DESIGNING FOR HEALTHY AGING
In April, I had the opportunity to attend the Healthy Aging Summit, hosted by Keiro Senior HealthCare at the Ethel Percy Andrus Gerontology Center at USC. The Summit presented the idea of “Healthy Aging”, a principle that I have thought about quite extensively throughout the many years I have worked in the field of nursing home design. If before, this concept was one of the many considered in the healthcare industry, it seems that “Healthy Aging” is gaining momentum. With the help of companies like Keiro Senior HealthCare, who truly are committed to the wellbeing of their residents, the “Healthy Aging” approach is beginning to resonate loudly throughout the senior care community.
What is “Healthy Aging”?
When we think about the process of aging, we often think of a growing frailty in our bodies, the slow advancement of illness, and the increasing need for medical monitoring and care. Our thoughts are primarily focused on the realm of treatment; after a problem has been identified is when we begin action to solve it. The concept of Healthy Aging can be briefly summed up as a function of prevention. After all, studies have shown that 70% of chronic illness is behavior driven. If we shift our way of thinking and implement beneficial lifestyle changes, even our genetic predispositions are able to be modified.
Healthy Aging and Building Design
What does this mean for architecture? How do we design and manage our buildings to encourage and exercise the many necessary elements of prevention? This is no simple task. Aside from adjusting dietary, activity, medical, and other facility-driven factors, we must consider the environment in which our seniors live. A new report from the Centers for Disease Control and Prevention recognizes three major factors that the patients’ environment must offer. First and most obvious is the concern for safety, specifically preventing falls. Falling often leads to a swift deterioration of both health and independence in seniors, which in turn is sometimes followed by depression and mental decline. This is perhaps the easiest factor to deal with by making the floors non-slip, eliminating awkward corners, spatial transitions, etc.
Improving Cognitive Function by stimulating the senses
The second factor of prevention expressed by the CDC is maintaining cognitive function and preventing its decline. To do this, we must provide an environment that stimulates the senses, evokes positive emotions, and helps relieve stress. This is a much more complex concept that may incorporate many different elements of design. Some ways of providing this stimulation are experimenting with natural light, colors and textures, water features, vegetation, and other experiential elements. However because we are designing for a healthcare environment, we must also be acutely aware of the effects these things might have from the perspective of the resident. To a visitor passing through, lights casting shadows on a wall through a screen may look pleasing. To an elderly patient with early onset Alzheimer’s, that same light may be confusing and disturbing. We must always work from this position of consideration for the resident, as it is their home we are designing.
Better Circulation Layout Encourages Physical Activity
The third factor the CDC recommends is the prevention and delay of disease or disability through the creation of an environment that encourages physical activity. Not only is this a huge aspect of health, but also arguably the most difficult to accomplish in an environment such as a nursing home, where most patients either need a lot of assistance, or are bedridden. In this case, I believe the best way to encourage physical activity is twofold: create places where people will want to go, and places where people will want to go through. The path that residents travel is just as important as the place they are going to. If the experience of getting somewhere is pleasant, it increases the chances of residents to actually start moving. This places a huge importance on corridors, walkways, and other paths of travel, not only in the sense of aesthetics, but also in intelligent planning of the building itself and the interrelationship of spaces to each other. A design method that strongly supports this concept is the incorporation of the outdoors with the indoors. For example, courtyards that are visible through glassed corridors provide that interconnection of space and visually urge residents to walk through them. Of course the destination spaces are also important, and the more dynamic the design of the space, the more interaction a resident can have with the room and the people in it. This naturally leads to both more physical activity and mental stimulation.
Ultimately, it is our responsibility as a society not only to take care of our elderly in sickness, but also to work hard to prevent that sickness from ever occurring. It is these and other ideas of “Healthy Aging” organizations such as Keiro Senior HealthCare are beginning to explore and implement. Keiro specifically takes this approach to heart. Founded in 1961, Keiro is the largest non-profit organization serving the Japanese-American community. With several facilities located throughout Los Angeles and its surrounding areas, Keiro implements what is known as “Genki”, or healthy and energetic, Living. Through their own Institute for Healthy Aging, Keiro has established this model of care throughout their facilities, and serves as a great example of what “Healthy Aging” means.