"It's becoming acceptable to talk about hospice," said Dr. Bernard Lee, associate chief medical officer, Metropolitan Jewish Healthcare System (MJHS), kicking off a breakout session at the 2014 EFA Conference on designing for hospice.
With that acceptance comes a better understanding of what it is and the design considerations that need to be made for these types of facilities. "Most think of it as a place," he said.
Rather, it can involve a variety of services and isn't just about relieving pain but thinking about the medical, psycho-social, and spiritual aspects of dying.
To illustrate that point, colleague Barbara Geddis, president, Geddis Architect, pointed to the recent 2014 FGI Guidelines, which expanded its definition of hospice care to include adult daycare, home-based services, small ambulatory and non-ambulatory residential care, and freestanding hospice environments.
In the case of MJHS, the provider has partnered with other healthcare organizations to add hospice care environments to existing residential and medical facilities as well as coordinate in-home care for patients both young and old.
Presenting a handful of case studies, the speakers discussed one project where MJHS added residential hospice to an existing apartment house, adding studio apartments, with kitchens as well as spaces for care givers, to the top floor. Another MJHS project is in the works in Queens, N.Y., and features a 17-bed hospice floor at an acute care hospital.
In both environments, the speakers said it was important for the design to take into account family members, who might need a chance to take a break, connect with family, or partake in their normal routines using amenities such as an on-site library, dining room, sibling play areas, and meditation spaces.
"It's all about creature comforts," Geddis said, adding that an important part of hospice design is providing families with equipment to cook their own meals. "And if they want it to be in the [resident] room, then it has to be in the room," she said.
Another key design consideration is knowing who your population is and being able to make the right accommodations, including spaces for worship, on-site pastoral care, and understanding religious and cultural customs when a family member dies. Some of the other key design lessons they shared included:
- Try to offer the use of private outdoor spaces for families as well as staff members
- Provide a variety of scenes, viewpoints, orientations, and vistas
- Interior colors and materials must suit the demographic population
- When locating with another use, the top or bottom floor is ideal for separation and privacy needs
- Incorporate a variety of lighting options in the bedroom and family spaces
The speakers said they plan to conduct POEs on the MJHS projects to further understand what's working in their hospice designs and where there's room to improve. Geddis also advised designers, architects, owners, and care teams to be gentle students and observers by listening to families and their stories.
"Hospice is not just the absence of pain, it's living, too," Geddis said.
