The world population is aging to the point that the World Health Organization estimates that by 2050, the proportion of people over 60 years in the world will double, from 11% in 2000 to 22% (2 billion people) by 2050.
This means that services for older people acquire increasing importance in our society and, in fact, in the recent years new models of old people centres are appearing to give specific attention to each period.
In previous publications we talked about assisted living apartments and public health centres, spaces designed to facilitate the daily lives of the healthy people and prepared to the moment when they may eventually be sick and well attended. But what happens when the old person becomes ill with no perspective of improvement?
When illness or old age reduce the survival perspective of the patient, we enter in periods where the person requires palliative care both physically and psychologically and, in many cases, the hospital or health centre are not prepared at an infrastructure and staff level to provide the specific care required by the person and their family in such a delicate moment.
In the recent years, following a trend that began in the United States, the centres called hospices are appearing, seeking to alleviate the physical and emotional pain of terminally ill patients and their families in their last days.
While it is true that most of palliative care are aimed to old people, these centres also serve cancer and other diseases in advanced stages patients, suffering from pain, such as AIDS, dementia or degenerative diseases.
In any case, it is always about patients with a need for improving their quality of life, pain relief and that require specialized professional help that takes into account their status and their loved ones.
That is why it is necessary to provide appropriate infrastructures to patients so that they receive the necessary professional support. Today we find different alternatives for palliative care centres, from units included inside hospitals to day care centres or home care teams.
However, we would like to highlight the hospices, dedicated exclusively to the care of terminally ill patients, with their own specific characteristics that differentiate them from other centres.
Palliative care hospices
Hospices date back to the late 60s, when British nurse Cicely Saunders founded in south London St Christopher’s Hospice -which would be the first modern hospice- in the UK.
It was a centre which combined clinical care, psychological support, training and research. This holistic approach provided a basis for new ways to treat and provide services that are currently developed worldwide.
Hospices have an uninterrupted visits timetable, tolerance to allow visits from the youngest members of the family and even pets. That is why they are centres with a different policy than hospitals.
Currently the society tends to avoid talking about death and focus the last days of life as a period of isolation, so sometimes the palliative care can become impersonal and in most cases paying little attention to communication between the patient, the family and the professional team.
In this sense, the design of palliative care hospices focuses on expanding care beyond the patient to support families, friends and the own professionals that support a significant emotional burden on their daily lives.
In these centres, the care is organized through multidisciplinary teams and includes units such as pain control, symptom relief, specific care of diseases, spiritual support, counselling, social support, complementary therapies, recreational activities, physiotherapy and bereavement care.
Let’s see in detail the main criteria to be considered in the design of hospices.
Design criteria for palliative care hospices
Among the main criteria to consider in the design of palliative care hospices, perhaps the most important of them is the relationship with nature.
The ability to have personal control over the environment and a sense of wellbeing and comfort are particularly important.
Therefore it should be considered the creation of the building own outdoor spaces, as well as the hospice extension to its nearest urban environment, through gardens, courtyards or terraces. These transitional spaces will also allow us to integrate the equipment in society, since it is interesting that these buildings are not isolated.
Personal control of the indoor environment is also very important for patients. Therefore, palliative care rooms often include lighting, visual, temperature and humidity control systems located near the beds of patients to facilitate their use.
As for the design of interior spaces, sustainability, durability and safety are the three key concepts. It is essential think of pavements and grip supports in common areas, as well as adapted toilets or raised beds inside the rooms, because patients will be very possibly aged and this will make their stay easier.
There are also considered spaces for family or friends. It is about relation, visiting or snack areas, or even more private spaces where they can relax. Rooms should also include the possibility for the family to stay in order to look after their loved ones.
The use of natural materials and colours, such as wood, is a universal key for the interior finishes. It is important to create a warm and pleasant environment, fleeing from the typical image of a hospital.
The furniture and accessories should also be based on domestic space helping to create more friendly and familiar spaces, avoiding the impersonality and making patients feel at home to enjoy his last days in a cheerful and comfortable atmosphere.
Finally, it also becomes especially relevant the interior decoration that allows to humanize the spaces generating areas of distraction that improve the mood of patients.
In this sense there can be used from paintings on the interior walls to games or elements for recreational activities that enrich the space and make it more enjoyable.
As always, we would like to finish remarking the commitment of CASA Solo with the design of sanitary spaces such as the remodelling and enlargement of the nursing home and day centre of the Saint Hospital of La Seu d’Urgell, one of our recent awards.
As architects, we are one of the steps of this process and our work can help to improve the quality of life of patients, families and professionals.
We assume this responsibility researching every day and putting to the service of our hospital customers all our experience and knowledge to improve together the quality and efficiency of health care in our country.