Residential Hospice Overview
(Adapted from the Friends of Hospice Ottawa and
the Hospice Association Ontario)
OVERVIEW
Residential hospices grow out of the needs of
people living with a life-threatening illness
who can no longer be cared for in their own
homes, yet do not require the expensive and
highly technical care of an acute hospital.
Hospices are designed to meet the needs of a
client and his/her loved ones when a curative
approach is no longer achievable.
Dignity House
Hospice, along with
Community Home Support
Lanark County, has identified such a
need in Lanark County. We are at the stage
now when such a hospice facility is needed.
As we look at
options for a residential hospice in Lanark
County, here are some of the general ideas and
concepts we would hope to incorporate into any
future Dignity House Hospice:
Hospice
design should meet the physical, emotional, and
social needs of its residents, and create a
place where people can die with dignity in a
well-supported, sustaining physical environment.
The Hospice movement, in Canada and abroad, is a
young movement with coherence, passion and focus
that works to fulfill what many of us wish for
in our last days – if we cannot die in our
homes, to die in a home-like setting, free of
pain, surrounded by the people we love. We see
hospice as an extension of home.
A hospice is
a community of both the dying and the living. It
is the place of last repose for the dying, but
also the context of last memories for many
caregivers and family members. Although it is
only home for a few hours, days, weeks or, at
most, months of life, it is one of the most
intense, difficult and emotionally charged times
we face as human beings.
The main
challenge, second only to fundraising, of
hospice design is to create a warm, home-like
environment in which the dying can live their
last days with humanity and dignity. We hope
that the Dignity House residential hospice in
Lanark County will be a product of the community
and meld with both the natural environment and
the community organizations that surround it.
At a
symbolic level, the hospice is a home. At a
functional level, it is a home, a care facility,
and a workplace. It is also a community meeting
place, a place of celebration of lives lived,
and a place of sharing knowledge and stories.
General principles for hospice
design, as laid out by the
Hospice Association of
Ontario, include:
home-like setting:
-
Focus on quality of life and
a positive experience for clients and their
loved ones (including features and
environments that are conducive to positive
memories)
-
Foster a cooperative
relationship with nearby homes, community
groups, services and facilities
-
Have a sustainable design
plan (every effort will be made to conserve
energy through use of energy efficient
appliances, light dimmers, recycling, indoor
plants and foliage, new windows, high
efficiency furnace etc.)
-
Needs accessibility (e.g.
wheelchair or companion chair, hospital bed,
internet)
-
Should create a place where
people like to work, whether as volunteers
or as paid professional
-
The hospice should have as
many characteristics of “home” as possible.
A few suggestions on defining
"home' that come from the Hospice Association of
Ontario Residential Hospice Manual:
-
Home should avoid the use of
institutional materials, hardware, and
arrangements. For instance, wherever
possible, materials should be warm and
natural.
-
The detailing of things such
as operable windows should emphasize ease of
personal control.
-
Floors should be rich woods,
warm carpets not cold tiles. Rather than the
harsh fluorescent fixtures so typical of
hospital environments, lighting should take
a softer form using more residential
lighting choices.
-
Home means an open and
inviting kitchen that draws people in any
time for snacks or tasty meals, its designed
to accentuate the pleasures of smell, taste,
and community.
-
Home means familiar features
like fireplaces, porches, patios, gardens,
generous rooms where a combination of
privacy and visiting are possible, with
flexibility so that if residents want to
surround themselves with familiar objects,
they can. Or if the bed needs to be oriented
in a certain direction, say for religious
reasons, it can be.
-
Home means appreciating that
different people, at different times of
their living and dying, will want different
degrees of activity and social interaction.
The social layout of the home should address
the needs of the residents for both very
social and highly private environments, as
well as the functional needs of the people
who work there.
-
Home is a vessel of memory.
Memory will play an important role in the
design of the clients’ rooms which will be
designed to house objects – e.g. photos and
artifacts – that make the past immediate,
and will take the form of niches, shelves,
nooks and crannies. For many clients, whose
entire world becomes their room, their own
room becomes a “family room” where children
play, people talk, relatives sleep, and
basic medical care and symptom management is
undertaken. Each room ideally will be
generously scaled as flexible space is
especially important.
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