PRE
THESIS
INTRODUCTION…
A hospice offers care to terminally
ill patients. With a range of services
including pain- symptom control,
therapies, psychological and social
support, rehabilitation, counselling,
spiritual care, financial advice and
support in bereavement. A hospice
supports not only patients but also
family members and caregivers to
cope with the challenges of life-
threatening illness.
HOSPICE
AIM…
Design a hospice care facility for terminally unwell human beings.
SCOPE OF DESIGN.
A hospice center is to be designed emphasis on any or all the
following areas.
1. Internal Circulation
2. Vehicular traffic Management
3. Services
4. Lighting and Ventilation
5. Water Conservation and Reuse
6. Waste Management.
7. Environmental and micro climate
8. User behavior and requirements.
9. Utility and space enhancement.
10. Form and function
11.circulation: horizontal and vertical.
12.site planning and landscape detailing.
13.structural details such as beam framing.
14.building services/ HVAC etc.
15.Design detailing considering the barrier free
environment.
16. parking details and standards.
17. Visitors safety / Firefighting system/ exists
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DESIGN BREIF…

Care facilities tend to prioritize functionality in their design approach which is ideal, but the
aesthetics and ambiance play a huge part in creating positive environments.

The challenge is to understand how design can be improved for better living of terminally ill.
Although the facilities and skilled staff of a hospice are what would create a soothing
environment to an extent, the tangible spaces that they are exposed to, during their stay in a
hospice, can contribute to their well-being.

There are many factors besides the functional part that are to be prioritized in designing care
for this tender age group. Exposing them to outdoor facilities, social interaction, and
engaging with nature in a positive manner are essential

OBJECTIVES…

Access: The layout should be such that it allows access to all areas in the hospice with
minimal support. Navigation must be easy in the event of unexpected medical emergencies.

Ambiance: surface treatment, material, color palette, lighting, and so many other design
elements can be used to generate nurturing and sensitive environments.

Experience: incorporating greenery and outdoor spaces like terraces, gardens, courtyards.

Security: A careful balance must be achieved to make the facility secure but not isolated
from the surrounding community.

A PLACE TO LIVE

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A Hospice is not only a “PLACE TO DIE” peacefully but rather a place ‘To Live’ with
better quality of living provided by good Palliative Care for the days that are left…!

An institution that takes care of advanced terminally ill cancer patient. It is neither a hospital
or a home. It is both offering the specialized care of a hospital with the love and care of
home.

HISTORY OF HOSPICE CARE:

Throughout time, people have suffered life-limiting illnesses but there
wasn’t always a system in place to make sure that their last days were comfortable.
In the nineteenth century, the action of hospice care was taken on primarily by women. They
were religious and philanthropic volunteers that serviced the sick across countries and
continents without knowledge of each other.
The attention hospice care would achieve in the next century would be because of these
women.

By the twentieth century, more hospitals with hospice care were established.
They became so vital that many facilities received more beds and more people joined to help
the cause. The Sisters of Charity was an organization in Ireland that helped the impoverished
population of Dublin in the nineteenth century, and by the twentieth, they had developed
other facilities across the globe.
This included St. Joseph’s Hospice, which was critical in the history of palliative care.

QUALITY OF DEATH

In 1967 Cicely Saunders influenced the modern concept of Hospice Care. Dr. Saunders
directed St. Christopher’s hospice in England and she was a champion in developing the
philosophy of end-of-life care and hospice practices that spread globally.

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In 1987, Dr. Declan Walsh established the first hospital-based palliative care center at the
Cleveland Center.
Medicare authorized formal hospice care in the 1990s and the treatment of such efforts was
taken more seriously.

In 2015, Lien collaboration and Economist Intelligence Unit had got together to publish the
‘Quality of Death Index‘. India ranked 67th among 80 countries in the world.
Recently, 2022 Eric A. Finkelstein and colleagues have published a cross-country
comparison of expert assessments of the quality of death and dying. India is 59th among 81
countries studied.

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 CANCER STATASTICS OF INDIA
The 2020 WHO ranking on cancer burden in terms of new yearly cases being reported had
ranked India at the third position after China and the US, respectively. The estimated number
of incident cases of cancer in India for the year 2022 was found to be 14,61,427 (crude
rate:100.4 per 100,000).

Cancer incidence estimates for 2022 & projection for 2025: Result from National
Cancer Registry Programme, India

Sathishkumar, Krishnan; Chaturvedi, Meesha; Das, Priyanka; Stephen, S.; Mathur, Prashant
Indian Journal of Medical Research156(4&5):598-607, Oct-Nov 2022.
doi: 10.4103/ijmr.ijmr_1821_22

Estimated age-wise number and incidence rate for all sites of cancer by sex – 2022.

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 TYPOLOGY

WHAT IS TYPE OF HOSPICE CARE PLACES ?

Here we have two types of cares

1. Palliative care Home.
2. Hospice care Home.

Palliative care is specialized medical care for people living with a serious
illness, such as cancer or heart failure. Patients in palliative care may receive
medical care for their symptoms, or palliative care, along with treatment intended to cure
their serious illness.

Palliative care is meant to enhance a person's current care by focusing on quality of life for
them and their family.

Palliative care can be helpful at any stage of illness and is best provided soon after a person is
diagnosed.
Improving quality of life and helping with symptoms, palliative care can help patients
understand their choices for medical treatment. The organized services available through

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palliative care may be helpful to any older person having a lot of general discomfort and
disability very late in life.
Like palliative care, hospice provides comprehensive comfort care as well as support for the
family, but,

In hospice, attempts to cure the person's illness are stopped. Hospice is provided for a
person with a terminal illness whose doctor believes he or she has six months or less to live if
the illness runs its natural course.

It's important for a patient to discuss hospice care options with their doctor. Sometimes,
people don't begin hospice care soon enough to take full advantage of the help it offers.

Perhaps they wait too long to begin hospice and they are too close to death. Or, some people
are not eligible for hospice care soon enough to receive its full benefit. Starting hospice early
may be able to provide months of meaningful care and quality time with loved ones.

Hospice care brings together a team of people with special skills among them nurses, doctors,
social workers, spiritual advisors, and trained volunteers. Everyone works together with the
person who is dying, the caregiver, and/or the family to provide the medical, emotional, and
spiritual support needed.

OUT PATIENT DEPT (OPD)

This is mainly for patients who have been discharged from the Hospice and need follow-up
treatment on their medication. Our in-house doctor is available for the same every afternoon
as required.

DAY CARE SERVICES

This is for patients who would like to stay at home, but would like to come in for day care
attention when needed. All necessary care is given to day care patients.

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HOME SERVICES
Some hospice may provide home care services according to patient requirement.

OCCUPATIONAL THERAPY
Those patients who are in a suitable condition, are encouraged to do some work to keep their
minds occupied. They make some decorations, or small articles, or paintings or writings,
under the supervision and encouragement of our occupational Therapist

REHABILITATION SERVICES
Whenever a patient is handicapped in any way, such as swellings on the limbs, stiffness, etc.,
rehabilitation services like treatment of oedema, physiotherapy etc. are given. Also, when
appliances are needed, like walkers etc. these are provided.

RELAXATION FACILITIES
We offer various relaxation facilities like music, TV, movies, games, outings etc. to make the
patient feel as relaxed as possible

SPIRITUAL SUPPORT
Each religion is equally respected. Spiritual counsellors for each religion are invited to
interact with the patients as needed. Besides, the sisters themselves interact spiritually with
the patient whenever needed and possible. There is, however, strictly no indoctrination of any
particular religion in the Hospice.

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Hospice care is underdeveloped globally to an extent that it shames us all. Good care at the
end of life and a dignified death should be regarded as basic human rights to which everyone
has access when the time comes Hospice and palliative care buildings have emerged as a new
and evolving architectural type.

The shift in the hospice movement to privileging hospice home-care is a significant factor in
the changing role of the hospice building typology.

Many professionals such as palliative and home-care nurses, bereavement counsellors,

palliative-care researchers and educators have emerged and are often accommodated and
centralized within new hospice buildings and palliative care units.

Different Spaces in Hospice center

1. Ward 16.Prayer room

2. Nurse station 17.Parlour
3. Toilet 18.Auditourium
4. Corridor 19.Morgue
5. Reception 20.Staff Quarters
6. Female ward 21.Vegetation
7. Family lounge 22.Security cabin.
8. Male lounge 23.Day care
9. Single bed room 24.Male Ward
10.Double bed room 25.Administration
11.Meditation/yoga 26.Courtyard
12.Drying yard 27.Laundry
13.Doctors cabin 28.Karma Karyam (Death-Rituals) hall
14.Kitchen
15.Nurse Lounge

Occupancy in space: Space occupancy is the measure of total employees in a workplace at a

given time. It's usually represented against the total capacity, to show occupancy rate.
We can also measure space occupancy within the context of square footage, which is most
common when facility managers seek to understand utilization.

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Core function recreational space General services
Auxiliary activities Arrival
General service area OPD
Axillary activities Registration
Kitchen Washroom
Stairs  and Ramp.

Doctor chamber 9 m² per chamber

Ward 8 m² per bed
Waiting area 1 square m² per patient or person
Nurse station 18 m²
Toilet 6 m² square
Patient relative interact to space 18  m²
Beach patient toilet with janitor 18 m² 3
Staff room 24 m²
Pharmacy 12 m² to 24 m² where is recommended
Outpatient registration 12 m²
Admission office 24 m square
Storage 12 m²
Recreational activity room for patient 2 m²

HOW IT HELPS SOCIETY:

Hospice care in India is still at an early stage of development and faces numerous problems.
Approaches to improve the application of Hospice care includes education, training and
research endeavors. Educational efforts in palliative and end-of-life care have benefitted
nurses, physicians and other disciplines associated with clinical care.

International Desktop study Campania Centre for the Unknown

National Desktop study

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Case study

Proposing Site.
Selection

https://www.google.com/maps/@18.3373303,82.8932948,9368m/data=!3m1!1e3

Vizag is a popular tourist destination mainly known for its beaches.

Located at a distance of 120 km from Vizag is a beautiful hill station called Araku
which is as popular as the beaches of Vizag. Blessed with enchanting streams, lush green
forests,
beautiful waterfalls, sprawling coffee plantations, rich landscape and wonderful weather.

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