Nursing the Care is a visionary initiative, set on weaving a seamless fabric of health services, care workers, and comprehensive care into existing residential spaces where they are most needed. By caring for the people that will take care of us we can create a positive loop effect that can include older adults and multiple generations. This is what we want to do in Axelborg together.
The Imperative of Health-Oriented Neighbourhoods
Nursing the Care prioritizes health services in neighbourhoods for an aging society. We must create inclusive, accessible spaces for multi-generational living while inspiring a new generation of health workers. By 2060, 1/3 of Europeans will be over 65. Denmark like other European countries faces a growing nursing shortage; home affordability for nurses is at a record low. Nursing home costs burden municipalities, while France and Germany see expanding "medical deserts." Modern healthcare contributes to formidable aging. Many old, though, experience isolation, loneliness, and cognitive decline requiring social contact and community involvement. Overstretched welfare systems need compassionate communities.
Graphic 1: Nursing the care brings closer active senior and integrated health services to renew durable our social housing
Danish Aging Trends and Healthcare Workforce Shortages
Denmark, like the rest of Europe, is experiencing significant demographic changes. Danish senior population is growing rapidly. 21% of Denmark's total population would be 65 or older in 2023.
Alongside the rise in the elderly population, the healthcare sector in Denmark is grappling with a shortage of trained professionals, both nurses and doctors. Denmark has a shortage of approximately 4000 nurses and 1000 doctors, further straining the nation's healthcare system. It is projected a shortage of 6.500 to 9.000 nurses by 2030.
Graphic 2: Shortage of health workers in Denmark
How can our neighbourhood inspire the next generation of health worker? Health Workforce Plan 2019 report projected that there would be a need for up to 9,000 additional nurses by 2030. Source: Eurostat
Graphic 3: Voluntary work
How we can synergize durably with active volunteers aged 65+? There is a need to despecialise but at the same time, not trespass roles. This is an important organizational change that should take place right where we live. 1/3 of people aged 65+ works voluntarily. Source: Eurostat
Graphic 4: 65+ Living alone in Denmark
Almost half of Danish aged 65+ live alone today. It is the highest rate in Europe.
Remarkably, active seniors 65+ contribute significantly to Denmark's voluntary workforce: 43% are engaged in voluntary work, demonstrating the significant contribution of this demographic to community life and civic engagement. It is interesting to mention that 10% of the social housing inhabitants in Denmark have a background in health care. Loneliness is one of the biggest problems associating to aging, we can help people healthier by living at home longer in a supportive community.
These trends underscore the urgency of Nursing the Care's mission: to design a built environment that facilitates sustainable, intergenerational, health-oriented communities. The need to address the aging population, healthcare workforce shortages, and the underutilized potential of active older adults is not only urgent but also an opportunity for innovative solutions that shape the future of our cities. Demographic shifts demand sustainable approaches to aging together. Living and dying is everyone's responsibility; our built environment should facilitate this. Historically, health-focused architecture played a strategic role. We propose placing health, aging, and dying at the centre of our social lives and communities.
Contributions to Intergenerational Living in social housing
Adapting existing public housing estate with new facilities that generates lasting values for a health-based intergenerational living.
We aim to strengthen civic society (#1) by locating health-related programs right where people live. With an age-friendly approach, we aim to bring nurses and caregivers closer to the population they are meant to serve, minimize commuting, and create new co-living concepts. Neighborhood planning with the health of its community at heart will support aspiring students, young professionals, and low-skilled personnel.
Image 1: Buying index for the health sector in many cities hits a record low record, many cannot afford to buy a place near where they work.
Heidi Engesland Samuelsen, Photo: Stein Bjørge.
Graphic 5: Nursing the care criticizes the segregated institutionalized living of our senior and aim to create new model more connected to our daily life.
We want to design new places that shift from institution to neighborhood. 80% of health factors happen outside medical care and our living places are where we should focus on.
Graphic 6: A typical healthcare center is made of program that a district would benefit from. How can we find new synergies that are inclusive and economically sustainable?
The implementation of this project unfolds in three phases, designed to infuse an innovative vision of health services into the fabric of community living, ensuring a diverse generational mix and housing affordability:
- Community engagement: Conducting site visits and initiating dialogue with the community through various forms of engagement presented as a film documentary, a workshop to design the fabric of nursing the care for the exhibition and a music event with music therapists during the housing day.
- Site analysis: Undertaking thorough research to understand the challenges and opportunities of integrating health and intergenerational concepts into the existing built environment.
- Project proposal: Developing a comprehensive proposal that includes design, housing typologies, mobility, and an economic model.
Image 2: LOCAL office. Bergen Health experts
“How can we facilitate such a change without losing the quality of the care and the social differences just become increasingly bigger?”
Image 3: Local community, Common House, Axelborg
“I wish that we can get a really good community here in Axelborg, and as well that we can create apartments here that we can grow old in. Apartments where you can get your care when you need it.”
Image 4: Ides & Sebahat, Community Garden, Axelborg
“I feel like we’re missing places outside where we can sit when we become older. We are inside our apartments a lot, we need places where we can sit outside and look at people passing by.”
Image 5: Steffen & Sten, Blue Cross Café, Axelborg
“Could there be some possibilities to create some paths or connections to open the place up? So that you see it more as one unit rather than housing and nursing care.”
Image 6: Anette & Betina, Blue Cross Thrift Store, Axelborg
“Volunteer work can be a supplement to this, but we need to think about it as a whole, how do we deal with this difference we see in health in this area?”
Image 7: Alice nurse at Axelborg
From our brief: ‘We need to inspire the new generation of health care workers to unlock the possibilities of new intergenerational communities.’
Actions for a Health-based project
Incorporating health elements into public housing is a core tenet of our strategy to foster multigenerational living spaces with robust health-based infrastructure. Our model proposes practical solutions within existing public housing that contribute to an intergenerational community, structured around three key themes:
- Housing: Develop new co-living typologies in public housing with adapted layouts for professional and non-professional carers, as well as for the elderly and their caregivers. Transform two-family flats into eight-room units by adapting the assisted-living model. Redesign two-room apartments for active seniors as first-time buyers and create last-time buyer apartments.
- Active ground floor: Introducing health-oriented facilities such as physiotherapy centres, music venues, and rehabilitation centres into the ground floor of residential buildings.
- Large interventions: Seamlessly integrating large care centres into existing housing estates, thus becoming integral components of the community fabric.
- New mobility pattern: Communal and regional distribution of health services and housing for health professionals.
Graphic 7: We adapt existing housing estate with new offer that generates lasting values for a health-based intergenerational living.
Weaving a fabric of welfare services into Axelborg
Neighbourhood for Generation is exhibited in Velux’s Living Places from 29th June until the 31th October 2023. The (Danish) National Museums Research Center for Social Urban Modelling (SUMO) is curating the exhibition. The exhibition is open 24 hours a day for the public to explore. We present a circular totem wrapped in a new fabric made at Axelborg as a statement of the first step of our project.
Nursing the care fabric is the fruit of a series of workshop at Axelborg with residents, kids from school in Horsens, social organisation on site Botrivsel and Genbrug Horsens run by Blå kors that is Denmark largest reuse centre located just next to Axelborg. This new fabric starts by creating lasting relations between our local community, social organisation, volunteers, and non-profits and it is wrapped around our totem as a call to act together.
The weaved textile is made from used fabrics coming from all the participants and the reuse centre cut in regular bands. There is no start or end, and the pattern is an open invitation to weave together.
Image 8: Weaving new relationships is manifested by a participatory process creating reason to meet and reason to stay.
The weaved textile is made from used fabrics coming from all the participants. There is no start or end, and the pattern is an open invitation to weave together.
From Epidauro, Haussmanian boulevard post-cholera or Finnish sanatorium post-tuberculose, the architecture of Health has played a strategic role at key moment. We believe that the demographic momentum of health as the broader idea of living a good life, growing old and dying embedded in a community of people of all ages, needs to be reinstalled as the central premise in our social lives and local communities and we believe it should take place right where we live, and right now.
Graphic 8: Nursing the care finds new opportunities between the key actors of the project, active seniors, health professionals, care givers and dependent seniors to define a new ecology of health where people need it the most.
LOCAL with Silje Lockert, Kjartan Neckelmann, Sofya Markova, Elida Mosquera, Jerome Picard, Miriam Sharp Pierson.
Sebastian Von Hofacker
With the support of:
Botrivsel with Bettina Bach, Annette Langgaard, Islim Kilic, Katrine Dethlefsen, Nasli Aslan
Albo with Steen Rosvang Andersen, Steffen Møller Borgbjerg
Social Craft Café
Axelborg Afdelingsbestyrelse, Linda Brammer Mikkelsen, Bente Sørensen, Louise Milo Brammer Tromborg
Genbrug Horsens Blå Kors
BL – Danmark Almene Boliger
For LBF – Landsbyggefonden
LOCAL is at the forefront of envisioning inclusive and multi-generational lifestyles. With a strong focus on creating spaces where individuals can thrive as they age, LOCAL has earned recognition for their award-winning concept, Greymatter. Sebastian von Hofacker is a doctor in palliative care and the academic director of Verdighetsenteret in Bergen. Anna Helle-Valle is a psychologist and works for Aldring og Helse and Siste Kapittel. Together, we are a consolidated group of professionals who are passionate about promoting a new approach to aging. We aim to create environments that prioritize well-being, dignity, and inclusivity, ultimately shaping the future of how we live together as we grow older.