Connecting Communities and Caregivers: Hospice Design
In part one of this new three-part series on healthcare design, Ila Burdette, principal at Perkins+Will, discusses the unique challenges of designing a hospice and how design can be used to create a welcoming magnet for the community. Photos are from hospices designed by Perkins+Will.
In the fast-moving world of healthcare design, Perkins+Will has been excited to explore the ways one particular building type, hospice, has emerged as a magnet of community affection. These small buildings, devoted to care for the terminally ill, have only been purpose-built in America since the 1980’s, although they spring from a European architectural tradition that is centuries old. (Think of medieval almshouses, orphanages, hostels, and hotels, even the castles of the Knights Hospitallers – all places where folks in dire straits received help.)
Here in the United States, hospices link not only patients and caregivers but also families, donors, volunteers, visitors and the wider community. Their growing circles of health are re-invigorating traditional healthcare relationships, becoming flourishing generative spaces.
How Does a Building Convey a Mission?
Since the challenge of hospice is to encourage patients and their families at their most difficult moments, caregivers’ first task is often reassurance to dispel anxiety. A welcoming campus and generous building can be powerful tools in this work. As tangible demonstrations of the organization’s concern, buildings are intentional invitations to the neighborhood. When the designs are truly successful, they express the staff’s extraordinary mission and help knit the end of life back into its mainstream.
Designing a Welcome
How can a complicated healthcare building be made approachable? Our goal is to provide a sense of refuge by creatively selecting building masses and materials that are both intriguing and familiar. Breaking the overall facility mass into small pods dematerializes it, transforming it into a collection of friendly forms that feels like a sociable village, not a formidable treatment center. The building scales itself down to greet the user, like a tall adult kneeling to talk with a small child.
Simple geometric shapes that echo local architectural styles create a sense of familiarity; for example, sloping and gabled roofs with large eaves recall barns and silos in rural areas. Warm textured materials like fieldstone, cedar and shingles impart natural color and help settle the building into its site, emphasizing its kinship to its particular place.
The literal approach to the building, the road leading to it, also shapes its personality. A winding drive that turns off a noisy rushed highway and takes its time meandering through moss-hung oaks to a hospice’s front door can give visitors breathing space to lay aside their distractions.
Another hospice contextually located in the center of a town, bordered by sidewalks where strolling neighbors exchange greetings, can be an immediate and active part of the local fabric, a good neighbor itself.
Still other hospices are located in wooded settings that afford glimpses from nearby streets; if the visual snippets are enticing, they coax passersby to visit and learn about the hospices’ mission. Whether and how a building reveals itself from a distance are clues that indicate its openness.
Next week we’ll think about the spaces inside hospices, and the ways they are shaped by the multitude of conversations there, everything from midnight chats around popcorn poppers to memorial services to garden rambles.
Ila Burdette AIA, LEED BD+C is a Principal with Perkins+Will where she leads the firm’s research and design of senior living projects, including hospices, continuing care retirement communities, assisted living, skilled nursing, and Alzheimer’s facilities.