David Green

The content for SAGE PLACE was developed by a multidisciplinary group of SAGE members who donated significant time and expertise toward this ongoing endeavor. SAGE is grateful for the contributions of the late David Green, who was an inspiration for person-centered care. 

The Hulda B. and Maurice L. Rothschild Foundation provided financial support in the development of the SAGE PLACE Resource Manual, Workbooks, and Seminar. SAGE is grateful for the late Robert Mayer, and the Rothschild Foundation, for support and encouragement in the development of SAGE PLACE.

      Robert Mayer

SAGE PLACE: Impetus & Evolution

PLACE is an acronym for Programming for Living & Achieving Culture Change Environments. The idea for devising a pre-architectural programming process originated during a SAGE Federation meeting in 2007. As discussions focused on creating exceptional environments for aging ebbed and flowed, conversations kept circling back to long-term care (LTC) communities striving to advance Person-Centered Care (PCC). The ideal approach involves a whole-systems change, often referred to as “Culture Change,” which affords the highest quality of living, working, and care through the team-based provision of PCC in a “home-like” environment. Many LTC communities struggle to overcome their debilitating institutional buildings that (predictably) create barriers to the full implementation of PCC practices. 

Faith Presbyterian Hospice T. Boone Pickens Center. PRDG Senior Living Architecture and Faulkner Design Group. Photography by PanaViz.

SAGE Federation members agreed that, while advancing PCC in familiar residential-style settings is the right and necessary thing to do, most LTC communities are not prepared to be strong and effective partners in the architectural design, renovation, addition, and/or new construction process. SAGE Federation members acknowledged that effectively partnering with the designers is very important to achieving a project which all stakeholders consider a success. When a strong client partners with a strong design team, a great building can result.

The strongest LTC clients achieve strength by broadly and effectively engaging the full range of internal stakeholders (e.g., Board of Directors, leadership, administration, management, care & facilities staff, residents, family members, etc.). Rather than importing outside solutions that become a new form of institutionalism, these LTC communities take it upon themselves to devise and create comprehensive solutions that respond and anticipate their contextualized needs and desires.

To this end, SAGE Federation and the Rothschild Foundation envisioned a “self-help” approach that would equip LTC providers with the tools necessary to carry out a pre-architectural programming process without the need for external consultants. This, ultimately, enables LTC communities to use their own internal resources, go at their own pace, and create their own unique functional program. To meet this challenge, SAGE capitalized upon the multiple perspectives offered by members representing LTC community leaders that had undertaken environmental design and construction as well as architects, interior designers, regulators, researchers, organizational consultants, and educators to devise and refine a pre-architectural programming process.

Similar to many passion-driven voyages that begin with a strong sense of destination and a more vague notion of how to get there, the road to completing SAGE PLACE has been much longer than expected with many twists and turns. The conclusion of this journey has resulted in the production of three distinct, but complimentary, SAGE PLACE products:

Resource Manual

PCC Team Workbooks

Facilitator Workshop


It is our intention that the SAGE PLACE Resource Manual, PCC Team Workbooks, and Facilitator Workshop may serve as your global positioning system (GPS) to guide you on your journey for Programming for Living and Achieving Culture Change Environments.

Resource Manual:

The SAGE PLACE Resource Manual provides an introduction to SAGE PLACE as well as a foundation for understanding the evolution of Person-Centered Care in the long-term care industry. The second part provides an overview and comparison of programming approaches, including: architectural, foundational, experiential, functional, and organizational. The third section focuses on implementing the SAGE PLACE process through leadership and team engagement, group facilitation strategies, selecting the right design professionals, and successfully engaging regulators. The Resource Manual concludes by providing practical precedents and case study examples.

PCC Team Workbooks:

The SAGE PLACE PCC Team Workbooks provide processes for engaging LTC community leadership, staff, residents, and others in the four stages of SAGE PLACE pre-architectural programming. The Foundational Programming workbook enables LTC community leadership to articulate the aspirations, purpose, and beliefs that will serve as the “directional compass” for all decision making other decision making. Building upon the outcomes of the Foundational Programming process, the Experiential Programming workbook assists interdisciplinary PCC Teams to consider the desired sensations and resulting impressions associated with all aspects of daily operations, activities, and care delivery. Next, the Functional Programming Workbook guides interdisciplinary PCC Teams through the identification of environmental features, spatial relationships, as well as furniture, finishes, and equipment that will enable them to facilitate the desired experiences. And, finally, the Organizational Programming Workbook enables interdisciplinary PCC Teams to think through the policies, procedures, practices, and guidelines that shape interactions.

Facilitator Workshop:

SAGE PLACE Facilitator Workshops are 1-day educational intensives scheduled throughout the year, typically in association with a complimentary national annual conference (i.e., Environments for Aging, LeadingAge, Pioneer Network, etc.). Facilitator Workshops are guided by SAGE PLACE Developers and Educators who familiarize attendees with the SAGE PLACE process through an initial introductory overview followed by an interactive “hands-on” facilitation workshop. In this way, the Facilitator Workshop is designed to assist organizations that have already invested in the SAGE PLACE pre-architectural programming process by further developing the knowledge and capability of their internal facilitators as well as provide a trial run for those that are considering investing in the process. Further, architects and regulators who are working with or would like to encourage LTC communities to use SAGE PLACE are also welcome and encouraged to attend.


The resource manual has been delivered to the publisher, Health Professions Press, and should be available through SAGE by the middle of 2016. The team workbooks are in the final stage of development and will be available as an accompanying tool with the SAGE PLACE Resource Manual.

For more information on SAGE PLACE, please contact Addie Abushousheh.

© 2019 The Society for the Advancement of Gerontological Environments. All rights reserved.

The Society for the Advancement of Gerontological Environments is a 501(c)(3) non-profit organization.

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