George Mark Children’s House by

2023 Other / California / USA / Built in 2021 /

The George Mark Children’s House was the first standalone pediatric palliative care center in the United States. Their work supports the unique needs of children with terminal illnesses and their families, including palliative, end-of-life and bereavement care.

The landscape architects were approached by the founder of the center to turn 1.3 underutilized acres into a restorative garden. The LAs brought leadership and vision to a project with no apparent source of funding, harnessing their design ingenuity and broad professional network, resulting in donations of engineering expertise, materials, contractor time and services of over $500,000.

The center was founded in 2004 as an alternative to the clinical nature of institutional settings. Medical equipment is tucked behind panels, the bedrooms have fun themes and it feels like a home as much as possible. Relieved from the stress of medical costs (which are fully covered by the center) and difficult decisions, families at the House can celebrate their remaining time together. The LAs reflected this ethos by designing at a residential scale and providing spaces for gathering.

The property had mature landscaping around the house as well as a network of wheelchair-accessible strolling paths, but the hillside was left fallow and underutilized. At the base of a hill, an existing chapel lay a short distance away, with its primary access through the parking lot.

The design plan focused on three groups of stakeholders with diverse needs: patients, family members, and caregivers. Patients are at different levels of need; families are made of both adults and children, and caregivers include medical and administrative staff, members of the care teams, and volunteers. The LAs worked with the stakeholders to identify the need for a continuous pedestrian connection, turning an existing drainageway into a riparian habitat, edible plants for the onsite kitchen, and a berry vineyard that culminates at a meditative overlook.

Sensory experiences are an integral part of the care plan for patients and special consideration was given to weaving opportunities to provide this throughout every other element.

A small memorial fountain had great significance at the GMCH, but its setting did not reflect that. A pot surrounded by stones engraved with the names of children and the date of their passing was tucked off to the side with no shade or seating. To better honor its significance, the area was transformed into a serene garden memorial. The reimagined fountain was carved from a block of basalt. The nearby hillside is held back by a retaining wall of boulders and stones, which in turn provides seating.

In order to accommodate a seasonal waterway, the LAs created a raised boardwalk, which not only suspends visitors above seasonal moving water, but creates percussive sound and vibration for those in wheelchairs. What was once an unsightly gravel ditch is now spanned by a cedar boardwalk and edged with riparian plantings, creating a functional, attractive habitat and pedestrian connection.

Close by is the main gathering space. It offers a variety of seating and an installation of interactive chimes. At once sculpture and musical instrument, the chimes are enjoyed by all, whether kids can actively engage, or watch and listen as their siblings make up songs. A wall fountain spills along the edge of the pathway. Young family members take a break to play in the fountain.. The patients’ fragile health does not allow them to play in the water, but they can delight in its sound and watch hummingbirds drink from its spouts.

While speaking with the staff and volunteers, the LAs found out that they were hosting a weekly potluck in the parking lot. An outdoor kitchen and dining area shaded by an arbor were added to provide a much needed place for staff or families to come together.

A series of wheelchair-accessible ramps leads visitors along raised vegetable beds and a small vineyard of table grapes and berry vines up the hill. Whimsical artworks designed dot the property, while ‘borrowed views’ of an open hillside on a neighboring property enhance the feeling of freedom, spaciousness and oneness with nature and sensory experience through plants.

The LAs discovered that the top of the hill provided views over the whole complex to San Francisco. They created a destination overlook crowned by a shade-providing tensile structure that takes on a birdlike appearance from the garden below.

Hummingbird Hill exists to support everyone in the GMCH community, whether it’s hosting a resident family celebrating a special milestone, a returning family remembering a child, or a community event or staff gathering.

After four years of donated time and construction support, it is a place of healing, where residents can safely spend time outdoors and families can enjoy quality time together. It is also a place for staff and caregivers to slip away before returning to their demanding and emotionally challenging work.

Photographer credit: Jason O’Rear
Project location: San Leandro, California, United States
Design year: Started 2017
Year Built: 2021


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