WALL+FLOOR - HEALTH CARE AS URBAN PLAYER

FACTSHEET

PLACE: Høje Gladsaxe, Copenhagen, Denmark
AREA: n/a
YEAR: 2023
CLIENT: Landsbyggefonden
TYPE: Healthcare, housing, repurposing
STATUS: International call for ideas, proposal
TEAM: Audun Hellemo/Kristin Hilde

RATING
SCALE (small>large)
STATUS (idea>built)
COMMERCIAL ($>$$$)

To make an intergenerational neighborhood; people of all ages must be able to remain in an area. Huge new hospitals and new “villages” for the elderly is in effect creating more segregated communities. Integrating services into established neighbourhoods with a certain density will be a more sustainable model over time.  The large investments needed in this sector in the coming years should do more to promote local services that has an additional potential to transform and improve the neighbourhoods they are a part of. This means upgrading and refitting existing apartments to new needs. Support should be provided for a range of needs (medical, practical, social) and have a physical presence that connect users and local resources. A meeting point is the result of needs and exchange of services, not “forced” social interaction that favors the most resourceful.

CHALLENGES

growing older population with new needs
demographic changes are happening fast, and the oldest population (+80 years) is growing the most. as a result, services for this age group will be in high demand in the coming years. with gradually better health in the society as a whole, the needs will be more differentiated than today. 

growing needs served by limited resources
the growing population of elderly means that an increasing number of people will be working with health care – in the nordic countries it is estimated than almost a third of the work force, more than the double of today, will be health care workers – while we already today lack personell in this sector. 

the biggest investments do little to improve our cities
the increasing needs from the health sector result in massive investments in new hospitals, care centres and senior housing. their monofunctional character and large scale often makes it difficult to integrate these functions well in the city fabric. thus, the sector that attracts the most spending, is not using its potential as a driving force for urban development.

the buildings we need are already built
to achieve our obligations towards the goals of the paris agreement, we can not build ourselves out of the mess we are in. new construction causing large co2 emissions should be limited, and more buildings should be reused, refitted and repurposed.

ghettofication of the elderly
limited space in facilities and access to health care personell means that only those with urgent needs are offered a place. the result is ”ghettos” where elderly are placed together with little contact with the surrounding social environment.  

little interaction between both people and ages
an increasing share of households consists of one single person, with less socializing and more loneliness across all ages. as the opposite; ”forced” socialisation in an institutionalised environment is becoming less attractive as the aging population celebrates individuality and personal preferences more than before.

centralised amenities and long distances
as a child of the 1960s planning regime, Høje Gladsaxe´s functional zoning creates long walking distances from the housing blocks to the centralised amenities in east. for people with mobility issues, these amenities are simply unavailable.

poor connections across
the programmatic division between north and south is further emphasized by the structure and sheer size of the housing blocks. openings on ground level are difficult to spot.

divided front and back
the functional zoning is also evident in the outdoor spaces, where the areas reserved for cars – once seen as a symbol of prosperity and progress – occupy the entire northern side, while green recreational areas are placed on the southern side. the facade rehabilitation done in the early 90s was typically only executed on the southern facade

little diversity in housing typologies
the entire area consists of housing blocks with apartments. despite a variety of apartment sizes they provide similar housing qualities catering to a limited market.

abundance of surface parking, 
low spatial quality
the area designated for parking on the northern side has little spatial or experiential qualities. in a city where the bike is the preferred mode of transport, the enormous parking lots seem like an anachronism. 

apartments not accessible for everyone
the apartments do not follow today´s building code for accessible apartments – if you need a bigger bathroom you have to move.

ACTIVATE THE SPACE!

The first step towards a intergenerational neighbourhood is to make it truly possible for all age groups to remain in the area.

Using a new model for local health care for the elderly; the proposal taps into the enormous resources that will have to be spent for future care and uses this as a tool to ignite urban development. 

Adapted to the specific situation at Høje Gladsaxe, the physical strategy is to activate space on the northern side: a combination of immediate and long term interventions that bring life both to the existing buildings and the ground plane; with program that over time connect the wall and the floor into an integrated urban experience where the needs of the elderly and the resources of the neighbourhood mixes and builds a stronger whole.

ACTIVATE THE WALL

reintroduce the access balcony as a social space!
The access balcony provides new potential entrances along the northern facade, making a range of new apartment layouts possible. With entrances from the access balcony, the image of the facade as a passive space of necessity changes to an active space.  

better bathroom facilities!
extending existing bathrooms to current accesibility standards so people can stay even if their needs change.

improve the facade threshold!
new entrances are combined with facade improvements to improve the connection between the interior and exterior spaces: the depth can vary with added seating, planters, extended apartments and more light and various degrees of transparency.

a new, integrated senior housing!
apartments in designated floors are transformed one by one into an integrated senior housing where the units are connected by, and relate to, the improved access balcony. in this way it is possible to do short walks and informal visits locally – forming a new social structure

facilitate new apartment types!
with added number of entrances, apartments can be used in more flexible ways – over time they can be divided, shared or rented out for a period of time; catering better to the needs of the single-person household. 

KEEP THE PEOPLE

follow the money!
healthcare is the government´s largest spending cost, projects that potentially decrease total spending will always be attractive for new investments and political attention

local is more efficient!
today´s home based services are wasting a lot of valuable time driving and looking for parking when the time should have been used giving care. with more local services in dense housing areas, transport needs are reduced to a minimum with more quality time as a result.

preventing is cheaper than treating!
with an aging population, every year spent healthy without need for extensive care is good for both the mental health as well as the budget. To share a cup of coffee with someone is sometimes better than a pill.

recruit in the neighbourhood!
with more people needed providing healthcare in the future and a more diversified services offered, the future helath staff will be a combination of professionals, volunteers and local youth each doing what they do best. recruiting locally strengthens the connections between residents and prevents the ”us” and ”them” mentality.

diverse services free up limited resources!
needs are different and changes over time. by offering a range of services from doctors, nurses, carers and volunteers according to specific needs, limited human resources are used where the need is.

keep the door open!
new digital health care tools can free up valuable resources, but a local facility needs a physical meeting point where drop-in questions, training, coordination or just a chat is offered. this must be inviting, with an open door and a low threshold to enter.

ACTIVATE THE FLOOR

use the existing structure as a starting point!
the existing garages define enclosed outdoor spaces that can be used as test beds for new programs. they can be repurposed, removed to create new paths, filled with new content or have new structures added to them.

add new housing typologies!
as qualities are added to the northern side, the large space´s potential for futher development is emphasized. new housing typologies will change how the scale of both the housing blocks and the open space is percieved and be attractive for tenants that are not staying in the area today.

involve the local community!
the local health centre is the first test bed. by involving the local community, new programs can be tested an added as a combination of temporary and permanent construction. 

define and improve new green spaces!
new construction must be used to define high quality green spaces for different uses and attract different age groups. from one big open space a hierarchy of public, semi-public and private green spaces is introduced for a fine grained urban fabric.

reduce number of parking spaces gradually!
by replacing a few parking spaces strategically linked to new program, quality is gradually introduced to the northern side. by doing this successfully, it is easier to remove more as the more projects are implemented.

build the city!
a difficult starting point can be transformed to a forward looking city by using a set of strategies for re-use, programming based on future needs and new construction. 

together they create inter-generational neighbourhoods.