| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 3.53 MB | Adobe PDF | |||
| 2.91 MB | Adobe PDF | |||
| 677.9 KB | Adobe PDF | |||
| 1.32 MB | Adobe PDF | |||
| 1.36 MB | Adobe PDF |
Abstract(s)
Em pleno século XXI, são vårias as fragilidades de que sofre o nosso sistema nacional de
saĂșde (SNS) relativamente ao apoio e inclusĂŁo de doentes com caracterĂsticas
demenciais. Estima-se que atĂ© 2037 existirĂŁo 322 mil casos de doentes com demĂȘncia,
segundo o relatĂłrio âHealth at a Glance 2017â da OCDE publicado a 10 de novembro de
2017, no qual Portugal foi considerado o 4Âș paĂs com mais casos por cada mil habitantes.
NĂșmeros que preocupam e devem levantar questĂ”es sobre o modo como as entidades
competentes estão a desenvolver métodos de reconhecimento, intervenção e adaptação
ao quadro que se apresenta.
Os problemas de saĂșde mental afetam a vida pessoal, profissional e familiar dos
indivĂduos, onde o estigma e a discriminação tĂȘm sido vetor na integração e acesso a
estruturas de apoio. Tendo em conta a situação atual, existe em Portugal uma resposta
insuficiente de cuidados continuados, que obriga um nĂșmero elevado de doentes a
ficarem internados nos hospitais ou a permanecerem nas próprias habitaçÔes, sem as
ajudas adequadas. A oferta de estruturas de apoio é insuficiente e assimétrica, face à s
necessidades existentes, sendo urgente criar unidades direcionadas para doentes com
doenças mentais. Ă expectĂĄvel que os doentes com saĂșde mental comprometida, possam
ter o mesmo direito de acessibilidade e equidade que todos os outros doentes integrados
em unidades de cuidados continuados.
Uma Unidade de Cuidados Continuados serve para possibilitar a passagem entre o meio
hospital e a habitação de cada doente, ou seja, mesmo depois de ter alta hospitalar, o
doente precisa de cuidados especĂficos (reabilitação, terapia, acompanhamento
psicolĂłgico, etc.) que sĂŁo fornecidos por estas unidades.
Existem trĂȘs graus de Unidade de Cuidados Continuados â convalescença, mĂ©dia
duração e longa duração â que diferem pelo tempo de permanĂȘncia. Outro grau, com
outras especificidades mais precisas, Ă© a Unidade de Cuidados Paliativos â fase final de
vida.
Instantaneamente ligado a este panorama, surge o tema da demĂȘncia, de como doentes
com quadros demenciais vivem e habitam o espaço, à priori concebido, e como é
relevante pensar numa arquitetura ampla e adaptada para unidades de cuidados
continuados.
Tendo como base de trabalho a demĂȘncia, considerou-se importante desenvolver este
tema a propĂłsito da elaboração do projeto de uma Unidade de Cuidados Continuados para a Santa Casa da MisericĂłrdia da CovilhĂŁ. O projeto em questĂŁo prevĂȘ uma lotação
de sessenta camas, trinta destinadas ao perĂodo de convalescença, que equivale Ă estadia
måxima de internamento de trinta dias, e outras trinta para uma estadia de média
duração, que equivale ao perĂodo de internamento entre trinta e noventa dias.
A demĂȘncia Ă© uma alteração da cognição, do normal funcionamento dos mecanismos
cerebrais, que perpetuam a confusão e as alteraçÔes comportamentais e emocionais.
Sabe-se que existem vĂĄrios tipos e graus de demĂȘncia e como Ă© difĂcil para o doente
estabelecer ligaçÔes de reconhecimento nas instituiçÔes, tanto na perceção espacial, ao
não reconhecer o ambiente em que estå inserido, como nas relaçÔes de empatia com os
profissionais de saĂșde.
Pretende-se que algumas estratégias arquitetónicas, criteriosamente introduzidas,
ajudem o doente a sentir-se confortåvel e integrado nas instalaçÔes, que privilegiam
vĂĄrias atividades ao ar livre e outros programas dinĂąmicos. Estes planos de atividades
(interior/exterior) tĂȘm um grau de importĂąncia significativo devido Ă melhoria
reveladora que os mesmos favorecem, obtendo resultados muito positivos para os
doentes.
A presente dissertação pretende contribuir para apreender conceitos Ășteis, uma vez que
pensar no passado, presente e futuro é a solução para uma arquitetura inclusiva tendo
como princĂpio fundamental, o ser humano. O paradigma da saĂșde mental Ă© dever
pĂșblico e projetar com conhecimento Ă© dever do arquiteto.
In the 21st century, there are several weaknesses that compromise our national health system, concerning the support and inclusion of patients with dementia characteristics. It is estimated that by 2037 there will be 322,000 cases of patients with dementia. According to the OECD's "Health at a Glance 2017", report published on November 10th, 2017, in which Portugal was considered the 4th country with the highest cases per 1,000 inhabitants. These figures are worrying and should raise questions on how the competent authorities are developing methods of recognition, intervention and adaptation to deal with the situation and data presented. Mental health problems affect of people's personal, professional and family life, where for stigma and discrimination have been a vector in the access and integration of support structures. According to the current data there is an insufficient response in Portugal of continued care, which demands many patients to remain in hospitals or to remain in their own homes, without adequate help. The provision of support structures is insufficient and asymmetric, in view of existing needs and it is urgent to create units targeted at patients with mental illnesses. Patients with impaired mental health are expected to have the same right of accessibility and equity as all other patients integrated into continuing care units. A Continuing Care Unit is supposed to enable the transition between the hospital environment and the housing of each patient. This is, even after being discharged from the hospital, the patient needs specific care (rehabilitation, therapy, psychological follow-up, etc.) that should be provided by these units. There are three levels of Continuing Care Unit â convalescence, medium duration and long duration â which differ according to permanence length. An extra level with more precise specificities is the Palliative Care Unit â for the final phase of life. Closely linked to the theme and panorama of dementia is the matter of how patients with dementia live and inhabit the space, a priori conceived, and how relevant it is to think of a broad architecture adapted for Continuous Care Units. Within the framework of dementia, and in the scope of our research work, we considered interesting/important to develop a project regarding the elaboration of a Continuing Care Unit for the Santa Casa da MisericĂłrdia of CovilhĂŁ. This project would provide for a capacity of sixty beds, thirty destined to the convalescence period, maximum of thirty days stay and another thirty for a medium stay, equivalent to a period of hospitalization between thirty and ninety days. Dementia is a change in cognition, i.e., in the normal functioning of brain mechanisms, which perpetuate confusion, as well as behavioral and emotional changes. It is known that there are various types and degrees of dementia and how difficult it is for the patient to establish recognition links in institutions, both in spatial perception, by not recognizing the environment in which he is inserted, as well as in the relations of empathy with health professionals. We believe that some architectural strategies, carefully introduced, will help the patient feel comfortable and integrated in the facilities, which will also favor various outdoor activities and other dynamic programs. These (indoor/outdoor) activity plans are significantly important, because of the improvement and positive results obtained with patients. This dissertation aims to contribute to apprehend useful concepts, since thinking about the past, present and future is the solution to an inclusive architecture, bearing in mind a fundamental principle, the human being. The mental health paradigm is public duty and designing wisely is the duty of Architects.
In the 21st century, there are several weaknesses that compromise our national health system, concerning the support and inclusion of patients with dementia characteristics. It is estimated that by 2037 there will be 322,000 cases of patients with dementia. According to the OECD's "Health at a Glance 2017", report published on November 10th, 2017, in which Portugal was considered the 4th country with the highest cases per 1,000 inhabitants. These figures are worrying and should raise questions on how the competent authorities are developing methods of recognition, intervention and adaptation to deal with the situation and data presented. Mental health problems affect of people's personal, professional and family life, where for stigma and discrimination have been a vector in the access and integration of support structures. According to the current data there is an insufficient response in Portugal of continued care, which demands many patients to remain in hospitals or to remain in their own homes, without adequate help. The provision of support structures is insufficient and asymmetric, in view of existing needs and it is urgent to create units targeted at patients with mental illnesses. Patients with impaired mental health are expected to have the same right of accessibility and equity as all other patients integrated into continuing care units. A Continuing Care Unit is supposed to enable the transition between the hospital environment and the housing of each patient. This is, even after being discharged from the hospital, the patient needs specific care (rehabilitation, therapy, psychological follow-up, etc.) that should be provided by these units. There are three levels of Continuing Care Unit â convalescence, medium duration and long duration â which differ according to permanence length. An extra level with more precise specificities is the Palliative Care Unit â for the final phase of life. Closely linked to the theme and panorama of dementia is the matter of how patients with dementia live and inhabit the space, a priori conceived, and how relevant it is to think of a broad architecture adapted for Continuous Care Units. Within the framework of dementia, and in the scope of our research work, we considered interesting/important to develop a project regarding the elaboration of a Continuing Care Unit for the Santa Casa da MisericĂłrdia of CovilhĂŁ. This project would provide for a capacity of sixty beds, thirty destined to the convalescence period, maximum of thirty days stay and another thirty for a medium stay, equivalent to a period of hospitalization between thirty and ninety days. Dementia is a change in cognition, i.e., in the normal functioning of brain mechanisms, which perpetuate confusion, as well as behavioral and emotional changes. It is known that there are various types and degrees of dementia and how difficult it is for the patient to establish recognition links in institutions, both in spatial perception, by not recognizing the environment in which he is inserted, as well as in the relations of empathy with health professionals. We believe that some architectural strategies, carefully introduced, will help the patient feel comfortable and integrated in the facilities, which will also favor various outdoor activities and other dynamic programs. These (indoor/outdoor) activity plans are significantly important, because of the improvement and positive results obtained with patients. This dissertation aims to contribute to apprehend useful concepts, since thinking about the past, present and future is the solution to an inclusive architecture, bearing in mind a fundamental principle, the human being. The mental health paradigm is public duty and designing wisely is the duty of Architects.
Description
Keywords
Arquitetura Inclusiva Criatividade DemĂȘncia Doente Perceção do Espaço SaĂșde Mental