ABSTRACT
Researches done in healthcare indicate that patient outcome is linked with the hospital‟s physical environment. This environment includes the specialised health facilities like Nursing homes which functions primarily as a place for rest, recovery and restoration of health and wellbeing of older adults through its facilities. In order to optimize performance in the face of challenging climatic conditions, the study streamlines to one of the principles of Sustainable Architecture – Indoor air quality. Recent research has linked recovery rate and prevention of ailments to the environment in which it is taking place. The objective of this study was to evaluate the effect of the condition/performance on the perceived Indoor Air Quality (IAQ) and the indoor air- related symptoms of senior‟s facilities. The methodological approach of the research is predicated on extensive literature review, qualitatively studying the Old people‟s home in Minna. In this study, Indoor air quality design considerations gotten from literature are used as a reference for comparison with what is found in property. The design considerations or Variables are expected to work as a reference for promoting environments that are adapted for the needs of older adults. The perceived IAQ and the related symptoms were collected by means of an indoor air questionnaire survey and observation schedule among the senior adults in the facility. The performance was significantly low in the facility, given Natural ventilation as 30%, Outdoor landscape as 5%, Indoor landscape as 0% and shading device as 65%, making residents prone to illness related to poor indoor air quality. Therefore, it is imperative that IAQ design consideration (Natural ventilation, Natural lightning, Landscape configurations, Shading devices) be adapted in the design of residential apartments for the elderly as it helps prevent, promote and provide a curative remedy for their well-being.
CHAPTER ONE
1.0 INTRODUCTION
This thesis presents findings from a qualitative and quantitative research study that was conducted in purposively selected Nursing home facilities in Nigeria. It highlights the ways in which the design considerations of indoor air quality principles were incorporated in their designs. In this introductory Chapter, the rationale for this study is explained and an overview of the thesis is provided. The Chapter starts off by presenting the context within which this study was conducted as well as the researcher‟s background. This is followed by statement of problem, the rationale and objectives of the study and then proceeds to briefly outline the research questions. Finally, an overview of the justification of the study and the scope of the research were highlighted.
1.1. Background of study
Nursing home refers to a health care institution that provides treatment with specialized medical and nursing staff as well as medical equipment serving as both an informative and educative environment for the convalescent, the elderly/physically disabled and also a retirement home (Bentayeb, 2015). The Institution strives in similar environment like other healthcare facility; a facility aimed at serving residence that are in need of rehabilitation services, care for prevention of nonacute, long-term conditions (Eckel,
2012). Specialty in diagnosis and clinical services are gotten outside the facility. Most residence are not necessarily bedridden, but are elderly and frail; some make use of aids like wheelchairs and walkers. These older adults are undergoing a recovery for long- term on illness but does not need to be in hospital, and others are undergoing preventive care services.
Treatment with advanced medications and technologies has been realized to be the fundamental aim of this area, however engaging in complex and more intensive process has an outcome of serious effects for the environment and humans. Therefore, it is imperative for seniors to receive care in order to maintain their identity as relates to their environment. Sustainability refers to the construction and applying the stages that are efficient in resources and environmentally accountable throughout the lifecycle of a building; from conceptualization to design, buildability, operation, maintenance, renovation, demolition. It also accrues to classical building concepts as relates to durability, economy, utility and comfort.
According to Harm (2011), “A sustainable healthcare facility promotes general health by the continuous reduction of adverse environment effects and on the long run eliminating diseases”. It recognizes the relationship between the environment and health, which is demonstrated through operations and strategy. It is a kind of facility that connects basic needs with primary practice for prevention and environmental activity by being involved with efforts to enhance community health and a sustainable economy. Residence for care of older adults which is in-here operationalized, a Nursing home is an important option for additional care and support.
1.2 Statement of problem
In Nigeria, as health reform sets in, health care facilities are gearing up for many challenges; some are not old to the healthcare industry, most are facing the existing challenges that has plagued for over 10 years. As identified by Ubbing (2011), the major problem in health centres, among others as too many patients, few employed physicians, inadequate communication between health providers is unhealthy healthcare environment. It is the desire of the author to investigate, and present a solution based on this investigation, the design of facilities needed by the medical profession for the specialized care of the aged and aging. The major area of concern is in the environment in which the medical staff is to work and the patient is to be treated and recuperated to a point when he can again be returned to his previous environment. It would be well for hospitals in the future to think about the responses of the patient, and his feeling of dignity, status, and position as a human being including a product requiring medical or surgical treatment. According to Karliner (2009), the health segment, by the use of a reasonable quantity in operation, constructions as well as resources of small, large, compound organizations, technical power employment with so much waste became a worry on the health sector. The World Health Organization, security-health cluster opined on producing medicine for prevention that, among others, one most respected and trusted sectors in the society is the health sector, also known to consume a lot of energy. Therefore, it enables the achievement of a healthy climatic condition that is efficient in cost (Heymann, 2008).
To create an environment that is friendly, the health sector should deploy fundamental measures like improving the design for healthcare, introducing a sustainable strategy for waste management and reduction in the use of chemicals and products that has minimal effect on the environment (Karliner, 2009). Hence, the need to provide such a facility in Nigeria to cater to recent findings in taking care of older adults. As such this study will assess strategic sustainable strategies in the design of health facilities to enhance patient’s well-being and caregivers with the use of nature to bring about treatment of illnesses that accompanies aging. Indoor environments are fundamental environmental factors capable of impacting health. The quality of air in the indoor environment of health care facilities
and other private and public buildings where people spend over 80% of their time daily is crucial for the overall health of old people (Harm, 2011). It is one of the main factors affecting the health, well-being and deteriorating conditions of the aged. The effect on health rises as exposure to and density of air pollution increases. Indoor air contains a complex mixture of bioaerosols such as fungi, bacteria and allergens along with non- biological particles contribute to about 25% to 34% of indoor air pollution. Sources of indoor bioaerosols are often located outdoors and particles are transferred to the inside through openings of the building envelope (windows, doors) and other components.
1.3 Aim and objectives.
The aim of this study was to assess principles of indoor air quality to improve healing environment for the patients. The aim is achieved through the following objectives:
i. To identify the principles of sustainable architecture.
ii. To examine the design requirement for Indoor air quality as a principle of sustainable architecture.
iii. To assess indoor air quality design consideration in the design of existing senior’s housing facilities and its effects on the residents.
iv. To propose a design of a senior housing facility using principles of IAQ that enhances indoor thermal performance so as to provide a safe and self-healing environment for older adults.
1.4 Research questions
The following are the questions that the research focused on answering.
i. What are the architectural features that can be applied in Nursing homes to meet the specific needs of the patients?
ii. To what extent have existing facilities applied indoor air quality considerations to create a self-healing and illness-prevention free environment?
iii. What components of indoor air quality as a principle of sustainable architecture can enhance wellbeing?
iv. How can IAQ principles be applied in a nursing home to enhance a self-healing environment?
1.5 Justification for the study
Long-term care also referred to as nursing home involves medical care and rehabilitation care made available to persons needing aids with living activities on a regular basis. It has been estimated that a minimum of 70 percent of persons above age 65 needs care services on long term at some point in their life. Long term care has been a major subject within the health economist due to the growth in the population of the elderly; this is because they are main providers of this care service. Studies in earlier times, including studies by Beukeboom et al. (2012), centred on the cost for effective care as well as the rate of requests for care-home services; so as to have a better understanding of how it functions.
Older adults today have it better than they did at any other point in history; medical advances enable the possibility of living longer and more comfortably than in the past. In the earlier years, there arose the need to improve the prospects of the chronically disabled, skilled caregiving, ingenuity, and resourcefulness as well as conserve expensive hospital facilities for the seniors. According to Abanyam (2013), services that should be incorporated include basic and skilled nursing care, rehabilitation, and a full range of other therapies, treatments, and programs for the optimal care and well-being of seniors‟ resident in this type of facility. Over the years, the model evolved to help improve the conditions in Nursing homes as recommended by National Institute of building services.
1.6 Scope of study
The depth of this project is to make a proposal for the provision of suitable facilities of a nursing home. The spaces provided in the facility will accommodate green design strategies to mitigate the negative impact of the environment thereby improving health and promoting sustainability. There shall be exploratory research of relevant literature and several research methods and comparative analysis of data that will be gotten from some selected case studies of which the outcome of the result will be demonstrated on a proposed nursing home in order that the research is authenticated.
This material content is developed to serve as a GUIDE for students to conduct academic research
ASSESSMENT OF INDOOR AIR QUALITY PRINCIPLES IN THE PROPOSED DESIGN OF A NURSING HOME IN ABUJA, FCT, NIGERIA
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