4 Designing dying well: toward a new architectural approach of in-patient palliative care environments

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Abstract

Neither a ‘hospital’ nor a ‘home’; the in-patient hospice has a unique architectural identity remaining largely undocumented. There is a plethora of architectural research regarding more common-place healthcare buildings such as hospitals and care-homes. (RIBA n.d) However the architecture of in-patient hospices is misunderstood in the role it can play in supporting the holistic principles of palliative care as backdrops for ‘not just a good death but a good life to the very end’ (Gawande 2014, pg. 245).

Reconciling the social and spatial this research aims to establish an authentic identity for in-patient hospices; developing opportunities and situations for environments that become ‘sympathetic extensions of our sense of ourselves’ (Bloomer KC + Moore CW 1977, pg. 78) enabling those at the end of their life to dwell with dignity.

An ethnographic study involving practise led design research; the research engages with experiences of the researcher and users of Welsh in-patient hospices alongside interrogations of existing architectural strategies. This inter-disciplinary methodology will provide a ‘back and forth’ movement to reflect with the community of practise upon design projects and fieldwork.

Foundation work concluded that ‘homely’ is a too broad and subjective concept with which to define meaningful architectural responses for the variety of users and uses of in-patient hospices. Building upon this initial visits to Welsh in-patient hospices and design primers of key moments of inhabitation aims to provide conclusions on how architecture can create and balance the individual phenomenological experiences and needs of patients family and staff.

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