Multi Residential Senior/Assisted Living

Design Considerations for Assisted and Senior Living Facilities

Michael Kerwin

Michael Kerwin

by Michael Kerwin

The continued growth of the aging population is driving the occupancy rates of senior care facilities and the development of new facilities. Owner/operators across the care spectrum, ranging from independent living through skilled nursing facilities, look to boost profits and operational efficiencies through consolidation, increasing market positions, and aligning themselves for the next generation entering their facilities. This article looks at some key drivers within the senior care industry that are having direct impact on the physical and technical design of care facilities.

Facility operator goals have to address their two major population groups: residents and family members/care managers. These two groups are often at odds: seniors with degenerating self-care skills and family members who may not acknowledge the need for or cannot provide the required care. Seniors may elect to enter a care environment near the independent living end of the spectrum, and/or family members may be selecting care environments for parents at the more intensive care end of the spectrum. In either case, the facility operator has to satisfy both business and customer service performance goals.

Business goals require facilities that operate efficiently while addressing multiple levels of care. This approach expands the spectrum of care that can be provided within a specific living environment. Instead of the traditional approach that builds separate facilities or areas for each level of care, the idea of creating spaces that support transitioning through multiple levels of care in the same space more closely resembles the urban phenomena of villages and spontaneous senior care communities. While there are practical limits to the level of care that can be provided without relocation of the resident, improvements in disease management, dementia care, and other medical breakthroughs will continue to extend these phases of people’s lives. Examples of the expanded-care spectrum approach include developing independent living apartments that can support “aging-in-place” without relocation by including accessible bathroom fixtures, safety bars, and discreet locations for medical equipment that can function as storage or meet other nonmedical needs when not required for treatment. Design considerations for safe later phase living such as turn-off timers on appliances, movement monitoring, and similar technologies, can be incorporated to support this approach. The design solution can be as simple as providing power outlets, spaces, and connectivity for the future implementation of these technologies.

Safety and security are vital for the welfare of residents and are key facility selection criteria, helping to competitively position properties in the crowded marketplace. Successful facilities need a coordinated security plan that acknowledges the privacy and independence of residents while providing for their safety and security at all levels of care. The growing threat awareness and demand for security are changing how people perceive their expectation of privacy, but there is still a general dislike of widespread surveillance. The desire and requirement for increased surveillance is expected to grow over time, so provisions should be included to support the future installation of additional surveillance within facilities.

Technology systems need to support the full range of business, medical, educational, and social needs. Owner/operator requirements include enterprise-class secure business networks to support marketing, financial management, operational, and residential/patient records applications. Residential technology requirements include communications, entertainment, security, and care-related systems. The increasing availability of relevant cloud-based or hosted technology solutions meet the need of operators and residents. Enterprise-level technology solutions can help to provide competitive services and customer experiences at reasonable cost; for example a virtualized unified communications system allows for single point personalized answering for telephone calls to any facility within the system. Centralized virtualized operational, financial, and care systems simplify disaster recovery and business continuity plans for the owner/operators at the most economical levels.

Senior residential and care facilities can be financially successful and attractive to residents through the inclusion of simple design considerations that support the business requirements, guest experience requirements, and facilitate the extended care spectrum with fewer guest relocations and space types. Leveraging the evolution of virtualized technology solutions reduces business costs, keeps service offerings current, and allows the operators to focus on the core business of care delivery.

Michael Kerwin, RCDD, CCS, DCCA, is principal at R.G. Vanderweil Engineers, LLP in Boston.

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