Obtrusive resemblance with existing large-scaled asylums

In October 1907, the jury expressed its great dismay with the outcome of the prize competition since ‘the ultimate solution for architectural space intended for Swedish poor relief aid was not accomplished’ (Svenska Fattigvårdsförbundet 1907). The majority of the 11 submitted proposals were assessed as ‘copies of older existing institutions which responded poorly to the demands of modern poor relief aid’. The jury found that all of them displayed a poor knowledge about the future occupants; merely a rectangular box that schematically represented a bed place with a number nearby, indicating the number of beds per room. Proposals within the category of the larger type of asylum for 50 residents were characterised as having an ‘obtrusive resemblance with existing large-scale asylums’ (Svenska Fattigvårdsförbundet 1907). The jury labelled them as ‘failures’ that demonstrated ‘an inconsistency between a home-like environment and a large-scale institution’ (Svenska Fattigvårdsförbundet 1907). Nevertheless, after the competition closed, one proposal with this condemnable design, but of a smaller size, was purchased for the touring exposition. The jurors expressed their deepest concern for the future, and they hoped that ‘the submitted drawings would spur architects and affiliated professions to invent new designs’ (Svenska Fattigvårdsförbundet 1907). The jury concluded that no first prize could be issued.

Three proposals in the category of 25 residents attracted the jury's interest (see Figure 1). The first one was a wooden building with a U-shaped floor plan, executed according to the Swedish version of the Art Nouveau movement. It had the motto ‘Sunflower’. The jury found ‘the spatial configuration and the facades … attractive’ with ‘the desirable home-like quality’. Some flaws were detected, but they were assessed as ‘easily correctable’ (Svenska Fattigvårdsförbundet 1907). The second proposal, with the motto ‘Chaffinch’, was a building in plastered brickwork with a C-shaped floor plan: it was found to be in ‘great need of revisions’ (Svenska Fattigvårdsförbundet 1907). The jury also discussed a third proposal, but they finally concluded that it was ‘uncorrectable’ (Svenska Fattigvårdsförbundet 1907). Eventually, the jury decided to award the second prize to the first proposal, and the third prize to the second one. After the competition, the two successful proposals were revised, and became part of a touring exposition that circulated in Sweden until the beginning of 1909. A third proposal from the competition was also exhibited specifically for the exposition. All three proposals were converted into normative drawings that conveyed the association's idea of the appropriate type of architecture for humanised poor relief aid. Despite the perceived failure of the competition, the jury assessment report formulated guidelines based on the assessment of all submitted proposals:

• • a home-like type of architecture that pertained to the building scale and with references to the vernacular type of architecture;

• • five persons sharing a single room was not appropriate – instead, a maximum of four persons could share a room;

• • based on the second prize-winning proposal, a two-person room would be approximately 10.5 square metres (m²) and a four-person room 16.5 m²; a one-patient room would be 8.9 m²;

• • there were two units, one for men and one for women, having one communal space for handiwork so that the residents could fulfil their assigned work hours;

• • the units were interconnected through a communal space that was used for meals and assemblies.

Figure 1. The successful proposals in the 1907 competition: the second prize proposal by architect J. J. Gate with the motto ‘Sunflower’ and the third prize-winning proposal by architect E. Spolén with the motto ‘Chaffinch’. Both proposals were executed in an Art Nouveau style with Swedish traits, and by two employees at the same architect's office in Stockholm. Neither of the proposals focused on the particular needs of the future residents: their presence was indicated by approximate bed sizes on the floor plans (Svenska Fattigvårdsförbundet 1907).

Architecture as an instrument for reforming poor relief aid

At least two buildings were erected according to the design of the second prize-winning proposal, one outside Stockholm. However, the SFF soon realised that making simple adjustments of the rewarded proposals to the topography of a particular site was not the best way of promoting a general improvement in buildings for poor relief aid. The association created its own architect's office, and an architect was contracted. This office converted the awarded proposals of the 1912 competition into a typology of appropriate buildings of different sizes for dependent and frail older people. In 1910, the building type that the SFF had developed in 1907 was renamed the ‘Old People's Home’. Rural municipalities were keen on using the SFF architect's office since they had to replace, or update, older buildings that dated back to between the 16th and 19th centuries. During the period from 1914 to 1918, some 26 new old people's homes, based on the SFF typology, were constructed, all in all accommodating some 1,200 older residents. Each new building was presented in the SFF magazine with factual details such as equipment, investment costs, number of residents and staffing requirements, along with photographs.

In 1918, the SFF's lobby work resulted in a new Poor Law Act that replaced the old one dating back to 1847. This law had replaced the previous one that had existed for over 200 years. The new Act obliged the municipalities to take responsibility for services to children, adults and frail older people (Höjer Reference Höjer1952: 103–4). Consequently, new buildings were required: care institutions for young children, work institutions for adults and old people's homes (Berge Reference Berge2007: 82; Sjögren Reference Sjögren1997: 75–8). The expansion of the municipal institutions was supervised by the Bureau for the Inspection of Poor Relief Aid (BIPRA) which was specially formed for this purpose. The leading representatives of the SFF, its secretary and architect, were appointed chairman and the bureau's expert on appropriate space for poor relief aid. In 1920, an expert commission, including these and other experts on poor relief aid, issued normative drawings for old people's homes and orphanages. To a large extent, this typology was based on the architecture experience of the SFF. The expansion of the new old people's homes was to be accomplished in 1929. This particular segment of the building market was completely controlled by the BIPRA, and only three architects had access to the potential commissions: the two architects of the BIPRA and the one of SFF (Göransson and Sundbärg Reference Göransson and Sundbärg1933). In the beginning of the 1930s, some 1,380 buildings, newly built or partly refurbished, had been constructed (Göransson and Sundbärg Reference Göransson and Sundbärg1933). In 1933, the architectural press started to evaluate the new old people's homes, but the assessment was harsh: they were perceived as ‘dark, badly ventilated and difficult to furnish’ (Göransson and Sundbärg Reference Göransson and Sundbärg1933).

Architecture for the ‘new old people's home’ in collision with existing beliefs

The architectural competition was suggested by the Royal Board of Social Welfare (RBSW) in response to the SAC report: ‘instead of poor relief institutions with an often mixed clientele of healthy and sick older persons, the goal is to create buildings with mainly single rooms for older people who experience normal ageing and who, in these buildings, will have a comfortable home without the institution-like character’ (Kungl. Socialstyrelsen 1948: 8). The ideas competition was launched in mid-December 1948. The appropriate number of residents of the new old people's home was a key issue, and, subsequently, the design task was twofold: either a home for 30 residents or a larger one for 80 residents. The programme contained two innovative demands which suggested an increased understanding of the future user: floor plans with symbols for furniture, and at least one three-dimensional interior or exterior view.

The drawing up of the competition programme revealed a tension between the members of the jury: architects of the functionalist movement versus the representatives of the SFF movement, the latter who had assumed key positions in the RBSW. The architect member paralleled the ‘new old people's home’ with any type of modern housing, and, thereby, emphasised the need for flexible solutions in order to allow for different usages over time: small-scale individual flats equipped with a hallway; a bathroom with a basin, a water closet and a bath-tub; a kitchenette; and a balcony. These innovations proposing individual flats were rejected by the other members of the jury and, as a consequence, normative drawings of one- or two-person rooms that had been recommended by two wartime committees replaced them. The individual bathroom was reduced to a single washing basin per resident and communal showers and occasional bath-tubs. The kitchen was turned into a communal kitchenette, integrated in the corridor, since a communal space for dining and socialising was advocated. The individual balcony was replaced by one large balcony close to the communal space.

The jury assessment and the awarded proposals

In June 1949, 66 proposals had been submitted, 43 proposals that dealt with the smaller type of old people's home (30 residents), and 23 proposals that focused on the larger residence for 80 residents. In both categories, the proposals supplied exterior views, but those for the larger buildings also included interior ones. Another difference was that the proposals in the smaller category supplied little information about adaptations to future residents, while the proposals of the larger category included floor plans with furniture arrangements, which aimed at describing an imagined older person's use of space. The majority of the submitted proposals were drawn up in a functionalistic architecture style: elongated buildings with corridors around interior garden space (see Figures 2 and 3). The average size of a one-person room was 15 m² and a two-person room of 19 m².

Figure 2. In the category of a new old people's home for 30 residents this proposal, with the motto of ‘Autumn Sun II’, by architect C. Laurent, received third prize in the 1948 architectural competition. A similar trait for all three of the awarded and purchased proposals in this category is the absence of future residents. The number of residents can only be envisioned by the closet arrangement in the niche for the washing basin (Kungl. Socialstyrelsen 1950).

Figure 3. In the category of a new old people's home for 80 residents, this proposal with the motto of ‘East-West’, by architect Aake E. Lindquist, received second prize in the 1948 architectural competition. In this category, the future residents were abundantly present by detailed floor plans of one- or two-person rooms with furniture arrangements. In addition, exterior and interior views with sketched older persons suggested an interaction between space and ageing (Kungl. Socialstyrelsen 1950).

The nine-member jury assessed all the submitted proposals by focusing on both emotional and sensuous aspects of architectural design, far from the rational approach that could be detected in the competition programme. The jury searched for elements and features in the suggested architecture that promoted a ‘home-like feeling’ (Kungl. Socialstyrelsen 1949: 1, 3). The floor plans were studied from a performative angle in order to assess whether the architects had allowed for a possibility to furnish comfortably and adapt space to the residents' various usages. The jury found that this aspect had not been ‘addressed … sufficiently in the design’, and that the layouts of the residents' rooms lacked ‘the desired comfortable and home-like feeling’ (Kungl. Socialstyrelsen 1949: 1, 3).

According to the architectural press, all of the proposals reflected a ‘too restricted competition programme that prohibited true new thinking’, and the only future-oriented outcome of the competition that could be identified was a new localisation principle – integrated in existing residential housing (Virke Reference Virke1950: 365). The jury concluded that ‘no proposal in either of the two categories had such outstanding qualities that this could motivate the jury to issue a first prize in any of the categories’ (Kungl. Socialstyrelsen 1949). In each category, two second and one third prize were designated. In addition, five proposals for the smaller home, and two proposals for the larger home, were purchased. However, the jury identified some features that would influence the architecture of the ‘new old people's homes:’

• • a cluster of mainly one-person rooms was organised around a communal space that contained a kitchen and a living room, which were accessible via a neutral passage from the residents' rooms;

• • units with a mixed composition of residents of both sexes;

• • a quadratic shape of the resident's rooms in order to promote a comfortable atmosphere and possibilities for furnishing and to adjusting the room to individual needs;

• • avoidance of over-long corridors, since corridors emphasised ‘an institutional feeling’ (Kungl. Socialstyrelsen 1949: 1);

• • a maintained small-scale architectural design, since the proposals in the category of housing for 80 residents made the jury realise that this would be ‘a bit on the large side for an old people's home’ (Kungl. Socialstyrelsen 1949: 2);

• • the integration of the old people's home in an existing residential built environment, although the jury admitted to the fact that ‘this possibility had not been foreseen’ in the competition programme.

The public reception of the ‘new old people's homes'

The representatives of the SAC and the RBSW argued that old people's homes were an ideal solution for municipal elder-care (Brodin Reference Brodin2005: 63; Gaunt Reference Gaunt1995: 378–9). In 1947, the Swedish Pensioners' Association (SPF) initiated a campaign against ‘the new old people's homes' (Gaunt Reference Gaunt1995: 371; Lo-Johansson Reference Lo-Johansson1952). This was led by the Swedish proletarian author Ivar Lo-Johansson, who assembled a documentary of living conditions in the existing old people's homes with explicit photographic material. The publication fuelled a fierce public reaction against the old people's homes, mainly among lower social class groups. The old people's home was seen as an obsolete outcome of poor relief aid (Brodin Reference Brodin2005: 62–6; Gaunt Reference Gaunt1999: 62–3; Jönsson Reference Jönsson2001: 150–62). The SPF and Lo-Johansson coined the credo of ‘home nursing instead of nursing homes' (Lo-Johansson Reference Lo-Johansson1949: 176, Reference Lo-Johansson1952).

The public acclaimed the so-called ‘pensioners’ homes' for being an appropriate type of housing for senior citizens. State subsidies for the construction of this type of housing had been introduced in 1938 in order to improve housing conditions in general for older people. The experts of the SAC and the RBSW dismissed this reaction as an effect of the mixed composition of residents in the old people's homes and the limited access to single rooms (SAC 1946: 28–9). The social democratic government, who collected the main share of their elective votes among lower social class groups, became associated with an authoritarian and paternalistic view (Lundquist Reference Lundquist1997). As a result, the architectural design of the ‘new old people's homes' was re-oriented in a resident-focused manner, similar to the small-scale flats for the upper social class pensioners, the so-called Pauvres Honteux (Gaunt Reference Gaunt1995).

Despite the public rejection of the old people's home, state subsidies continued the expansion and compromised the home-like and small-scale environment that had been introduced in the competition of 1907 (Lidmar Reference Lidmar1981: 41). Instead, the board started to promote centrally situated large-scale institutions with at least 50 residents (Kungl. Socialstyrelsen 1955, 1965, 1967; Lidmar Reference Lidmar1981; Sjukvårdens Planerings- och Rationaliseringsinstitut (SPRI) 1968, 1971; Svenska Kommunförbundet 1968). The architectural competition of 1948 was caught in the turmoil, which led to the parsimonious wartime recommendations that had preceded the competition being maintained until the beginning of the 1980s (Lidmar Reference Lidmar1980: 9; Reference Lidmar1981: 48–9; Socialstyrelsen 1970).

The architectural competition on local nursing homes

In 1975, the number of beds in old people's homes was approximately 60,000 distributed among 1,154 facilities (Socialutredningen 1977: 137; Wånell and Schön Reference Wånell and Schön2005: 10). The wartime recommendations made a large-scale refurbishment of the existing old people's homes inevitable, since these had become obsolete in comparison with housing in the ordinary stock of flats. Approximately two-thirds of the residents had access to an individual lavatory, but 92.5 per cent lacked a shower or a bath (Pensionärsundersökningen 1977). The SPRI, the national Institute for the Planning and Rationalisation of Health and Social Welfare Services in Sweden, which has been responsible for research on architecture for health care since the 1920s on behalf of the counties and the municipalities, was commissioned to find new solutions. The SPRI introduced the idea of ‘local nursing homes’ as a replacement for the old people's homes. This type of housing was also envisioned to solve the problem of various nursing homes, at the local and regional levels, where older persons with long-term medical conditions lived together with persons who required social care (SPRI 1979 b: 3, 16). The report echoed the public indignation of the 1970s, and the ‘local nursing home’ should be ‘a dignified place for people in existentially difficult circumstances’ (SPRI 1979 b: 21).

An open ideas architectural competition was launched in 1979. The design task was to create ‘an existential renewal for patients in local nursing homes’ by emphasising the ‘the home-like milieu’ (SPRI 1979a: 3). The competition programme was a booklet with an extensive six-section appendix with SPRI reports concerning (a) the patient's view of the long-term environment; (b) the existential situation of being a relative to a person with a long-term medical condition; (c) a list of of spatial requirements for local nursing homes; (d) the integration of nursing homes in residential areas; (e) the relationship between inner and outer space; and (f) the functionality of hospital beds, and hospital transportation beds. The booklet advocated personalised social care, but the focus on nursing care transformed the older person from previously being a resident in an old people's home into becoming a patient in a nursing home.

The jury assessment and the rewarded proposals

By the end of the competition period, in October 1979, some 55 proposals had been submitted (SPRI 1980). In accordance with the competition programme, the proposals presented the envisioned architectural spaces in three-dimensional exterior and interior views along with floor plans and sections, which demonstrated furniture arrangements and various usages of space (SPRI 1979 a: 9–10) (see Figures 4 and 5). All the submitting authors had included the human experience of space. A seven-member jury examined the submitted proposals. By the end of the assessment period, eight proposals were accepted, but no first, second or third prizes were awarded. Among the successful proposals, two honorary mentions were issued. According to the competition secretary the prize was an indication of the ranking order that demonstrated the jury's preference (Solvej Fridell, personal communication, 2010). The prize sums were SEK40,000, SEK25,000 and SEK15,000.

Figure 4. One of the awarded proposals in the competition, bearing the motto of ‘Indoor Space vs. Outdoor Space’, by the architect's firm Carlstedts Arkitektkontor, Stockholm. It received the sum of SEK25,000. This proposal excelled in presenting the perceived space of the architectural design. The design was presented in schematic drawings, but also as photographs from a model of the envisioned space. It suggested mainly one-person rooms, with some rooms shared by two persons (SPRI 1980).

Figure 5. Another proposal in the competition that was awarded SEK15,000. This proposal had the motto of ‘Five Little Houses’, and it was conceived by the architect's firm BLP Arkitekter AB, Stockholm. The perception of the architectural design is presented in linear perspectives, with varying light. Six one-person rooms along with one two-person room constitute a unit with a protected atrium environment (SPRI 1980).

In order to evaluate the proposals, the jury primarily took the perspective of a person with a long-term medical condition. Consequently, this person's access to indoor or outdoor space and the available zones of privacy and semi-privacy found in communally shared space were scrutinised (SPRI 1980: 6). The jury prioritised flexible usages of the care unit. The relationship between the individual patient's room and the communal space for dining and socialising was explored in terms of homeliness. Globally, the unit was evaluated according to the degree to which it fulfilled the demands of an optimal care environment (SPRI 1980: 8–10). In their assessment, they placed the following spatial qualities in the foreground:

• • based on the eight successful proposals, the average size of a one-person room was 19.7 m² and a two-person room was 38.0 m²;

• • the presence of exterior and interior views for a bed-confined person;

• • the relationship between the bed's location compared to the bathroom was important, together with ‘alternative bed arrangements in the patients’ rooms’ (SPRI 1980: 6);

• • hygiene space could be shared by two patients (SPRI 1980: 8), but in order to emphasise the ‘patient's integrity’ there was a need for ‘a neutral passage from the bed to the hygiene space’ (SPRI 1980: 7–8);

• • the concept of ‘being in the reach of’ (Buttimer Reference Buttimer, Buttimer and Seamon1980: 170), thereby indicating the closeness between the patients and the care staff, and the subsequent social contacts between them;

• • the jury emphasised that ‘the nursing home could only function as an appropriate care environment for long-term living if it simultaneously constituted an ideal work environment for the staff’ (SPRI 1980: 5).

The impact of the 1979 competition on architecture for the frail ageing

The focus on the sensuous aspect of architectural design in order to create a home-like and supportive atmosphere was in line with the contemporary normalisation principle for people with cognitive or functional disabilities. A year after the competition, the SPRI assembled a report with the eight awarded proposals (SPRI 1980). The publication also included the jury's deliberations on the necessary spatial qualities that should exist in a nursing home. However, these guidelines were of little direct influence since the forecasted expansion of nursing homes never occurred. The prognoses of the SPRI proved to be erroneous: by 1985, the number of beds in the 233 new nursing homes was 7,820 (Hansson Reference Hansson1989: 10) instead of the envisioned 30,984 long-term beds in either geriatric wards, or regional or local nursing homes integrated in a residential context, which the SPRI predicted in the competition programme (SPRI 1976: 60; 1979a: 3).

During the 1980s, the official view on ageing as a period of an increasing dependency and poor health changed towards an active ageing consensus, which stated that the ageing process can be manipulated by the individual, primary health care and the supportive role of society's elder-care services (Brodin Reference Brodin2005: 90–1). The new Social Services Act (SoL) of 1982 emphasised independence and self-determination (Brodin Reference Brodin2005: 90), which turned both the nursing home (local or regional) and the old people's home into obsolete forms of architecture for frail older people. This prepared the way for de-hospitalised elder-care, which necessitated an organisational and regulatory change of municipal versus regional responsibilities (Brodin Reference Brodin2005: 99–119). However, this policy change involved another type of housing for older people which had evolved in the ordinary stock of housing, the so-called ‘residences with elder-care services’.

The ‘residences with elder-care services’ started to flourish during the 1970s, when home care changed from mainly a house-keeping function with some assistance in activities of daily living towards professional elder-care combined with primary health-care services (Brodin Reference Brodin2005: 60–1). This type of housing was a category in between the nursing home and the old people's home (Johansson and Andersson Reference Johansson and Andersson1979; Lidmar Reference Lidmar1980) and it had slowly developed on a parallel track to the expansion of old people's homes and the introduction of home-based elder-care services during the period of 1950–1970 (Gaunt Reference Gaunt, Gaunt and Lantz1996: 40, 48–9). The individual home, appropriated during different stages in life, became the ‘ideal place to grow old’ (Bergh Reference Bergh, Gaunt and Lantz1996).

In a socio-political context, the three competitions elucidate the shift from the old people's home of the liberal welfare regime to the contemporary residential care home of today's egalitarian welfare regime. Rooted in the long tradition of poor relief aid, the architectural framework of this type of housing manifests the cultural beliefs and motivations that have accompanied the evolution of modern care and caring for dependent and frail older people (Laws Reference Laws, Jamieson, Harper and Victor1997). The three cases of Swedish architectural competitions demonstrate how political visions for social work stated in competition programmes have generated new architectural design (Darke Reference Darke and Cross1984). The three national competitions suggest the necessary presence of relational thinking in order to promote innovation in architecture (Lipstadt, Reference Lipstadt, Rönn and Andersson2011: 69–71), active on three levels: firstly, by the organising actor (the competition documentation), secondly by the participating architects (the submitted proposals) and, thirdly, during the jury deliberations (the jury assessment report). The 20th century has led to a steadily increasing focus on the relationship between architectural design and the user and his/her individual needs; the individualised space versus the communal one and the work environment (Andersson Reference Andersson2011; Frampton Reference Frampton1982; Östnäs Reference Östnäs1984; Rice Reference Rice2009; Sandström Reference Sandström1989). Architecture, elder-care and the ageing process have merged into an increasingly greater awareness and knowledge that this space has to reflect the ordinary residential situation.