Sacred Spaces in the Hospital Setting Rev. Connie Madden MDiv, BCC Chaplain Coordinator St. Louis Children’s Hospital
Sacred Spaces: Learning Objectives 1. To understand what elements are common to sacred spaces in the pediatric hospital setting 2. To view research surrounding what aspects of our sacred spaces are most helpful for family coping 3. To create our own sacred space design
Definition of a Sacred Spacein a Hospital Setting • A therapeutic space for a designated purpose • Intention is to help patients and families connect with meaning, to provide restoration, to connect with faith resources • To liberate families and patients, if only temporarily, from the captivity of the health care environment
History of Healthcare Setting(Whitehouse, Varni, Seid, et. al, 2001) In the Middle Ages, monasteries offered patients courtyards bordering rooms, seasonal plants, and places to sit or walk. (Warner, 1995)
History of Healthcare Setting(Whitehouse, Varni, Seid, et. al, 2001) Germ Theory of Illness of Louis Pasteur and Claude Bernard in the 19th century changed focus of disease treatment and hospital function to sterile, contained environment, with patient comfort as a low priority. (Lindheim & Syme, 1983)
History of Healthcare Setting(Whitehouse, Varni, Seid, et. al, 2001) Increased healthcare competition and focus on patient satisfaction in the United States in the 1990’s with new research on psychology of architecture changed priorities for space utilization. (Horsburgh, 1995)
Movement to Family Centered Care(www.ipfcc.org) “The Institute for Family-Centered Care was established in 1992 to advance the understanding and practice of family-centered care in all settings where individuals of all ages and their families receive care and support.” “In every encounter, health and human service professionals will seek to build on the strengths of patients and families, enhancing their confidence and competence. The health care delivery system will recognize and encourage patient and family strengths, choice, and independence.”www.ipfcc.org/about/index.htm
Environment and Design:Family Centered Carehttp://www.ipfcc.org/advance/topics/keyconsiderations.html Family Support Art Play Areas Spiritual Support Information and Education Nature and the Out of Doors
“Hospital patients should never be imbued with the idea that they are sick…Health should be constantly before their eyes. “ Frank Lloyd Wright(Horsburgh, 739)
“A true hospital should be a place where any of us would love to go as to a vacation.” TF Hanlin(Hanlin, 711)
What to consider for creating a Sacred Space(Horsburgh, 738) • Purpose and intention for space- -Meditation -Stress relief -Interaction -Familiarity -Resources for participants -Specific space needs
What to Consider for Creating a Sacred Space • Research Driven Designs (Whitehouse, et. al., 302) • Budget (Whitehouse et. al., 302) • Connection to Local Resources and History (Lindheim & Syme, 352)
Types of Sacred Spaces in Hospital Settings • Gardens • Chapels • Bereavement Rooms
Efficacy of Integrating Nature in Healthcare Settings • Gardens can reduce stress and health related complaints among patients (Cooper-Marcus & Barnes, 1999; Ulrich, 1984; Verderber, 1986) • Gardens increase patient and staff satisfaction (Paine & Francis, 1990; Cooper-Marcus and Barnes, 1995) • Gardens are important for hospitalized children and parents (Strain & Grossman, 1975; Horsburgh, 1995; Carpman & Grant, 1993)
How Gardens Impact Differing Age Groups • Adults prefer natural to urban landscapes (Ulrich, 1977; Balling and Falk, 1982; Orians & Heerwegen, 1995; Schroeder, 1995) • Adults prefer scenes with trees, grass, water, visible sky, rocks, flowers and birds (Olds, 1989) • During stress, going to nature helped adults’ mood improve (Cooper-Marcus, 1995)
Important Aspects of Gardens for Children • Children love functional elements of nature, such as climbing, throwing, touching (Gibson, 1979; van Andel, 1990) • Children love places of refuge and hiding (van Andel, 1990; Kirkby, 1989) • Children need outdoor play, opportunities for play leadership, connections between the indoors/outdoors (Cooper-Marcus and Barnes, 1999)
Study at Children’s Hospital and Health Center, San Diego, of the Leichtag Family Healing Garden(Whitehouse et. al., 2001) 52 adults, 12 children were surveyed, including staff, patients and families Adults most enjoyed : -Sound of running water (33%) -Bright colors (25%) -Being outside in a garden (23%) -Flowers, trees, plants and greenery (23%) -Artwork (19%)
Study at Children’s Hospital and Health Center, San Diego, of the Leichtag Family Healing Garden(Whitehouse et. al., 2001) Children most enjoyed: -Artwork (83%) -Fountain, sound of running water (83 %) -Being outside in a garden (33%) -Flowers, trees, plants, greenery (33%)
Family comments about the St. Louis Children’s Hospital Garden “Even though I don’t have it in me (to come), I want you all to know how important it is to me that A. is mentioned in the garden. We spent a lot of time here in the garden during all of her treatments…The first circle window, she would get in there, sit and look out. It was peaceful for her as bad as she felt through all of her chemo. She loved to be outside…Ithank all of you for the garden” -note from A’s mom for the memorial service last year
Uses for Hospital Gardens • Visits by Family, Patients and Staff • Interactions and Discovery • Craft Projects by Patients to Decorate
Uses for Hospital Gardens(continued) • Connection with Community, concerts, celebrations, diversity awareness, artwork • Extubations, bereavement services • Connection with the Seasons in a Timeless Setting
Chapels In the past, chapels have been designed according to the affiliation of the healthcare setting (ie: faith-based, military specifications, etc.) or donor preferences
ChapelsProblems of Past designs • Static faith elements often excluded certain faith groups • Static furniture impeded sense of privacy and limited possibilities for use • Generalized space became like a waiting room versus sacred space
Hospitals Changing Chapel Design and Use(“Kaiser unveils meditation room,” Roseville Press-Tribune, 2/5/11, Christian, Sena.) Kaiser Roseville Medical Center had no official chapel or meditation space --Meditation room became like a waiting lounge because of lack of purpose and design --New space includes stained glass window with nature symbols, chairs arranged for privacy but not sleeping, prayer bowl for prayer requests, kneeling stools, various religious sacred texts, prayer rugs
Hospitals Changing Chapel Design and Use(“Kaiser unveils meditation room,” Roseville Press-Tribune, 2/5/11, Christian, Sena.) • UC Davis Medical Center in Sacramento -move to an “all faith chapel” • Sutter Health Women’s and Children’s Center -40 seat meditation room for 2013 • Kansas City Children’s Mercy- -chapel design decided by Interfaith local community clergy council
Cincinnati Children’s Hospital http://www.cincinnatichildrens.org/svc/alpha/p/pastoral/tour.htm
Texas Children’s Hospitalhttp://www.texaschildrens.org/AllAbout/VisitingTheHospital/SpiritualCare.aspx
Pediatric Chapel Design Considerations • Honor Diversity in design, elements, spiritual item offerings-yet preserve some familiarity to location • Think of common themes- prayer, community connection, privacy, nature • Integrate Child friendly elements-art, interaction, water sounds
Pediatric Chapel Design Considerations • Have movable elements to transition use • Utilize local faith leaders and their specific ideas of the needs of their people • Remember setting specific goals of the chapel-What does our hospital want and need?
St. Louis Children’s Hospital Bereavement Room • Private space for grieving families, families awaiting funeral home pickup, or for extubations • Includes home-like décor, refrigerator, blanket warmer, bathroom, phone, adjustable lighting, privacy doors, sound proof walls, security button • Small refrigeration unit allows children to stay in our hospital until pickup versus transition to adult hospital morgue
References Balling, J. D. & Falk, J. H. (1982). Development of visual preference for natural environments. Environment and Behavior, 14, 5-38. Carpman, J. R. & Grant, M. A. (1993). Design that Cares: Planning Health Facilities for Patients and Visitors (2nd edition). Chicago: American Hospital Publishing. Cooper-Marcus, C. & Barnes, M. (1995) Gardens in Healthcare Facilities: Uses, Therapeutic Benefits, and Design Recommendations. Martinez, CA: The Center for Health Design. Cooper-Marcus, C. & Barnes, M. (1999) Healing Gardens: Therapeutic Benefits and Design Recommendations. New York: John Wiley & Sons. Pp. 323-384. Gibson, E. J. (1979). The Ecological Approach to Visual Perception. Boston: Houghton-Mifflin. Hamlin, T.F. Architecture of Hospitals, Pencil Points, 1940:21 (11): 711-20. Horsburgh, C.R. Jr. (1995). Healing by design. The New England Journal of Medicine, 333, 735-740. www.healinglandscapes.org/resources-related-organizations.html www.ipfcc.org “Kaiser unveils meditation room, “ Roseville Press-Tribune, 2/5/11.
References Kirkby, M. (1989). Nature as a refuge in children’s environments. Children’s Environments Quarterly, 6. 7-12. Lindheim, R. & Syme, S. L. (1983) Environments, people and health. Annual Review of Public Health, 4, 335-339. “Making hospital chapel welcoming to all faiths.” Bay Citizen, reprinted in the New York Times, 10/21/10. Orians, G. & Heerwegen, H. (1995). Evolved responses to landscapes. In Barkow, J., Cosmides, L. & Tooby, J. (Eds), The Adapted Mind: Evolutionary Psychology and the Generation of Culture. Oxford: Oxford University Press. Olds, A. R. (1989). Nature as healer. Children’s Environments Quarterly, 6, 27-32. Paine, R. & Francis, C. (1990). Hospital outdoor spaces. In C. C. Marcus & C. Francis (Eds.), People Places: Design Guidelines for Urban Open Spaces. New York: Van Nostrand Reinhold. pp. 263-290. Schroeder, H. W. (1995). Preference and meaning for arboretum landscapes: Combining quantitative data. In A. Sinha (Ed.), Readings in Environmental Psychology and Landscape Perception. San Diego: Academic Press. Strain, J. J. & Grossman, S. (1975). Psychological reactions to medical illness and hospitalization. In Strain, J. J. & Grossman, S. (Eds.) Psychological Care of the Medically Ill: a Primer in Liaison Psychiatry. New York: Appleton-Century-Crofts. pp. 23-26.
References Ulrich, R. S. (1984) View through a window may influence recovery from surgery. Science, 224, 420-421. Ulrich, R. S. (1977) Visual landscape preference: A model and application. Man-Environment Systems, 7, 279-293. van Andel, J. (1990). Places children like, dislike, and fear. Children’s Environments Quarterly, 7, 24-21. Verderber, S. F. (1986) Dimensions of person-window transactions in the hospital environment. Environment and Behavior, 18, 450-466. Warner, S.B. Jr. (1995). The periodic rediscoveries of restorative gardens: 1100-present. In M. Francis, P. Lindsey & J.S.Rice (Eds), The Healing Dimensions of People-plant Relations: Proceedings of a Research Symposium. Davis, CA. University of California, Davis, Center for Design Research, pp. 5-12. Whitehouse, Sandra, et. Al. (2001) Evaluating a Children’s Hospital Garden Environment: Utilization and Consumer Satisfaction. Journal for Environmental Psychology, 21, 301-314.