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Optimal Design Considerations for Hospices: A Repository for the Latest Developments in Hospice Design

Architects, interior designers and landscape architects are invited to submit drawings/plans capturing key elements of design for hospices.

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Who is your idea designed for and how does it reimagine the end-of-life experience?

This project is intended to raise international standards of architectural, interior and landscape design for spaces intended for dying patients and their families. While the field of architecture is largely focused on rendering spaces for optimal living, little attention has been paid to how to create spaces that are optimal for people approaching end-of-life. This will include integration of technology in new creative ways, in order to facilitate connectedness to people, places and events.

REFINEMENT!!!!

Here is what we have done:

1. We sent an email to about 30 people (patients, family members, healthcare providers, healthcare administrators; and people working in the design industry). SEE OpenIDEO.1.pdf

2. The email explained what OpenIDEO is, briefly what our idea is about, and our need to get their feedback! SEE OpenIDEO.2.pdf

3. We also sent them a copy of what our User Experience map looks like so far! SEE OpenIDEO.3.pdf (or if you prefer, check out the images above).

4. They also received a copy of our 'what to prototype' document. SEE OpenIDEO.4.pdf

5. Last but not least, we have been collecting all of their feedback; and here is what we have heard so far!! SEE OpenIDEO.5.pdf

Based on what we are hearing from patients, bereaved families, healthcare providers, healthcare administrators, IT business consultants and designers, we remain convinced that there is a real need for this project, and that it could help facilitate and inform the design of those critically important spaces intended for dying patients and their families, worldwide.


Our team remains excited about this project, and having heard from all of our key stakeholders, is convinced that this idea is a winner!!


Harvey, Shelly and George.


The spaces in which we live our lives are important. So too are the spaces we will spend our final months, weeks and days of life; as we are accompanied by those who care most about us, anticipating the inevitability of death. With the growing rates of cancer, our aging population and the challenges associated with mounting disability and frailty, the need for hospice facilities is ever increasing. While much of architectural design focuses on spaces for healthily living, far less attention has been paid to key elements of design optimal for dying patients and their families. These spaces must accommodate certain practical elements, such as accessibility, equipment placement and storage; and the various accouterments of healthcare provision; but must also impart a feeling of tranquility, refuge and healing. Design should consider facilities with easy access to the outdoors, and the ability to shift a room's focus from community to privacy. Current hospice design is polarized around two populations, infants and young children, and older adults. Other specialty hospice facilities (such as adolescent and young adult; or indigenous people and culturally sensitive spaces) are also of great interest in this project.

This project will invite architects, interior designers, landscape architects and healthcare professionals worldwide to submit their design ideas, by way of design drawings and/or more fully developed plans and photographs, illustrating core elements of optimal architectural approaches in rendering these unique spaces. These submissions will be housed in a publicly available repository located on the Canadian Virtual Hospice (www.virtualhospice.ca), thus providing an unprecedented resource that will inform the creation of healing spaces for the dying worldwide.

What early, lightweight experiment might you try out in your own community to find out if the idea will meet your expectations?

The Manitoba Government is committed to create an International Centre on Dignity and Palliative Care (ICDPC). This project is still in its early phases, and fundraising and land acquisition are currently underway. The ideas gleaned from this Hospice Design OpenIDEO could be used to help inform the design of three hospice facilities (Indigenous Hospice; Pediatric Hospice; Adult Hospice), which will be constructed as part of ICDPC.

What skills, input or guidance from the OpenIDEO community would be most helpful in building out or refining your idea?

This idea will benefit greatly from the input of the OpenIDEO community. It contains elements that implicate the field of architecture, interior design, landscape architecture, palliative care; but will also require input from business experts, social medial experts, and IT experts, to help facilitate key aspects of this international initiative.

Tell us about your work experience:

George Cibinel is a highly experienced, creative and successful architect; and consultant on the International Centre on Dignity and Palliative Care. Dr. Chochinov holds the only Canada Research Chair in Palliative Care. Shelly Cory is the Executive Director of the Canadian Virtual Hospice

This idea emerged from

  • A group brainstorm

8 comments

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Photo of Selene Seltzer
Team

We at Southern Oregon Friend of Hospice (SOFH) in the Rogue Valley of Southern Oregon, USA are in the process of remodeling an existing structure into a Residential Hospice House licensed as Residential Care Facility. We have been working with architects, designers as well a taking input from Clinical Healthcare Hospice providers. We would be happy to collaborate with you. Feel free to contact us. I am a Clinical Healthcare Chaplain (EOL and Pall Care) and former design professional currently working on the project's Facilities Team.

Harvey -Here's a thought. In view of what I interpret as the "scoring" aspect of this Ideo Challenge (and the goal of moving forward....) you might consider adding the responses found in your refinement documents individually as comments and include each person as part of your team for the "team building" aspect.

Best,
Selene Seltzer

Photo of Harvey
Team

Hello Selene,



Thank you for contacting me. I recall a series of meetings we held with bereaved family members, asking them to share their insights as to hospices should be designed. The information we collected was extraordinary; including reflections on the size a bed should be ("big enough for two people to sleep or cuddle together"), room furnishings ("chairs that recline into comfortable beds to accommodate family to sleep over"); doors that can be shut 'silently' without disturbing anyone's sleep; and the list, touching on every single facet of how these spaces should be designed to best meet the needs of patients and families, goes on and on.



This was part of our inspiration for this project. People thinking about these issues and contemplating these spaces can collectively raise the design bar worldwide. This will help ensure that terminally ill patients - accompanied by those they love - can live out their final months, weeks and days in a setting that will best accommodate all of their needs.



That is our vision. It is one we think many, just like your group in Southern Oregon, will be drawn to.



Kind regards,
 
Harvey

Harvey Max Chochinov MD PhD FRSC
Distinguished Professor, Department of Psychiatry, University of Manitoba
Canada Research Chair in Palliative Care
Director, Manitoba Palliative Care Research Unit

Photo of Selene Seltzer
Team

Thanks Harvey for responding.

We at Southern Oregon Friends of Hospice, a 501(c)(3) non-profit, share your passion to provide quality end of life care in residential facilities.

SOFOH originally supported our local hospice programs and educational programs regarding end-of-life care by making gifts of money raised through our resale shop. In 2013, local hospice providers asked us to focus on raising funds to build a hospice-centered residential care facility (RCF), as they believed such a facility will provide a bigger benefit to patients and their families than financial gifts to local hospices.

In response, we have shifted our priorities to provide a collaborative “social model” hospice-focused residential facility run by SOFOH. Our on-site 24/7 care teams will enfold individualized plans of care by all of the four local Medicare-certified hospice agency’s visiting staff including hospice physicians, nurses, social workers, chaplains and volunteers.

Our focus is on enhancing the quality of the end-of-life experience, recognizing the individual’s need for comfort, human touch, freedom from pain and fear, allowing for quality time for sharing memories with loved ones. We wish to ensure that patients die with dignity and respect while valuing their individuality and traditions.

After much searching for the right site to build or the right building to renovate, in late 2015 SOFOH found a historic home for sale. The home had been renovated to maintain the historic look and feel while including modern features and systems updates. This peaceful 1.6-acre parcel is in turn surrounded by a 19-acre park. The property is ideally located just minutes from the two hospitals in Medford. When planned renovations are complete, the home will accommodate twelve (12) hospice and/or palliative care patients at a time.

The SOFOH Board of Directors and Executive Director have overseen the purchase contract and fundraising to purchase this home. We have recruited assistance from many professionals in the area who are lending their expertise and advice to help complete the project successfully.

We have a population of only 291,000 in our two rural counties spanning 4,444 square miles, yet we have well over a hundred healthcare administrators, healthcare professionals (physicians, nurses, social workers, CNAs, PT, OT, chaplains), design professionals (architects, architectural designers, interior designers, landscape designers), business leaders, community members and bereaved family members consulting and serving on committees for our project. We are taking input from them all. We plan to begin accepting patients in Fall 2017. We expect that our facility will serve about 100 patients per year, as well as their families and loved ones.

While this type of end-of-life model is not yet common in the United States, the growing need for end-of-life care services and questions of how to provide for our dying community members begs for innovative, caring solutions. This facility will be the first of its kind in southern Oregon.

We at SOFOH all agree that a repository of design ideas would have made our process easier. We feel as many of your responders to your questionnaire state, that we are re-inventing the wheel as we proceed. We too have received input and design requests about the sizes of the beds, room furnishings, placement of nursing stations, etc. So we wholeheartedly support your idea of a worldwide, web-accessible repository of design ideas and, if you choose to move forward, we would be willing to participate in surveys/studies to see how over-time our design implementations were received. We think it is important to receive feedback from all our users – house staff, visiting staff, patients and family members to make this most vulnerable of times an experience of support and care.

I believe we will implement many suggestions from your Refinement doc, including those from ‘Senior Consultant, Facilities planning firm’, gathering data on “lessons learned” - what has been done and is working well. As well as gathering information in categories by type – patient spaces, family support, clinical support, outdoor amenities etc.-- that will help people classify their contribution.

The mission of SOFOH is to expand awareness and disseminate information to change the culture of death and dying. We can make greater impact and effect greater change by working together collaboratively. We appreciate your suggestions submitted to the IDEO Challenge and our connection. You have helped our process and we hope we can help yours.

We wish you great success with this project! It will help us all!

Best,
Selene Seltzer
Clinical Healthcare Chaplain
Former Design Professional
Southern Oregon Friends of Hospice - Hospice House Facilities Team Member

Photo of Harvey
Team

Dear Selene,



I am so grateful you took the time to share your experiences; and offer such powerful affirmation for our proposal. More tangibly than anything else, it demonstrates that people who are tasked with creating optimal spaces for patients nearing death need this resource, which will allow them to tap into the collective wisdom of others who have faced this challenge.



The fact that you are able to use the feedback we received to inform the design of your hospice, and that you would be willing to share your insights within a global design repository, says LOUDLY this project is needed and viable!



Warm regard

Harvey

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