Designing for Death: Bettering End-of-Life Experiences

Case Study
Death Café

The Death café is a free-range event designed ‘to increase awareness of death with a view to helping people make the most of their [finite] lives’, according to its website. It is a ‘social franchise’ that anyone and everyone can participate in or even host, as long as they follow the rules set by Death Café founder Jon Underwood, who inaugurated the first Death Café at his house in Hackney, in 2011.

Death Café

Death Cafés must be run as not-for-profit events in an accessible, respectful and confidential space, with ‘no intention of leading anyone to any conclusion, product or course of action’, and where non-alcoholic refreshments and food (especially cake) should be supplied. As long as people sign up to these principles, they can call their event a Death Café, make use of the ‘guide’ available on the DeathCafé website (that Underwood developed with his mother, psychotherapist Sue Barsky Reid). They can publicise their event on the same website, and its Facebook page.

Since 2011 the movement has spread across Europe, North America and Australasia. Death Cafés have been held in all kinds of places, from cemeteries to yurts, island retreats to the Royal Festival Hall. To date, more than 3,460 Death Cafes have been held. In 2015, Underwood and his team launched a campaign to raise money for a permanent Death Café space in London, but despite attracting 182 investors and raising nearly £40,000, they didn’t meet their initial targets, so that particular project is on hold. Nonetheless, the Death Café notice  board is still bristling with ongoing events, from San Diego to New Zealand.

Case Study
Denmark’s First Urban Hospice

Gleaming like a gem amid the surrounding brick facades, Urban Hospice in Copenhagen sets a whole new benchmark for hospice design.

Urban Hospice in Copenhagen

Situated in Frederiksberg, one of the leafier, more affluent neighbourhoods of Copenhagen, it replaces an existing 10-bed hospice facility, but does so in such a way as to create a beacon for the community, shining a light on aspirational end-of-life care.

Nord Architects worked closely with client Diakonissestiftelsen and its employees to develop a unique project for ‘the last journey’. Nord’s priority was to create a safe and comforting environment, using knowledge it had garnered through its own experience plus extensive consultations with staff, patients and families.

The main building has been scaled in such a way as to fit into its two-storey surroundings, its contours curved and shaped so as to minimise intrusion and maximise a sense of privacy. There are four courtyards in and around the building, for patients, for staff and also for family. All bedrooms have openable windows and doors on to terracing – this is a consideration that staff insisted on, according to project architect Steffan Iwersen, due to a superstition that ‘when people are dying they want to open a window so the spirit can go out and back into the universe – instead of into the ventilation system’.

High-quality materials have been used inside and out, from oak interior window frames to the exterior metal panels, a mixture of brass and copper, which will fade from the current gold to a warm brown colour, patinated according to exposure to sun, wind and rain. Doors and windows on to the curving central courtyard also feature curving glass, adding to the bespoke, crafted feel. Throughout the plan, the architects have blended rectilinear and curved elements to create a rhythm and form that maximises choice between privacy and communality, while very attentive to views and light. The elegant bedrooms have 3m-high ceilings, with 2.7m-high windows.

Very much inspired by the Maggie’s Centre philosophy – behind the UK’s pioneering programme of elegant, architecturally outstanding buildings set within hospitals to provide emotional support for those with cancer – the Urban Hospice brings home the notion that death can be embraced within a community, in an accessible, inclusive and dignified way. On opening in June this year, it was declared ‘A good place to die’ by Danish national newspaper Politiken.

Location Frederiksberg, Copenhagen, Denmark
Architect: NORD Architects
Client Diakonissestiftelsen
Size 2,233 sq m, 16 beds
Construction costs £5.25m
Completed June 2016
Landscape architect MASU Planning
Engineering: Rambøll

 

Case Study
Conversation starter: My Gift of Grace

Nick Jehlens and his design partner launched the Action Mill nearly 20 years ago to investigate how design could be deployed to promote social change. Finding routes into the right conversation became their speciality. But it was around 2012, while interviewing hospice nurses about e_ ectiveness at work, that they stumbled across a fact which steered the course of their practice in a whole new direction: one of the single most important factors in how well patients and their families deal with death is whether they have had any conversations around it; these nurses could immediately spot which families had and which had not. Far too many people don’t even know where to begin.

Responding to a California Healthcare Foundation challenge to design a tool that would help people talk about death, they created a prototype of a game, My Gift of Grace, which was initially tied into a monthly event but is now, thanks to a kickstarter campaign, for sale through their new dedicated company Common Practice, and in circulation across the USA, Mexico and the UK.

Starting those tricky conversations is the priority of the game, but the idea is also to have fun and to open up the game to a whole variety of players. It consists of a set of open-ended questions that help to identify priorities and values, as well as missed opportunities. There are ‘Thank you’ chips, like bingo chips, that players give to each other to express appreciation for things they have said or done, and which reveal a different layer of priorities.

My Gift of Grace was created as a prototype game by Nick Jehlens and his design partner in response to a challenge to design a tool to help people talk about death

Popular with libraries and community groups, it has also been spotted as a hugely useful tool within a healthcare setting, with various trials and research initiatives underway to help both patients and medical staff ensure that they can honour the patient’s priorities in life, rather than focus on death.

 

Case Study
Järva Burial Ground

In Scandinavia a kind of secular Protestantism prevails, with the rituals around death still very much dictated by the Protestant Church. A dignified burial in a special place, says Danish landscape architect Kristine Jensen, should not be restricted to those who qualify for it through their Christian faith – or those who can afford to be interred in a church graveyard. Working together with fellow Danish architect Poul Ingemann, the pair have designed a new kind of burial site in Järväfältet, north of Stockholm, which will be open to all people, of all faiths. It will serve as a setting for all sorts of religious and non-religious burial rites.

Järva Burial Ground

The location for the competition winning design, organised by the Municipality of Stockholm in October 2009 and awarded in 2010, is a large recreational area that is part of an existing nature and heritage reserve, where traces of ancient, pre-Christian religious practices already exist, and whose presence will be highlighted in Jensen’s rich and varied landscaping. The scheme aims to add high architectural and artistic value to the area, creating a strong identity, based on botanical and cultural diversity.

With construction starting in 2016, the transformation will be achieved slowly, over two years, with all burial sites arranged in small, autonomous units. Jensen proposes that each unit might have its own character, specific to its location, with buildings or structures that allow for a variety of rituals and symbolic expressions.

Client: Municipality of Stockholm
Architecture and landscape design Arkitekt Kristine Jensens Tegnestue and Poul Ingemann
Area 60,000 sq m
Cost 250 million SEK
Completion 2018

 

Case Study
Hospice Within A Hospital

Grantham and District Hospital scored a first in UK healthcare in 2014, when it added a calm and nurturing hospice to its own campus, thereby easing and speeding up the transition of patients at a terminal stage of their lives to a place that could provide all the care and support patients and their families needed. This six-bed, £1.2m unit was developed through three partner clients, with architecture and design consultancy provided by Franklin Ellis. Extensive consultations with staff, volunteers and stakeholders helped in the creation of the welcoming and appropriate kind of spaces required.

Hospice Within A Hospital

The project involved the extensive refurbishment and extension of an existing ward to create six en-suite rooms, a reception, children’s play area, a quiet room, a relatives room and private gardens. It involved a radical upgrade to the existing fabric of a single-storey Sixties’ building, with major structural interventions and great attention given to junctions of the new and existing spaces. The priority was to create a building that was experienced as spacious, light and welcoming throughout. All the bedrooms and shared areas connect to an landscaped garden. Bi-fold glazed doors provide access to the garden year round. An over-sailing roof gives protection and shade, connecting the new and old buildings. Warm timber floors and internal window frames add to the domestic feel, enhanced by a theme of ‘Trees’ that inspired the choice of colours, materials and patterns for fabric, furniture and fittings.

Client: South West Lincolnshire Clinical Commissioning Group, St Barnabas Lincolnshire Hospice, and United Lincolnshire Hospitals NHS Trust
Architect: Holmes Miller architecture, interiors and landscaping Franklin Ellis Architects
Cost £1.2m
Completion 2014

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