TO STUDY MODERN HOSPICE

DESIGNS:THE ARCHITECTURE
OF PALLIATIVE CARE AND
HEALING
LETS START FROM THE END
SUBMITTED BY - PRACHI MANTRI, 22

INTRODUCTION
1.1

BACKGOUND OF THE STUDY

MODERN HOSPICE DESIGN: THE ARCHITECTURE OF PALLIATIVE

CARE
For a long time, it has been believed that both are natural and man-made
environment have a profound impact on our psychological wellbeing and how we
interact with each other. In this regard, it is believed that there are certain
principles underlying architecture and built environment which if followed, can
help to create added human social and environmental value to our world, and for
this reason it is even more important that the best possible environment is
engendered by the design of buildings, such as HOSPICE, which provides a vital
haven to people at very challenging times in their own lives as well as their
families.
A hospice is a place for the care of the terminally ill. Palliative care is therapy
that focuses on decreasing pain and suffering by providing patients with
medication for relief of their symptoms and with comfort and support.
Hospice care, which involves helping ill patients and their families during the last
period of life, is an integral part of palliative care.
Palliative care generally consists of physician care, nursing care, personal
assistance with activities of daily living, medical social work, music and art
therapy, companionship, and psycho-logical and bereavement counselling.
Caregivers, widely referred to as the palliative care team, consist of
psychiatrists, psychologists, physicians, nurses, physical therapists, music and
art therapists, occupational therapists, and legal and financial advisors
available to advise patients and their families even throughout the
bereavement period. Architectural places are created for living and also for
dying. Perhaps because the acts of death and dying are often gruelling and kept
secretive, sparse literature is dedicated to endoflife environments that facilitate
a good death.
The World Health Organization (WHO) defines palliative care as The active total
care of patients whose disease is not responsive to curative treatment.

Pall i a t i v e a r c h i t e c t u r e c a n e n h a n c e t h e f i n a l m o n t h s , d a y s
even hours of life. A supportive hospice setting
p o s s e s s e s t h e power to imaginatively capture and express in
pragmatic and ins p i r i t u a l t e r m s t h e t r a n s i t i o n t o t h a t w h i c h
may lie beyond life h e r e o n e a r t h . A e s t h e t i c
e x p e r i e n c e s , n a t u r e , n u r t u r a n c e , respite,
r e c o n c i l i a t i o n , c l o s u r e , a n d d a y - t o - d a y f u n c t i o n a l s u p port
are at the centre of the hospice equation.

Some of the basic principles to be kept in mind while designing with

greater empathy and sensitivity, whilst always bearing in mind that the
end of life care brings its own very special challenges and opportunities to
create the best environment are as follows:

Natural Environment
Natural Materials
The elements
Arts and Crafts
Legibility (Semi-public ,public, semi-private ,less private)
Respecting time
Comfort
Dignity
Beauty
Robustness and economy

Architecture should defend man at its

weakest
- Alvar Aalto
Modern Hospice Design ask whether there is yet a distinctive architectural
style to hospice buildings, combining their sombre, pastoral purpose with
a sense of affirmation , dignity in dying and the completion of lifes
meaning.
1.2

CRITERIA OF SELECTION:

There is a growing concern with the conditions in which many older people
die at home or at hospital. The traditional hospital building and settings
are merely places particularly where death is diagnosed, announced and
attended. There is a real need to improve the environment in end of life
care. Cancer has become one of the ten leading causes of death in India.
Over 7 lakh new cases of cancer and 3 lakh deaths occur annually due to
cancer. Nearly 15 lakh patients require facilities for diagnosis, treatment
and follow up at a given time.
There is a limit to cure but no limit to CARE and when there is no cure,
then there is a greater need for CARE

HOSPICE MOVEMENT

It is found that cancer patients are suffering for want of care and it is also
a problem for their family and the relatives as they are unable to provide
the required care. Thus Palliative Care Centre becomes imperative. With a
view to take care of such people, it is proposed to establish a Hospice for
terminally ill cancer patients. With keen awareness, major dilemmas in the
architecture of hospices are explored. The text unearths a staggering list
of design questions to ponder: domestic or professional appearance? Final
destination or a treatment centre? Removal of deceased bodies by the
front door or disguised from the hospice mortuary? Religious symbols or
secular? Small or large massing of the building? Less expensive multi
bedded accommodations where patients give each other support, or more
expensive single rooms? Overorchestrating the emotions in design with
too much stained glass and chandelier lighting, or design that is quiet and
more ambiguous in form and function?
"You matter because of who you are. You matter to the last moment of
your life, and we will do all we can, not only to help you die peacefully, but
also to live until you die.
-Dame Cicely Saunders, Hospice Founder

1.3

HYPOTHESIS

Space enhances and influences the process of healing of the dying cancer
affected patients.
1.4 AIM:
To gain an understanding of how physical environment and spatial
configuration influences the healing process of a dying person through
comparative analysis of hospice centres with various ideologies and
concepts.
How modern designs and techniques can be implemented into bringing
some changes in the care of the affected cancer patients?
How to make more user interactive spaces
1.5 OBJECTIVES:

Study how behaviour gets affected by environment.

Study spaces in reference with health care hygiene.
Study the needs of the patients.
Study various examples of exiting hospice cancer centres in India
Compare hospice care units with foreign modern techniques
Study the conditions of the exiting hospice centres in India.

Conclude the role of nature in healing

METHODOLOGY:
Studying the modern hospice architecture through various surveys,
interview the cancer affected patients and case studies of various hospice
care centres in India and abroad . Some examples of such centres
include :

Maggies Centre for Cancer Care ,Manchester by Norman Foster

Maggies Centre for Cancer Care ,Hong kong by Frank O Gehry
Maggies Centre for Cancer Care ,England by Thomas Heatherwick
Karunashya ,Banglore ,India
Shanti Avedna at Mumbai