Environments for Aging - Fall 2017 - 26

meaningful involvement in decision-making and engagement in operations. "It allowed us to start listening to the consumer, listening to
the resident, and pushing back on the status quo that's always been
there," Cinelli says.
This trend also brought the emergence of new efforts to support
person-centered care through the built environment. Elements like
access to nature and daylight became priorities. "Oftentimes in old
institutional models, daylight wasn't one of the driving factors. I think,
for us, that's what really began to change how we looked at spaces
and the way we started to lay out these projects," says Eric
McRoberts, partner at RLPS Architects (Lancaster, Pa.). Additionally,
ideas of resident dignity surfaced and resulted in private bedrooms
and baths, as well as residential kitchens where food is prepared and
served, and additional dining options.
More deeply, designers began asking questions of not only residents but staff about why earlier efforts to deinstitutionalize weren't
necessarily working. For example, outdoor spaces would be provided
but no one would use them, says Jane Rohde, principal of JSR Associates Inc. (Catonsville, Md.). "You'd build a building on very little input
and then didn't understand why it wasn't being operated efficiently or
there was low staff satisfaction, residents couldn't get in and out of
the toilet room by themselves, or whatever the case may be. It didn't

take long to evaluate where the gap was," Rohde says. "The
harder part has been bridging the gap and getting information
from people to get the operational side and the design side to
understand this is a mutual benefit."
One approach that's emerged is recognizing there's no onesize-fits-all response and that simply incorporating daylight and a
household model isn't enough to achieve person-centeredness.
"If you give someone a household model and they're trying to operate it on a centralized system, the physical environment doesn't
support what they're trying to do operationally," Rohde says.
Designers discovered over time the critical importance of staff
training and maintaining message, especially across leadership
changes. Cinelli recalls designing a project where the owner
encouraged a deconstruction of the traditional nursing home
model, but by the time the community opened, a new adminis-

Submitted by Encompass Interiors
An urban infill project, the campus
occupied one city block in the downtown
core, integrating an existing 1928 building
with an 1871 historic hotel. The senior
community, including independent
living, assisted living, and specialty care,
was joined on the site with mixed-use
development, linking residents to the town
and revitalizing the neighborhood.

Submitted by NBBJ Residents
and staff were engaged in the
design process for this skilled
nursing community, to define the
qualities that would provide the
best environment for veterans,
such as creating more privacy by
using a Y-shaped resident room
that broke doubles into two private
single rooms.

2004

Avalon Square
Waukesha, Wis.

[[RUN WITH DINING
WITH LAKE VIEW,
MIDDLE, PAGE 49]]

2005

Saint John's
on the Lake

Milwaukee

trator and director of nursing who hadn't been involved in early
planning stages defaulted to using it the way they knew how.
"What was missing was that we didn't give them an owner's
manual of what we recorded early on to make sure they understood why we made all these changes, what operations drove it.
Because all of a sudden, the concierge desk was being used as
a nurses' station," he says.

2006

Washington
State Veterans
Home
Retsil, Wash.

[[RUN WITH
MIDDLE, LEFT
EXTERIOR ON
PAGE 57]]

EFAmagazine.com * Fall 2017

Submitted by AG Architecture
A repositioning project of the
continuing care retirement community
(CCRC), the goal of the new
construction and remodel work was to
allow the CCRC to remain competitive.
Efforts included the reduction of skilled
nursing beds by 40 percent to achieve
a person-centered environment with
larger resident rooms and mostly
private bathrooms.

[[RUN WITH
RESIDENT ROOM,
THIRD FROM TOP
PAGE 89]]

[[RUN WITH POOL
PHOTO, PAGE 81]]

2007
Friendship
2007
Haven

Fort Dodge, Iowa

Submitted by Tremain Architects &
Planners Ltd. In an effort to attract
independent, active seniors to
the community, this repositioning
program includes one-story assisted
living households with direct access
to gardens and a fitness center
with a swimming pool, cardio and
strength-training equipment, and a
massage room.

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Environments for Aging - Fall 2017

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