an unmasked death death: an architectural response to the american fear of dying
“an un-masked death� olivia binette thesis booklet may 8 2019 syracuse university school of architecture primary advisor: matthew celmer
contents thesis contention
1
death in america
3
a “good� death
7
hospice as mask
13
death positive movement
27
death un-masked
31
interaction as driver
37
all together
45
quote bank
57
bibliography
61
appendix
65
thesis contention The presence of death in our lives allows us all the individually restrictive circumstance of time. Every one of us is held to the same unknown quantity of days allowed on this planet, and without death, we would not have the gratitude or ambition to live our lives to the absolute fullest. Yet particularly in the United States, the stigma of death has been somberly altered. Death has become a terrifying finality that comes once medicine has failed. We easily forget we are not meant to live forever, and because of this spend endless amounts of time, money, and hope on treatments that create an astronomical amount of unnecessary suffering. We are now dying most frequently in hospitals, a place designed for healing, not life and death. These buildings are not equipped to handle the intense emotion created from the over-extension of life, and are failing us by altering our perception of what death truly is. In an attempt to counter this rejection of death, hospice care was created, eliminating the over-medicalization of death and instead prioritizing pain relief. Advertised as emphasizing comfort, these spaces move the dying into environments in which they can live out their final days. But still, the design falls short; in place of over-medicalization we simply have camouflage. The dying are hidden behind banal and overly contextual facades into residences that poorly attempt to mimic occupants’ own homes. Life continues on as normally as possible, as does the inability to confront death head on. Just as hospice design was a reaction of death in the hospital, this thesis will create a new standard of living for the last few months of life. It will celebrate life while memorializing death, which, in turn, will attempt to invigorate the current American stigma of death. There is unique possibility that comes with the ability of knowing when you may die, and this thesis will create a new form of residence which forces patients to be uncomfortable; to both celebrate their lives and interact with their imminent fate. While we may not be able to decide when we will die, or from what cause, changing the environment in which we die could completely alter the way we live completely. 1
2
death in america
“If we’re going to be living to be 120, we’ll be spending a third of our lives in hospital. Hospitals will have to become like cities – but nice places.” - Charles Jencks, architectural theorist and historian
3
where are we dying? where do we want to be dying? Currently in America, thirty-five percent of us are dying within the walls of a hospital1. Due to the advancement of medicine, we are able to catch diseases much earlier and even prevent them from progressing, resulting in an extreme lengthening of our lives. In the past century, our life expectancy has nearly doubled, and increased more than it had in the previous 8,000 years. But as we live longer, we are doing so with many more diseases. We are suffering in hospital beds as we endure endless tests, scans, and trials in order to continually extend our lives2. A quarter of us are also dying in assisted living facilities, so tied down by age and disease that we are no longer able to care for ourselves. individual suffering birth
suffering of others death
diagnosis
time
life
birth
death
diagnosis
time
life
Despite the current numbers, an overwhelming seventy-one percent of us would much rather die at home, surrounded by family and in a setting where we are most comfortable3.
4
1. Morbidity and Mortality Weekly Report (Centers for Disease Control and Prevention, 2017) 2. A Better Way to Care for the Dying, (The Economist, 2017). 3. Ibid.
current
hope
hospital
35%
9%
home
25%
71%
long term care facility
25%
1%
hospice
15%
7%
*remaining 12% reported that they were not sure
5
6
a “good” death
“Our ultimate goal, after all, is not a good death but a good life to the very end.” -Atul Gawande, american surgeon and author
7
the privilege of dying well
More and more often, patients in America are being given the unique knowledge of when their lives will actually end. In these situations, we are able to decide the most suitable path of how to spend our final days. While some decide to fight the odds and undergo continuous medicinal treatment, others choose to respect, acknowledge and accept death’s presence. This brings up the question of how we can best die: is there even such thing as a “good� death? In most cases, Americans would choose to spend their final days in the comfort of their own homes. While preferred, this is not a viable option for everyone. In order to be able to do this, you must posses a certain amount of privilege, ranging from less-restrictive disease types, being a home-owner, or being able to afford at-home staff.
In response to this, the hospice industry is gaining traction. It is the most easily affordable, with over eighty-five percent of costs covered by Medicare4, and its entire purpose is to help us die at home. Hospice can be brought to you wherever you may be, but in cases of people with the least privilege, hospice creates and invites you into an environment that mimics the traditional American home. While the biggest objective of hospice is supposed to be the acceptance of dying, this does not yet exist architecturally. The spaces in which hospice patients die are merely poor duplications of average versions of the places in which these patients existed prior to diagnosis. The entire reason for wanting to die at home lies within a fear of change and an unwillingness to move, neither which hospice successfully addresses. By attempting to recreate the home, hospice hides death behind a false sense of normality. While this form of end of life care successfully highlights a problem, no solution is yet present. The role of architecture can fit crucially in beginning to attempt to solve the problems within the current American norm of masking death.
8
4. Hospice Care Statistics, (Johns Hopkins Medicine, 2018).
privilege needed
monetary
care type
Medicare assistance
family support
other prerequisites
home
none
none
have family to help with care needs
must own a home
hospice at home
$36/day
87.9%
none
must own a home
“granny pod� at home
$85,000 $125,000
none
have home-owning family to help with care needs
none
assisted living
$123 / day
rare
none
none
hospice
$36/day + $123/day
87.9% + rare
none
none
$155 / day
87.9%
none
none
within
assisted living
hospice in facility
9
the industry of hospice
If most Americans consider dying at home to be the closest possible way of achieving a “good” death, then hospice is the second. An option for people with six months or less to live, hospice care relieves family members of caregiver roles and brings patients comfort over cure in home-like environments. If the dying do not have a place to live or they require more frequent attention, they are accepted to live in hospice facilities. Nurses and volunteers are available at all times of the day and night, and patients are given their own bedrooms and bathrooms. Occupants are allowed up to six months stay, and family is welcome to visit any time. The primary focuses for these spaces are comfort, user specificity, and accessibility. This industry is an attempt at an acknowledgment of death, and in this way is a step in the right direction. Hospice’s refusal to let death terrify us into undergoing unnecessary medicinal treatment is admirable, but these ideals do not yet translate architecturally. What does translate, however, is hospice’s attempt at comfort, which is where this thesis disagrees. The current architecture of hospice is comfort through a mimicry of home; an environment as familiar as possible that allows patients to make spaces their own. User specificity can range from hanging favorite artwork on the walls to making sure favorite meals are frequently available. But here, is the sensation of comfort really productive?
In an industry with endless amounts of subjectivity per patient, how can you truly replicate the environment of every single patient’s home? Each hospice facility is slightly different, but the majority attempt to simply recreate the average residence of the neighborhood in which they are located. The primary death desire of the average american is to die at home, so why poorly attempt to re-create this when it isn’t possible to do? Hospice simply cannot be a replica of anyone’s home, so why not use the opportunity to create something better? Currently in hospice’s attempt of producing comfort, they are not doing so for the benefit of their patients, but instead camouflaging them into society, and even furthering the cancerous american norm of hiding death.
10
comfort volunteers cooking - filling house with good smells
comfort prioritized
family visits allowed 24/7
user specificity can bring own artwork, furniture, etc. private bathroom private storage space, medical equipment can be kept away
accessibility nurses and staff always nearby
privacy of own room still maintained
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hospice as mask
“Do I prefer to grow up and relate to life directly, or do I choose to live and die in fear?� -Pema Chodron, american buddhist author
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mary’s haven as case study
Mary’s Haven, a small two-bedroom hospice care center located in Saratoga Springs, New York, is a perfect example of the modern hospice facility. It is located in a small residential neighborhood about half an hour outside of Albany. Looking through multiple scales, you can see that each aspect of its design contributes to its camouflage into the fabric of residential New York.
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New York state
Saratoga Springs, NY
New Street, Saratoga Springs, NY
mary’s haven
35 New Street, Saratoga Springs, NY
first floor, 35 New Street, Saratoga Springs, NY 15
rochester
syracuse
buffalo albany
yonkers new york city
In 2011, the Washington Post published the first ever database of every hospice in the United States. It listed 41 hospice centers in New York, 7 of which are located in major city centers, proving that even at this scale hospice is hiding its patients. Only 17% of hospices exist in the biggest six cities in New York, where over half of the state’s population lives. Every day hospice residents are being pushed into suburban neighborhoods all over the state where they are less likely to be seen.
16
http://www.washingtonpost.com/wp-srv/special/business/hospice-quality/
new york state total population: 19,000,000 people
new york city: 8,500,400 buffalo: 254,000 rochester: 207, 200 yonkers: 201,700 syracuse: 142,000 albany: 97,800 9.453,100 people or 49.75% of new york residents
new york state total hospices: 41
new york city: 6 buffalo: 0 rochester: 1 yonkers: 0 syracuse: 0 albany: 0
12 hospices or 17.07% of new york hospices 17
mary’s haven
18
Saratoga is a small city in New York of about 28,000 people. From this map you can see that Mary’s Haven has been moved away from the city center into a more private neighborhood. Although this was done to provide peace and quiet for residents, it is unintentionally contributing to the hidden American death. Because of its location, only a small range of people living in Saratoga would even know that a hospice facility is located there, let alone be likely to interact with it or its residents. 19
20
At the neighborhood scale, Mary’s Haven sits alongside single family homes to its right, and a small park to its left. It is slightly larger than any other home on the street, but elsewise fits seamlessly into the existing fabric of the neighborhood. This means that even the people who pass by often may not even realize the building’s function. 21
22
The front facade of Mary’s Haven mimics the residential style of its context completely. The only exterior clues that might lead a passerby to understand the interior program would be the removable wheelchair ramp (that is brought inside when not in use) and small sign located on the garage reading the words “Mary’s Haven” (no mention of the word hospice was even written by its owners).
23
attic:
business space/ death space
miscellaneous storage
second oor: grieving space for families with pull-out couch for extra bed if necessary office space where business aspects are conducted business storage garage:
24
ďŹ rst oor: patient bedrooms and bathrooms living room, dining room, and kitchen patient belongings storage
basement:
death space
business space/
patient space/ hidden space
landscaping and outdoor supplies
storage of wheelchairs, medicine, extra bathing products, adult diapers, etc. laundry facilities business and fundraiser storage
Inside, Mary’s Haven is horizontally divided into spaces that do or do not interact with death. In the basement, second floor, and attic, the crude elements of death are everywhere: medical supplies, business spaces, and grieving family members are provided space. On the first floor, all elements of death are hidden from residents, resulting in an interior camouflage as well.
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death positive
“Death is the engine that keeps us running, giving us the motivation to achieve, learn, love, and create.� -Caitlin Doughty, mortician, author, and founder of the Order of the Good Death
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the movement
Created by the Order of the Good Death, the Death Positive Movement was founded six years ago, bringing together people who shared the same core beliefs that the subject of death should not be tiptoed around. The members of this group are made up of morticians, artists, writers, architects, researchers, fashion designers, historians, and even a few doctors. Below you can see the exact objects that this group is hoping to achieve
Statement of Intention: 1. I believe that by hiding death and dying behind closed doors we do more harm than good to our society. 2. I believe that the culture of silence around death should be broken through discussion, gatherings, art, innovation, and scholarship. 3. I believe that talking about and engaging with my inevitable death is not morbid, but displays a natural curiosity about the human condition. 4. I believe that the dead body is not dangerous, and that everyone should be empowered (should they wish to be) to be involved in care for their own dead. 5. I believe that the laws that govern death, dying and end-of-life care should ensure that a person’s wishes are honored, regardless of sexual, gender, racial or religious identity. 6. I believe that my death should be handled in a way that does not do great harm to the environment. 7. I believe that my family and friends should know my end-of-life wishes, and that I should have the necessary paperwork to back-up those wishes. 8. I believe that my open, honest advocacy around death can make a difference, and can change culture.
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Figure 1: Hansa Bergwall and Ian Thomas, “WeCroak,” accessed September 18, 2018 Figure 2: “Morbid Anatomy,” Morbid Anatomy, , accessed November 10, 2018
While this movement was only named a few years ago, the ideas behind it are not quite so new. People across the world have often found new ways to celebrate death for what it truly is, and new examples are continuing to appear every day.
figure 1:
WeCroak App Based on bhutanese principles that thinking about death five times daily will bring total happiness, the app acts as a tool to remind the user of their iminnent death five times a day at random. figure 2:
Morbid Anatomy Museum This Brooklyn-based museum “celebrates things that fall through the cracks”, and owns everything from taxadermy to wax figures.
figure 3:
Occupation of Loss Danish architecture firm OMA has created a semi-circle of columns which mimic Zoroastrian ‘towers of silence’ and broadcast the truth in grief by echoing noises of mourners inside.
figure 4:
Conjurer’s Kitchen Cakes A pastry chef in the United Kingdom makes her living by selling morbid cakes for all occasions.
Figure 3: Dan Howarth, “OMA’s Monumental Concrete Wells Host Mourners at New York’s Park Avenue Armory,” Dezeen, November 13, 2017, , accessed October 15, 2018 Figure 4: “Cakes: The Dark Side,” The Conjurer’s Kitchen, , accessed December 10, 2018
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30
death un-masked
“Death destroys a man: the idea of death saves him.� -E. M. Forester, English novelist and librettist
31
death un-masked
While the death positive movement is slowly gaining popularity, nothing like it yet exists within the architectural world. This gap in design provides us with a unique opportunity to make a difference not just in the lives of end of life patients, but in the lives of every person on this planet. Death is one of the only things that each of us has in common, and therefore creating this new type of residence would benefit us all. Through design we can properly celebrate the end of our lives and come to terms with the uncomfort that death currently brings. Moving forwards, this thesis will design an entirely new form of end of life care that will first, internally provide a home for older patients who wish to come to terms with the end of their lives, and second, externally act as a billboard for younger people who have yet to consider their own death or the death of others. It will achieve these things primarily by bringing this new form of care to urban centers and through the use of transparency.
dying
pre-death
post-death
(6 months)
diagnosis
death
hospice: an extension of life
hospital: a rejection of death THIS THESIS: a celebration of life becoming death time
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site: 2 5th Avenue, New York, NY
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the site In order to correct the architectural failure that is a camouflaged death within American hospice, this thesis creates a completely new approach to how we could live the last few months of our lives. Located in the heart of the most populated city in America, this new design will be placed in Washington Square Park, in NYC, where it will engage people of all ages from all over the world. While Greenwich Village is a majority residential area, 55,000 tourists come to visit the park every single day, and the neighboring NYU campus is home to another 50,000 people- its students and faculty. This will allow the site fantastic visibility to a great variety of people while also providing a quieter atmosphere. The site’s history with death is also important as Washington Square Park is actually a mass grave itself, being home to over 20,000 bodies placed there after the yellow fever outbreak in the 1800’s. This new design will build on that tone of death by facing it head on and expanding on the architectural possibility that lies in the hospice industry: this unique ability of knowing when you will likely die. By first and foremost prioritizing human interaction, conversation becomes the primary driver of design.
RESIDENTIAL/ MIXED-USE
ACADEMIC
WA VE
RL YP
LA
34
CE
MA CD OU GA LS TR EE T
8T
HS
EE
T
WA S
5T
HA VE
NU
E
TR
HI
NG
TO
N
SQ
UA
RE
NO
RT
SO
UT
UA
RE
EA
ST
H
SQ TO N NG HI WA S
RE
ET
UA
RE
SQ
ST
N
ON
TO
PS
NG
OM
HI
TH
WA S
H
WA S
35
HI
NG
TO
36
interaction as driver
“Those who have the strength and the love to sit with a dying patient in the silence that goes beyond words will know that this moment is neither frightening nor painful, but a peaceful cessation of the functioning of the body.� -Dr. Elizabeth Kubler Ross, Swiss-American psychiatrist, author, and pioneer in near-death studies
37
identifying interactions
Generally as we get close to death, we tend to retreat back to quieter and more private spaces, as we crave less and less social interaction. I believe that this need can stem from the lack of a platform and the knowledge of how to have productive conversation, both with the ones we love and with everyday people around us who have no idea what it is like to be dying themselves. By designing spaces specifically to promote these important conversations, we can completely alter the American experience of death, and un-mask the entire process of dying. To start, four main user groups for this new hospice have been identified. The hospice patients, or residents, make up the primary group, followed by hospice staff, resident’s family and friends, and finally and most uniquely, the public. Next, by creating a matrix of all user groups, we can identify cruicial conversations, interactions, or program types to use as primary design drivers. This ensures that the main focus of the hospice design is always central to the advancement of our idea of death through conversation, therefore un-masking death piece by piece.
resident
38
family & friends
staff
public
Scanned with CamScanner
39
interaction spaces
Next, six major interactions types are prioritized and identified. They are then made into physical spaces to be used by any of the four occupant types. Spaces “live”, “grieve”, “empathize”, “support”, “collaborate”, and “share” have all been designed through the criteria of visibility, sound, color, and occupancy to create the best environment to have the exact interaction needed. Seeing how subjective each individual‘s process of dying is, these spaces simultaneously have been designed to be flexible so as to adapt to any form of conversation that may be needed. Starting with the most private, Live spaces are the areas closest to residential. They are the only spaces in the entire building closed off to the public, and are each surrounded with a semi-private buffer zone. Residents are given a private bathroom and very small bedroom to dissuade them from spending time inside. Storage is located on the exterior of the unit to provide maximum visibility to all occupants of the building. Grieve spaces allow for intimate conversation between two or three people, and drop down half of a level to provide privacy for the grieving while simultaneously echoing into the floor below as a permanent reminder of its existence. Support spaces are much more public in that they are not enclosed- allowing the occupants nearly complete visual privacy while maintaining a connection to the rest of the floor through sound and light. Empathize spaces follow a similar form to grieve but are larger- giving a higher range of visibility on both levels above and below while creating a semi-private atmosphere ideal for group meetings between people sharing similar circumstances. Collaborate spaces provide a semi-enclosed space with a table and chairs, lifted higher into the air for maximum visibility that is ideal for group conversation and meetings, but are given a much higher sound barrier. Finally, Share spaces are completely public, nested into the floor to provide unified group seating and again drop down below to create a visual connection to the level below. These spaces would be used for a variety of things including group therapy sessions, poetry readings, or public discussions. While all five forms serve different functions, they each utilize a circular form to maximize visibility and accessibility from all directions. They also all maintain some kind of connection to their surroundings, never allowing for complete privacy (except in Live) in order to emphasize the unity that all humans have through death. In addition, supplementary spaces for teaching, dining, and displaying personal work are interspersed, creating reason for the public to begin to meander up through the space.
40
TEACH a space to share knowledge of a subject with students
DISPLAY place to display artwork, writings, etc. on the subject of death written by residents and guests
DINE A place where meals are held which represents
41
LIVE a space to make one’s home in a particular place visibility occupancy color sound
GRIEVE a space to feel sadness as a result of loss
visibility occupancy color sound
SUPPORT a space for profesionals to provide comfort, encouragement, or assistance to a small group of people
visibility occupancy color sound
42
EMPATHIZE a space to have the feeling or understanding of what another person is thinking or feeling
visibility occupancy color sound
COLLABORATE a space to work together, especially in some literary, art, or social undertaking
visibility occupancy color sound
SHARE a space to talk about personal experiences or feelings with others
visibility occupancy color sound
43
44
all together “Dying is an art, like everything else� -Sylvia Plath
45
The entire circulation of the building is made up of wheelchair ramps that allow for residents to be able to flow through the building regardless of their condition. Interaction spaces are dispersed through spiral ramps that alternate in direction on every floor, guiding occupants through the entire space to create the maximum amount of interaction between users. One main pathway suggests to occupants where they should turn next, gently guiding them away from more private zones and up through the building. The continuous ramp system is supplemented with horizontal platforms that provide relief from the constant slope and provide entry to the interaction spaces that are arranged based on factors of need, proximity to circulation, traffic flow, and the program of each individual floor. On the exterior, the building is wrapped in a softly transparent façade that shifts in opacity to provide different levels of visibility while maintaining a softly lit interior for the resident’s comfort. Starting from the ground level, you have the immediate option to travel down the first spiral ramp and into the basement level where a gallery is located, supplemented by collaborate and teach spaces. You can also continue from the exterior through and up the first ramp and into the lobby of the building, which contains an abundance of seating and the most public of all interaction spaces- support and share. Traveling up the second spiral ramp, you will find a small residential zone to the right, but will be directed via the circulation pathway in the opposite direction to a death-centric library on the left. On one floor up you will find a dining area where all user groups can meet to share a meal together, again providing a reminder that we are all similar regardless of our health. Finally, on the fourth and top floor exists another residential zone as well as a rooftop garden overlooking Washington Square Park. You can see the circulation systems identified in the diagram on page 50, alongside an additional diagram denoting levels of privacy throughout the building. “Private suggested” zones are residential zones that are much denser and provide program specifically for the people living there. Public zones both on the interior and exterior are completely open to the public to allow for greater visibility of the process of dying. Exterior spaces are crucial, as they provide views to the park and subtly remind the users of the naturality of this entire process of dying.
46
47
FLOOR 1 lobby grive support share
x1 x2 x3
FLOOR -1 gallery collaborate teach
48
x1 x1
FLOOR 4 rooftop garden live grieve empathize share
x3 x1 x1 x1
FLOOR 3 dining collaborate share
x2 x2
FLOOR 2 library live grieve support empathize share
x5 x1 x1 x1 x1
49
elevator & stair core
main meandering circulation path
side entrance from Washington Square Park
50
suggested private
public interior
public exterior
51
52
53
This new form of hospice forces people to be uncomfortable; to interact with and confront this big idea of death. By designing spaces specifically to foster conversation and connection, residents are both pushed out of their comfort zones and given a platform on which to speak about their experiences however they may like and in any of the scales of spaces they may like. Whether they are dying themselves or are merely a student visiting for a lecture, the discussion of death created by this space will, in turn, invigorate the current American stigma of death.
54
55
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quote bank
a selection of quotes from WeCroak, an app designed around the bhutanese principle that we will reach ultimate happiness only once we meditate on death five times per day.
57
“Woody Allen had famously typified the attitude most of us find amusing and normal: ‘It’s not that I’m afraid to die, I just don’t want to be there when it happens.’ Funny, yes; but the tragic distortion is that when you avoid death, you also avoid life. And I don’t know about you, but I want to be there through all of it.” - Joan Halifax, American Zen Buddhist teacher, hospice caregiver, author, anthropologist, ecologist, and civil rights activist “One should not lose the joy of living in the fear of dying.” -Maggie Jencks “The myth of cancer kills as surely as the tumors.” -Maggie Jencks “If we’re going to be living to be 120, we’ll be spending a third of our lives in hospital. Hospitals will have to become like cities – but nice places.” - Charles Jencks, architectural theorist and historian “Yet, in a bizarre, backwards way, death is the light by which the shadow of all life’s meaning is measured. Without death, everything would feel inconsequential, all experience arbitrary, all metrics and values suddenly zero.” -Mark Manson, author of “The Subtle Art of Not Giving a F***” “I cannot escape death; but cannot I escape the dread of it? Must I die trembling and lamenting?” -Epictetus, greek philosopher “Without an ever-present sense of death life is insipid.” -Muriel Spark “As men, we are all equal in the presence of death.” -Publilius Syrus, latin mime writer “Death is not the greatest loss in life, The greatest loss is what dies inside of us while we live.” -Norman Cousins, political journalist and world peace advocate “No matter how much you’ve been warned, Death always comes without knocking. Why now? Is the cry. Why so soon? It’s the cry of a child being called home at dusk.” -Margaret Atwood, author of “The Handmaid’s Tale” “Death destroys a man: the idea of Death saves him.” -E. M. Forester, English novelist and librettist “i think well of my life, for the same reason I must think well of my death.” Zhuangzi “One must live as if it would be forever, and as if one might die each moment. Always both at once.” -Mary Renault “Life has only this to offer: itself and death.” -Erica Doyle
58
“I shall not die of a cold. I shall die of having lived.” -Willa Cather “It is very difficult to feel convinced that death could happen at any moment. We tend to feel that since we have survived so far, our continuation is secure. But thousands of people die every day, and few of them expected to” -Sangye Khadro “Dying is an art, like everything else” -Sylvia Plath “I do not fear death. I had been dead for billions and billions of years before I was born, and had not suffered the slightest inconvenience from it.” -Mark Twain “Life is a hard battle anyway. If we laugh and sing a little as we fight the good fight of freedom, it makes it all go easier. I will not allow my life’s light to be determined by the darkness around me.” -Sojourner Truth “Do I prefer to grow up and relate to life directly, or do I choose to live and die in fear?” -Pema Chodron “People who contemplate the end actually behave in healthier ways - and therefore may actually live longer.” -Eric Baker “Analysis of death is not for the sake of becoming fearful but to appreciate this precious lifetime.” -Dalai Lama “To know the physical body will cease to exist at some point--that this life will end-- changes us. I’ve felt this knowledge like an electric shock and also as a kind of honeyed happiness.” -Sallie Tisdale “I tremble to say there’s good in death, because I’ve looked into the eyes of the grieving mother and I’ve seen the heartbreak of the stricken widow, but I’ve also seen something more in death, something good. Death’s hands aren’t all bony and cold.” -Caleb Wilde “It is difficult for people of advanced years to start remembering they must die. It is best to form the habit while young.” -Muriel Spark “Let’s think about ants for a minute. Millions of ants die every day, and do we care? No. And I’m sure the ants feel the same way about us.” -Joe Brainard “Those who have the strength and the love to sit with a dying patient in the silence that goes beyond words will know that this moment is neither frightening nor painful, but a peaceful cessation of the functioning of the body.” -Dr. Elizabeth Kubler Ross
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bibliography
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appendix
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maggie’s centres
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NEWCASTLE, ENGLAND
DUNDEE, SCOTLAND
GARTNAVEL, SCOTLAND
TED CULLINAN, 2013
FRANK GEHRY, 2003
OMA, 2011
MERSEYSIDE, ENGLAND
FORTH VALLEY, SCOTLAND
OLDHAM, ENGLAND
CARMODY GROARKE, 2014
NORD, 2017
dRMM, 2017
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urban hospice
PUBLIC MIDDLE GROUND PRIVATE
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PUBLIC MIDDLE GROUND PRIVATE
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