On a daily basis, HDR’s architects and engineers model buildings on their computers, calculate fire ratings, design signage, measure travel distances, coordinate ceiling heights, and so much more. We think about buildings in terms of their setbacks, height requirements, structure, and compliance to laws. Specifically in healthcare design, we strive to shorten a nurse’s travel time, provide efficiency in department layouts, and add windows to patient rooms, for example.
Have you ever considered that these buildings may be the last spaces that a person sees?
In mid-April, I attended the Hospice Palliative Care Ontario (HPCO) conference in Richmond Hill, Ontario, Canada. Most of the attendees were nurses, doctors, care providers, and personal support workers who work alongside dying patients. As peculiar as it may sound for an intern architect to attend a conference on palliative care, I gained a unique perspective on the types of events that go on within the spaces that we work on every day.
Dying is not fundamentally a medical event; it’s a social event that happens within a family and a community. The journey that a person goes through at the end of his or her life often involves friends, family members, and medical staff. From listening to stories and experiences shared by those who work with the dying every day at this conference, it became apparent to me that what people value the most near the end of life is to be with people who will listen to them, who will read to them, and who will talk with them. That’s because they are facing the terrifying reality that they will soon take their last breath. They begin to grieve the loss of what they will never achieve and face the reality of the goals that they will never accomplish.
Above all else, they merely want to feel comfortable during their last days. Often the hospital or hospice facility will be the last place they will ever visit before they close their eyes for the final time. What do they see? How does the space make them feel? What are they surrounded by?
“Where we die is a key part in how we die”(Allison Killing, architect and urban designer). Of course, most people prefer to die at home, but this often isn’t suitable for medical reasons. So they are brought to a place that has unfamiliar views, materials, sounds, and people—the spaces that HDR works on every day.
Hospital walls witness some of life’s greatest joys, as well as deep sadness. Hospitals are where many take their first breath, and others take their last. So many life-changing events take place within the walls that our architects and engineers design. Consequently, architecture plays a fundamental role in the process of dying.
The dying are still living. When people do not have much left to give to their life, they tend to soak in as much as they can in the time they have left. This often happens in healthcare facilities, which is why our work at HDR is so important.
“When a flower doesn’t bloom, you fix the environment in which it grows, not the flower” (Alexander Den Heijer, author).