Due to rapid advances in medical science, we are all living longer and the need to accommodate an aging population will inevitably result in a requirement for more care homes to be built over the coming decades.
With an increasing body of research supporting what optimal assisted senior living should look like, what are the elements that need to be considered for a project starting from scratch with a blank slate?
Like many things in life, there is no singular one-size-fits-all silver bullet, but rather a variety of contributions and insights key stakeholders, ranging from urban planners to architects and developers, can bring to the table to ensure seniors moving into residential care can make the most of their twilight years.
“Location, Location, Location” is a well understood precept in property circles and it remains just as valid when selecting the perfect care facility as it is for newlyweds buying their first home.
Unfortunately for prospective residents, the default option for developers looking to construct new facilities is often to opt for out-of-town greenfield sites as this allows for the creation of familiar and predictable modular designs.
The downside is that this can cause more of a jolt for the resident facing the already difficult decision to move out of their existing home and leave them feeling cut off from friends, family and local amenities.
One potential solution for developers is a more precise targeting of adaptive reuse projects in urban centers where by existing structures are repurposed to create new care facilities.
Not only is this a more environmentally friendly approach but it can reduce the development costs that need to be recovered and maintain a connection to the community.
WJW Architects, a Chicago-based firm specializing in research-based design for disabled populations has taken this concept one step further in its recent project to renovate the dilapidated former Ravenswood Hospital structure located in the Chicago neighborhood of the same name.
The facility, which opened last year, not only offers state of the art amenities for senior living but the project also took advantage of a newly passed Illinois law to significantly ease the sometimes-painful transition for residents moving into elderly care.
Under the new legislation, assisted senior living can be shared with other types of housing providing certain parameters, such as separate entranceways, are met.
One of the first projects of its kind nationwide, there are provisions for independent living on the upper floors with supported living occupying the lower floors.
Should a resident reach a point where they require more hands-on care, they can easily transition to the other part of the building with a minimum of upheaval while maintaining the considerable benefit of familiar surroundings and locale.
Heidi Wang, a partner at WJW says, “Nowadays, those moving into elderly care for the first time still want to be engaged in their regular community life. They don’t want to be in some former strip mall on the edge of town or out in the corn fields because that’s the only available new construction land.”
She continues, “I think more consumers are going to be demanding these kinds of places. We’re increasingly seeing it in the market where seniors want to be in more walkable liveable communities.”
Naturally, not all large urban sites will be viable for adaptive reuse and Wang says that the firm have to use their expertise to separate the wheat from the chaff – often turning away more proposals from civic authorities than they accept.
Nevertheless, she strongly feels that property developers for the elderly care sector need to start being more innovative and open-minded.
“We attend the Environments for Aging Conference every year and that is full of like-minded professionals like ourselves who are trying to advance the cause.
“Ultimately, however, we’re not the financiers of these projects. We can have all the best ideas in the world but if the developer doesn’t see the value in it, or doesn’t understand the payback, then it falls on deaf ears. It’s our job to show them what the positive impact can be,” Wang says.
It’s what’s on the inside that counts
Of course, picking the ideal location and transition arrangements is only half the battle and WJW has also undertaken extensive research on the interior design elements that promote the most accessible living experience possible.
As Todd Wiltse, another partner at WJW, explains, “There are have been layers and layers of legislation affecting senior living which have been developed since the 1960s but it’s a case of recognizing that those are just a starting point,” says Wiltse.
“Of course, we have to comply but they don’t begin to touch on the complex spectrum of issues seniors in assisted living might experience in managing and manipulating their environment.”
Here, the devil truly is in the detail and might incorporate more obvious provisions like how to fairly disperse elevators so that some residents aren’t forced to walk long distances to the sensible location of grab bars and lean rails.
Other elements, particularly related to residents experiencing cognitive difficulties, are far less tangible.
For example, Wang recounts observing on one project that some residents found the shadows cast in the dining area by the tree branches outside to be disturbing.
She also refers to the fact that even something as seemingly innocuous as selecting the wrong piece of artwork, like a pattern that might be seen to resemble slithering snakes or the wrong texture on a piece of furniture, can have unforeseen consequences.
Wang emphasizes the importance of diligent research and observation:
“The only way we can understand what’s working is to go back and observe for ourselves how people are using the space we’ve designed and sit down and talk with the residents and staff. With Covid, we’ve been restricted in our access to occupied buildings but I’m hoping that we can get back as soon as possible,” she says.
With advancements continuing to appear in relation to connected care, health monitoring using wearable devices and voice activation through the proliferation of low-cost consumer units like Amazon Alexa, the workload is unlikely to let up any time soon.
The way society cares for those who have given the most over the course of a long life will keep evolving and changing. More predictably is that the best starting point will always be that when the time comes to make the move – they end up in the most accessible, affirming and welcoming environment that they can.