Academic journal article Care Management Journals

The Production of Hospice Space: Conceptualizing the Space of Caring and Dying

Academic journal article Care Management Journals

The Production of Hospice Space: Conceptualizing the Space of Caring and Dying

Article excerpt

THE PRODUCTION OF HOSPICE SPACE: CONCEPTUALIzING THE SPACE OF CARING AND DyING Sarah McGann Farnham, Surrey, England, Burlington, VT: Ashgate Publishing, 2013, 122 pp., $94.95 (hardcover).

Thehome,thehospital,andthehospiceare three common spaces that accommodate deathanddyingincontemporaryWestern society.Butisthehospicemerelyabuilding orisitaphilosophythatstandsonthecon- ceptthatplacesspaceandspatialpractices asthemainpriority?Thatisthequestion which the author seeks to investigate. Writing fromanarchitect'spointofview, Dr. McGann arguesthatthe hospiceisa philosophy-a philosophy which asserts dying with dignity for the terminally ill andagingpopulationisparamountinthe designofthephysicalbuildform.

Theauthorprovidesahistoricalanalysis ofthedevelopmentofthemodernhospice movement.Shereviewstheearly20th-cen- tury model, founded mostly by religious groupsinlargehouses,inwhichthehospice care sought to provide refuge to the dying poorwhoweredeniedadmissionbyhospi- tals.Althoughtherehasbeenadvancement in the modern hospital building where it is recognized for functioning efficiently as alargeinstitutionofmedicalpracticesand placefortreatment,theauthorcontendsthat "thepatientbecameasmallcoginthewheel ofthisgreatmachine."Thelargerhospital environment resulted in a "loss of identity andcontrolforthepatient."Shenotesthat theflawswithdealingwiththedyinginthe hospitalbuildings,inlargepart,influenced themodernhospicemovement.

The development of the philosophy of the modern hospice movement in the 1960s is discussed throughout the book. Emphasisisplacedonthenotionthatthe space should provide care for patients in advancedstagesofterminalillnessinways thatattendtotheirmedicalneedsandaidin copingwiththementaldistress.Thebook makesreferencetotheevolutioninthehos- picecommunity,whereithastransformed intoaplaceofworkandeducationforstaff, aplaceofrefugeandcareandpatients,and aplaceofsupportforfamilies.Theauthor consistently provides evidence to support thoseclaims.Forinstance,shecitessocietal changesthatadverselyimpactedthehome as a viable hospice space. Because of the "increasedgeographicmobilityoffamilies, higherdivorceratesandgreatereconomic demands placed on women to return to work,"thehomewasfoundtobelesssuit- ableasaplaceforthedyingandthefamily asalesssuitablecaretaker. …

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