How Designers Are Transforming the Senior Living Experience

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Solomon Cordwell Buenz designed The Mather South, based in Evanston, Ill. The CCRC was recently recognized by The American Institute of Architects as a citation award recipient. (Photo provided)

Vibrancy and variety — those words are permeating the senior living design space as top designers look toward the future for guidance in planning today’s newest senior housing developments. And they’re not looking back.

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Rooms that can easily switch between memory care and assisted living, depending on demand; easily accessible wellness spaces; and balancing the clinical aspect of post-acute care with a home-like experience are some of the ways new senior living products are taking shape, architect Joyce Polhamus tells SHN.

As the leader of the Health Design Studio in SmithGroup JJR’s San Francisco office, and past chair and emeritus member of the American Institute of Architects (AIA) Design for Aging Knowledge Community (DFA), Polhamus directs the planning and design process for a range of senior living, post-acute care and other health-oriented facilities.

Polhamus sat down with SHN to discuss how senior living designers are stepping away from tried and true product models, taking cues from an aging baby boomer population, which has different demands than the aging population before them; and how the emergence of Accountable Care Organizations (ACOs) are transforming senior living design.

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Senior Housing News: Many senior living leaders say independent living is the new assisted living, and assisted living is the long-term care that skilled nursing used to be 20 years ago. What are you seeing?

Joyce Polhamus: The trend is that people are not seeking to move into independent living and when they do need a service that is when they look toward moving, so it is more what we call assisted living. But, assisted living needs to be more robust because people are looking to be somewhat independent and have the benefit of social interaction that independent living provides.

SHN: What does that mean for today’s assisted living?

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JP: What I’m seeing in assisted living, such as in our Peninsula Health Care project, is that people move in for apartment-style living units that are modest in size, but also in the building there’s a gracious lobby, living room, area dining room — so it’s pulling people together in a more vibrant, lively environment that is more akin to independent living, in some ways, with all the amenities that independent living provides.

[Editor’s note: SmithGroup JJR is designing the Peninsula Health Care District’s new 150,000-square-foot assisted living and memory care facility in Burlingame, Calif. The development is slated to open in 2016.]

In the past, people in assisted living needed a lot of help. Now, people are still going in on a need basis but they don’t want to change their life to be one step away from a nursing home. They still want a vibrant, active environment.

Assisted living has more amenities, services — more variety and options. For example, all assisted living facilities are starting to have some kind of bistro, spa or exercise amenity. In the ‘80s, when assisted living was the supplement to skilled nursing, they had a common living room, dining room and had bedrooms units. At that time, it was a nice alternative, but now it’s gone beyond that and expanded to be more desirable — to border independent living. When you go into [assisted living facilities] now, there’s a concierge desk, billiards room nearby; it feels like an engaged common area; not a lobby that is one piece.

Assisted living units have gotten bigger. People are downsizing, but not ready to go to dorm-room size. A two bedroom is the desirable market spot.

SHN: How are developers preparing for both assisted living and memory care demand?

JP: One of the things that is unique about the Peninsula Health Care District project, scheduled to open in 2016, is that it is flexible for assisted or memory care. We planned one floor for memory care and the four floors above are for assisted living. So, if the bottom floor needs to become assisted living we can combine units. Two memory care units can combine to become an assisted living unit. It’s a unique unit configuration.

And, two assisted living units make three memory care units. Memory care folks don’t have the benefit of using the entire building, so they need to have more dining and living options on that floor that’s what we are focusing on in trying to get assisted living and memory care to be more flexible.

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Solomon Cordwell Buenz designed The Mather South, based in Evanston, Ill. The CCRC was recently recognized by The American Institute of Architects as a citation award recipient. (Photo provided)

SHN: How are the emerging roles between healthcare systems and senior living facilities impacting design?

JP: Providers are doing some long-term care, short-term care and rehab. One provider in Michigan was the first one I saw really trying to cater to health care providers in the area to be the discharge [facility] of choice.

The rooms themselves are not like little apartments, but more like health care rooms — but nicer. They’re bathroom accessible, and have a nurse server [station?] at the entry to the unit’s door so nurses can put meds there. Wooden walls make the institutional part of the hospital environment and make it more comfortable.

So, short-term stay and rehab units are becoming more residential in character when incorporated into the senior living environment. If you’re receiving short-term care in a longer-term care setting you want to feel like you’re working toward getting out. Designers are de-institutionalizing the rehab part and trying to build a relationship with these patients so that then in five, 10 years from now if they need to put mom in long-term care they’ll feel comfortable [taking her there].

SHN: How might the formation of ACOs impact senior living facility design?

JP: Many of these places [that offer short-term care and rehab] also have a fitness component that is visible and accessible to people when they walk in. ACOs will have an impact with the facility’s health and wellness amenities.

In a continuing care retirement community (CCRC) I would like to see the fitness area when you first walk in, so I feel like I”m going to a place where I feel like I can keep functioning at a high level.

Often, when you visit someone in assisted living, or long-term care you’re visiting in his or her bedroom unit. If I knew that on my way to work, I could stop by, meet my mother for coffee and use the exercise equipment then I could incorporate that into a daily routine. And, then my mom gets somebody to meet her. You want [an exercise area] to be accessible from the front.

So, with the emergence of ACOs the benefits of a healthy lifestyle and improving ones lifestyle are going to be more prominent in senior living communities, and ones that provide the rehab services are more open to that.

SHN: Memory care facilities are projected to be in high demand as the number of those 65 and older with Alzheimer’s disease may nearly triple by 2050. What are some emerging memory care design trends?

JP: It’s treating the environment to be one people still want to be engaged in. Yes, it needs to have visibility and a common area where people will congregate, but create variety within that.

A major trend is putting the kitchen area as part of the memory care unit. An open kitchen area is more reminiscent of home. Creating a variety of things where people can have interaction is big.

The units still need to be secure, so it’s creating some variety. For example, that you can be in a dining room area in the morning and then you can sit by a deck area on the other side of the building with a different light in the afternoon. I like when memory care buildings have windows on different sides. It’s breaking up the common space so that it flows. So, you can see from one space to another but there’s a variety of interactions that can occur.

Too many buildings just have one open room. I’m seeing more variety of physical space and engagement areas that are still safe and secure, but there’s a variety of them. The memory care units now look more like the assisted living units [of the past].

And you see memory care and assisted living coming together. The memory care environment is much more rich and engaging than it used to be.

SHN: How do you determine which senior living designs were successful and which ones flopped?

JP: Post-occupancy is a great way to see what does and doesn’t work. American Institute of Architects (AIA) Design for Aging Knowledge Community (DFA) is trying to promote new ways of thinking.

For so long people just did what was done in the past because they thought it worked. We want to encourage people to explore new ways of thinking so we’re also trying to get younger architects designing for older people.

They think it’s not exciting, but it is.

Written by Cassandra Dowell

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