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A CARE HOME FULL OF HEART AND SOUL
The redesign of St Joseph’s Home shows how architecture
can improve care by taking an empathic approach
Bringing the ground floor to every floor for residents to
move among the lush greenery.
Abstract: Built originally in 1978, St Joseph’s Home was transformed from a single storey building
into a six-storey building with a roof-top garden equipped with assisted living, hospice, aged care,
and dementia facilities. The redesign by SAA Architects, a member of the Surbana Jurong Group,
was completed in 2016. The redesign positioned St Joseph’s Home as the first care home in
Singapore where elderly residents could interact with the children using the infant and childcare
centre built on the premises. Taking an empathic approach to design, our architects immersed
themselves in the process of understanding the needs of the people who would live and work in
St Joseph’s Home. In the redesign process, they built a community through a shared love for the
chapel of the home, plenty of green spaces, with natural light and ventilation. The redevelopment
received an award at the World Architecture News Awards (Healthcare Category) in 2019.
PRACTISING EMPATHY – AN EXPERIENCE IN IMMERSIVE DESIGN
The architect’s profession is deeply rooted in the ambition to serve people better, especially those who
feel vulnerable in unfamiliar environments, among which the nursing home is an example. Together with the forward-looking team of St Joseph’s Home (SJH) and through an immersive design process, we as architects were able to create a new model of Nursing Home in Singapore, with care, love and faith at the very core. This is an account of the SJH design experience from inside out,
which opened our eyes to the true meaning at the heart of a project and testifies that our work as
architects can and should be as fulfilling and life-giving as this.
Before we embarked on the project, we, as architects, asked ourselves the following questions:
We immersed ourselves in their daily operations: understanding how many residents each nursing team oversees; what challenges they face in space planning; what situations are prone to trigger resident’s anxiety; and, what exactly is the condition and ability of different groups of residents.
The practice of empathy in design required us to watch and observe the people using SJH in detail.
Our first encounter with the residents of SJH was in May 2014. It was a late morning and the pace
of life there was slow. We stepped into a large green courtyard surrounded by a single-storey
building. The materiality of the building was sturdy, with brick walls and terracotta roofs giving a
strong sense of authenticity to the existing home. Inside the single storey building with a large roof
overhang, and as we walked through the home, we found that it was punctuated with internal
courtyards and day spaces filled with daylight.
Existing residence before the redesign by SAA Architects: A single storey building in brick and terracotta. (Photo: Charles Arnal)
Existing residence: Serene and generous courtyards punctuated the spaces of the home. (Photo: Charles Arnal)
Inside, residents, mainly wheelchair bound, gathered around tables in small groups, while others
preferred to be on their own. Another group of residents who were bed-bound stayed in their
bedrooms, although they were aware of the activity around them. Moving them out of their room
was too challenging due to the bulkiness of their bed, so they were largely confined to the bedroom.
There was an air of expectancy around, perhaps the residents were waiting for the highlights of
their day – meal-time or organised activities. The nurses appeared alert and observant, having a
precise schedule to follow.
In fact, we found that the religious sisters were always, but discreetly, present. They are the
guardian angels of the home and make sure that all residents, including nurses, are well.
Existing residence before the redesign by SAA Architects: Expanse of the main courtyard looking towards the Chapel. (Photo: Charles Arnal)
The majority of residents were wheelchair-bound, and even though the facility was a single-storey,
the spaces and fixtures posed challenges to them. Some were making large detours to avoid a
single step to access the courtyard. Another resident was trying to grab a glass of water by himself
just like he would do at “home”. However, the sink was too high and the tap too far. Once
successful, he left rolling on his wheelchair with the glass of water clamped between his legs.
Even getting a glass of water was a challenge.
Essentially, we realised that small details like these were dramatically affecting residents’ autonomy
and reducing their ability to take care of themselves.
Apart from observing the challenges faced by the residents, our workshops with the sisters and
healthcare workers immersed ourselves in their daily operations: understanding how many
residents each nursing team oversees; what challenges they face in space planning; what
situations are prone to trigger resident’s anxiety; and what exactly is the condition and ability of
different groups of residents.
While some residents are less mobile because they are wheelchair or bedbound, others may be more
mobile but affected by dementia. The issue was how to keep them safe as they moved around.
Together the healthcare workers and the design team developed the concept of “families” consisting
of clusters of bedrooms at with a shared living room and pantry, with a view looking out to the
central garden and chapel at the centre of SJH. We tested all nursing equipment to size the space
properly but also focused on how to keep residents mobile without compromising their safety.
The collective dreaming and building of the home with community. (Photo: Charles Arnal)
We had no idea how much energy, love and resilience was required in the daily duties of the care
team, to continue giving care to the best of their ability. We also realised how taxing the work of healthcare workers are, when taking care of residents with dementia, as they may get agitated and distressed when they are unable to recognise their care-giver, often while bathing. These are daily traumatic upsetting experiences
for them, as much as they are heart-breaking experiences for the nurses. We understood that they
were caring and giving without conditions. We were moved to help them with better convenience
and intuitiveness.
We understood it was critical for the new facility to become an enabler that enhances autonomy and
movement for all while facilitating the delivery of care.
BRINGING THE GROUND LEVEL TO
EVERY FLOOR
In general, and despite the slow pace in the home, mobility appeared paramount to everyone. Some
residents would go around continuously and enjoy doing so to pass the time. It was clear that the garden
surrounding the chapel and courtyards punctuating indoor spaces were the main incentive to for
residents to move around.
Bringing the ground floor to every floor by lacing a green loop around to encourage mobility and vantage points. (Photo: Aaron Pocock Photography)
The redesigned SJH would need to provide opportunities for movement around each floor and help
residents feel empowered. Widening the green spaces surrounding the home at regular intervals
would also allow bedbound residents to be comfortably wheeled outdoors to enjoy the breeze – just
like other residents. Offering them a variety of vantage points along this green journey would
improve their daily routine and facilitate the work of nursing staff. The presence of greenery along
corridors and the use of the right material to convey a sense of home would become crucial to
shape a home that residents would hopefully connect with.
As we worked closely with the religious sisters who operate the home, we found that they were
focused on the resident’s comfort and wellbeing. How to provide better care – This was the only
thing that really mattered to them, and we were constantly inspired to help them as we immersed
ourselves in the process of designing SJH.
Having built such a level of empathy through the early design workshop process, we gravitated
towards the choice of a terracotta façade as an effective way to pay tribute to the memory of the
original place while sustaining the idea of “home”.
Greenery-filled corridors are woven along the periphery of every floor to enhance residents’ access to nature. (Graphic: SAA Architects)
PUTTING THE DIGNITY OF THE USER FIRST
The “Peace Room”, contrary to being hidden away at the back of house, is given a dignified and discreet space, tucked beside the home’s main lobby. The [deceased] resident would leave this home which welcomed him or her, by the same manner, through the front door.
The most memorable feature of the redesign was to raise the profile of one specific room in the new
home.
The room that other nursing homes might typically call the “last room” – usually one hidden away at
the back of a home where a deceased resident is housed while awaiting funeral arrangements –
is placed beside the main lobby at the entrance to SJH.
Named the Peace Room, this room is given a dignified yet discreet space in the main entrance of the
SJH, signifying there is dignity in death. It is the belief of the religious sisters that as all residents of the
home enter from the front door, they should eventually leave from the same door too.
The idea of a home away from home became even stronger when we realised that SJH was not only
a home for elderly residents receiving care but also for the religious sisters and nursing staff
themselves. At level 1, the sisters’ accommodations required total privacy and some open space for
gardening while the rooftop at level 6 would house staff dormitories and recreational spaces. Levels 2
to 5 were allocated to elderly residents. We found this proximity between the accommodations of
sisters, nurses and residents meaningful since it was representative of a model of care that celebrates
dignity and respect.
STAYING CONNECTED THROUGH FAITH AND A SHARED HISTORY
When we began considering a multi-storey building for the new home, we realised that disconnecting
residents from the ground-floor green courtyard was the biggest threat to the original character of SJH.
It was not ideal for residents, who would now live on the upper floors, to feel detached from the
greenery on the ground.
Hence, we reimagined a courtyard that would stretch to every floor, imparting to residents the feeling
of still being connected to the ground. Every floor would then feel like a ground floor, allowing residents
a view out to the chapel like they used to. The design communicates the value of being grounded in
strong connections – to the land, to the chapel’s rich heritage, and to the religious faith of this
community.
The design communicates the value of being grounded in strong connections – to the land, to the chapel’s rich heritage, and to the religious faith of this community.
At the same time, the multi-story building would need to remain at a human, friendly and intimate
scale. From what we have seen and learnt through design workshops with the clients, we designed
for rooms to be clustered and screened for privacy, with each cluster grouped around a living room
which opens to generous plant boxes and framed views of the chapel. We called each of these
clusters a “family”.
Mindful about what matters to this community – their history, faith and the work of caring and nursing. (Photo: Aaron Pocock Photography. Graphic: SAA
Architects).
The religious sisters always saw the home as a welcoming place for community, friends and
volunteers. The home and chapel are strongly anchored in the community around and visitors
represent a source of energy that energises residents. At the heart of the home is a childcare centre,
which is open to the nursing staff and neighbouring community, and a playground where residents
and children can mingle and participate in daily activities.
Overall, the team also aimed to design for community, mobility and dignity. First, the team
incorporated and strengthened the existing chapel as a beacon for the whole redevelopment.
We also maximised the natural ventilation, day light, and sun shading by orientating every ward
at an angle determined by the prevailing winds and sun-lighting.
From a home with over 100 beds, SJH had 412 beds after it was redeveloped into a person-centred
space for nursing, hospice care, therapy and even community services for people of all races and
religions.
Despite the greater built-up area, the result is a home-like environment with wide corridors for easy
mobility. Terracotta screens provide privacy and natural ventilation. The access to plenty of greenery
also reduces stress levels for residents and the staff at the home.
Community at the centre of the home, an inter-generational playground in the heart of the courtyard. (Photo: Aaron Pocock Photography)
A GENUINE AND RESPECTFUL PARTNERSHIP
At our project kick-off meeting, the religious sisters
welcomed us with warm smiles and greetings. Our
design proposal was placed on an easel with a candle lit
in front of it. We prayed before starting our meeting and
we were told that SJH’s team had fallen in love with our
proposal.
We were greatly humbled by this unusual warmth and
expression of a client, which inspired us to put our hearts
and souls into the project. Respect and love fuelled
every step of the project development until completion.
A close collaboration founded on partnership and respect.
(Photo: Charles Arnal)
CLOSING THE LOOP OF THE IMMERSIVE DESIGN JOURNEY
After handing over the new home to the care team in 2017 and residents started to move in, we
received an invitation from Sister Geraldine, the Executive Director of St Joseph’s Home, to stay
overnight and get a first-hand experience of the building.
On top of being incredibly mindful and generous, this invitation was a precious opportunity for us to
close the loop of our Immersive Design journey.
Upon arrival, we observed how quickly the care team had personalised some of the living spaces
bringing life and vibrancy in the interiors. The previously bare dining space was now equipped with al
fresco dining décor, adorned with faux bricks, vivid colours, topped with decorative awnings and
surrounded by artificial plants.
In other spaces, columns were wrapped with colourful ribbons and circular paper folded origami,
while multicolour garlands and other pom-pom crafts appeared hanging from the ceiling.
Our architects’ mind being naturally drawn towards minimalist and sleek spaces, we were initially
surprised. However, we quickly understood that this was the process of creating elements of a relatable
domestic environment for the elderly residents to integrate and adjust back into living in the new
building. In fact, we were spectators of something beautiful as it had successfully become a Home.
This experience taught us a lot about the user perception of the spaces we create, and that good
design goes beyond a photogenic magazine-worthy minimalist space. The beauty and sense of
affection that good architecture can impart to its occupants also comes from the successful and intuitive
personalisation done by its users – who ultimately are the ones who give ‘home’ its true meaning.
Home is where the heart is.
Light from the chapel represents a beacon of hope for the residents in this home. (Photo: Aaron Pocock Photography)
Project
St Joseph’s Home
Location
36 Jurong West St. 24, Singapore 648141
Size
22,054 sqm
Status
Completed 2016
Client
Catholic Welfare Services Singapore
Services
Nursing home
Collaboration
BES Technologies (Hydrotherapy Pool design advice)
Firm / BU
SAA Architects Pte Ltd
Project Lead
Chan Chee Lun
Project Team
Michael Leong, Chan Chee Lun, Charles Arnal, Darryl Toma
Keywords
Nursing home, senior care, inter-generational, empathic design
The SEEDS Journal, started by the architectural teams across the Surbana Jurong Group in Feb 2021, is a
platform for sharing their perspectives on all things architectural. SEEDS epitomises the desire of the Surbana
Jurong Group to Enrich, Engage, Discover and Share ideas among the Group’s architects in 40 countries, covering
North Asia, ASEAN, Middle East, Australia and New Zealand, the Pacific region, the United States and Canada.
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