Breaking from traditional approaches to hospice care that are often modeled after skilled-nursing settings, AG Architecture Inc. (Wauwatosa, Wis.) worked with Haven Hospice to pursue a new design direction by bringing resident-centered care to the Homer J. Sr. & Fern O. Custead Care Center in Orange Park, Fla.

“When you stop and think about it, isn’t dealing with a person’s last few days the ultimate in resident and family care?” says Eugene R. Guszkowski, senior principal, AG Architecture.

Shaping the effort are inventive ways to reduce any visible signs of the clinical workings of the facility. That design approach helped earn the project a Citation of Merit in Healthcare Design’s Architectural and Interior Design Showcase. The jury praised the facility’s “calming residential feel” and made note of its efforts to “be cutting edge and depart from traditional hospice models.” (For more on the four Citation of Merit winners and Healthcare Design's entire Showcase supplement, see the September 2013 issue.)

The key to the design is a component Guszkowski himself wasn’t sold on at first: a raceway layout. “I was pretty resistant to the raceway, because to me that reeks of ‘hospital.’ And it seems like such an idea to double-load to create two corridors when one will do, but I think that was a very successful way to take some of the [clinical components]—supplies, med room drugs, all those types of things—and very neatly tuck them into that raceway,” he says. 

The move toward creating a comfortable, residential setting supports patients as well as their family members, who over the course of an average two-week stay would likely spend long hours at the facility. “What’s different about [hospice] is that instead of thinking about the resident—although we have the resident accommodated—we’re enlarging it to think about their family. Each resident is like five or six people,” Guszkowski says.

For example, with the service wing in place to house back-of-house operations, the care center is then divided into two nine-bed neighborhoods that are organized around living rooms where families can spend time privately or interact with one another. Larger resident rooms feature large windows and accommodate family members with pull-out furnishings for overnight stays, while private family bathrooms support extended visits. Other touches include kitchen areas and children’s play rooms, plus plenty of access to the outdoors with a number of porches and landscaped courtyards.

To achieve a homey environment, Guszkowski says it’s scale that makes the difference. “We’re very familiar with living rooms that are 14 by 20 or dining rooms that are a certain size. To us, that’s a key we manipulate. We try to think in terms of what are the kinds of spaces you expect to find in a house,” he says.

Even the campus itself supports this design direction, thanks to a site with a large number of live oak trees that Haven Hospice wished to preserve. To do so, the design team opted to build separate buildings for its administrative pavilion and the care center. Combined with the program that breaks the care center down into different components, the overall feeling accomplished is that of a collection of buildings.

“People like funky downtown walking areas or new town centers with a public square. Everyone wants to create the charm of historic villages. This overall design was a good example of that,” Guszkowski says.

For more on the 2013 Healthcare Design Architectural and Interior Design Showcase Citation of Merit winners and other Showcase coverage, see: