Coming out of the Covid-19 pandemic, senior living operators may be more motivated than ever before to promote resident health and wellness, and there is a growing body of evidence that the way communities are designed and built plays a key role in supporting this goal.
“I think this next generation of seniors is not looking to necessarily move into a community to be cared for,” Leslie Moldow, principal at global architecture and design firm Perkins Eastman, told Senior Housing News. “They will consider moving into a community if they see an opportunity to be their best selves, live their best life and be capable and engaged as long as possible.”
A new study from Perkins Eastman shows what the future might hold regarding wellness-centric design in senior living. And although the study analyzed responses that were collected well before Covid-19 between 2015 and 2017, it could help deepen operators’ understanding of what residents might like to see in their communities from a wellness design perspective.
The study focused on three primary dimensions of wellness that are impacting residents’ quality of life: physical, social/emotional, and intellectual wellness. By analyzing how residents viewed new construction and renovation projects designed by Perkins Eastman at three communities, the study’s authors provided a window into which design strategies might help promote whole-person wellness — and, in the process, which might attract more residents in the future.
The study surveyed residents in two stages: before construction at their community (when applicable), and after construction and occupancy. In total, 381 residents across two sites participated in the pre-construction stage, while 543 residents across three sites participated in the post-construction and occupancy stage.
But Perkins Eastman is far from the only firm that views wellness as among the most important guiding principles for future senior housing designs. In light of their experience during Covid-19, the next generation of senior living consumers almost certainly will be looking for communities that support their health and wellness across various domains — and, they will be willing to pay a premium to live in these settings, Manny Gonzalez, managing principal for the 55-plus practice group at architecture firm KTGY, recently told SHN.
And while the Perkins Eastman study focused on three nonprofit communities offering a continuum of care, a variety of different types of senior living providers — including Watermark Retirement and SRG Senior Living — are pursuing new wellness models and are constructing their communities accordingly.
Elements of wellness
Many senior living communities over the years have fostered wellness through activities and events that promote socialization, exercise and intellectual growth. But operations are just one piece of the wellness puzzle.
“Architects need to link operations and design,” said Moldow, who contributed to the study. “If you get a mismatch of designing a building one way, and it’s operating another, it just never feels comfortable.”
There is evidence from the study that the right kind of design can actually boost residents’ perceptions of wellness, or at least foster healthier behaviors, according to Emily Chmielewski, a senior design researcher and senior associate at Perkins Eastman.
“I think the biggest takeaway is that the design has had a positive impact [on wellness], and that residents recognize that design has a place in their wellness,” Chmielewski told SHN.
The study landed on 10 different strategies for fostering resident wellness in senior living design. These include designs that give residents more autonomy and control, promote certain patterns of movement, imbue feelings of home and give residents plenty of access to naturally lit or outdoor spaces.
These strategies can take many different forms.
For example, MonteCedro, a life plan community that opened four years ago in Altadena, California, features a library space with a variety of seating options for residents, promoting autonomy. The design also locates two major activity spaces — a theater and an auditorium — at opposite ends of the community, with space for dining and sitting between them. This encourages patterns of movement that promote socialization, according to the study.
At MonteCedro, 94% of the study’s respondents said the built environment provides good to excellent support of their physical wellness. Newly moved-in residents also said the community’s access to physical wellness resources, and its ability to foster regular exercise, were “better” than their previous living situations — by a measure of 46% and 37%, respectfully.
The study also found that the vast majority of those residents said the designs helped support “no change” to aspects of their physical wellness. This is a theme that carried over into some of the study’s other questions — but it’s an indication that the designs are indeed working as intended, Chmielewski said.
“Over a period of time, especially with an older population, you would naturally expect some decline,” she explained. “So, it was really interesting to see how many people experienced no change over the two-year or so period of time we were doing this research.”
MonteCedro was also designed to include spaces where residents could spontaneously interact. One of the community’s dining spaces is in the center of the community’s main thoroughfare, maximizing visibility and increasing the chances that residents run into one another. And the community offers outdoor connections in the form of bright, airy and inviting spaces.
According to the study, 92% of the respondents from MonteCedro said the community provides “good” to “excellent” support of their social/emotional wellness, while 95% said it provides “good” to “excellent” support of their intellectual wellness.
At another community — Spring Lake Village in Santa Rosa, California — a campus expansion added 62 new independent living homes and renovated the community’s “village center.” This project also included the relocation, addition and enhancement of certain amenities to increase residents’ holistic wellness. The renovations included a new auditorium, fitness center, heated pool, library and bistro.
The design promoted use of an indoor pool by circulating residents around it, and by giving them a view inside through floor-to-ceiling glass windows. The design also fostered outdoor interactions through patios and shaded walking paths.
Perkins Eastman was able to study residents’ reactions before and after the renovation project. According to the survey, support of physical wellness improved from 84% in the first survey to 94% in the second. Likewise, support of social/emotional wellness improved 9 percentage points from the first survey to the second, going from 83% to 92%; and support of intellectual wellness improved 11 percentage points, going from from 81% to 92%.
A new 11-story tower dubbed “The Summit” at Rockwood South Hill is an example of another design approach to supporting wellness. The Spokane, Washington life plan community, managed by Rockwood Retirement Communities, incorporates biophilic design, which is meant to connect people to the natural world around them. Perkins Eastman also reimagined Rockwood’s existing Ridge Tower as part of the project.
“[Biophilic design] is about recognizing that human beings belong in the natural world as biological creatures, and that to separate us is bad for us,” Moldow said.
Literally creating more connections between residents and outdoor spaces is emerging as a key design trend fueled by the Covid-19 pandemic. Gathering outdoors is safer from an infection control perspective than congregating indoors, and giving people easy access to fresh air helps alleviate the burden of living in isolation from others.
Biophilic design goes further by not only creating access points to the outdoors, but in finding various ways to create a sense of being connected with the natural world even while inside.
At Rockwood, designers used natural materials along with certain motifs, patterns, and color palettes to help conjure the outdoors inside the community’s walls.
The community has an in-house wellness program through LiveWell. The program focuses on holistic wellness, and encompasses all aspects of the community, from programming to architecture and design, according to Andrew Gorton, the community’s general manager.
Near the entrance of the Summit building, the designers incorporated a waterfall feature that evokes the Spokane River and its waterfalls. And, the building’s units have balconies so residents can enjoy the outdoors without leaving their units. The Summit was also intentionally oriented toward the rest of the community in order to draw residents into its amenity spaces.
Inside the building, the designers located a living room area within its winding, curved “riverwalk” corridor, with comfortable places to sit while bathed in natural light. The building was also designed with ample access to amenity spaces — such as a game room and library — and dining venues that lead into one another, creating more avenues for engagement.
“Everybody ends up walking through this path, through the dining areas, on the way to fitness or wherever they’re going,” Gorton said. “So, there ends up being a lot of casual interaction.”
In general, the spaces have gone a long way in boosting the holistic wellness of the community’s residents, Gorton added.
“People are attracted to these spaces and find them very pleasant, whether they realize it or not,” he told SHN.
And the residents agree, at least according to the Perkins Eastman study. Before the Summit project opened, 81% of Rockwood’s residents said the community supported their physical wellness. Afterward, 94% said the same thing.
The biophilic design — with amenity spaces that include abundant daylight and views to the surrounding outdoors — may have also encouraged residents to increase their participation in activities and fitness classes, the study found.
Nearly half of the community’s residents (46%) also said they lingered longer in the new amenity spaces and dining venues, while 62% said they appreciated the choice offered by the amenity spaces, and 68% said they appreciated the choice of dining venues.
“We have a lot of mixing of residents from all the living areas,” Gorton said. “Now, it’s easy for folks in the houses to get up and enjoy the amenities.”
Residents also reported feeling better, with 73% of residents reporting the community supported their social and emotional wellness “well” or “very well” before the project opened, and 93% reporting the same afterward. But the biggest gain came in residents’ intellectual wellness, which jumped from 61% before the project, to 91% afterward. Part of that may have to do with easier access to space’s library, theater and art studio.
Although Rockwood’s residents currently can’t benefit from the community’s in-person wellness programs the same way they did before the pandemic, the community’s design has helped them stay well in the meantime. In particular, the long corridor with views of the outdoors has come in handy as residents have sought to get their daily steps in.
“A little bit of that goes a long way,” Gorton said. “It’s amazing what it does for folks.”