New trends in medium / long term in-patient care for the elderly from scott tallon walker architects
The client brief for St Patrick’s Hospital was explicit in setting out high level qualitative aspirations for this project to provide a new, forward looking facility to replace antiquated and densely occupied nineteenth century accommodation. The building provides medium / long term in-patient care of 75 elderly patients with highly complex needs and 44 palliative care patients, together with day-care and rehabilitation services.
The design addresses the aspirations of the brief in numerous ways. Primarily it is strongly informed by evidence-based principles and by a design approach which seeks to positively support the moment-to-moment experience of all those who engage with the care environment, all within an efficient nursing setting. Privacy and dignity are key components, particularly for the nature of patients involved.
Entry to the building is via a central atrium which provides a shared communal space (the heart; ‘crai’ in Irish) and social focus. Wings of patient bedrooms are arranged to the immediate south of the heart with direct access and very short journey length to them. Patient bedrooms look out either onto the wider landscape setting, including a scheduled ancient monument adjacent to the site, or to landscaped courts opening to the landscape. South-easterly outlook (morning sun) is prioritised to support the well-being of long stay patients. The journey to any bedroom involves no more than one major change in direction and has an unbroken sequence of landscape views to ease orientation.
Patients are accommodated in single ensuite bedrooms sized to accommodate high levels of disability, variable acuity, and with space for relatives to spend extensive time in the room. The interior design seeks to background the essential medical and nursing equipment such the predominant ambience is one of quality rather than care equipment. The arrangement of the plan lends itself to emerging nursing models of care such as the ‘teaghlach’ (‘household‘) model as they may emerge in Ireland. Service and administrative facilities are provided to the north of the heart with basement access for privacy where this is appropriate, promoting the segregation of patient/public and supporting functions.