Realizing homeliness in palliative care: inpatient and family perspectives on designing the built environment

Abstract This article reports 36 in-depth interviews with patients (n = 20) and family members of palliative care patients (n = 16), during an inpatient stay within one of four contemporary palliative care facilities. Interviews were conducted to understand how patients and families felt the built environment supported their experience of palliative care, and the ways that it did not. Over the past decade, a growing body of literature has sought to understand how architectural design can support wellbeing within palliative care settings. Yet, despite evidence that promotes the prioritization of privacy, homeliness, and nature, the sheer complexity of hospital procurement often results in compromises to the successful implementation of best design practice. Here we argue that a deeper understanding of what these environmental affordances mean to patients being treated for a terminal illness, and to their families, may encourage a necessary re-examination of the ease with which these provisions are compromised relative to considerations of risk, cost, or convenience (in building construction and/or maintenance). Importantly, our findings confirm that privacy, homeliness, and nature do not operate in isolation but in accord to shape experiences of palliative care.