Professional Documents
Culture Documents
Literature Study
Literature Study
Indian context:
India, the land of cultures and different religions has its own history and stories. The
different languages and its religions define every individual from others yet they are
same when they come under certain situations where they had to accept the fact of
their lives.
The kumbh mela's in India still shows how people stick to their roots and their rituals.
They are known as the world's largest religious gathering space. People from
different corner of the world come to these places for their mental peace. Not only
Hindus, but also people from other religions come and spend their time for their
spiritual knowledge also known as PARA VIDHYA.
These activities, where a lot in olden days with many ashrams in India .The country
was known for the style in which people lived in olden days .The orders, and ashrams
that they stayed in, had everything that people needed. In olden days people used to
visit or even stay in ashrams to achieve certain motives in their life. Young kids
studied for a certain period of time in an ashram called as GURUKUL.
In the same way, people who were interested in sports and wars had a different
ashrams and people interested in dance and music learnt in NATYASHASTRA
ashram. Out of many other ashrams such as GRAHASTH ASHRAM,
BRAHMACHARI ASHRAM, AKHADADALI ASHRAM, etc.,
VANAPRASTH ASHRAM was one such ashram where people use to go in their
last days. These people were either old or suffering from some non-curable disease.
What is Vanaprastha?
Vanaprastha means ''retiring into a forest’’.
These ashrams are certainly not restricted to one type of religion but also can now
be used by any user groups of any religion and age or both. Not only in India, but
also other countries like the US, the UK etc. have such ashrams with other names.
These ashrams helped human beings of those ages to keep their spirits alive and
organized because originally Indian Yogis considered human life to have a span of
100 years and it was divided into 4 stages.
The first 25 years of age were spent in Bramhacharyashram, the next 25 to 50 years
of age in Grihasthashram, followed by 50 to 75 years of age
in Vanaprasthashram, where you start delegating and preparing yourself for further
journey and the final 75 to 100 years of age were enjoyed in Sanyasashram, where
you are not bound by your normal duties. Sanyasashram is the last stage after you
have completed the normal duties, when you are totally free because other people
have taken over and you start walking the path of spirituality.
We are now even more modernized and so well developed that the concept of going
to vanaprasthashram has vanished. Still the concept of vanaprasthashram is been
seen in a very different manner.
There are the places where people suffering from terminal illness like cancer,
tumors, etc. and people who are abandoned stay during their last stages of their lives
so that they can spend their last days in peace.
VANAPRASTHASHRAM HOSPICE?
Hospice is a modern name for vanaprasthashram. During olden days people used to
go to vanaprasthashram when they almost completed their marital life or when they
were done with their happy life as they want spiritual peace during their last days.
In the modern world full of competition, we are all stressed and our life is filled with
complications and at the end the day all that one need is a peaceful life.
Hence people in their last days search for a peaceful and calm life. On the other hand
people suffering from few chronic disease and know that their life is going to end
soon search for a peaceful and happy life so that they can spend their last days in
peace hence we can easily say that in today's world the term hospice is related to the
olden word vanaprasthashram.
In short, hospice is a modernized name for vanaprasthashram in today's context.
500 A.D -
- Community as a group responded because death often posed direct threat to
the entire community.
- In some cases, ill person would be excluded from the group and left to die
on their own.
- The places where these patients were kept were supposedly the first hospice.
6th Century -
- Monasteries started to take in sick and those disabled or unable to support
themselves.
- Wealthy women and widows started working in these monasteries as their
first nurses.
11th Century -
- When rise of crusading movement saw ill and incurable, they were permitted
into places dedicated to treatment by Crusaders.
14th Century -
- The order of Knights Hospitaller of St. John of Jerusalem opened first
hospice in Rhodes, meant to provide refuge for travelers and care for ill
and dying.
Middle Ages -
- Hospices flourished in the Middle Ages, but languished as religious orders
became dispersed.
17th Century –
- France revived hospice by the Daughters of Charity of Saint Vincent de
Paul and until 1900, six hospices were formed and served.
Mid-19th Century-
- The U.K - Attention was drawn with Lancet and the British Medical
Journal publishing articles, four more hospices were established in London by
1905
In 1950’s –
- Cicely Saunders developed many of the foundational principles of modern
hospice care.
About Dame Cicely Mary Saunders
- Dame Cicely Mary Saunders (22 June 1918 -14 July'05), was an English
Anglican nurse, social worker, physician and writer, involved with many
International universities.
-She is best known for her role in the birth of the hospice movement, emphasizing
the importance of palliative care in modern medicine.
-Ms. Saunders introduced the idea of "total pain", which included physical,
emotional, social, and spiritual distress.
-In 1967, St Christopher's Hospice, the world's first purpose-built hospice, was
established.
-The hospice was founded on the principles of combining teaching and clinical
research, expert pain and symptom relief with holistic care to meet the physical,
social, psychological and spiritual needs of its patients and those of their family
and friends.
- It was a place where patients could garden, write, talk and get their hair done.
- Death marks the end of a transition phase – the time approaching death becomes
the transition period, where one is preparing for the transition.
- This time period, like incubation period, should be spent in a comfortable, caring
and dignified environment.
LITERATURE
STUDY
Hospice Care
Considered to be the model for quality and compassionate care for people facing a
life-limiting illness or injury. Hospice care involves a team-oriented approach to
expert medical care, pain management, and emotional and spiritual support
expressly tailored to the patient's needs and wishes. Support is provided to the
patient's loved ones as well. At the center of hospice and palliative care is the belief
that each of us has the right to die pain-free and with dignity, and that their families
will receive the necessary support to do so.
Hospice is specialized type of care for those facing a life-limiting illness, their
families and their caregivers.
The word hospice is derived from Latin word 'hospitium' a place where a guest
receives hospitality.
The words 'hospital' ,'hotel' & 'hostel' all derive from same Latin root, and
suggest places of comfort, support and care.
Hospice care addresses the patient’s physical, emotional, social and spiritual
needs.
Hospice care also helps the patient’s family caregivers.
Hospice care takes place in the patient’s home or in a home-like setting.
Hospice care concentrates on managing a patient’s pain and other symptoms so
that the patient may live as comfortable as possible and make the most of the
time that remains.
PURPOSE
To provide LTC (Long Term Care) facilities with an overview and guidelines for
partnering with Medicare-certified hospice to benefit terminally ill residents and
their families and review responsibilities of the facility as well as the hospice to
provide palliative care.
The core issues of developing palliative care in Indian setting keeping in mind
the ethical, spiritual and legal issues.
OBJECTIVES
To describe the proposed project and associated works together with the
requirements for carrying out the proposed development.
To identify and describe the elements of the community and environment likely
to be affected by the proposed developments.
To establish the baseline environmental and social scenario of the project site and
its surroundings.
To identify and quantify emission sources and determine the significance of
impacts on sensitive receptors.
To identify, predict and evaluate environmental and social impacts during the
construction and usage of the project in relation to the sensitive receptors.
To develop an Environmental Management Plan that identifies the negative
impacts and develops mitigation measures so as to minimize pollution,
environmental disturbance and nuisance during construction and operations of
the development.
To design and specify the monitoring and audit requirements necessary to ensure
the implementation and the effectiveness of the mitigation measures adopted.
providers must be responsive to the unique needs of the resident and his/her
desires
HOSPICE SERVICES
Skilled nursing
Medical social services
Personal care
Spiritual care
Volunteer support
Physician services
BENEFITS OF HOSPICE
By selecting hospice, resident has clearly asked that his/her care be focused
on palliation
Added attention to pain management and other symptoms related to life-
ending illness
One-on-one emotional support for the resident and the family
May have financial relief due to hospice paying for medication ,supplies, and
equipment related to terminal illness
Volunteers visit residents and provide interaction with the resident and/or
family.
Symptom Control
Informed System
consent Efficiency
Medication
Communication
Prioritization
Terminal Agitation
Terminal agitation often surprises many family members and caregivers alike. The
loved one who is usually calm, suddenly and unexpectedly becomes agitated and
restless. The patients near the end of a terminal illness may experience profound
mood changes. Therefore, terminal agitation is often accompanied by mood swings
or personality changes which leave caregivers feeling helpless and bewildered. The
sudden onset of behavior changes differentiates terminal agitation from the
personality changes of dementia which are usually gradual.
User Groups
With the time, the concept of olden design has changed to new ones with a better
space. Now the old vanaprasthashram is been replaced by hospices in this modern
times and so the type of people coming to this place has been changing. Unlike the
olden days, now even the young people and kids suffering from terminal illness and
many other serious problems, can now register themselves and stay there to spend
their last days of life.
Not only people suffering from serious illness, but also people who want to stay
away from the competitive world, and want to spend some time in peace and serenity
to gain spiritual knowledge and increase it, can also come and stay for few days.
It also contains spaces for the local people where people can come there during the
evenings after their office hours and spend some quality time, as it can turn out to be
a good recreational place for the city as well.
Related Behaviors
Restlessness Verbalizations
Hallucination
Confusion Inability to sleep Impaired
Incoherence sleep
Paranoia Wakefulness/insomnia Sleep
Disorientation disturbance
Difficulty focusing
Inability to concentration
This is the reason that a hospice should do this by exploring with people their unique
sources of faith and hope, helping them to recognize their own spiritual nature and
individual practice of faith, or by just being there.
Spiritual Care represents the concern for an individual as a whole person – a unity
of body, mind, and spirit. All individuals are unique and of value. It is our hope that,
through the Spiritual Care staff, the meaning of life’s journey can be understood and
interpreted. Spiritual Care is available without regard for gender, race, national
origin or religious affiliation, or previous enrolment in hospice.
Functionalities of a Hospice
Contacts the patient and/or family member to discuss needs so that spiritual
care can be provided in a manner respectful of their faith.
Provides a compassionate listening presence, allowing patients and families to
share feelings and concerns.
Provides support for families in their grief process as they anticipate the loss
of their loved one.
Contacts patient’s clergy at patient/family request.
Helps provide religious practices and rituals including: prayer, scripture
reading, sacraments of baptism, worship, communion and anointing, plus other
spiritual resources as needs arise.
Makes routine and emergency visits with patient and/ or family when they
desire support during loved one’s terminal illness.
Provides consultation in ethical decision making
Helps with mediation of stressful situations.
Provides Spiritual Care in homes, long term care facilities, hospitals or
inpatient settings.
Tube Feeding
As the person get older or have health problems, they may not be able to swallow
normally or take in enough food or water. If they want food and water, they can
choose to receive them by tubes. This fact sheet can help them decide if they want
to try tube feeding. The time to make this choice is when they feel well and have the
facts they need. They can ask questions and talk with their doctor and others. They
can also think about what being alive means to them. Tube feeding may or may not
work for all. There may be side effects. The doctor who knows the patient best can
help them make their decision.
M&M is a therapeutic use of music (not music therapy) for patients with early
Alzheimer’s disease or other forms of dementia. It is designed for patients where
music has been an important part of their lives and they are alert enough to enjoy.
Patients will listen to music with a volunteer on iPods with a customized playlist
based on input from them, or their family.
Relaxation Therapies
Music Therapy
Music therapy is a recognized health profession proven to manage physical
symptoms, enhance mood and stimulate memory recall. The board certified music
therapist (MTBC) uses live music to provide pain management and offer emotional
support for patients while also supporting their families. Music therapy is a patient-
centered and non-invasive approach to end-of-life care.
Among the 40 countries ranked, for end of life care services they provide to their
citizens, the UK was at the top of the chart followed by AUSTRALIA and NEW
ZEALAND. Sadly INDIA was at the bottom behind UGANDA.
"We have patients who have huge wounds or swellings. Some with oesophageal
cancer are fed through a tube, there are some who have little tissue left on their
faces. But we never think for a moment that euthanasia is an answer," said one of
the volunteers at the 100-bedded hospice.
Less than 1% of India’s 1.3 billion population has access to palliative care. The
efforts by pioneers over the last quarter of a century have resulted in progress,
some of which may hold lessons for the rest of the developing world. In recent
years, a few of the major barriers have begun to be overcome. The South Indian
state of Kerala, which has 3% of India’s population, stands out in terms of
achieving coverage of palliative care. This has been achieved initially by non-
government charitable activity, which catalyzed the creation of a government
palliative care policy.
Design Objectives
1) The first part is recreational space - This space consists of local people and people
in a better stage say in a starting stage. these spaces will mostly have open spaces
and activity spaces such as:
gathering spaces
sitting area
informal spaces
halls
meditation rooms
open spaces for meditation
open air theatre
2) In the second part of the design, the space will consist of the informal activity
spaces which will act as a bridge between the 1st and the 3rd part it allows the
minimum local crowd to enter and contains most of the informal spaces.
3) The third part will contain the major part of hospice where people during their end
days can stay live with their parents or stay in a community.
Even though certain open spaces should be designed to encourage a certain kind
of user group through designed ‘ownership’, the outdoor environment should cater
for a diverse community and their different accessibility and requirements. The
residential environment should be designed to foster and encourage independence.
Autonomy, independence, and usefulness are fostered by providing
personalization opportunities and control over the design.
Limitations
Minimum structural details of the design will be given
More focus in the design will be given on the ethical behavior of the people
coming the major focus of the design will be given for the spiritual care of the
people
We also need to see that the rooms and the wash rooms designed are barrier free and
are provided with sufficient amount of oxygen to it for their health purposes We
being architects should take care of the people coming in the hospice and their
parents there are again people coming with their parents and also people coming
who were left abandon spaces can be designed in such a way that the people staying
in it should feel homely and safe at the same time proper medication and track can
be kept on their health on day to day bases.
DATA
COLLECTION
Standards
Standards are very important for an architectural design specially for such kind of
spaces where all kind of people come majorly, elderly people. Hence it is important
to provide a barrier free design for people. For a barrier free standard first we need
to understand the type of people coming n their anthropometry.
Adequate space should be allocated for persons using mobility devices, e.g.
wheelchairs, crutches and walkers, as well as those walking with the
assistance of other persons
The range of reach (forward and side; with or without obstruction) of a
person in a wheelchair should be taken into consideration
Attention should be given to dimensions of wheelchairs used locally.
Standard size of wheel chair has been taken as 1050mm x 750mm (as per
ISI).
Range of Reach
Allow a space at least 350 mm deep and 700 mm high under a counter, stand, etc.
* A wheelchair user’s movement pivots around his or her shoulders. Therefore, the
range of reach is limited, approximately 630 mm for an adult male.
* While sitting in a wheelchair, the height of the eyes from the floor is about 1190
mm for an adult male.
* A wheelchair has a footplate and leg rest attached in front of the seat. (The footplate
extends about 350 mm in front of the knee).
The footplate may prevent a wheelchair user from getting close enough to an object.
Allow a space at least 350 mm deep and 700 mm high under a counter, stand, etc.
Semi-Ambulatory Disabilities
People with impaired walking, people who use walking aids such as crutches or
canes, who are amputees, and people who have chest ailments or heart disease fall
in this category. The people in this category include those who cannot walk without
a cane and those who have some trouble in their upper or lower limbs although they
can walk unassisted.
Design requirements
Sidewalk width
Walkway should be constructed with a non-slip material & different from rest
of the area.
The walkway should not cross vehicular traffic.
The manhole, tree or any other obstructions in the walkway should be avoided.
Guiding block at the starting of walkway & finishing of the walkway should
be provided.
Guiding block can be of red chequered tile, smooth rubble finish, prima
regina, Naveen tiles or any other material with a different texture as compared
to the rest of the area.
Parking
Every building should have at least one entrance accessible to the handicapped and
shall be indicated by proper signage. This entrance shall be approached through a
ramp together with the stepped entry.
Ramped Approach
Ramp shall be finished with non-slip material to enter the building. Minimum width
or ramp shall be 1800 mm. with maximum gradient 1:12, length of ramp shall not
exceed 9.0 M having double handrail at a might of 800 and 900 mm on both sides
extending 300 mm. beyond top and bottom of the ramp. Minimum gap from the
adjacent wall to the hand rail shall be 50 mm.
Cross Section of Ramp
When climbing a ramp in a wheelchair, the upper limbs must bear the burden
of propelling the body up the ramp.
When descending a ramp in a wheelchair, especially on steep ramps, there is
a possibility of the wheelchair running out of control because the user must
manually control the speed.
Prevent the installation of steep ramps.
Stepped Approach
For stepped approach size of tread shall not be less than 300 mm. and maximum
riser shall be 150 mm. Provision of 900 mm high hand rail on both sides of the
stepped approach similar to the ramped approach.
Detail of a Railing
Entrance Landing
Entrance landing shall be provided adjacent to ramp with the minimum dimension
1800 x 2000 mm. The entrance landing that adjoin the top end of a slope shall be
provided with floor materials to attract the attention of visually impaired persons
(limited to colored floor material whose color and brightness is conspicuously
different from that of the surrounding floor material or the material that emit
different sound to guide visually impaired persons hereinafter referred to as “guiding
floor material”. Finishes shall have a non-slip surface with a texture traversable by
a wheel chair. Curbs wherever provided should blend to a common level .
The corridor connecting the entrance/exit for handicapped leading directly outdoors
to a place where information concerning the overall use of the specified building can
be provided to visually impaired persons either by a person or by signs, shall be
provided as follows:
a) ‘Guiding floor materials’ shall be provided or devices that emit sound to guide
visually impaired persons.
b) The minimum width shall be 1500 mm.
c) In case there is a difference of level slope ways shall be provided with a slope of
1:12.
d) Hand rails shall be provided for ramps/slope ways.
Required Width for Passage of Wheelchair
The wheelchair body itself is about 650 mm wide. Allowing for the use of hands and
arms outside the wheelchair, the passage must be as wide as 900 mm or more.
The diagram shows the space required to turn a wheelchair. The required width to
turn a wheelchair. Protruding objects, such as directional signs, tree branches, wires,
guy ropes, public telephone booths, benches and ornamental fixtures should be
installed with consideration of the range of a visually impaired person’s cane.
Minimum clear opening of the entrance door shall be 900 mm. and it shall not be
provided with a step that obstructs the passage of a wheel chair user. Threshold shall
not be raised more than 12 mm.
Wherever lift is required as per bye-laws, provision of at least one lift shall be made
for the wheel chair user with the following cage dimensions of lift recommended for
passenger lift of 13 persons capacity by Indian Standards.
a) A hand rail not less than 600 mm. long at 800-1000 mm. above floor level shall
be fixed adjacent to the control panel.
b) The lift lobby shall be of an inside measurement of 1800 x 1800 mm. or more.
c) The time of an automatically closing door should or minimum 5 seconds and the
closing speed should not exceed 0.25 M/ Sec.
d) The interior of the cage shall be provided with a device that audibly indicates the
floor the cage has reached and indicates that the door of the cage for entrance/exit
is either open or closed.
TOILETS
One special W.C. in a set of toilet shall be provided for the use of handicapped with
essential provision of wash basin near the entrance for the handicapped.
Counters
To make a counter easily accessible for a wheel chair user, allow a space about
700mm high and 350mm deep under the counter.
Water Fountains (Drinking)
Allow sufficient space around the water fountain to make it easily accessible for
wheel chair users. Depending on the type of water fountain allow a space about 700
mm high and 350 mm deep under the fountain.
Telephones
Allow a space about 700 mm high and 350 mm deep under the telephone stand. The
telephone receiver must be placed at a height of 1 IO cm or less.
Mailboxes
RESIDENTIAL BUILDING
KITCHEN
Floor space should allow easy wheelchair movement between worktop, sink
and cooking stove.
A 1500 mm min. width should be provided for wheelchair turns between
counter and opposite wall.
Worktops, sinks, and cooking area should be at the same level at a height of
780 mm - 800 mm high from floor.
A knee room of 700 mm high should be provided under the sink. Base cabinet
storage space with hinged doors and fixed or adjustable shelves should be
avoided.
Base cabinets are most usable with drawers of various depths. Pullout vertical
units at one or both sides of the work centres are desirable.
Maximum height of shelves over worktop is 1200 mm. A min. gap of 400
mm. should be provided between the edge of work top and top shelves. Side
reach for low shelf height should be 300 mm.
Living Room & Bed Room
At least 1500 mm turning in space for wheel chair should be kept near all entry
points to the living area.
BATHROOM
The basin should be installed at a height and position for convenient access
by wheelchair users.
The basin should have appropriate knee clearance and foot clearance space
for wheelchair users.
Sufficient clear space for wheelchair users should be provided in front of the
basin. The mirror should be so installed as to permit its use by wheelchair
users.
Shower cubicles should have seats whose width and height facilitate easy
transfer by wheelchair users.
Shower cubicles should have grab rails at a height and position that allows for
easy gripping by wheelchair users.
Shower cubicles should have call buttons or other signals devices at a
height and position easily reached in an emergency.
Sufficient space should be provided beside shower cubicles for transfer
by wheelchair users.
Shower doors, locks or catches should be of a type that can be opened
from the outside in an emergency.
Shower doors should preferably be of a sliding or outward
opening type.
These recommendations are relevant for communal bathing
facilities for low-income households.
WC or toilet compartments should have enough floor space for wheelchair
users to enter and exit.
The toilet bowl should be of a type (e.g. wall-hung) and in such a position as
to permit easy approach by wheelchair users.
The seat of the toilet bowl should be at the correct height for wheelchair users.
WC compartments should have support rails at a position and height suitable
for wheelchair users and other persons with physical disabilities. Upward-
folding support bars are recommended to allow lateral transfer from a
wheelchair.
A toilet paper dispenser should be so installed as to be easily used by a person
with physical impairments sitting on the toilet.
Fittings, such as soap dispenser, electric hand dryer and mirror, should be low
enough for a wheelchair user to use comfortably.
The wash basin should be at a height that is easily accessible for wheelchair
users.
Lever-type taps should be installed to wash basins.
Floor finishes should be of non-slip material.
Doors should be either of the sliding or outward-opening type.
Locks to toilet doors or cubicles should be of a type that can be opened from
outside in case of emergency
Hence it is necessary to provide a good PHC (Primary Health Care unit) in the centre
to provide a good medication and for the people staying over there. A medical unit
must also be provided in the place where they stay.
National Rural Health Mission (NRHM) was launched to strengthen the Rural Public
Health System and has since met many hopes and expectations. The Mission seeks
to provide effective health care to the rural populace throughout the country with
special focus on the States and Union Territories (UTs), which have weak public
health indicators.
Infrastructure
The PHC should have a building of its own. The surroundings should be clean. The
details are as follows: PHC Building
Location
It should be centrally located in an easily accessible area. The area chosen should
have facilities for electricity, all weather road communication, adequate water
supply and telephone. At a place, where a PHC is already located, another health
centre/SC should not be established to avoid the wastage of human resources. PHC
should be away from garbage collection, cattle shed, water logging area, etc. PHC
shall have proper boundary wall and gate.
Area
It should be well planned with the entire necessary infrastructure. It should be well
lit and ventilated with as much use of natural light and ventilation as possible. Indian
Public Health Standards (IPHS) Guidelines for Primary Health Centers 13 The plinth
area would vary from 375 to 450 sq. meters depending on whether an OT facility is
opted for.
Sign-age
The building should have a prominent board displaying the name of the Centre in
the local language at the gate and on the building. PHC should have pictorial,
bilingual directional and layout sign-age of all the departments and public utilities
(toilets, drinking water). Prominent display boards in local language providing
information regarding the services available/user charges/fee and the timings of the
centre. Relevant IEC material shall be displayed at strategic locations. Citizen
charter including patient rights and responsibilities shall be displayed at OPD and
Entrance in local language.
Disaster Prevention
Measures should be taken for all new upcoming facilities in seismic 5 zone or other
disaster prone areas. Building and the internal structure should be made disaster
proof especially earthquake proof, flood proof and equipped with fire protection
measures. Earthquake proof measures - structural and non-structural should be built
in to withstand quake as per geographical/state govt. guidelines. Non-structural
features like fastening the shelves, almirahs, equipment etc. are even more essential
than structural changes in the buildings. Since it is likely to increase the cost
substantially, these measures may especially be taken on priority in known
earthquake prone areas. PHC should not be located in low lying area to prevent
flooding as far as possible.
Firefighting equipment
Fire extinguishers, sand buckets etc. should be available and maintained to be readily
available when needed. Staff should be trained in using firefighting equipment. All
PHCs should have Disaster Management Plan in line with the District Disaster
management Plan. All health staff should be trained and well conversant with
disaster prevention and management aspects. Surprise mock drills should be
conducted at regular intervals.
Waiting Area
a) This should have adequate space and seating arrangements for waiting
clients/patients as per patient load. The walls should carry posters imparting
health education.
b) Booklets/leaflets in local language may be provided in the waiting area for the
same purpose.
c) Toilets with adequate water supply separate for males and females should be
available. Waiting area should have adequate number of fans, coolers,
benches or chairs.
d) Safe Drinking water should be available in the patient’s waiting area. There
should be proper notice displaying departments of the centre, available
services, name of the doctors, users’ fee details and list of members of the
Rogi Kalyan Samiti/Hospital Management Committee. A locked
complaint/suggestion box should be provided and it should be ensured that
the complaints/suggestions are looked into at regular intervals and addressed.
The surroundings should be kept clean with no water logging and vector
breeding places in and around the centre.
DESKTOP CASE
STUDY
STUDY 1- North London Hospice / Allford Hall Monaghan Morris
A single-storey, multi-pitched
extension at the rear completes the
L-shaped plan and frames a south-
facing private courtyard for the
enjoyment of patients. Conceived
from both the inside-out and the
outside-in, the expansive windows
set around a simple palette of brick
and timber, ensure a series of light
and airy spaces that are well-connected both physically and visually with their
external environment.
CASE STUDY……………………………………SHANTI AVEDNA ASHRAM
LIVE CASE STUDY
CASE STUDY-1 …………………………………KARUNASHRAYA
KARNATAKA
Z