By John Stone
At Serenity Gardens, winter
has surrounded us. My mother’s room
is way too warm for me,
just right for her—with an extra sweater.
Outside, this uneasy year, her 93rd,
lurches through December.
She is surely serene in this place,
thanks to whatever goodness;
queen of the electronic piano.
Among my chief duties now
I have become her human calendar,
a stay against time, her reach for the past.
Each visit, we review the years.
We sit and we talk, fragile mother,
This afternoon, I assemble for her
some semblance of my long-dead
father, the only husband she had.
I tell her his story.
We study his photograph.
Do you remember him, I ask?
She looks again.
No, she answers, softly. No.
But isn’t he good looking!
She smiles. I chuckle.
In the gathering dark,
we cry a bit together:
I for what she has forgotten,
she for what I remember.
John Stone was an essayist, cardiologist, and lecturer who served as professor of medicine, associate dean, and director of admissions at the Emory University School of Medicine. His verse, enhanced by his privileged perspective as a physician, gives the reader an intimate glimpse into the complex dynamics affecting the aging and their family members.
There are a few senior housing trends that are particularly hot in the assisted living and nursing home housing industry, resulting in a few design implications. One size definitely does not fit all. For the next 18 years, 10,000 baby boomers a day turn 65- this is a number that’s been thrown around lately although many sources are citing 8,000 (does this discrepancy matter in the grand scheme of things?). The U.S. Bureau of statistics say that Health Care Aides will be the fastest growing occupation between 2010 and 2020. It’s no wonder that Baby Boomers are set to change the face of nursing homes, assisted living and elder communities. There are dozens of articles talking about the new trends taking place and on the horizon. Part of this trend is because of the rising number younger residents. Did you know that nationally, the 65 and under population in nursing homes jumped by more than 27 million from 1999 to 2008? The term “nursing home patient” has changed dramatically in recent years. We will see unprecedented numbers of assisted living and nursing home patients between the sheer numbers of Boomers coupled with the growing number of younger patients.
Senior living centers and nursing homes will be expanding their internet access hot spots, making it easier all the time for people to find more ways to connect to loved ones and friends. Not only are residents demanding more connectivity, many places have and will provide training on how to use Skype, gmail and social media outlets like Facebook. Even dementia patients who sometimes have difficulty with the phone may benefit from videoconferencing with loved ones with the help of health care providers. Technology will be in the forefront of the mind when building a facility from the ground, up. It will allows owners to plan for future technologies and create a supportive infrastructure.
Naturally there will be in an increase in the use of personal electronic devices by residents and their visitor’s like ipads, Kindles and other tablets. The stationary computer will become a thing of the past. One thing to keep in mind is the presence of too much auditory clutter. The pervasive noise, talking, beeping, music, games, the watching of videos can can range from an annoyance to causing tremendous stress on some residents. The designing of facilities do not stop when the architectural, acoustical, engineering and landscape components are complete. As spaces live and breath organizational practices and culture begin to take over. Its important with the push to get social and wifi’d that sound control be taken into consideration, especially with diverse age groups. Establishing protocols for use of personal electronic devices can help define the appropriate baseline noise level of the residence and/or common spaces. When noise crosses pathways and enters someone else’s personal space, so does the responsibility of controlling it.
Nursing homes and assisted living centers, at worst, conjure images of drab finishes, sterile rooms and ugly institutional lighting. You already know this is an issue and many facilities are being renovated, many tout an elegant lifestyle, still more are downright posh. Many patients and their adult children are demanding interiors more in line with a upscale hotel or restaurant with amenities to spare and owners and developers are listening. However, it is the designers challenge to satisfy these needs while keeping the integrity of the facility’s medical purpose- after all this is their reason for being. Research shows that the average time spent in assisted living is only 2.5-3 years and most people who leave do so because they need more care.
Many elderly patients suffer from more than one malady and many assisted living facilities can accommodate residents with a full range of challenges- up to a point. What might be an acceptable design for an Assisted Living residence is not the right solution for a nursing home. In nursing homes, lighting is a particular issue that is cause for much agitation – it can’t be too light or too dim. Shiny floors or busy carpeting can cause anxiety and cause confusion- especially with residents suffering from dementia and depth perception issues. Nursing homes are currently facing a shortage of beds and assisted living facilities are stepping up to provide a more home-like atmosphere for those in need of memory care. (source: Assisted Living Facilities ) Designing for two distinct populations can be exacting.
Competition will be fierce with the rising demand for senior housing. Residents as well as their families will be shopping and comparing notes, sizing up the amenities, and looking for the perfect fit. The most successful facilities will not just have a logo or a set of values and beguiling interiors, it will be the promise of an experience for the resident that will guarantee the most comprehensive care and the best environment. The Green House Project is a radically new model of care for long-term nursing home residents and gaining ground in the U.S. To combat the loneliness, helplessness and boredom that afflicts so many people in traditional nursing homes, they promise genuine human caring in an environment, connected to community and nature resulting in a happier and fulfilling life. Another promising brand may be Houses for Betty set to be built in Gaithersburg, MD. These cottages are geared towards residents who either have or are pre-disposed to Alzheimer’s or related dementias.
A recent study found that social isolation and loneliness increases the risk of death in elderly people. (source: Science Alert) This is no surprise coming from a society that extols the virtue of self-reliance. Once a person is no longer working, no longer able to take care of themselves- they lose their relevance in society and their social networks shrink. To increase community connectivity elder-care experts have suggested that a family areas be constructed on site at senior housing facilities. They tell architects that having an area with benches, picnic tables and things for kids to climb on would encourage family visits and more interaction with the professional care staff. To facilitate residents’ participation in volunteerism, planners of an housing community called Homestead Village provided onsite office facilities for voluntary organizations, such as the American Cancer Society and the American Heart Association.
Senior housing trends in the U.S. could take a lesson from across the pond as our senior housing is typically built outside of the mainstream community, geographically and socially isolationg. The Flesseman Center in Amsterdam overlooks a busy subway station, providing proximity that is both practical and entertaining for residents with limited mobility. In Finland, the Old People’s Home and Health Center of Oitti was constructed over a busy pedestrian thoroughfare connecting two parts of town- the foot traffic can be viewed from the center’s dining room and provides ample opportunity for people watching. At the Kuuselan Palvelukoti project in Finland, the swimming pool, restaurant, and sauna are open to elderly residents and neighbors of the project. (all examples from Social Capital and Successful Aging).
By: Amy Blanco