Environments for Aging - Spring 2021 - 18

COMMUNITY
in a rural or suburban environment, a series
of small, one-story buildings is very normal,
while a nine-story midrise with ground-floor
retail would feel very out of place.
While this seems elementary, the senior
living industry historically has struggled to
implement this kind of thinking. Instead, the
industry has spent a lot of time and energy
perfecting the " big box " assisted living/memory support building as an archetypal approach
to suburban senior housing. However, the
residents of these places are coming from
one or two-story houses with a few bedrooms
and living and dining room spaces that they
shared with a small group of family members.
At a moment when they're struggling to hold
onto the most basic things, such as what to
eat, when to wake, and how to spend free
time, we're asking them to wake up in an
environment that bears little resemblance to
the one they've known for the better part of
their adult lives.
More nuanced, but perhaps also more
crucial, is considering a person's cultural

experience. The food we eat, the music we
listen to, when we like to get up in the morning, and how we like to spend our time are all
key factors that determine the daily rhythms
of our lives. However, these are also factors
that get regulated and dictated by caregivers,
laws, and family, among others, when an older
adult moves into a residential care setting.
Smaller-scale settings, like the small house
model, begin to answer this question because
residents are able to maintain more autonomy
and connection to their pre-dementia life,
but they don't address it fully when it comes
to who actually lives together in that house.
Some operators are addressing this through
" lifestyle groups, " in which residents are
matched into houses based on daily rhythms
and personal preferences. While this may not
lead to a house of dementia residents who all
enjoy the same sub-genre of classical music,
it may help group residents who are all late
sleepers within the same household. Technology provides the opportunity to take this idea
to the next level. For example, algorithms in

the vein of dating apps are used to find life
partners, so why can't we use the same
techniques to match older adults with roommates who won't be turning on the television
at 6 a.m. when others are trying to sleep?

End the segregation of
residents with dementia

When it comes to empowering older adults
living with dementia, there's an inescapable
contradiction between our aspirations and
the realities of the environments we create.
In the United States, environments housing
older adults living with dementia are classified
for " institutional " use. There are many vestiges of this institutional archetype, most notably the mandate that exit doors are always
locked (except in case of emergency) and
residents are restricted from coming or going
from the building. The industry has reverse
engineered the process by taking highly
regulated, institutional environments and trying to make them feel normal and residential

EFAmagazine.com * Spring 2021

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Environments for Aging - Spring 2021

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