Thesis (BS Architecture) University of the Philippines Mindanao, 2019

In western countries, it is common for patients who need continuing care after their hospitalization to be admitted in specialized health care facilities. Terminally-sick patients can continue to seek medical services in hospice homes or palliative care facilities where the approach is more on the caring instead of curing. In the local context, the Philippines has seen the establishment of hospice homes and cancer centers through the years as advocates have continued to push for this cause. In addition, hospice-palliative care is also availed by older adults diagnosed with chronic or terminal illness in aged care residential facilities that have adapted to the changing needs of the elderly population. When diagnosed with terminal-illness, the end-of-life process is a difficult journey to go through not only for the dying, but also for the caregivers – families and healthcare providers alike. This thesis aimed to establish the considerations in designing the built environment of residential facilities that provide hospice-palliative care.
The first part of the research was to gain insights from the users of the residential facilities covered. Participants of the semi-structured interviews included three administrators, two healthcare providers (nurse and caregiver), two family members, and one social worker. The elderly residents, due to physical and psychological limitations were no longer interviewed. Using thematic analysis, the following themes emerged: 1) experiences in providing and receiving care in a palliative care facility; 2) insights about the built environment; 3) activities being implemented in the facility; and 4) impacts/effects of these activities. The second part of the research was a preferential survey for recreational and religious activities that help promote a dignified end of life process. The emerging themes were derived from the core ideas coded from the information gathered during the semi-structured interviews.
The results showed that the built and non-built environments are vital to the experiences of the residents as well as the families and care-providers. From the analysis of the results, it was concluded that when the physical, psycho-social, recreational, and spiritual needs are met, the persons involved in the dying process (patient and carers) transition from the five stages of grief (identified by Kubler-Ross) to acceptance and a dignified end-of-life process.
The core ideas derived from the thematic analysis were applied in the design process of a hospice-palliative care center as an architectural translation for this thesis.