Previous Events

"SAGE DAY” WISCONSIN EVENT HISTORY

SAGE DAY events listed below are planned one day events that highlight recently completed projects in an effort to share and learn how others can transform environments throughout the region. A multi-disciplined team of professionals is assembled for each SAGE DAY. The team performs a post occupancy evaluation (POE) related to the SAGE principles for design. These events are tremendous, collaborative resources for providers and designers to learn from to begin their journey for change in the industry.

2011 SAGE DAY was held on May 18th, 2011 at Samaritan Health Center, West Bend, WI and was well attend.

2009 SAGE DAY at Milwaukee Jewish Home, Milwaukee, WI

2005 SAGE DAY at St. Marys Care Center, Madison, WI

On October 13, 2005 SAGE Wisconsin sponsored a SAGE Day that featured St. Marys Care Center in Madison, Wisconsin. A seven person multidisciplinary team assembled in September to conduct a Post Occupancy Evaluation (POE) of the facility. The daylong activities, hosted by Administrator Bill Bender, included a tour of the building as well as a brief review of the project history, project objectives, staffing, design features and project costs. Following a tour of the facility in which the team became acquainted with the physical environment, they had the opportunity to sit down and speak with staff and residents.

Approximately sixty people attended the POE Day presentation and were afforded a tour of the building, as well as a multidisciplinary review by the team and St. Marys staff. The POE team discussed their observations in relation to the SAGE Design Principles based on OBRA (1987). One example of this was the issue of personal autonomy. Residents have the freedom and are encouraged to personalize their rooms. Some other talking points that came up were:

St. Marys efforts to allow staff to have a voice in which household they would like to work, and to maintain continuity of staffing in order to reinforce relationships between residents and staff.

Residents have access to safe and secure communal outdoor and indoor spaces.

St. Marys was designed to create a supportive environment that is resident centered. It minimized resident disruption through the development of smaller households, decentralized dining on the households, the omission of overhead paging, and the use of carpeting that help to reduce noise.

The presentation allowed registrants to hear candid discussions by the team, St. Marys staff, as well as comments of the attendees themselves. In addition, David Soens of the Department of Health and Family Services shared information relative to general code issues in nursing homes on topics such as wireless call systems and soiled utility rooms, and Brian Schoeneck gave an overview of the state nursing homes and some financial incentives for remodeling projects.

2003 - SAGE DAY at Upland Hills Nursing and Rehabilitation Center, Dodgeville, WI.

Two major areas frequently reported by the elderly are boredom and loneliness. With this in mind, Upland Hills was designed to enhance opportunities for people to enjoy more sensory stimulation, and opened its doors in August 2002.

The project includes a new 44 bed long-term care and rehab center with four large homes or households. Each household features a living area; a dining area; a parlor with porch; nine bathrooms; seven private bedroom suites; and two double bedroom suites. Two households share a sunroom adjacent to an outdoor neighborhood courtyard. These courtyards have bird and squirrel feeders, flowers, and fountains that can be easily accessed and enjoyed. The four households connect to a "neighborhood center" for group activities. A skywalk, which is known as "Main Street", bridges the new hospital addition and the neighborhood center.

2002 – SAGE DAY at Brewster Village, Appleton, WI

Brewster Village, which began operations on October 1, 2001 is a 204 bed free-standing, skilled nursing facility owned and operated by Outagamie County.

Planning for the project started in 1995 when Outagamie County began to consider alternatives because of needed, costly renovations to the old Health Center. The heating plant was outdated, roofs needed to be replaced, and the plumbing and electrical in the 1940’s section of the building were inadequate. Other options that were explored included privatization and expansion of services.

Once the decision was made to build a replacement facility, Outagamie County hired an owner’s consultant whose primary responsibilities were to assist with identifying program requirements and review design concepts. We were fortunate to have Gerald Weisman as our consultant. As the project developed, a research opportunity evolved. UW-Milwaukee’s School of Architecture and Urban Planning was interested in examining how environments affect behavior and psychological functioning. They wanted to compare how resident behavior, staff satisfaction, and family perceptions were affected by different environments. Andrew Alden, then a graduate student at UW-Milwaukee, is currently preparing Phase 3 of that study.

2001 SAGE DAY at Attic Angel Place, Madison, WI

On September 20, 2001 SAGE WI sponsored a SAGE Day that featured Attic Angel Place located in Madison, WI. An eight member multidisciplinary team assembled in August to conduct a post occupancy evaluation (POE) of the facility. Mary Ann Drescher, President of Attic Angel Place, lead the daylong activities with a thorough and candid review of the recently completed complex. Attic Angel Place history, project objectives, state regulator involvement, staffing, design features and project costs were presented to the POE team for evaluation. A tour of the facility ensued where the team was introduced to the physical environment as well as interaction with residents and staff. The POE team then convened to discuss their observations and plan their presentation.

The goal of the project was to design a new community that would provide a continuum of care, offering independent living apartments, household style assisted living suites, and a skilled nursing facility. In its previous home, "The Towers" (located at North Segoe Road) Attic Angel was landlocked and unable to provide the mid-level of assisted care within its current structure.

Located on 15 acres, Attic Angel Place achieved its vision, now housing three levels of care within the 188,000 square foot building. The RCAC includes 74 apartments for independent living and 36 assisted living suites designed in a household model. The skilled nursing facility holds 44 beds for short-term recuperative care and long-term needs. Independent apartments are spread across four floors along two wings of the building. On the opposite wing, the skilled nursing facility resides on the first floor with two floors of assisted living households above.

Approximately thirty people attended the POE day presentation and were afforded a multidisciplinary review by the team as well as a tour of the complex. True to all SAGE educational functions; the presentations, tour, and dialogue were candid and informative.

1999 SAGE DAY at St. Francis Home, Fond du Lac, WI

On March 31, 1998, St. Francis Home opened the doors to its new facility located adjacent to the previous home. Using the "household" design concept in nursing home care, the new home generates a more home-like feeling for its residents. Eight single rooms are clustered around a central living room area in each household, an arrangement that encourages residents to come out and visit with other residents, friends, and family. Nursing staff gain from the concept as well. Stationed within the household, they become more familiar with the singular needs of their residents and, at the same time, enjoy the ease of working in a smaller area. The new St. Francis Home has 106 licensed beds. A 13 unit RCAC in the newly remodeled "old" nursing home and a 30 apartment independent living facility complete the continuum of care.

1998 SAGE DAY at Evergreen Retirement Community, Oshkosh, WI

Bringing Evergreen's Household/Neighborhood, Creekview, to the reality of construction and operation in June of 1997 took ten years of visioning, planning, revising, and hard work by many people working together.

The dream of Creekview began in 1987 following a formal evaluation of Evergreen's Health Center which identified a number of physical limitations in the current structure. These limitations were a barrier to providing residents with the best possible living arrangements and maintaining Evergreen's high standards of care - a hallmark of the organization since its inception.

With persistence, Evergreen developed an architectural design that satisfies all the criteria important to residents, family members, and primary care givers.

In November 1995, a change in the rules of the Wisconsin Stats Resource Allocation Program (RAP) became effective that allowed up to three innovative nursing home demonstration projects. Until the rule change was complete, Evergreen could not submit an application to build Creekview since the cost per bed would exceed the limits under the current rule.

The hope is that Evergreen's decade of making the dream come true will change and improve nursing home design throughout the United States and improve the quality of life for elderly people requiring 24 hour nursing care everywhere.

1997 SAGE DAY at Marquardt Manor, Watertown, WI

Marquardt Manor is a 140 bed skilled nursing facility. In 1997, it completed a $3.7 million renovation and facility addition. The project provided Marquardt with 100% private resident rooms, replacing its former 51 semi-private and 38 private rooms.

SAGE WISCONSIN EDUCATIONAL SESSIONS

2002 -"Creating a Vision of Long-term Care Environments Through Collaboration”.

On March 19, 2002, SAGE WI partnered with the Wisconsin Alzheimer 's Institute and the Wisconsin Association of Homes and Services for the Aging to present, "Creating a Vision of Long-term Care Environments Through Collaboration. The day began with a compelling and futuristic view of what’s in store for us through the eyes of Leland R. Kaiser, Ph.D.

Keynote Speaker - Leland R. Kaiser, PhD. - Leland R. Kaiser is founder and president of Kaiser Consulting, a healthcare consulting firm located in Brighton, Colorado. He is co-founder of the Kaiser Institute, and advanced fellowship program for health professionals. Dr. Kaiser is a writer, lecturer, and health policy analyst at the forefront of the "healthier communities movement" in the United States. He holds appointments as Associate Professor in the Executive Program in Health Administration, Graduate School of Business Administration, University of Colorado at Denver, and as a faculty member in the doctoral program at Greenwich University.

As a health futurist, Dr. Kaiser has been responsible for sparking the imagination of audiences worldwide to change obsolete mindsets and welcome new opportunities to design a healthier society. He is also a pioneer in the development of electronic teaching technologies in universities without walls. Dr. Kaiser holds post-graduate degrees from the University of Denver, University of Colorado, and University of Pittsburgh. His areas of professional training include clinical psychology, social psychology, higher education, healthcare administration and public health. He is the author of more than 200 monographs, journal articles and videotapes and the training manual, "Mapping Your Future; A Lifework Planning Guide for Health Care Professionals."

This thought-provoking presentation and discussion was followed by in-depth presentations and displays by 12 architects and senior care providers that featured the latest trends in long-term care and senior living environments throughout the state of Wisconsin.

The day concluded with an in-depth review by the provider, architect and regulator for Village Shalom, Kansas. Village Shalom is a continuing care retirement community serving 160 residents in Overland Park, Kansas. The risk for sponsoring this program was well worth the reward, as over sixty attendees shared a daylong educational experience that all agreed will help change the future of long-term care environments.

On September 10, 2002 SAGE WI sponsored a SAGE Day that featured Brewster Village located in Appleton, WI. An eight member multidisciplinary team assembled in August to conduct a post occupancy evaluation (POE) of the facility. David Rothmann, Administrator, lead the daylong activities with a thorough and candid review of the recently completed complex. Past history, project objectives, state regulator involvement, staffing, design features and project costs were presented to the POE team for evaluation. A tour of the facility ensued where the team was introduced to the physical environment as well as interaction with residents and staff. The POE team then convened to discuss their observations and plan their presentation.

Approximately sixty people attended the POE day presentation and were afforded a multidisciplinary review by the team as well as a tour of the complex. Of special interest to many was the research initiative that began during the programming phase of this project. Gerald Weisman, from the Institute on Aging and Environment, provided the attendees with a unique perspective that documented the former replacement facility's environmental and behavioral characteristics. On-going research was presented that demonstrated the positive effects that the new environment has had for the various project stakeholders. True to all SAGE educational functions, the presentations, tour, and dialogue were both candid and informative.

This year's activities represent SAGE WI’s 5^th featured facility POE and our 5^th educational symposium. The SAGE WI Steering Committee will be planning future educational efforts with our next meeting scheduled in early October. So look forward to more from the SAGE WI "Cheeseheads”.

2000 - "Designing Long Term Care Environments for the New Millennium" was co-sponsored by SAGE Wisconsin and the Wisconsin Alzheimer's Institute (WAI). The symposium, funded in part by a grant from the Helen C. Bader Foundation, was held March 9, 2000 at the Pyle Center on the campus of the University of Wisconsin - Madison.

The program was designed to provide participants with the latest information about state-of-the-art living environments for older adults, especially those with Alzheimer's and other dementia. The program was structured to allow and encourage extensive interactions and exchanges among the multi-discipline professionals presenting and attending.

The mission of the Wisconsin Alzheimer's Institute is dedicated to improving the availability of services and the quality of care provided to persons affected by Alzheimer's disease and related dementias. In collaboration with community organizations, the WAI aims to improve the quality of life for persons affected by dementia through research, education, training, program development and public advocacy.

Keynote Speaker - Margaret P. Calkins, PhD - Dr. Calkins is President of IDEAS, Inc.; (Innovative Designs in Environments for an Aging Society), an education, research and consultation firm dedicated to exploring the therapeutic potential of the environment - social, organizational, and physical - particularly as it relates to frail and impaired older adults. She is also Senior Fellow Emeritus of the Institute on Aging and Environment at the University of Wisconsin - Milwaukee. As a member of several national organizations and panels which focus on issues of care for cognitively impaired older Americans, she speaks frequently at conferences both here in the United States and abroad. She has published extensively, and her book Design for Dementia: Planning Environments for the Elderly and the Confused was the first comprehensive design guide for special care units. Dr. Calkins is currently Principle Investigator on three grants from the National Institutes of Health. One will develop an alternative to traditional consultation services, in which facility-specific consultation on the creation of supportive environment for people with dementia will be provided without requiring a site visit, which will allow consultation to be more modestly priced. She recently completed her doctorate, which explored ways to describe and classify those characteristics of SCUs that relate to the impaired ability of people with dementia to receive, manage, and interpret stimulation and information from their environment.

1998 - "Quality of Life: Universal Design Concepts for he Frail Older Adult" featured internationally acclaimed architect, Victor Regnier as keynote speaker, and was held on May 21, 1998 at the Holiday Inn and Convention Center in Stevens Point. This symposium was sponsored by SAGE Wisconsin .

Keynote Speaker - Victor Regnier, FAIA - Victor Regnier holds a joint professorship between the USC School of Architecture and the Leonard Davis School of Gerontology, the only joint appointment of this nature in the US. From 1992 until January 1996, he served as the Dean of the School of Architecture.

As a scholar, he has published several books and articles dealing with various aspects of housing for the elderly including a recent award winning monograph entitled Assisted Living Housing for the Elderly: Design Innovations from the United States and Europe (VanNostrand, 1994).

As a researcher, he has directed 21 projects dealing with the social and behavioral impact of the environment on older people, children, and the homeless. His design research findings have been presented at over 100 professional and scientific conferences as well as more than 30 university symposia. Professor Regnier has also received teaching awards including a recent selection as one of nine USC Mortar Board Professors of the Year in 1994/95.

As a designer, he has provided consultation advice on over 250 building projects in 28 states. The only person who holds fellowship status in both the Gerontological Society of America and the American Institute of Architects, he has also received recognition for his scholarship in the form of awards from the American Society of Landscape Architects, the American Planning Association, the Swedish-American Foundation, Progressive Architecture, and the Fulbright Association.

Prior to joining the USC faculty, Professor Regnier held a joint appointment between the School of Architecture and the Program of Housing Research and Development at the University of Illinois, Champaign-Urbana.

The Learning Objectives for the symposium were:

Identify universal design concepts that promote quality of life for frail older adults.

Review creative housing and re-design options for older adults.

Examine international examples of design for the frail and elderly.

Discuss ways in which design impacts quality of life for the frail elderly.

Understand perspectives of different disciplines on design and quality of life issues.

Explore ways in which design-based collaboration among various disciplines can improve quality of life for older adults.

Understand the goals of universal design concepts in individual facilities.

Identify obstacles to the application of responsive design concepts.

Explore ways to overcome obstacles through the use of universal design concepts.

1996 "Developing Design Principles for Nursing Home Regulation" , a state wide workshop for Wisconsin nursing home providers, developers, architects, interior designers, regulators, and consumers, was held on June 20, 1996 at the Ramada Inn, Capital Conference Center in Madison. The workshop objective was to validate and apply principles for designing nursing home environments. The symposium was sponsored by SAGE Wisconsin ; The Wisconsin Department of Health and Social Services (DHSS); and the University of Wisconsin - Milwaukee (UW-M), Institute on Aging and Environment. Co-sponsors included the Wisconsin Board on Aging and Long Term Care; the Wisconsin Health Care Association; the Wisconsin County Homes Association; and the Wisconsin Association of Homes and Services for the Aging.

Keynote Speakers - Brian Hofland, PhD, Senior Vice President, Retirement Research Foundation (Chicago, Illinois) - Brian is responsible for planning, developing, and managing an $8 million annual grant program supporting research, policy, demonstration models, and service projects in the field of aging with an emphasis on long term care.

Gerald Weisman, PhD, Professor of Architecture, Institute on Aging and Environment, School of Architecture and Urban Development, University of Wisconsin, Milwaukee - Gerald has done extensive research into the impact of environments on the elderly and publishes and presents frequently on his findings. He has much practical experience, counseling on development projects and with organizations interested in enhancing existing settings. He has been a consultant for over 70 projects in the US and Canada, including a replacement campus for the Philadelphia Geriatric Center and the Helen Bader Center at the Milwaukee Jewish Home. Dr. Weisman is Chair of the PhD program in architecture (Environment-Behavior Studies) and serves on numerous committees on campus, as well as the Steering Committee of the AIA/ACSA Aging Design Research Program. He is a juror for the AIA Academy of Architecture and Health Design for Aging Facility Review and is a member of the Environmental Design Research Association Board of Directors.

1995 "Developing a Partnership for Change in Nursing Home Design". This symposium was held on November 15 at the Holidome Convention and Expo Center, Stevens Point, and was sponsored by SAGE Wisconsin.

Keynote Speaker - Lorraine G. Hiatt, PhD- Dr. Hiatt is a well known gerontologist, environmental psychologist, consultant, and researcher and one of the country's best known expert in dimension design. She is noted for her work in physical plant design and collaborated on a large number of nursing home dementia units and adult daycare programs.

Dr. Hiatt teaches at Harvard University's Graduate School of Design and is author of "Nursing Home Renovation: Designed for Reform." She earned her doctorate in environmental psychology from City University of New York. A consultant for more than 100 retirement communities, Dr. Hiatt has worked with residences, nursing homes, elder day centers, and hospitals. She has implemented environmental features for increased independence, restraint reduction, and staff efficiency, drawing on her research in technology and sensory function. Her current studies focus on innovative design and the regulatory process, building configuration and operational costs, and design for people with dementia living in home or institutional settings.

The Learning Objectives for the symposium were:

Create a vision for better built environments for older adults.

Outline current research that supports the vision.

Discuss innovations and best practices from around Wisconsin and the US.

Identify and describe ways to remove barriers to the vision.

Outline the status of Wisconsin nursing homes in moving toward a more resident-focused environment.

Discuss problems encountered with codes and agency support in working towards a more resident-focused environment.

Discuss what changes Wisconsin nursing home providers want to see in nursing home designs.

Discuss Wisconsin-specific best preferred practices, obstacles, and innovative approaches.

Develop your "vision" based upon multi-disciplinary viewpoints.

Foster collaboration among agencies, providers, and developers in Wisconsin.

Summaries:

Almost half of the respondents were not involved in renovation or new construction of a major nursing home project in the last five years. A quarter of the respondents were associated with both, renovation and new construction. Also, a fifth was involved with renovation and 5% with new construction.

Approximately a third did not anticipate renovation or new construction in the next five years. However, a majority expressed future involvement with renovation (23%), new construction (15%) or both (16%).

Of the half that encountered problems with regulatory codes in the past, a total of 24%were affected by Chapter 150, HSS132 and Medicare/Medicaid regulations. The same set of codes were expressed in 27% of the responses anticipating problems in the future.

A majority of the responses indicated support from various local, state, and federal agencies, mostly from the Bureau of Quality Compliance (16%). Other sources of support included local and county agencies (8%), DHSS (8%), and the Alzheimer's Association, Division of Health and State survey teams and WAHSA; 6% each. There was no response, however, from a quarter of the respondents.

Agencies that resisted respondents' attempts to create a better nursing home environment ranged similarly from local to federal agencies; the Bureau of Quality Compliance and the State featuring in 12% and 13% of the responses, respectively. While 20% did not respond to this question, the remaining were divided; local and county agencies (8%), DHSS (5%), OBRA (5%) reimbursement issues (5%), and other issues.

Resident outcomes such as satisfaction and participation were expressed by 35% of the respondents as results of innovations made while moving toward a more resident-focused model. Capital costs were found to increase whereas an equal number of responses expressed either increased or decreased operating costs. Family and staff participation and satisfaction accounted for 18% of the responses.

A fifth of the respondents would like to see nursing home design that affords more privacy to the residents, while 17% would prefer extra space. An almost equal number of responses expressed program issues/facilities (13%) and the desire for innovations in communications/technology and equipment (11%). Ten percent of the responses recommended building a sense of community while also making the environment more home-like (7%) and non-threatening.