A Holistic Design Approach
How integrating interior and exterior environments can improve
quality of life for seniors.
by Greg Hunteman, AIA, and Patrick Smith, ASAL, LEED AP, of Pi Architects
Holistic Living
Healthy interaction among residents, family and staff members; active community participation; and improved occupancy. These are just a few of the results of a holistic approach to design. An experienced design team communicates the benefits to a community’s operator, as well as staff members during the design process. So what are the elements of holistic design? One is creating opportunities for residents to socialize with one another and to become more physically active, while also providing space for privacy and contemplation. For example: Designing rooms and sitting areas near the outdoors can create more flexibility for residents to come and go as they please, which can be stimulating to all the senses (e.g., residents can hear birds chirping, they can watch their friends play shuffleboard, they can smell the fresh fall air, sip on a tasty beverage, etc.).
All of these opportunities can improve overall health and wellbeing; it can also encourage family and loved ones to visit more often. In fact, family members are twice as likely to visit a senior living community if it has well-designed outdoor activity areas, such as a children’s playground, walking path, putting green or bocce ball court.
Is a Holistic Approach Worth the Price?
When you are exploring the cost of better integration of the outside with the inside, you need to consider the long-term benefits and improved marketability. A new community that wraps itself around the exterior spaces can take advantage of existing site features, such as trees and foliage, to expand a community’s living areas to the outside.
Existing communities can incorporate cost-effective improvements by adding enclosed porches, raised planters, secured courtyards, conditioned sunrooms or changing window treatments to increase the daylight exposure for residents. By doing this, you will:
• better regulate residents’ sleep cycle by allowing them to see when the sun rises and sets
• regulate residents’ melatonin and serotonin levels, which reduces depression
• provide residents with Vitamin D, which is necessary to process calcium for stronger bones
All of these benefits come from just 30 to 60 minutes of sunlight exposure per day. Improved resident comfort can translate into a community that has maximized its full potential; thus, the simple renovations can be invaluable to a senior living community.
Accommodating, Not Controlling Behavior
Imagine being confined to one building for the remainder of your life, unable to go outside when you choose. This is the case for many people who live in long-term care environments. Sadly, this confinement contributes to high levels of depression and anxiety. By creating safe and accessible outdoor spaces that residents can use as they please, operators and staff members can drastically improve the health and mental awareness of seniors. Providers should go beyond “accommodating” and start thinking more along the lines of “providing.” This is the concept behind the Centers for Medicare & Medicaid Services (CMS) Federal Licensure Tag (F Tag) 242 that calls for “self-determination and participation.” It is said that safety is a perception, and this is true whether you are a caregiver or a resident. If it doesn’t appear to be safe outside, residents will stay inside and caregivers won’t allow residents to go outside. But by keeping outdoor areas safe, clean and visible from public areas, a provider can greatly increase the perception of safety, which is much more accommodating for residents because they will feel less controlled.
The Key Message
A successfully designed building can encourage the use of exterior spaces while also allowing their benefits to flow into the building. Through the judicious use of windows, accessible walkways, conditioned porches, exterior activity areas and family amenities, communities can enjoy the advantages of improved resident, family and staff satisfaction. These benefits can lead to improved occupancies and community values.
*For more information about Pi Architects, please visit www.piarch.com.