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Margo Annemans
KU Leuven

14/07/2022| By
Koen Koen Coomans,
+ 1
Ann Ann Heylighen

The term ‘hospice’ refers to both a philosophy of end-of-life care and a building type, dedicated to offering this care. Hospice care strives to offer dignity, personal choice, peace, calm, and freedom from pain. Hospice care is anchored in space and spatial practices; however this relation is understudied. It is a rather new building type, for which architects have few historical references, post-occupancy evaluations, or direct experiences available. The prospect of replacing a Belgian hospice offered an opportunity for a case study. We aim to understand how the built environment of a hospice affects experiences of care, and discuss design considerations derived from that. Our qualitative research approach was based on principles of Grounded Theory and combined observations with semi-structured interviews with six staff members, six volunteers, three relatives and eight patients. Our analysis shows that the built environment contributes to hospice care by the balance it affords between privacy and social interaction, by the discrete ways in which it affords offering high-level care, and by its human scale and relation to the natural environment. Insights gained challenge hospice designers to consider how meaningful encounters are often spontaneously triggered by daily activities; guests’ lifeworld changes in size; a delicate balance is required between proximity and seclusion; the built environment can support the ethos of staff and volunteers; aspects of environmental support (e.g. accessibility) are intertwined with aspects of emotional comfort (e.g. hominess); high-level care can be offered in discrete ways.

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15/06/2022| By
Margo Margo Annemans,
+ 1
Ann Ann Heylighen

People in rehabilitation have been found to be motivated to be physically active by accessible and attractive outdoor environments, both vicinity of healthcare facilities and in the larger neighbor-hood. Nevertheless, even when available, outside space is not always optimally used. We aim to gain insight into how the outdoor environment of a rehabilitation center, on and beyond its prem-ises, hampers or supports patients to be physically active. We conducted a qualitative ethnograph-ic study informed by quantitative physical activity data. Semi-structured and walking interviews with 16 patients from one rehabilitation center were supported by output from activity trackers. Two focus-group interviews with four nurses and a physio- and an ergo-therapist provided extra perspectives. All data were inductively analyzed guided by a grounded-theory based approach. An analysis of sensory information, affordances and meaning making showed a wide variety in the roles the outdoor environment plays in patients’ physical activity, both inside and outside the building, ranging from patients travelling to near villages to others staying inside all day but en-joying the view when walking to the end of the hallway. Concrete destinations motivate patients to go outside and be physically active, but also smaller interventions like avoiding even the smallest physical boundaries, facilitating visual control, and providing psychological support have a positive impact. If a rehabilitation center is to encourage physical activity amongst pa-tients, inside and outside, it is important that inside and outside spaces are connected physically, visually, and psychologically.

 330 views