Growing Old Gracefully

Dec. 31, 2002
Today’s Senior Living Environments Facilitate Quality of Life and Quality Care
It’s inevitable. We’re all growing old. Don’t fret; those sterile, institutional “homes” we once shuddered to think of ourselves living in have evolved. Today’s living environments for seniors are taking cues from the hospitality industry – rather than the hospital.Complete with high style, high-speed dial-up connections, and quality furnishings, many of the new senior living residences may appear at first glance to be upscale hotels or resorts. Offering amenities such as libraries, computer centers, multiple cafés and restaurants, beauty salons, and transportation to and from shopping centers, doctor appointments, and scenic lookouts, aging never looked more luxurious. “We always had the goal of home-like. Even the nursing facility (the most medically intensive of steps in senior living) has the goal of a hospitality environment,” says Dennis Cope, president, Office of Dennis Cope/Architect, Redmond, WA.Higher expectations and the availability of products suited to these environments have resulted in greater comfort, style, and increased amenities. “[Seniors] are looking for something that looks a little bit more like their home, and on the other hand manufacturers of flooring and draperies, wallcoverings, etc. have made products available that have institutional durability, but have more of a hospitality or home-like look to them,” explains C. Daniel Wardrop, studio director, Morris Architects, Houston.Independent LivingIndependent Living residences for seniors range from single-family, one- or two-story homes to condominiums or apartments. Run by a reputable management company, independent living provides an option to young seniors who may not want to be bothered with the yard work and other responsibilities of owning a home. At properties in Huntsville and Birmingham, AL, owned by Daniel Corp., the Independent Living homes range from 1,800 to 2,500 square feet, and are within a fenced community providing additional safety and security to residents. “You also get full maintenance on the exterior of your home and your yard, and some limited maintenance on the inside of your home,” says Shaw Flippen, development director at Birmingham, AL-based Daniel Corp., of additional advantages.Closely resembling a typical apartment, Independent Living units are usually between one and three bedrooms, and can have as many as two senior-friendly bathrooms and a full kitchen. Units are accessed from an interior corridor, and the facility offers a main entrance (to ensure access control and security) and lobby area reminiscent of hospitality design.Assisted LivingFor seniors in need of additional care, Assisted Living is the best option. These facilities are typically apartment-style buildings in which staff provide residents help with getting dressed, bathing, medical reminders, and other daily activities. “These are non-medical, non-nursing, non-licensed services called ADLs, activities of daily living,” says Cope.The emphasis remains on high-quality finishes and a home-like atmosphere. However, as the services increase, unit size is reduced. Assisted Living apartments are usually one or two bedrooms in size, and contain a senior-friendly bathroom and small kitchenette or microwave. “The room is really only for sleeping. The emphasis is really to get the socialization level of people up,” explains Wardrop.Amenities such as congregate dining, travel planning, bistros doling out snacks and coffee by day and wine in the evening, along with transportation services, offer comfort and enjoyment for residents.Some Assisted Living facilities offer care for individuals suffering from memory loss or dementia. This area of specialized care has received significant attention in the last five years, and requires heightened monitoring of residents. Because individuals can become easily confused, facility design should address ease of circulation throughout the wing or building.Standalone Assisted Living facilities grew in numbers during the late ’90s. “In most states you don’t need to license such a facility, which was a certain appeal for developers,” explains Cope. The seemingly weak economy has resulted in many owners waiting longer for 100-percent occupancy due to overbuilding.Skilled CareWhen an individual’s health deteriorates to the point of needing heightened medical attention, Skilled Care (also called Nursing Care) Facilities are best able to meet these needs. Providing a complete meal service, the Skilled Care environment is equipped to address 24-hour medical concerns. “In Skilled Nursing, all meals are provided, medicines are distributed, and doctors come regularly. It’s a medical environment for maintaining someone who’s of very frail health or in the later stages of dementia,” explains Cope. As compared to Assisted Living apartments, Skilled Care units contain even less square-footage – a strategy used to control expenditures.“Nursing/Skilled Care development has really experienced a slowdown recently because of the high cost of insurance,” says Flippen. Additionally, in some states where it is necessary to obtain a certificate of need, it can be difficult for developers to receive licensure for the beds.CCRCsAddressing the complete continuum of care, Continuing Care Retirement Communities (CCRCs) are springing up everywhere. These campus communities typically offer a mix of the different levels of care. This allows residents to age in place, meaning that as a senior’s health deteriorates they can be moved from an Independent Living single-family home or apartment, to an Assisted Living unit, and then to Skilled Care – all while living on the same campus and maintaining the same friendships. “There are generally provisions for moving around the community that are both easy to do financially and easy to do administratively,” says David W. Minnigan, senior design architect, Earl Swensson Associates Inc., Nashville.The campus plan can tend to take on the feel of a real town. “There may be a pedestrian Main Street, where there might be a place for beauty, shopping, and different restaurants, cafés, craft areas, theatres; it really becomes this wonderful community where the people in these different facilities (whether it’s Assisted, Independent, or Skilled) can get together,” explains Alan Bright, vice president and senior project designer, HOK Inc., San Francisco.“The number of seniors is going to do nothing but increase in the next five to 10 years as the baby boomers age. What we’ve got to do is try to cater to those folks – and they’re a different type of client,” explains Flippen. In 2011, baby boomers (individuals born between 1946 and 1964) will begin to turn 65.As a whole, they are in better physical shape; reliant on computers, e-mail, and the Internet; and, in many cases, more educated than the seniors that past facilities were designed to accommodate. “In the old days, my grandparents were content to be home on a Saturday night. You have a generation now that is part of the computer age and wants a higher level of involvement and entertainment – whether it’s golfing, [a] spa, or movie lounges,” says Brian D. McFarlane, vice president and project director, HKS Inc., Dallas.In each type of environment, quality of life has been ramped up via facilities that are designed to treat seniors as people, rather than patients. The emphasis is on interaction, socialization, and continuum of care.Jana J. Madsen ([email protected]) is senior editor at Buildings magazine.

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