic demands and consists of steel and white laminated surfaces; Furniture in the
dining area are wooden dining tables and chairs with steel frame and wooden seating ;
furniture in lounge area of wooden tables and armchair and a couch with wooden frame
and textile covered cushions. How is the room characterized by materials and textures ?
In regards to materials and textures, the room is considered quite institutional, as the
vinyl floor and acoustic ceiling are predominant. The furniture in the lounge area have
textile covered cushions although the dominant wooden frames and general design of
these are institutional recognizable. Are the use of materials and textures consistent and
deliberate ?The furniture in the lounge area, kitchen area and dining area is varied,
although it does not accentuate any stories or define a consistent use. The materials in the
dayroom are not distinguished from the other areas of the hospital, and it may be different
to tell the difference between various rooms. In general the materials and textures seem
chosen and applied haphazardly , and there is a overall lack of homogeneity in the
hospital in this regard.

5.1.4 CONCLUSIVE REMARKS:

Lund University Hospital is a case illustrating the good intention of improving the social
spaces in the existing hospital wards. t is a significant progress just to call attention to the
problem of unfulfilled common areas, and with the enhanced focus from the staff, some
hospitals are taking the lead- and in Lund with various success. The fact that a fair
amount of square meters are dedicated to the dayroom is positive, and the room even has
some small elements, where the intersection between the homely atmosphere and the
public space is combined although not convincingly enough. The room is still
experienced quite institutional, especially expressed by the overall materials like vinyl
flooring and acoustic ceiling sheets, and the lack of tactile and sensory elements. The idea
of letting the kitchen be a central part of the room is in general good and even
recognizable from our own home but the fact that it is closed off from the patients may
instead work as an amplified reminder of hospitalization? The kitchen table towards the
patent area, is however a self-service are which share familiar elements, although the
freshly brewed coffee, which is chosen for its homely character, instantly turn
institutional when being served in 3 litter coffee pot with stacked industry cups. The small

38
details could easily have been better thought through, and why should the patients not
have access to a smaller part of the real kitchen themselves?
In general the dayroom in Lund meets many of these adversative examples, where the
intention lacks completion due to small details that easily could have been improved if
they were only in focus. The room is therefore experienced as institutional even though
some positive elements do exist, and the future design of these spaces needs a more
holistic approach towards material use and the general perception of space. Compared to
the other dayrooms experienced in Lund University Hospital, the KAVA ward is indeed a
consolation. On the floor below the dayroom is a 15 m2 room in the middle of the
building envelope with no windows and natural lightning, and consequently it seems to be
empty most of the day. The spaces for social support in future hospitals should, in regards
to design and planning, be more holistic and well considered, than it is experienced in
Lund.

5.2 CASE -2 Shri . Siddhivinayak Ganapati Cancer Hospital

Location: Miraj, Maharashtra, india,

Project Work Status: Completed Projects
Project Completed: 1997
The main idea behind the project was to create an environment that does not convey the
conventional, dull, dark, smelly and confined ambiance of a typical hospital. Good light,
ventilation and a lively open interaction with nature became the paramount criteria. The
hospital building is well illuminated and ventilated, incorporating plants and landscaping
to bring about colourful, bright, soothing and reposeful mood. The landscaping and
building have thus somewhat therapeutic value.

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5.3 THE HOMELY ATMOSPHERE :
5.3.1 HOW TO DEVELOP SOCIAL INTERACTION:
As concluded, my research is that spaces for social support in future hospital
environments is defined as an intersection between the public space and physical
environments with a comfortable, homely atmosphere a social place, where patients
engage meetings and social interaction, thus enabling social support. The first step
towards social support is consequently for the patients to meet each other, which may
include the theories of Gehl and Hall , described in the previous chapter 'The public space
how to promote social interaction'. The next step is to develop this initial social
interaction to intense level, and this process is believed to require specific demands of the
physical environment. h our daily life these levels of superficial conversations are usually
performed with our families or close relatives in safe and familiar surroundings. When
hospitalized, the family contact may be reduced and the environment today is often
characterized by institutional settings far from familiar and well-known. Hence, the two
aspects that form the basis of this social interaction and support in our everyday life are
apparently not present today From architectural point of view it is very difficult to raise
the visits in patients room. instead, other patient and staff can act as a family member at
that point of time may be even for better social support in some he health related issues.
In hospitals patient are confined to such environment where the general freedom of
choice is strictly limited. However, the things concerning the social interaction and the
allocated social spaces do not necessarily have to be so different from the spaces we
recognize from our daily life and our own homes. By changing the design of hospital
dayroom of patient to an inviting ,familiar and homely environment recognizable for the
patients leads to better social support our daily life and our own homes. By changing the
design of hospital dayroom of patient to an inviting ,familiar and homely environment
recognizable for the patients leads to better social support.
5.3.2 Feeling at home:
Home is by the anthropologist Mark Vacher defined as a connection between a human
being and a physical object. This object is usually a building, although more primitive
units also perform as homes with the same psychological characteristics. A home is
personal and intimate, and not something you can buy. When we talk about houses we are
capable of describing them without mentioning the people living there but when we
describe a home it always belong to someone. Houses are not only frames for people,
people are framed by houses and the things they harbour, at the same time as people

40
project their own emotions, dreams and hopes onto the things and the spaces that
constitute the house. That our homes are personal is exemplified by Sjorslev , who define
a building as a house as soon as someone moves in, although this house is not a home
until it is personalized and the resident have supplied his individual touch. Our home is
therefore filled with personal objects, memories, heirlooms, etc., and even though our
daily use of these objects may be of functional or aesthetic character, the sentimental
value often exceeds the functional value by far.

Final
ly, the details and arrangement of furniture should reflect a homely environment. The size
of room, furniture orientation and the room accessones like artwork. greenery, light
fittings, etc.. are important aspects that should be incorporated and considered along with
the design of the space, in order to design a historic social space facilitating social
interaction and support.
5.3.3 Home outside Home:
Future social spaces with a familiar and homely atmosphere by implementing some
fundamental characteristics derived from our homes and everyday life. One of these
characteristics is the activities and potential functions of the room. Today many of the
daily activities and routines in the hospital are performed without involving the patent,
where for instance meals are planned in advance, cooked in large industrial kitchens and
served at certain times. Another essential characteristic related to the homely atmosphere
s believed to be the materials and textures of the dayrooms. Today these rooms are often
marked as institutional and are often decorated and furnished as the bedrooms, hence the

41
 distinction between the dayroom and the rest of the
hospital are often immaterial. The materials used in
today's hospitals May be the same as we use in our
own home but the way they are used have very
different conceptions. Textiles are for instance a
material that is used rather carelessly, and does not
derive the potential as we experience in our
domestic environment. At homes the textiles are
applied for curtains, cushions, blanket,.etc.. all
adding a tactile perception to the material, which
imply comfort and coziness to the space and
experience. Today this critique may be noticed in
many hospitals, as the high restriction in regards to hygienic and durability demands have
excluded nearly all tactile materials, including textiles, from many applications. However,
recent research and development in smart textiles is improving the potential use of
textiles in new recognizable ways n future hospital that is used rather carelessly, and does
not derive the potential as we experience in our domestic environment. At homes the
textiles are applied for curtains, cushions, blanket,.etc.. all adding a tactile perception to
the material, which imply comfort and coziness to the space and experience. Today this
critique may be noticed in many hospitals, as the high restriction in regards to hygienic
and durability demands have excluded nearly all tactile materials, including textiles, from
many applications. However, recent research and development in smart textiles is
improving the potential use of textiles in new recognizable ways in future hospital
environments, where the use of tactile and sensory materials, like textiles, would be
possible to implement with great beneficial value. Finally, the details and arrangement of
furniture should reflect a homely environment The size of the room, furniture orientation
and the room accessories like artwork, greenery, light fittings, etc. are important aspects
that should be incorporated and considered along with the design of the space, in order to
design a holistic social space facilitating social interaction and support environments,
where the use of tactile and sensory materials, like textiles, would be possible to
implement with great beneficial value. Finally, the details and arrangement of furniture
should reflect a homely environment The size of the room, furniture orientation and the
room accessories like artwork, greenery, light fittings, etc. are important aspects that

42
should be incorporated and considered along with the design of the space, in order to
design a holistic social space facilitating social interaction and support.

Textile use in a living area of single patient Room fortis hospital.

5.3.4 Summary:
The homely atmosphere in future hospitals may be difficult to define, as our home is
usually very personal and individual and therefore impossible to transfer directly to a
heath care environment.
 However, it is the research of this project, that by implementing three fundamental
characteristics of our home and everyday life, including functions; materials and
textures and details, it is possible to create a more homely atmosphere in the social
spaces, than we experience today.
 This atmosphere is considered beneficial for the more developed levels of social
interaction and social support, as the conversations in safe, comfortable and
homely environments are believed to be more outspoken and emotional than the
acquaintances in the regular, standardized and clinical dayrooms we experience
today.

43
6. CONCLUSION
The ability of architecture to heal the mental and physical illness with the different
planning parameters and the elements that can enhance healing has been explored.
Without compromising on the need, the ability of all patients to be outdoors in a good
environment is, in my view, the absolutely greatest strength in the design of this caring
environment. The spontaneous process of making architecture, it's almost as if we
formulate our own "abstract ide as of what we envisage a space to be, through special
images from memory we assemble architecture to be a part of the real world. t not only
seems that art is inherent in all of us, it is also possible that architecture is inherent in all
of us. As an act of healing it is symbolic of our perseverance as a species to I ve a
fulfilled existence. n exploring art as healing, architecture as an art and lastly, architecture
as a healing space, I can deduce that the common bond between them is that art does have
healing qualities and it can be said that such healing qualities provide therapeutic
harmony in all of us. I believe its effects may be limitless in measuring the benefits to he
Self. The journey of healing through art seems to be a process of retrospection, Self
growth and Self discovery. This investigation has brought about key design objectives
that may be crucial in space making concepts for my healing architecture in healthcare
design.
The purpose of creating a green oasis which patients can retreat to unescorted by staff, in
my opinion, has to be achieved. Even in a number of problems where the outdoor
environments are concerned, everyone agrees that the existence of the gardens and light
courts is something absolutely positive and something that is very good for the patients. It
is also clear that being allowed out in the gardens is perceived as conferring an
opportunity of greater sovereignty. H this way I think the aim of increasing normalcy has
been achieved Patients often experience different needs from time to time, and so the
architect should consciously design the place or the environment so as to facilitate the
process which recovery in the design process, the architects should consciously reduce
the institutional ambience and create such Salutogenic design which will shift the
pathogenic approach .As I see it, there is scope for the patients to use different parts of the
environment, both indoors and outdoors depending on the stage of the recovery process
they have come to. Outdoor spaces are always with lusting green and the sound of water
to heal their agitation. Indoor is more towards the sunlight that enhance the healing and
the ventilation to give the patient high level of conformability. With the aid of my detail

44
study and the precedents I have concluded four connections that has to be consciously
addressed while designing
1. The connection with the personalized environment Healing begins when one is in a
space of Homely atmosphere. The physical space however is one that must be
comfortable and a reflection of oneself. The physical environments have great influence
on our social behaviour and the possibilities for patents to engage social activities
promoting social support. The common spaces should provide more than just the
possibility for patents to form this basic contact.
2. The connection to sensory experience: The integration of all the senses helps complete
the highest potential of an environment to allow for healing to emerge. As, Human beings
cannot I we without natural surroundings. The symbiotic relationship that exists between
the two is one that has to be nurtured. A physical and visual link with nature has positive
beneficial qualities that help in healing and health in general.
3. The connection with Light: Natural sunlight kills harmful bacteria and cleans air. Apart
from these obvious natural benefits of sunlight, natural light - when controlled gives a
space character that is sensual so giving a space an emotive quality which can be felt by
the end-user Light is also a symbol of growth and life as it benefits the natural world in
that way.
4. The connection with the City: The city environment is harsh and busy and tends not to
offer many places or spaces of retrospection and contemplation. The site should be a part
of the city but detached from the fast pace.
The end user should be able to arrive conveniently with public transport to the site to
allow a large catchment of people seeking a place for healing. The site should also be in a
place that is not difficult to navigate and find.

8. INFERENCE:
From the listered evidence reasoning I heared by like to convey that is to analys the
existing healing environment systems of techniques and to create a design guideline.

45
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kgd-architeture.com/portfoliopage/fortis-hospital-gurgaon-i-healthcare-4/
soundofarchitecture.com/blog/architectural-healing-how-the-built-form-changes-lives
archinect.com/firms/project/14168405/medicity-medanta
Dilani,Alan. "Psychosocially SupportiveDesign. "World Health Design Journal
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