Design Considerations for Senior Care

A facelift for an existing nursing home (above) conveys both dignity and comfort. Let us review the key considerations when designing for senior living.

Senior care facilities often include multiple levels of care and, we believe, should be designed to foster holistic well-being, support, and a sense of community for their residents. Collaboration between architects, healthcare professionals, and caregivers can create senior care facilities that prioritize the physical, emotional, and social well-being of those in need of support. By balancing the complementary design influences of residential–scale compartmentalization and efficient service centralization, we have been able to create environments that enhance the quality of life for residents and support their unique needs.

Compartmentalizing refers to subdividing large facilities into care neighborhoods with the aim to instill a sense of familiarity and belonging within a larger structure. Childress & Cunningham’s implementation of the “Small House” concept produces shared living room, dining room, and kitchen spaces with a more comfortable residential scale, all within easy walking distance to patient bedrooms.

Each neighborhood is uniquely themed, fostering a sense of identity and belonging for residents. This approach becomes particularly important when catering to specific care needs, such as memory care, skilled nursing, assisted living, and bariatric care. Designing spaces that are tailored to the unique requirements of each care type ensures that residents receive the appropriate level of support.

In memory care, for instance, the environment can be crafted with careful consideration of residents with cognitive impairments. Built-in opportunities for unique and memorable self expression should be combined with security features that protect against accidental wandering away from the facility. Reminiscence therapy is a therapeutic approach used in senior care settings to evoke memories and encourage conversations about past experiences. Spaces designed to allow objects, photographs, music, or other sensory stimuli to trigger memories can support the emotional well-being of these residents.

For skilled nursing, the emphasis will be on creating areas with ready access to advanced medical equipment and close monitoring by medical staff. Optimal staff to patient ratios may tend more towards 15 to 20 beds in a care neighborhood, calling for greater attention to be paid to maintaining a comfortable residential feel.

While assisted living will need to be designed for medical access similar to skilled nursing, the residents may enjoy greater levels of autonomy. Spaces can be designed to foster independent activity, such as with communal kitchens, and hobby or activity rooms. Nurse stations and other support spaces shall be within close proximity, and can be designed to blend in, such as with features for staff use built into cabinetry that resemble a residential kitchen. For Christian Care Communities this particular nurse station includes a service counter for daily meal distribution.

Independent living can be included on the campus often with a mix of ranch town houses and gracious apartments of 1-bedroom, 2-bedroom, and 2-bedroom with den designs. Striking a balance between independence and necessary support, they will have accessibility features unobtrusively built in. While independent living may be detached, it should still be in easy walking distance to other services that may be provided on the campus, like physical therapy.

As the US population is living longer but becoming less healthy overall, demand is increasing for bariatric care. Where the staff is trained to provide such care, facilities need to be designed to accommodate the unique needs of residents with mobility challenges and specialized medical requirements. Larger doors and a hoist track mounted to the ceiling help with patient movement between bed and bathroom. One or two such resident rooms may be included in the mix of other level-of-care neighborhoods.

Limiting sightlines and minimizing the remoteness of dining or living spaces helps to avoid an institutional feel often associated with large care facilities. This involves careful planning of layouts to eliminate long, stark corridors, creating an environment that feels more like home. Elements designed to provide privacy and a sense of belonging can still allow for resident safety and efficient supervision by staff. The goal is to create a comfortable and familiar atmosphere, a place that can be called Home.

Featured here, Childress & Cunningham designed this 18-bed skilled nursing building with the character of a large ranch home, both inside and out. Warm and welcoming design choices, including residential-style furniture, colors, and decor, contribute to an environment that enhances the comfort and familiarity of the space. This shift in aesthetics acknowledges the emotional and psychological impact of the physical environment on the well-being of elderly residents.

We have found that planning for two such skilled nursing neighborhoods (each with 12 to 18 beds) arranged back-to-back on a single story, or stacked in a multistory building, can deliver efficiency of services comparable to that achieved in a conventional nursing home with long hospital-like corridors.

Centralizing certain functions in a senior care facility can enhance operational efficiency, communication, and overall care quality. The key is to carefully assess which functions can be centralized to optimize efficiency without compromising personalized care and resident satisfaction. Locating common needs like food preparation, laundry, and visitors/security in core areas supports efficient resource management, technology integration, and standardized reporting, contributing to better financial management and optimized staffing levels.

Some functions like resident care plans, medication management, daily activities, dining, housekeeping, and maintenance can still be dispersed to support spaces within the care neighborhoods, facilitating efficient, personalized, and responsive services. This approach ensures that residents have access to necessary services without compromising the efficiency of facility operations.

When reinventing an existing senior care facility to bring it up to modern standards of care, a comprehensive approach is required. Renovations should focus on creating environments that are conducive to the unique challenges and requirements of each care type.

Additionally, new additions to the facility can be designed to address shortcomings and incorporate contemporary design elements. This could include introducing new styles of units that accommodate senior preferences, such as private rooms and assisted living cottages. Creating new spaces for onsite entertainment, commercial, or social activities further enhances the overall quality of life for residents.

The importance of design in senior care facilities extends far beyond aesthetics. It is a holistic approach that encompasses the physical, emotional, and psychological well-being of elderly residents. Childress & Cunningham designs senior care facilities to be environments that promote comfort, dignity, and community. As the demand for quality senior care continues to grow, investing in well-designed facilities becomes not only a practical necessity but also a testament to our commitment to ensuring a dignified and fulfilling life for our clients’ aging residents.