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The dying patient: taboo, controversy and missing terms of reference for designers—an architectural perspective
  1. Annie Bellamy1,
  2. Sam Clark1,
  3. Sally Anstey2
  1. 1 Welsh School of Architecture, Cardiff University, Cardiff, UK
  2. 2 School of Healthcare Sciences, Cardiff University, Cardiff, UK
  1. Correspondence to Annie Bellamy, Welsh School of Architecture, Cardiff University, Cardiff CF10 3AT, UK; bellamyas{at}


Contemporary society has grown seemingly detached from the realities of growing old and subsequently, dying. A consequence, perhaps, of death becoming increasingly overmedicalised, nearly one in two UK nationals die institutional deaths. In this article we, two architectural scholars engaged in teaching, research and practice and a nurse and healthcare scholar with a focus on end-of-life care and peoples’ experiences, wish to draw attention to a controversy resulting from a paucity in current literature on the terms of reference of the dying ‘patient’ as we navigate the future implications of the COVID-19 pandemic. This contributes to a relative lack of touchstones for architects to refer to when designing person-centred palliative care environments. Unlike common building types, architects are extremely unlikely to have lived experience of palliative care environments as patients; and therefore, require the help of healthcare professionals to imagine and empathise with the requirements of a person dying away from home. This paper includes a review of ageing and dying literature to understand, and distil from an architectural perspective, who, design professionals, are designing for and to remember the nuanced characteristics of those we hold a duty of care toward. We ask readers to heed the importance of accurate terms of reference, especially when commissioning and/or designing environments of palliative care. Furthermore, we put forward an appeal for interdisciplinary collaboration to develop a framework for codesigning positive experiences of person-centred care and environments at the end of life.

  • architecture
  • palliative care
  • end-of-life care
  • built environment
  • care of the elderly

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  • Contributors Conception or design of the work: AB and SC. Drafting the article: AB, SC and SA. Critical revision of the article: AB. Final approval of the version to be published: AB, SC and SA.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.