End-of-life care serves patients facing terminal illnesses, often those in their final months or years, by offering a compassionate blend of physical, emotional, and spiritual support. It includes hospice care—where the focus shifts from curative treatments to enhancing comfort and quality of life for patients and their families.

Within hospice environments, the goal is not only to manage symptoms but also to create a space that respects the dignity of each individual. This care approach encompasses a range of supportive practices, from palliative care to emotional support, designed to minimize suffering and provide comfort in the end-of-life stage. As designers, we face the unique challenge of creating spaces that balance comfort and dignity with essential functionality.

Numerous studies show that strong social support can improve the quality of life for patients in hospice care. Furthermore, individuals with a supportive social network cope better with pain.¹ Designers can support these needs by creating outdoor spaces where patients and families can relax, connect, and enjoy nature together. Meditation or prayer rooms can also offer families a space for reflection, comfort, and solace during difficult times.

Elements like privacy, open spaces, natural light, and green spaces are crucial to enhancing comfort for hospice patients. In this article, we’ll explore how these design elements foster a peaceful, comforting environment for those in their final stages of life.

BALANCING PRIVACY AND VISIBILITY

In a hospice environment, the thoughtful arrangement of private and open spaces significantly influences both visibility and privacy, impacting the comfort of patients, families, and staff alike. A well-designed “privacy gradient” places administrative and working spaces at the facility’s entrance, followed by common areas, and reserves private patient rooms for the most secluded areas. This intentional layout allows patients to enjoy privacy in spaces that benefit from natural daylight and calming views.

Acoustic insulation is another critical factor, reducing noise disturbances to foster a peaceful atmosphere. Dedicated consultation rooms also enhance privacy, providing quiet, intimate settings for discussions between families and medical staff. This approach respects patients’ personal space while also creating a structured environment that meets the distinct needs of everyone involved in end-of-life care.

ACCESS TO OPEN SPACES

For terminally ill patients who may be bedridden or face mobility challenges, thoughtfully designed open spaces become essential touchpoints for comfort and connection. These spaces—such as outdoor patios, serene gardens, or quiet courtyards—should be easily accessible from patient rooms, reducing movement strain. Each area can offer different seating arrangements, such as benches, cozy nooks, or even recliners, allowing patients and families to choose spaces that suit their needs.

Open spaces also encourage families to gather in a more relaxed, home-like setting, fostering moments of connection that are particularly precious during end-of-life care. By prioritizing ease of access and a thoughtful layout, hospice design can significantly enhance the quality of life, offering a welcoming environment for shared memories and peaceful reflection.

DAYLIGHTING FOR MENTAL HEALTH

For patients battling chronic illnesses, depression and anxiety are common. Access to natural sunlight can play a crucial role in supporting mental health, as exposure to daylight has been shown to elevate mood, reduce stress, and help regulate circadian rhythms. These rhythms, our body’s natural sleep-wake cycles, are profoundly influenced by sunlight; maintaining them can improve sleep quality and reduce anxiety—both essential for comfort in hospice care. Sunlight is also a natural source of Vitamin D, a deficiency of which is linked to an increased risk of depression and anxiety.²

By incorporating large windows, skylights, or sunrooms into hospice design, facilities can ensure patients benefit from daily doses of sunlight. Well-lit spaces not only create a warm, welcoming atmosphere but also support a holistic approach to care, treating mental and emotional well-being as essential to the overall comfort of hospice patients. Thoughtful daylighting design is essential in fostering a positive, uplifting environment that can significantly impact patients’ quality of life, promoting peaceful rest and emotional resilience.

INCORPORATING NATURE-INSPIRED SPACES

Exposure to nature has a profound, positive impact on patients’ well-being, with both visual and physical contact providing significant psychological and spiritual benefits. Nature-inspired spaces, such as gardens, green walls, and natural landscapes, have been shown to reduce anxiety and fear, fostering a sense of calm and relaxation.³ These spaces offer more than just a pleasant view; they become healing environments where patients can connect with the natural world, which can ease stress and promote peace. Studies also indicate that extended time in natural settings can lessen patients’ reliance on pain medications, as the tranquility of these landscapes helps alleviate discomfort.⁴

By designing hospice facilities that bring nature closer—whether through garden views, indoor plants, or outdoor walking paths—spaces become a natural sanctuary, supporting a holistic approach to end-of-life care that prioritizes comfort and tranquility.

IN CONCLUSION

In hospice design, each thoughtful choice can contribute to an environment prioritizing peace, comfort, and dignity. By balancing private and open spaces, harnessing natural light, and incorporating nature, we create settings that support not only the physical needs of patients but also their emotional and spiritual well-being. These compassionate spaces honor life, offering solace and connection at its most delicate stage.

REFERENCES

1. Rosenfeld, et al., 1996. Pain in ambulatory AIDS patients. II: Impact of pain on psychological functioning and quality of life. Pain, 68(2-3), pp. 323-328. ↩︎
2. Kouba, BR, Camargo, A, Gil-Mohapel, J, and Rodrigues, ALS. Molecular basis underlying the therapeutic potential of vitamin D for the treatment of depression and anxiety. Int J Mol Sci. (2022) 23:7077. doi: 10.3390/ijms23137077 ↩︎
3. Verderber S, Refuerzo BJ. Innovations in Hospice Architecture. Taylor & Francis e-Library; 2003. Accessed February 17, 2023. [Google Scholar] ↩︎
4.  Binfoh T. Architecture for the terminally ill: A proposed hospice facility design for Ghana. ir.knust.edu.gh. Published online 2008. Accessed February 17, 2023.  ↩︎