Environments for Aging - Spring 2021 - 17

COMMUNITY
Mill Hill Residence, a Maplewood Senior
Living community in West Yarmouth,
Mass., that offers assisted living and
memory care options, uses homelike
furnishings and lighting within intimately
scaled public areas to create spaces
that feel curated while still providing
opportunities for personalization.

Shifting mindsets

Adapting environments to support the unique needs of
individuals with dementia can ease the transition from home
to a residential care setting By Jennifer Sodo and Max Winters

SARAH MECHLING/PERKINS EASTMAN

magine if, without warning, you woke up
tomorrow morning in an entirely different
setting: an unfamiliar place, with strange
tasks and routines that were totally foreign to
you. Then imagine that you are not allowed to
leave or interact with anyone outside of your
environment. While it sounds jarring to most
of us, this experience is the unfortunate reality
for many older adults living with dementia who
reside in congregate living settings throughout
our country. The built environment can either
empower people going through this kind of
upheaval in their lives or it can be an impediment that makes the transition to a new living
environment frustrating and frightening.
In the last few years, Perkins Eastman has
done a considerable amount of research,
development, and application with senior living organizations to explore how senior living
communities can better support older adults
living with dementia. Here are three broad
themes that have emerged from that work.

Balance the specific and
the general

Environments that truly empower older adults
living with dementia are ones with the ability
to respond to the specific and unique needs
of the individual. Traditional approaches
congregate dozens of people together in the
same environment based on basic similarities:
age, gender, daily schedule, etc. But a living
room that you share with 31 other people
can't possibly respond to you as an individual.
It can't have your wedding photo up on the
mantle or the afghan your mother knitted for
you draped over your favorite chair. But what
about a living room you share with six other
people? Perkins Eastman's findings show that
a seven-person residence offers a scale that
allows those living there to invest personally in
their environment. This response isn't limited
to a small house model, either. Creating
smaller, grouped spaces within a larger floor

plan, such as utilizing a midrise building to
accommodate 24 seven-person households
over nine floors, is a way to achieve a similar
environment without starting from scratch.
In addition to reducing the scale of the
house architecturally, interior design is key
to acknowledging the self-expressive needs
of older adults living with dementia. Balancing the specific elements that allow each
household to feel unique while maintaining
a level of replication that provides a costefficient design to construct and maintain is
a challenge. One strategy to address this is a
" tiered " approach, where elements like trim,
flooring, and appliances are replicated across
all households. In the next tier, another set of
elements such as furniture, paint colors, upholstery, and accessories are specific to each
household in the community but distinctive
across the whole development. The final tier
of personalization comes from the residents
themselves, as details are designed into the
spaces that allow residents to add their own
touch, such as alcoves and shelves to showcase personal photos and treasured items or
an area where a resident can put a favorite
armchair or writing desk.

Define " normal " regionally
and culturally

A key tenet of easing the transition from
home to a residential care setting is to maintain as many of the aspects as possible that
made up the person's normal life pre-move.
As soon as a care provider puts this tenet
into practice, however, a series of questions
quickly emerge: Normal for whom? Normal
for where? And normal for when?
At the earliest stages of planning a community, crucial decisions such as where to
site the building, how to organize spaces, and
what cultural and regional elements to incorporate must be addressed. This is important
because one person's sense of home can be
vastly different from another's. For example,
Spring 2021 * EFAmagazine.com

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Environments for Aging - Spring 2021

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