Author Archives: Lindsay Erb

Hospice director lends expertise to Healthcare design team training



The team watched a video about hospice space and furniture, including this chair that folds out to a bed.

A typical CTA “lunch-and-learn” consists of a visitor arriving, lunches in tow, offering information on their latest and greatest products for designers to consider on future projects. During a recent session, however, members of CTA’s Healthcare group participated in a different sort of lunch-and-learn. Annie Estvold, LCSW — Executive Director of the Caldwell, ID, branch of Heart ‘n Home Hospice & Palliative Care and a veteran social worker — shared her expertise on priorities during end-of-life care. She provided tips on sensitive design approaches from both patients’ and family members’ points of view; shared stories of clients she’s worked with; and described the roles of members of a typical hospice team when called upon by a family or healthcare facility, stressing that their collective goal is always to provide a “good death.”

The most moving portion of the presentation was when Estvold asked participants — with healthcare-related disciplines spanning architecture, interior design, and landscape architecture — to imagine they had been diagnosed with a terminal illness, envision what their final “dying space” might look like, and sketch or describe it on a blank piece of paper (see main image). She talked the team though a meditation-like exercise where we had to think about what the space felt like, smelled like, and sounded like; what we may be seeing or looking at; and who might be there with us in our final hours. It was both powerful and emotional, and because we are a close-knit group, we were comfortable enough to share what we had drawn and written, which varied from being in personal homes to favorite vacation spots to out in nature near a river or meadow.

“It was impressive to see the CTA team’s commitment to fully understanding the needs of patients, family, and care teams,” Estvold said after the exercise.

The takeaway was to reflect on the fact that not one of us mentioned envisioning a sterile environment with hoses and blinking equipment. None of us heard beeping, or other patients and families in the corridors outside our rooms. When we are designing skilled nursing homes or even hospital patient rooms, these are the things to consider in our designs; not everyone gets to spend their last months, days, or hours in the comfort of their own homes. They are in the buildings or hospitals we design, and our spaces should be flexible and warm; and provide views to nature or art that ease patients’ minds, places for family members to be comfortable and relaxed, and room for hospice workers or facility staff to be behind the scenes helping both the patient and family members in experiencing their “good death.”

CTA Healthcare team members described how they felt after the training:

Holly Dawson, landscape architect-in-training:
“It was a great presentation and ideal exercise to really put ourselves in the shoes of who we are designing for. I was glad to see so many people wanting elements of nature to be present in their ‘dying space,’ but also recognizing the challenge that they may not physically have access to an outdoor space. From a landscape architecture point of view, it is a good reminder that people can experience a ‘designed space’ differently. In this case, the view or placement of landscape elements outside a window can function just as importantly as its relationship to the building.”

Natalie Miller, interior designer:
“This was a very essential and moving presentation. As an interior designer, this reinforced to me how important the space is that one is in at the end of life.”

Jackie Bull, architect-in-training:
“This training was valuable as we were able to watch and listen, as well as perform design tasks. It provided a good reminder of the opportunity we have as designers to create spaces where people come together, support each other, and build a community.”

Amy Lindgren, architect:
“I like doing exercises like this. It puts me in the mind frame of the people I design for every day, and reminds me that I may be utilizing these facilities one day —  not only as a patient, but possibly for a loved one.”

Tim Miller, principal/co-leader of Healthcare group:
“There are always different ways to measure one’s perception. This session made us put ourselves in the spotlight. It heightened my awareness of how personal design can be, and how our designs can truly influence an experience.”