Building scale and well-being in a hospice: a qualitative exploration

Abstract

ObjectiveThis study explored how built space plays out in palliative care, focusing on spatial aspects that could support or hamper patients’, relatives’ and caregivers’ well-being.MethodsThis study was conducted in a freestanding small-scale hospice combining a residential part for eight guests with a day-care part for groups of about five persons. Observations were combined with semistructured, individual interviews with eight guests (sometimes accompanied by relatives) and three focus-group interviews with staff, volunteers and relatives. All interviews were audio-recorded and transcribed verbatim. Data were analysed based on the Qualitative Analysis Guide of Leuven.ResultsThe most important spatial aspects that impact on physical and social well-being in palliative care turned out to be the building scale and physical proximity. The small-scale setting counters the (often negative) association of palliative care with hospital environments. When the medical condition of the guest allows, it makes communal or outdoor spaces reachable, which enhances emotional and social well-being. In worse conditions, it still makes that care and nature are always nearby. The compactness of communal spaces intensifies social contacts.ConclusionsThe building scale and physical proximity play out in the relationship between the building and its surroundings, between the residential and the day-care parts and among people within the building. Future research could investigate to what extent these spatial aspects are relevant in more conventional palliative care units or even in general hospital wards.

The role of the built environment in experiences of hospice care: challenges for hospice design

“…Rasmussen & Edvardsson (2007) describe the choice between proximity and seclusion as part of 'creating an atmosphere of safety'. Our study shows how this safety can be created by spaces that offer the choice to retreat while still staying nearby (Annemans et al 2020).…”

Design-Related Impacts on End-of-Life Experience: A Brief Report of Findings from an Exploratory Qualitative Study

“…This study is consistent with other research that has highlighted the correlation of spatial environments with the social aspects of EoLC. 4 , 11 , 12 , 20 , 36 As Table 1 shows, the 6 identified themes indicate the interdependence of social and spatial dimensions, highlighting the need for integrating and addressing them consciously within the EoLC environment.…”

“…10 Recent research continues to suggest that social and spatial elements are pertinent (and often, interdependent) within EoLC facilities; however, the evidence base on these aspects is far from comprehensive. 11,12 Moreover, cultures of death and dying have shifted considerably over time, 13 as have the places where people spend their last days, with many deaths occurring in different EoLC settings. 14 Despite the common preference for and upward trend towards dying at home in the United States (30.7%), a substantial proportion of deaths still occur in institutions such as hospitals (29.8%); nursing facilities (20.8%); and hospice facilities (8.3%).…”

“… 10 Recent research continues to suggest that social and spatial elements are pertinent (and often, interdependent) within EoLC facilities; however, the evidence base on these aspects is far from comprehensive. 11 , 12 …”

Status, demand and practice models of palliative day-care clinics and day hospices: a scoping review

“…19 Corr and Corr 34 portrayed day-care as a suitable introduction to the hospice environment for terminally ill patients, enabling them to stay at home for as long as possible. Finally, the literature described some free-standing palliative day-care clinics and day hospices, 35 as well as palliative day-care clinics and day hospices integrated with residential hospices or hospitals, 15 32 35 36 or community centres. 28 The analysed studies showed that most palliative day-care clinics and day hospices were staffed with a multidisciplinary team providing a diversity of services and activities.…”