Keep All Thee ‘Til the End
12th March 2018
A Sort of Homecoming
Researchers from the Cicely Saunders Institute, King’s College London and the Institute for Health and Care Research and University of Maastricht, the Netherlands have published research identifying the important elements for creating a hospice setting.
The researchers were interested to find out what set St Christopher’s Hospice apart from hospital care of the dying at the time the hospice was created. They systematically analysed archive material from 1953 to 1980 from the Cicely Saunders Archives at King’s College London. Five themes emerged – home/homelike; community; consideration of others; link with the outside world and privacy. What emerged from their research was that in contrast to acute care, hospices formulate their own lifeworld to support and engage patients. Lifeworlds are culture-sensitive and this underlines the need for variation in design and organization of hospices around the world.
St Christopher’s was intended as a place that would provide specialist care to those suffering from incurable illnesses with sensitivity to the needs of patients and families. Cicely Saunders’ early work had explored the idea of ‘total pain’ – that pain is not only a physiological experience but also has spiritual, psychological and social dimensions. St Christopher’s Hospice was developed after careful consideration of this philosophy and led to a different way of dying, a philosophy that spread and became the bedrock of a new medical specialty – palliative care – that could be adapted to different environments. The research shows that St Christopher’s was quite different to the hospitals of the time. It was a “home from home” and the physical environment was vital. For healthcare professionals it is important to consider the impact of physical space and organisation on patients and families since these can have important impact on their experiences.
“This time, that can be so hard or so dreary, will be changed into one of peace, security and meaning – a sort of homecoming’’
West E, Onwuteaka-Philipsen B. Philipsen H, Higginson IJ, Pasman HRW. 1 ‘‘Keep All Thee ‘Til the End’’: Reclaiming the Lifeworld for Patients in the Hospice Setting. Journal of Death & Dying. 0(0) 1–14. 2017. DOI: 10.1177/0030222817697040