Venerable by Design: Best Practices for Senior Housing

The number of aging Americans in need of assisted-living services and housing will explode in the near future, as the country’s 50+ population swells to 132 million by 2030.

In addition to continued demand and growth, this market sector is also experiencing new expectations of service, quality of environment, sustainability, and holistic approaches to aging in place.

The best assisted-living facilities address the complex needs and varying acuity levels of this population through a design approach that respects the need for independence, while providing creative solutions for promoting wellness, engagement, socialization and dignity. Here are a few ways that we do that at The Architectural Team:

A continuum of care on one campus. A common approach to differing levels of care requirements is to build specialized facilities: independent living, assisted living, skilled nursing, memory care, and so on. But some providers are finding it’s better to co-locate residents with varying care types. Bringing distinct care modes onto a single campus, or even under one roof, helps to ease transitions for residents whose needs will fluctuate over time. Relocations and separations of spouses are often linked to generalized anxiety and declines in health and morale. Providing a continuum of care allows couples with differing needs to remain close together. Different care providers adopt different degrees of integration between groups of varying acuity, however. Some take the position that separation of populations according to frailty better promotes wellness and dignity, while others try to minimize moves between living environments and maximize the ‘aging in place’ philosophy to the extent that individuals remain in their original apartments as long as possible.

Living the good life. Residents spend the vast majority of their time on site, so the optimal environments for them should be stimulating, pleasurable, and safe. Newer communities—with designs that borrow key attributes from hospitality models—focus on amenities such as dining alternatives, spa and salon services, community rooms, fitness centers, and visual and physical access to garden areas. To keep residents active and engaged, open and semi-open plans enable visual connections between the various program elements. Combined with looping circulation patterns to avoid dead-ending, such an approach provides sequenced destinations to encourage ambulation, reduce back-tracking and provide a richer interior architecture experience.

Inspired and inviting spaces. Depending on the market and setting, interiors can be designed to be simultaneously suitable for an aging population and supportive of a lifestyle that may exude elegance and luxury or the familiar comfort of a home that reflects the unique character of the local community. In either case, the design team should pay close attention to maintaining personal dignity by discreetly addressing the physical infirmity of the resident. Experienced design experts select furniture with an upscale residential feel, but scaled specifically for seniors and upholstered with contract-grade fabrics specific to this demographic. Because exposure to natural light promotes elevated mood and reduces depression, contemporary assisted-living facilities should also provide increased window areas, particularly in common spaces. But experienced designers know to temper this strategy with project-specific shading solutions and sensitivity to building orientation, as seniors often suffer from thinning irises, exacerbating glare.

Memory care, redux. The best designers will stay abreast of research in this quickly evolving field to develop the best strategies for reducing “elopement” impulses, the industry term for when a resident wanders off-site alone. In some cases, thoughtful design of memory care facilities eliminates such triggers by providing controlled views to the outdoors, sometimes to safe, enclosed outdoor spaces. These allow residents to go out of the building without the danger of wandering off. In other cases, the design eliminates triggers by focusing on framed local views without the distraction of cars, pedestrian motion or distant vistas, which tend to elicit an elopement response. The interior environment requires more lighting control to moderate “sundowning,” the agitation in memory care residents often associated with dusk.

Michael Liu, AIA, is a principal with The Architectural Team, Inc., a Chelsea, Mass., firm that has designed more than 55 senior living communities for thousands of residents and currently has 15 projects in various stages of development providing more than 1,000 units.