Vetter Health Services, Inc., Brookestone, Caring Households for Seniors

Facility Contact: Cheri Mundt, Executive Director

Firm: Vetter Health Services, Inc., (402) 895-3932

Design Team: Mitchell Scott Elliott, AIA, Design Architect; Linda Stigge, ASID, Interior Designer (Vetter Health Services, Inc.); Gary Churchill, Project Architect (RDG Schutte Wilscam Birge, Inc.); Greg Schnackel, Mechanical/Electrical Engineer (The Dale Schnackel Company); Rhonda Distefano, Construction Project Manager (The Weitz Company)

Photography: Ervin Photography

Resident Capacity: 120

Space/Resident (sq. ft.): 600

Total Area (sq. ft.): 72,000

Total Cost (excluding land): $8,843,733

Cost/Sq. Ft.: $122.83

Completion: June 2000

Ownership strategies for achieving these goals included maximizing the availability of private rooms; creating an environment that enhanced staff’s ability to care for residents; providing residents with individual choice and maximum independence; and providing an environment that was “visitor-friendly” and embraced community involvement.

The design was based on the “universal caregiver” model. It is organized around six households where intimate groups of 18 to 22 residents are served by a team of “homemakers,” who are trained to provide personal assistance, dining, housekeeping, activities, laundry and therapeutic bathing within the households. The homemakers are permanently assigned to specific residents to promote positive, relationship-based interaction.

Brookestone’s cluster concept reduces maximum travel distance to 55 feet from resident rooms to household dining. Each household is organized around a Country Kitchen, a focal point for staff-resident interaction at mealtimes and other gatherings. The Country Kitchen also functions as a discrete work area for the homemakers. Single-loaded corridors serve many of the resident rooms in the facility, providing residents with visual and physical access to natural daylight and outdoor spaces.

Each household includes a Bathing Spa with a choice of whirlpool bath or accessible shower. Residential washers and dryers are provided within the bathing areas.

In the overall design of Brookestone, three households are dedicated to residents with healthcare needs and three for those with Alzheimer’s disease. A Village Commons area separates these distinct households and includes the main entrance, along with all public and support spaces. The Village Commons, which begins at the visitor parking lot, is designed to celebrate life, while reducing the anxiety of those who are fearful of nursing homes. Visitors cross over a landscaped, running brook as they enter and are greeted by a concierge. The hospitality environment is further enhanced by a baby-grand player piano in the Grand Foyer.

In the 60-seat interfaith chapel, located off of the Grand Foyer, Old and New Testament biblical themes were used for the stained-glass clerestory windows to meet residents’ varied spiritual needs. Also located in the Village Commons are the Brookestone CafT and the Great Room, which supports multiple functions, including restaurant dining for 60 and “people development” for the staff.

Through the Village Commons, visitors and staff access the three, 20-person, secure “Memory Support Households” for residents at various stages of Alzheimer’s disease. Support spaces for these households are located to eliminate the unhealthy stimuli caused by food and laundry equipment. Residents have controlled access to secure, outdoor courtyards.

The discreet use of technology is a significant design feature of Brookestone. Homemakers wear vibrating pagers tied into all the life-safety systems. All zone and hall lights have been eliminated from the call system. Virtually all system noises have been eliminated from the environment.

The design of Brookestone embraces community relationships outside the building. The wellness center, used by elders from the community, is located in the Village Commons. The Great Room is a significant gathering spot for community groups. The Parlor in Memory Support is used for Alzheimer’s support groups and serves as a community resource center for families and caregiving professionals.

The planning and design of Brookestone was a collaborative effort between members of the design team and the Alzheimer’s Association. The fire marshal and the health department were included early in the process, and both state agencies worked with the owner’s development team to ensure that Brookestone reflected the intent of the regulations while providing a quality living environment. The State of Nebraska subsequently revised its healthcare regulations and used Brookestone as a model for those revisions.