by Ann Melite
I’ve heard many architects, designers, and providers equate the design of senior living communities with hospitality design. Although we strive is to appeal to residents, families, and staff from a marketing as well as visual perspective, successful outcomes in the design for an aging population is a specialized skill acquired from continual education. Here are some eye-opening statistics:
- According to the Agency on Aging, the number of persons 65 years or older was 41.4 million in 2011. (the most recent year for which data are available). They represented 13.3% of the U.S. population, over one in every eight Americans. The number of Americans aged 45-64 – who will reach 65 over the next two decades – increased by 33% during this period.
- Between 1980 and 2010, the centenarian population experienced a larger percentage increase than did the total population. There were 53,364 persons aged 100 or more in 2010 (0.13% of the total 65+ population). This is a 66% increase from the 1980 figure of 32,194.
- There are more than 5.4 million people in the United States currently affected by Alzheimers/Dementia (AD). That number is expected to increase fourfold by the year 2050.
- 10-20% of people age 65 and older have Mild Cognitive Impairment (MCI). It’s estimated that as many as 15% of those individuals progress from MCI to dementia each year.
Considering that the average resident age in assisted living communities is now 86.9 years, and 50% of residents in skilled nursing homes are 75 years and older, then statistically a great proportion of seniors in both assisted and skilled communities are affected by either MCI or A/D. Additionally, increased physical frailty increases dramatically in persons in their 80’s and older.
Most of the new projects on which I have been asked to consult involve renovations of, additions to, or new construction of Alzheimer/Dementia communities. Clearly, providers are both responding to and anticipating the growing demand for housing for this population. The frustration for all is the lack of knowledge and training required to address aging residents’ physical, psycho-social, environmental, and cognitive needs.
When asked for my observations of a newly constructed assisted living/memory care community, I commented on how a particular carpet pattern that was specified in all the assisted living common areas may be unsafe for residents due to its’ bold serpentine pattern and strong visual color contrast. The response given was that fact only pertained to residents with cognitive impairment or A/D. The reality is that while age related vision changes are exacerbated by brain changes in residents with Alzheimers/Dementia, depth perception and other age related eye issues can start as early as our 40’s and 50’s. The contrast between light and dark colors in flooring patterns may cause “visual cliffing” making the dark colors recede, and the lighter colors become prominent. The net result can be an appearance of differing heights in flooring, causing missteps and falls.
Contrast is, however, critical when defining vertical and horizontal planes. For example, there needs to be a definitive contrast between the flooring and the wall/base, chair seats and flooring, etc. Long corridors with “matching” carpet, base, and wall paint all the same color makes it difficult for residents to define the true floor height. Acoustics in these communities are also often overlooked. Dealing with loud and disruptive noise levels can be physically and emotionally challenging to the hearing impaired, and may result in what is perceived as behavioral issues in the cognitively impaired. Vaulted or high ceilings may look beautiful, but can create loud, overstimulating spaces when not properly designed for the associated sounds of music, kitchen noises, loud conversations, call systems, etc.
Designing communities for an aging population that provide an environment of safety, empowerment, and dignity is paramount. The built environment has tremendous impact on the population in general, but becomes even more critical when those who reside within are experiencing physical, cognitive, and psycho-social challenges. Yes, we want communities to be attractive, but conveying a sense of home, while enhancing resident safety and security is imperative to a successful project and community. In the rush to capitalize on the burgeoning senior population and what we feel will be required from just an amenity perspective, we need to be responsible in our roles as designers of senior living environments through on-going education and evidence-based design.
Ann Melite, MA,NCIDQ, CDP is Principal of Melite Design, LLC based in Canton, Conn.