Spaces of compassion at the periphery : enhancing feelings of dignity and meaningfulness in patients and their loved ones through spatial solutions in end-of-life care

Abstract

In my thesis, I studied how the environment can enhance the quality of life in end-of-life (EOL) care settings, by addressing the physical and emotional needs of patients and their loved ones. Through research, I demonstrated how the environment plays a crucial role in providing dignity and meaning, improving quality of life transversally among all the parties involved in the end-of-life journey. My thesis aimed to create a spatial concept for a modern hospice in the European north.

I started with literature research, interviews with palliative care nurses, a hospice volunteer and educator, and a visit to the Terhokoti hospice in Helsinki, Finland. I delved into historical and contemporary perspectives, studying the key moments and developments in modern Hospice care. My research examples key figures and events such as physician Dame Cicely Saunders, with her concept of “total pain” to the impact of the AIDS epidemic on care practices. Key findings of my research underline the importance of informed design choices in improving quality of life (QOL) in end-of-life care environments. These key design elements include for example access to nature, natural lighting and a balance between communal and personal spaces that maintain feelings of agency and autonomy in patients.

Based on my findings, I propose a conceptual design for a modern hospice, located in the European North, with aesthetic and material choices that are informed by Nordic design principles and cultural traditions. The spatial concept presents twelve resident rooms, with additional spaces for social encounters and private discussion or reflection. Two courtyards between the common area provide a seamless transition between interior and outside spaces. The design is informed by research and practical guidelines, ensuring a holistic approach to spatial solutions in palliative care.

In conclusion, my thesis demonstrates the importance of design choices in EOL-care that are derived from a deep understanding of its users’ needs through peer-reviewed research and culturally informed choices. By involving care professionals to understand the key features of the environment, I have designed a hospice that helps to foster meaning, and feelings of dignity whilst reducing suffering in patients and their loved ones.