This study examines how architectural design navigates the threshold between life and death in paediatric palliative care environments. While ‘homelike’ hospice models have gained attention, little research has addressed how spatial design engages with the presence of death. Drawing on interdisciplinary literature, from architectural theory and death studies to medical humanities, this paper explores how children’s and adolescents’ hospices negotiate death through spatial choices. The key question guiding this research is: how is death made spatially present or absent in places that support life while anticipating its end? Through a comparative analysis of six hospices in Australia and the UK, supported by a review of medical literature and interviews with fourteen medical experts and eight architects, the study identifies a range of design strategies: euphemistic room names, concealed suites, transitional thresholds, and therapeutic landscapes. These elements reflect a spatial tension between maintaining everyday routines and acknowledging the reality of loss. Rather than expressing monumentality through scale or form, these hospices demonstrate a quieter, domestic-scale architecture that facilitates rituals, memory, and emotional continuity. They are not traditional memorials, yet they act as active sites of remembrance. The study reframes hospice design as part of a care continuum that supports enduring relationships with grief.
Nasab et al. (2025) studied this question.