May 7, 2001 -- We all have an internalized,
TV-movie-of-the-week image of the typical senior center -- long, bleak
corridors, dim lighting, drab colors, morose residents. Not a very pretty
picture -- but it's one that is rapidly changing as a coalition of architects,
designers, healthcare providers, and senior citizens lead a nationwide effort
to transform these "facilities" into "homes.
A growing body of research tells us that the physical
environment in which a patient receives care can play a vital role in how
quickly she recovers and how well she does later. This message is being heard
loud and clear at senior centers across the country, where bright colors and
progressive architectural design elements are being incorporated to improve
residents' quality of life.
When Nancy Levitt's mother was first diagnosed with dementia 14 years ago at age 78, the doctor told her she could safely drive to familiar places. But Levitt, 61, who volunteers at UCLA's Center on Aging in Los Angeles, was still nervous. Unexplained nicks and dents started appearing on her mother's car. She forgot where she parked. Levitt tried to discuss driving safety with her mother, but she angrily denied there was a problem. Then, she would forget their talks about driving altogether.
"Twenty years ago, conventional nursing homes looked like
hospitals -- based on the medical model," says Uriel Cohen, ArchD,
professor of architecture at the University of Wisconsin, in Madison. "They
kept residents medicated and warm, but they were essentially designed like a
hospital with little special activity except the celebration of holidays. They
were not really a place to live in. They were a place for treatment."
Ten years ago in his book
Holding on to Home: Designing Environments for People with Dementia, Cohen recommended
that caregiving spaces should focus on smaller groups of residents.
Architecturally this is achieved by moving away from long corridors, which
Cohen describes as "social deserts," toward cluster neighborhoods of
10-14 rooms grouped around a social space or a living room, a kitchen, and
access to a small patio or garden.
That way, for instance, instead of residents being awakened at
7 a.m. and herded into a large dining room, they can wake up at different times
of the day and get their own breakfast.
"It allows for more control, more flexibility, and more
participation in the activities of daily living," he explains.
"Almost universally in this country we see nursing homes as
a place where people are strapped to wheelchairs in corridors looking
half-comatose, says Roger Landry, MD, MPH, an expert on aging and a consultant
on the development of senior facilities. He believes the biggest challenge to
incorporating more progressive design elements into senior living environments
is overcoming our own biases.
"Since only 30% of successful aging is due to genetics, and
70% is due to lifestyle, which is under our control, the architectural template
for building assisted-living centers will radically change," says Landry.
"They will have more common areas for social engagement, wellness centers
that have resistance training so that people stay independent longer, a cyber
café to stay engaged, walking paths, and a pool, which is absolutely necessary
for low-impact aerobic exercise."
Designers See the Light
Keeping elderly people mobile is essential to maintaining a
high quality of life -- and mobility and good design go hand in hand, experts