SAA Architects

Project Name: St Josephs’ Nursing Home
Location: Singapore, Singapore
Date Designed: -
Date Completed: 2017
Size: 22,022 sqm
Client: Catholic Welfare Services Singapore
Programme: Healthcare

ABOUT SAA Architects
SAA is a leading full-service architecture practice headquartered in Singapore. With over 50 years of design and built expertise, they are committed to the pursuit of excellence in the design and delivery of people-oriented architecture that connects communities with their urban environments.
Guided by the core values of being Urbanistic, Humanistic, and Optimistic, their practice delivers projects that connect and engage seamlessly with the built environment; creating meaningful relationships by placing people and communities at the centre of their design.
At SAA, 200 multinational professionals collaborate closely with partners and clients to respond to design challenges in an increasingly complex, technology-driven world; bringing specialist expertise to the various sectors that they engage in.

ABOUT St Josephs’ Nursing Home
St. Joseph’s Home is a nursing home for the aged in a densely populated residential district in the West of Singapore. After the renovation of the nursing home, the amenities were greatly improved, with an increment from 139 beds to 412 beds. The revamped facilities also include an improved landscape design that encourages interactivity and improves the quality of living in the nursing home.

St Josephs’ Nursing Home

Interview with LEONG Michael of SAA Architects
Insights and Takeaways
1. ADVICE TO YOUNG ARCHITECTS?
I have been an architect for 20 years by now. So I practiced for about seven years in public agency, and the rest of it was in the private sector. And so I’ve seen both sides of the practice and both from a government agency and as a private practicing architect, and I think something that is quite universal to all of us as architects.
As far as somebody who has worked 20 years as an architect is concerned. It is actually very important for you to not just see it as a job. Okay. So over my 20 years both in the private and public sector, I have seen many friends and colleagues who have in a way through in the tower, okay had decided that architecture is not your cup of tea.
And these architects are people who have studied for five, six years, even after registering and finally come to a conclusion that this is not what they want to do. So there are many other alternatives for them to choose from. I find that it is a pity when we started out being very aspirational. And so I find that a great misfortune because you will have devoted many years of your life pursuing something that you definitely believe in and therefore you’re here. And I think a lot of such cases are avoidable. And I feel that the issue sometimes is that when we look at Architecture as a job or sometimes we use the word day job, right? It is actually not going to be worth the while. You will find that it is going to be very backbreaking, it is going to be quite heartbreaking sometimes also. And a lot of effort that you put in, maybe just torn into pieces, just like that. If you think that your crits in school are bad enough, wait till you come out and practice. So, as long as we continue to think that it is a job that we do in order to make a living, it is not going to work because the nature of Architecture is that there is such an important element of perhaps the word I would use is Mission that there is a sense of mission in architecture that, if you do not get into depth, you will not be able to find the energy to sustain you.

2. HOW DOES COVID AFFECT YOUR WORK?
I don’t really have much vision about it. In fact, I think the whole vision is quite blurred now. And I think I have more concerns and worries about the whole situation rather than the vision but I will say that there is always room for us to change a concern into an opportunity and my concern is mainly that because it has become so evident that human interaction actually can be cut out from our meetings and the way we do things and all that. This kind of meeting that we are having now, it has become the norm. And it has become something that continues to pull people further and further away from each other physically, even though you can talk virtually, but it is never going to be the same as a face to face interaction. And young people are already finding it harder to interact with one another, and to read body language and to be able to see the nuances in human interaction compared to the older generation. My generation would find it harder than my parents’ generation, because we will have a lot more technology than they do, but younger generations like you will be a lot more technically savvy than my generation. So you would actually have more challenges in terms of the ability to interact with people as an overall statement as a general trend. Perhaps some individuals are different. So, I will say that, in this COVID situation, what everybody has become more and more used to is this kind of virtual interaction and my worry about that is that we start to get used to it. And we are desensitized, from the lack of human interaction. And we, we start to lose what defines us as human beings which is actually the relationship that we have with each other and this relationship between human beings is not just a virtual relationship, it has to be a complete and holistic person to person relationship. And that I find is something that is more and more disturbing to me, especially for young children, I have two young kids and actually not that young, one’s a teenager and sometimes I observe how they interact with people and I realized that there is already a difference between different generations. So, that would become a handicap in a real life situation. When you go out to the world and when you try to solve problems with the builders on site, on projects, or in any kind of situation that you will find in life. You will not be able to solve them by just having very good virtual skills and being tech savvy. It’s all about how do you persuade one another? How do you give and take? How do you accept each other’s views? Things like that is actually something that will have to be honed over a long period of time, through human interaction. And that’s, that’s my worry. But I feel that it is also possible to think about how we take advantage of it, in the sense that we have so much technology now, we have a better control of technology. Is it not possible that we can use this technology to work less and live more?

Interview Transcript
Q1: You have completed a variety of projects from big commercial malls, public and private residential projects, nursing homes, MRT stations, what is your design philosophy towards your projects? And what do you think are the different impacts of these projects on the community?
SAA is involved in a large variety of projects and each project has a very specific requirement, and each client also has a very specific focus that they would like to achieve for the project. So you won’t have a one size fits all situation as every project has its own needs and challenges. What I try to always achieve is to create spaces that make people want to go back over and over again. What defines this kind of space is something that is quite universal, that is the comfort that people can find when they go to a space. Comfort is not only physical, it is also psychological. When we talk about psychological comfort, it is not found in all type of spaces. I think those spaces that people always feel attracted to, and want to return to are those with a lot of life and a lot of people that you can interact with. There’s a strong sense of community. There’s also generally a lot of nature that instinctively draws people to it. Comfort is a simple word, but not something simple to achieve.
If you’re talking about public spaces, there isn’t really an owner to the space. It is something that belongs to everybody. Anybody can actually go there and use the facility if they feel like it.
However, some public spaces work better than others because there is a sense of ownership in the people who use them. Ownership makes the key difference between successful public spaces and those that don’t work so well. So the question to ask is, how do you get people to get a sense of ownership to the public space? If you just put yourself in the shoes of a visitor to two different public squares, and one is more attractive and makes you feel more comfortable than the other. You will feel that you want to go back to the one that gives you more comfort, and you will want to always ensure that this level of comfort is preserved there. Therefore, you have an ownership of that space. When you see that there is rubbish on the floor, you will feel more inclined to pick it up. When you see that something is damaged, you feel more inclined to call the manager to come in and repair it, because you are the one using it, and you want to make sure that when you come back, you always get to enjoy it. So that’s what I mean by an ownership of a public space. What we need to do is to design something that is comfortable and attractive enough so that people feel that they own the space and therefore know that space will continue to be nice and attractive for everybody to come.

Q2: What are some ways to give back to the community when you design these spaces?
I think giving back to the community is something that not all projects are able to do to the same extent. The larger the project, the greater the impact on the company and community. A lot of our projects that we do in SAA, actually fall within that category because they are genuinely quite large and they have a lot of different users. One of the things that we need to be careful about when we introduce a new project especially a large one is to make sure that it will not create a negative impact on the existing urban fabric. That sometimes happens when you have a shopping mall that comes in and actually soaks up the entire business of the entire area. The smaller businesses that have been there for a long time start to lose their customers. It is because they are cut off from the people that used to come to their shops, and nobody visits the shop anymore. Eventually they might go out of business. So, when we introduce a big development like this, one of the very important thing is to make sure that we are always able to still allow the existing businesses and existing communities to go on and continue to do what they have been doing, in fact, maybe do even better than what they had before because you are bringing in more life. It makes a very big difference by the way we design them, by the way we connect to the existing developments. What is also quite important to think about is to make sure that within the project that you are doing, there are different types of spaces in which the commercial and non commercial activity can coexist. What that means is that you don’t always feel that you have to pay or you have to spend money in order to come and use this space. There are spaces where anybody can just feel very free to go to, and that’s actually very much about giving back to the community. Because when we talk about a community, it is a group of people who may not want to always spend money every time you enter into your building. They may just want to be there to perhaps find a quiet place to read a book or to be walking the dog or to meet up with friends. So we must design spaces for this kind of very casual and informal activity to take place while not attracting undesirable social behavior. That is how we can give back to the community. But again it takes a lot of thinking to find that balance.

Q3: St. Joseph Nursing Home was one of the first Intergenerational facilities in Singapore. Were there any learning points from designing the Intergenerational facilities in the Home?
St. Joseph Nursing home is run by one of the Canossian Sisters. It is a religious organization and it is very much in their ethos to care about the dignity of the elderly. So, they are very progressive in exploring ways to achieve that intent. Bringing children into their environment in what we sometimes call intergenerational care is something that is quite unheard of in Singapore because of the way nursing homes were previously set up and operated. This is not something that is commonly seen, in fact it has never been seen before. The equipments like those in the playground were specially designed for somebody sitting in a wheelchair and a child to play side by side. There was one that is a basketball hoop that somebody on the wheelchair can throw at and there is also space for a child to do that together. Then there are things that see-saw and all that, which are done solely for the purpose of bringing different generations together. Other than that, there are also spaces where we allow activities that sometimes are quite large in nature because if you have young people coming, children coming in and you have elderly, who are a little bit less mobile, you actually need to create a lot of space for these activities to take place because of maneuvering space and all that. So that kind of spatial consideration is important.
We also learnt that we have to be careful in training or educating the young people on interacting with the elderly. For instance, what the sisters do in St. Joseph Home, when they bring the young people to visit the seniors right is to tell them that you need to sanitize your hands before you go and visit uncles and aunties. That is very different from telling them that, “Okay, now that you have visited uncles and aunties, go and sanitize your hands”. It has a completely different effect. If you ask them to sanitize their hands before that, it shows that they need to be caring for the uncles and aunties and cannot spread any viruses to them, because we do not want them to get sick. But if you ask them to sanitize their hands after, that means you are telling them that there may be some diseases that the uncles and aunties might have, so you better sanitize after you have visited them.
So we learn small things like that, sometimes may not be architectural in nature. But I think design is not just architecture. Design goes beyond that. As a designer, you need to think of how a space is used, how you program the space, and how you work with the users. What kind of mindsets do you want to help them to cultivate? I think all these are actually very important parts of the overall success of the space, not just the hardware itself.

Q4: Moving on to questions on the St. Joseph nursing home. We wanted to know more about what was the driver behind the design in terms of form or in terms of the programs that you guys are introducing, and what were the stakeholders’ involvement in that project? Were there any opinions taken to decide on design decisions you made?
So the St. Joseph home or SGH project is a very interesting one that we were quite attached to. And we feel that there’s a lot of very good lessons that we have learned from it. In fact, when it all started, we were brought to the previous site, which was a single story nursing home, a very beautiful site. And we went there and the managers brought us around, showed us how they operate the site, how they allow the residents to use the spaces around the very beautiful garden setting. There was this large quadrangle which is in the middle and there’s lots of planting, there is a very nice naturally ventilated walkway that goes around it. And you can actually roam around and you can actually move around quite freely as a resident or as visitors. So, that’s what I saw when I went to the site and started looking and thinking about how we approach the design of this space. The design brief was, however, very challenging, we needed to increase the number of beds by about three times of what it was, which is actually a very tall order. Increasing three times normally would mean that you have to build upwards and from a single storey building, what we needed to do was to start considering how to stack it up to like a five or seven six storey building. And that was the design constraint that we were given but at the same time, that was also the opportunity for us to turn into something interesting. So, if you ask what is the driver behind the project, I will say that the driver is a simple question of how can we retain this experience of being on the ground, up into the sky. And that I found out was actually very important for somebody who is staying in a nursing home.
There are a couple of things that are the hallmarks of failure of a nursing home. And one of it is actually the inability to move around. So the lack of mobility will result in things like boredom. Because if you’re always stuck on your wheelchair in a corner on a bed and you can’t move, you’re always going to be looking at the ceiling or you’re going to be looking at, perhaps a window if you’re lucky, but you’re always going to be looking at the same thing. And the problem of being in a nursing home is that there is a lack of variety of experience for the person. And when you are actually limited in terms of what you can see and what you can experience, your sense of life starts to go away. And that is one of the main issues of a nursing home. And therefore what we wanted to do on day one was really to find ways to allow the residents to be able to move around, no matter which floor they’re on. And if you have done some research about the project, you will have noticed that there is actually a garden that loops around on every floor of the nursing home, no matter which floor you’re on and this encourages the residents to actually continue to walk around the rooms, where they live on, and that is actually very important in helping them to maintain a sense of life and a level of energy that is very important for upkeeping the health that they have. So, I will say that, this is something that has been driving the project and we managed to actually do it quite effectively, I would say, and therefore, I think that’s something that the owners are also quite happy about. So there were some workshops that were conducted during the design process. And these are actually very useful because it is not a one way traffic. It’s actually a two way design process. So you talk to the users and you get insights from them, or issues that you deal with and you incorporate all these into your design before you finalize and get built.
Very proud of the work that you’re doing, they must first be happy. If they are upset about the space that they have, if you can’t wait to get out of that place, then you cannot expect them to be doing a good piece of work in their day job. Generally, I think they’re all quite delighted by what they see over there. If there’s anything that I would have done differently, I think perhaps it’s actually to do more of what we have done which is the gardens that we have created.
I would say that if I were to do anything, if I can do something differently, it is actually more of what we have done. So, to really extend the ability for people to walk, to be close to nature, even more than what there is now.

Q5: Can you elaborate a little bit more about the workshop? Were the elderly involved as well?
There are all kinds of workshops that we actually conduct and workshops need to be an interactive process. And when we have workshops with other types of stakeholders in hospitals it involves a lot of people who will be actually operating the space. And if the elderly residents are unable to contribute to the workshop, we will need to involve people who work with them very closely. For example, their caregivers, the people who really know them very well, know what kind of problems they go through everyday. Then we involve these people in the workshop so that they can give you the input that is very real, very grounded so that when we design the space it is also designed with a lot of relevance to the actual end users. So it’s not easy to conduct a workshop. But if you have done it a few times, you sort of know, what is the best way to get insights from people. So there’s a certain technique of doing it, so that it becomes effective. And I think as architects, this is a tool that we are seeing ourselves using more and more over the years. And certainly in the years to come. If you want to be collaborative, if you want to be open minded about design solutions, then that is one very useful thing to adopt.

Q6: One of the highlights of the St. Joseph Nursing home is the Green Belt that allows the elderly not only those who are bedridden, but also those who might not be able to go down and walk around the space, I think those are very good considerations that you had, other than those two groups of elderly, since there is a large spectrum of elderly, and St. Joseph Nursing home also has dementia patients. So, given that there is a whole spectrum of the elderly, what are the other challenges that you guys planned for or those that you faced when you are designing for the elderlies in various conditions?
I think all of us will become old one day and, in fact, as a country Singapore is growing old very quickly. And if you look at some statistics, you will know that in 10 years time, about 25% or a quarter of people in Singapore are going to be more than 65 years old. Okay. So retirees will stop working. And when we start to become some we start to become older, a lot of us, we will start to lose our basic functional skills. And when we talk about this loss of skills, in the clinical language, they call it Activities of Daily Living, or ADL.
There are some basic ADLs that all of us are taking for granted, like changing your own clothes, feeding yourself, taking a cab or taking a MRT, simple things like that.
So we actually take some of these things for granted. And you’ll find that as we start to grow old, we will start to lose one or two of some of these functions.
And these are actually very critical functions, that when we have it, we don’t really think about it. But when we lose them, it affects us tremendously. And you will not be able to imagine how badly it will affect you. If you lose the function of let’s say, going to the toilet yourself.
You can imagine that every time you need to pee, somebody must bring you to the toilet and help you. Can imagine that now if you have to go and brush your teeth. You can’t even do it yourself and somebody must help hold your hands to do it for you. This is the loss of ability to do basic things by ourselves,actually has a very massive emotional impact on people. And therefore, they become quite unhappy. A lot of times, you can sometimes look at an old person. You find that, in a way, when you look at a photograph of old people, you tend to see a lot of them being rather unhappy. And I think a lot of it is actually because they are starting to lose some of this ability to do things for themselves. And then that will bring you a lot of unhappiness. And I think, if you were to design spaces for elderly, and if you were to work on environments for elderly’s usage, you must not forget about that. And we must therefore, always look at how we can design the environment to make the elderly happy.
Help them to forget about some of these physical limitations that they have. Are there things that we can bring to the elderly environment in order to just give them an element of delight, or things that they enjoy in all kinds of environments, it doesn’t just have to be in the nursing home.
And how do we bring in things that you think that will give them just a little bit more happiness in their life? And I think that is something very useful for us to remember. Like children. I don’t know whether you know, but the elderly people, they actually feel much better. In fact, their blood pressure will fall a little bit when they come into contact with young children.
So that is something that I have heard from many people, and I think it’s true. So there are many of such indicators that show that there are ways that you can actually bring certain elements into contact with old people. And that will help them to feel happier. And as Architects, as designers, definitely there’s a lot of room for us to introduce that in the environment that we design for them.

Q7: Have you had a chance to go back to the St. Joseph nursing home to take a look at the spaces you had designed? And what are other than your own reflections were there feedback given on those spaces that you designed and looking from a critical point of view, is there anything that you would have done differently, looking back?
Yeah, I did go back a couple of times after completion, either to talk to the managers or to bring other visitors to take a look. And I would say that a lot of the time, they are always quite happy with the facilities that we have designed for them, there was actually once when we were walking around and it was I think, maybe 6.30 to 7pm around there definitely after 6, and as I was walking with the manager in the gardens on the ground floor, there was some nursing stuff who were hanging around in this dining area on the ground level. And so the manager was bringing me around, started to talk to them and said, “Eh, why are you guys still here? I thought your shift is over” because they have shifts right? It is a 24 hour thing. So “why are you guys still here, you know it is supposed to be the night shift now.” And then they smile and say “No, no, we like it here.” And, and the manager laughed and so he told me that sometimes what is very interesting is that the staff who work there, they will actually come early, and they would leave late, they wouldn’t come on the dot and leave on the dot. And sometimes what they tell him is that they find it actually to be nicer in the Home rather than outside. So they would actually spend more time in the Home rather than to go home early. Which is actually very heartening to hear.