What makes a space compassionate? Is it the architecture, the atmosphere, or the intention behind its design and use? These questions were at the heart of a recent interdisciplinary exploration by participants in a global Fellowship in Compassionate Spaces.
Drawing professionals from palliative care, medicine, nursing, architecture, social work, academics, history, journalism and design, the fellowship invited participants to briefly reflect on their personal and professional experiences to collectively unpack the meaning and potential of “compassionate spaces.”
What emerged was not a singular definition, but a rich tapestry of perspectives, highlighting that compassionate spaces are as much about internal states as they are about external conditions. Below is a synthesis of key themes that arose during this inquiry, which holds valuable implications for palliative care environments and beyond.
Psychological Safety and Emotional Well-being
A recurring thread across the reflections was the fundamental importance of psychological safety. Participants described compassionate spaces as environments where individuals feel safe to be vulnerable, where their emotions are acknowledged, and their presence is respected.
One healthcare professional from East Africa emphasised that compassionate spaces must allow individuals to express themselves without fear of being judged. Another participant working in mental health noted that such spaces cultivate mindfulness and acceptance, allowing people to feel “held” even in silence. These insights resonate deeply with palliative care, where emotional presence often outweighs clinical intervention.
Design and Architecture: Beyond Aesthetics
Architects and designers in the fellowship underscored that compassionate design goes beyond aesthetics. It involves creating spaces that are physically accessible, emotionally resonant, and responsive to the needs of diverse users.
One architect with extensive experience in elder care stressed that design must support dignity, especially for older adults. This involves more than ramps and wide doors—it means thoughtful attention to lighting, sound, textures, and flow. Another designer focused on the importance of natural elements, like access to sunlight and ventilation, as critical to fostering a sense of well-being.
A third contributor working in healthcare architecture described how simple spatial changes—reducing harsh lighting, minimising noise, and ensuring privacy—can dramatically impact how safe and supported people feel in hospitals and clinics.
Inclusivity and Accessibility
Creating compassionate spaces also means addressing who is often excluded from them. Several participants highlighted how conventional design practices fail to accommodate people with disabilities, especially those who are neurodivergent.
One psychiatrist described public infrastructure (airports, cinemas, and even hospitals) as “sensory hostile” for autistic individuals. She called for a shift toward sensory-friendly spaces that reduce overstimulation. A social worker emphasised the importance of participatory design, advocating for meaningful collaboration with disability rights groups. An architect working on public infrastructure projects shared how small changes, like textured flooring for the visually impaired or accessible transport routes, can drastically increase usability and emotional comfort.
Inclusivity, participants agreed, is not just about compliance with accessibility codes but about actively designing for dignity.
Compassionate Spaces in Healthcare
Several healthcare professionals reflected on how the idea of a compassionate space directly influences patient care and staff well-being. For some, the term evoked a room where silence and attentive listening were as healing as medication. For others, it meant places of respite for overworked healthcare providers.
One clinician working in remote communities described moments when sitting quietly beside a patient, rather than offering advice or intervention, became a profound act of compassion. Another shared their hospital’s efforts to create rest areas for nursing staff, recognising that caregiver exhaustion undermines compassionate care.
An oncologist summarised it succinctly: a compassionate space is where healing, comfort, and dignity intersect, for both patients and the people who care for them.
Internal vs. External Compassion
A striking insight across many reflections was the idea that compassion must begin internally. Several participants described compassionate spaces not just as physical environments but as internal states cultivated through self-awareness, silence, and intentional presence.
One participant described her practice of retreating into inner stillness before engaging with patients or community members, a space of “internal refuge” that informed her outward actions. Another drew from Buddhist teachings, emphasising that empathy for others flows most easily when rooted in self-compassion.
This dual perspective—compassion as both an internal disposition and an external condition—challenges healthcare providers to reflect not only on how they design spaces but also on how they inhabit them.
Systemic and Cultural Dimensions
Compassionate spaces cannot be understood in isolation from the broader societal systems in which they exist. Some contributors argued that the creation of such spaces requires actively addressing structural injustices and social inequalities.
One participant described working in communities where systemic poverty, inadequate infrastructure, and institutional neglect made it nearly impossible to sustain compassionate environments. Another spoke of hospitals where aggressive television programming played in waiting areas, creating a jarring contrast with the emotional vulnerability of patients nearby.
Others emphasized the need for governments and institutions to invest in compassionate communities—through policies, funding, and training. Without such support, they warned, compassionate design risks becoming a well-meaning but superficial gesture.
Reflections and Tensions
Not all participants felt clear or confident about the term “compassionate space.” Some expressed uncertainty, noting that the concept felt fluid and difficult to define. One reflected that while the term initially confused her, it eventually opened up new ways of thinking about her work and surroundings.
Another participant raised a provocative question: Is compassion a universal human trait, or is it shaped by culture? His reflections challenged others to consider how ideas about care, dignity, and emotional expression vary across regions and traditions.
Several also pointed to the challenge of working in under-resourced settings. Space, time, staff, and supplies are often limited, raising the difficult question of how to create compassionate environments when basic needs are not being met.
Toward Actionable Compassion
Despite these tensions, certain guiding principles emerged across disciplines and cultures. Participants consistently called for the following:
- Design environments that prioritise sensory and psychological comfort, especially for those who are vulnerable or marginalised.
- Cultivate internal self-compassion as a foundation for external empathy and patient care.
- Address systemic inequities as part of the effort to create truly compassionate spaces.
- Extend compassion to caregivers and staff, not just patients or clients, recognising the toll that care work can take.
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Thank you to Marianne Buchegger for permission to use her photograph.
http://www.instituteofpalliativemedicine.org/
( Fellowship in Compassionate Spaces is an online participatory learning program run by the Institute of Palliative Medicine, with support from the Kerala Chapter of the Indian Institute of Architects)
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