October 1, 2006 |

The New Look in Senior Living: Two Approaches Toward Social Interaction

The new look in senior living:
Two approaches toward social interaction

Based on interviews with Dan Rosenthal, Principal and Director of the Senior Living Group, The Lawrence Group Architects; and Steve Brown, Associate and Project Director, Bernardon Haber Holloway Architects, PC

Whether building a grand-scale CCRC or a budget-friendly assisted living facility, an emphasis on social interaction is key. Two very different designs-one a project in progress and the other new construction-both place an emphasis on social interaction among residents, as well as interaction between residents and the greater community. The Stratford at WestClay, part of The Village at WestClay in Carmel, Indiana, and Meadow Ridge Assisted Living Facility at Willow Valley in Kennett Square, Pennsylvania, showcase current design trends in senior housing. They define their campuses with opportunities for social and physical activities to enhance the mind and body. The Village at WestClay, a traditional neighborhood development, recalls a 19th century main street and its surrounding community. With its Arts and Crafts style, Willow Valley is nestled in the Pennsylvania countryside, reminiscent of an early'20th century country estate. The catalysts behind these projects recently explained their designs-and the reasons behind them-to Nursing Homes/Long Term Care Management.

Dan Rosenthal is a Principal and Director of the Senior Living Group at The Lawrence Group Architects, the architectural designer of The Stratford at WestClay. An upscale retirement community located within The Village of WestClay, a traditional neighborhood development in Carmel, Indiana, The Stratford at WestClay is scheduled for completion in October 2007.

Traditional neighborhood developments (TNDs) are a response to new urbanist philosophies. Elizabeth Plater-Zyberk and AndrTs Duany, who've been really at the forefront of new urbanism, designed one of the first new urbanist communities in the country, called Seaside, in Florida (The Truman Show was filmed at Seaside). It really is a wonderful community, and it incorporates a lot of the ideals of new urbanism.

Post'World War II America evolved with a reliance on the automobile. Through a combination of flight from urban areas that were perceived as being high crime areas, and because of the freedom afforded by the automobile, we developed suburban communities. As a result, we spread our resources far across the landscape. People still worked in a downtown area, but they might have lived an hour away-so you get this fragmented society. You break down the bonds of community that really served the country very well in an earlier time. Hearken back to the turn of the 20th century, and you see the main streets in small towns and communities functioning very well. People lived close to where they worked, they lived close to where they recreated, and there was a real sense of community. In addition, the public spaces were "activated" by restaurants and retail, as well as dense housing, as Jane Jacobs, the well-known writer, activist, and student of successful urban environments noted in her work, which includes The Death and Life of Great American Cities and The Economy of Cities.

We blame the automobile for a lot of this fragmentation. New urbanism tries to integrate the automobile into our high-tech environment, our modern society, so that the car is really not the dominant element in our community. The development of narrower streets slows down the automobile and makes public ways more pedestrian-friendly. Trying to create diversity within a community prevents having a large residential community on one side of town and a large commercial community on the other side of town. You want people to be able to walk to work. You want diversity not just in function, but also in the types of housing available. You also want urban activity over a more extended portion of the day.

Can you create a community away from the downtown area that incorporates these ideals? That's where you get the TND. You've got a sense of a main street. You've got diverse housing, diversity in function, and mixed uses-all within a relatively small community. A new urbanist community is not just detached single-family homes. You want to have denser housing in areas, as well as larger single-family residences. We have quadplexes, duplexes, apartments, and condos. Also, the cost of housing is more diverse. You may have a townhome across the street from quadplexes or within the same community. It's a very exciting marriage. We're getting calls from a lot of traditional neighborhood developers who want to incorporate senior housing components within their communities. It supports the ideal-diversity of ages, as well as diversity in functions.

All of these ideals really meld well into what we think about as good senior housing. We're trying to create socialization in our communities and our CCRCs. Any good long-term care facility or CCRC wants to facilitate socialization. In a CCRC, there is a diversity of care, but what can be done on a societal level in the community to facilitate more interaction with the outlying community? At WestClay, there are "pocket parks" within a quarter of a mile of each residence. A pocket park is a small village green that may have some recreational element (like bocce ball) or a fountain or gazebo. It's a place for gatherings. WestClay has a park where many people like to have their wedding ceremonies. It is a walkable village-you have somewhat controlled the automobile so that it is not as dangerous to walk around the neighborhood. Ideally, you have also created an environment with a nightlife. The theory is that with commercial activity at night you will see less crime. The more eyes one has on the street, the greater the deterrent is.

You try to create focal points in the community. It may be a village center, a park, or a swimming pool. All these elements are integrated in The Village of WestClay. The Stratford has much more independent living than assisted living or comprehensive care. But even with the comprehensive care there's an opportunity to go outside. Three or four small vehicles called "The Stratford Surreys"-basically red bubble-topped golf carts-will be used to shuttle the residents to and from the village center. We've created a lot of opportunities internal to our site, such as courtyards, for outdoor recreation. We've also created internal recreation in the form of theaters, media centers, a swimming pool, a billiards hall, a fitness center, and a variety of dining venues.

The assisted, skilled, and Alzheimer's components are much smaller in these facilities. I don't know if that's a trend, but I am seeing it in our projects. And I think both sides benefit; staff-to-resident ratios are better and it creates a less institutional feeling because there may only be 12 residents served by a single dining hall and a smaller staff, whereas the entire facility may have more than 200 residents. From a marketing standpoint, residents want to move into the independent living side, but they also want to have the comfort of knowing that a higher level of care is available. There are distinct "neighborhoods" for assisted living, comprehensive care, and Alzheimer's care, which is within a secured environment with a private courtyard. All of the distinct components have their own dining venues. The use of the other amenities may be programmed at different times; for instance, the use of the pool may be limited by the activity that has been programmed for that time slot.

There still are the common challenges that you have in most CCRCs. How can you make your operations more efficient? If you have central recreation facilities that independent bungalow dwellers can use as well as assisted living dwellers, then you're taking advantage of some efficiencies-you're also providing some valuable services. You can have a central, commercial kitchen that may support a lot of satellite kitchens throughout the facility, bringing a craft kitchen closer to the skilled nursing environment. Activities of daily living are not just basic and mundane, they are opportunities for bringing pleasure and richness to somebody's life. If you can smell the food that's being prepared, if you can watch the food being prepared in your dining environment, that's adding to the richness of life.

In our quadplex bungalow neighborhoods, I see high density. I see much more concentration on pedestrian paths between buildings and from the quadplex bungalow neighborhood to the main building, which serves as the recreational and dining center. We're facilitating pedestrian movement better than we have in the past. There's an opportunity for having a front door from a pedestrian path instead of creating the front door from a driveway.

When you have a high density and you still have a high proportion of independent living residents driving, you have to accommodate their cars in a community that really is pedestrian focused. Underground garages are often the solution. The benefit is that there is great convenience in being able to drive under the building and take an elevator to your dwelling, but there are added costs to that solution.

The architectural elements are rather controlled in a TND. You have restrictive covenants; in some communities that may be the architectural style. In The Village of WestClay, the buildings must be designed to reflect a certain 19th century period and only certain architectural styles are allowed. So how do you integrate modern-functioning buildings into a 19th century fatade? We've come up with clever ways to hide rooftop equipment-using mansards and parapets-that really reflect what you would have seen on a 19th century main street. Constant challenges are how to hide back-of-house functions-dumpsters, cooling towers, and transformers-from pedestrian paths and from the views within the building. These facilities are dense, so you have to be clever about how to accommodate air-conditioning systems and infrastructure. We're seeing four-story buildings with courtyards and most of the equipment on the roof, and we're screening the rooftop so that it is integrated in the community.

There are great opportunities for sustainable architecture-green architecture. I think there are opportunities for incorporating the LEED (Leadership in Energy and Environmental Design) ideals in the TND, such as having a green roof. We're also using less land. Higher density housing is, in itself, a sustainable solution. There are always opportunities for conserving water resources, for instance, with the use of new technologies. These projects have incorporated very high-tech, low-voltage systems. We're using the electronics of a smart building for elopement control, security, keyless entries, and point-of-service monitoring. I think we can also use some of that technology for mechanical/electrical systems' efficiencies; for example, lighting systems can be used to help integrate daylighting and minimize artificial lighting. There is also the opportunity in the operations to incorporate green activities. Many of The Stratford's residents in other sites have expressed interest in recycling, which can be an opportunity for additional social interaction.

For more information, phone (866) 680-5700 or visit www.thelawrencegroup.com.

Steve Brown is an Associate and Project Director at Bernardon Haber Holloway Architects, PC, the architects-of-record for the design of Meadow Ridge at Willow Valley, an assisted living facility in Willow Street, Pennsylvania.

The men's lounge. Dan Gair (www.blinddogphoto.com)

Our goal was to create a homelike environment with spacious rooms that have a warm, residential feel; to capture the views of the Lancaster County countryside; and to design a variety of unit types while adhering to a strict budget.

A typical country kitchen. Dan Gair (www.blinddogphoto.com)
The trend in the senior care industry is to design facilities that evoke a sense of home rather than that of a healthcare institution. Residents are coming to a new place to live-their next home. And that's what we created at Meadow Ridge, an atmosphere where residents have moved in with some new friends in a large country estate. The style of Meadow Ridge is American Arts and Crafts, which stresses simple forms, natural materials such as wood, and a straightforward decorative style.

Our first task was to determine a building shape that would offer the residents ample views of the Lancaster County countryside, especially views from the residential units. The result is a four-story, Y-shaped building. Because of the Y-shape of the building, the wide corridors, which are functionally necessary, were designed with careful consideration. So as not to appear as long passageways that are tedious to travel, we worked with the interior designers and developed breaks in the corridors that were divided into sections and trimmed out with wood panels. We used custom crown moldings, arches, and trim around these sections to assist resident wayfinding. Benches are strategically placed to offer a resting spot, if necessary. The incorporation of translucent interior decorative glazing along the hall-ways adds visual interest and invites you into the adjacent rooms.

Country kitchens can be found on each floor. It's customary for people to spend a significant amount of time in their kitchens at home with their friends and neighbors. Residents at Meadow Ridge can still enjoy that same social interaction in these country kitchens. A separate cafT serves as another gathering area where one can go to enjoy the company of friends, sip a cup of tea, or read the paper while taking in the scenic views. An outdoor patio adjacent to the cafT calls the residents outside to view the valley beyond. Large dining rooms with beautiful color palettes and comfortable seating offer residents additional views of the countryside while they enjoy the foodservice, ambience, and company of family and friends.

The upper level of the two-story lobby features a decorative railing and serves as an art gallery, offering a display area where residents have the freedom to express themselves with their paintings. The basement area of Meadow Ridge is set up as a men's lounge. Traditionally, women in assisted living facilities outnumber men. However, the men still need a special place to go, whether it's to play billiards or pursue a hobby. The lounge is equivalent to that area in their former homes where they could go to relax. There's a workshop adjacent to the lounge for small woodworking and painting projects. Although the lounge is set up as the "men's space," women are welcome.

Willow Valley offers one- and two-bedroom apartments instead of the traditional studio. All apartments have large windows that capture panoramic views and allow for natural light. The abundant use of glass and an open floor plan for maneuvering in wheelchairs or with walkers make the apartments feel larger than they really are. Each apartment is fully accessible to allow residents to continue to reside in their apartments even as they become more physically dependent.

The two-bedroom units give residents an opportunity to be with their spouses, or even a friend or a relative. If the level of care and mobility of a husband and wife differ, it's reassuring to know that they don't need to be in two separate buildings to receive their individualized care.

Instead of using a standard flush door, which is a less expensive option, we used a two-panel door to follow the Arts and Crafts style. The doors still meet code regulations but give a more residential feel to the apartments.

The building is masonry and concrete plank construction with a brick fatade. This type of construction requires that you stay within certain limitations of the spans of the building. We accomplished the varying apartment types by modifying the shape inside the units to two or three different modules to give variety to the floor plans.

It's important to understand the structure of the building and the utilities required for the building. When we designed the units, we designed them back to back, using a left-hand and right-hand plan. Consequently, the bathroom and plumbing are back to back within the same structural module. Because the structural module is repeated, it is more cost-effective for the builder and the owner. Even though the shell is the same and the interior is a mirror image of the other side, a left-hand unit and a right-hand unit feel different. The location of the entry door can change; it can be at one corner of the unit or at the middle of the unit. Multiple construction methods are what drive the costs up. Repeating the construction of the modules saves money. We centralized the plumbing in one corner of the unit as much as possible, leaving open space for windows, wall space, and other living areas.

By standardizing the units, which make up approximately 75% of the building, costs were kept to a minimum. That allowed us to trim out the common spaces with more wood and wood base, and use decorative glass to open up spaces. The ceilings are laid out with soffits where steel beams occur. Instead of hiding the beams by dropping the ceiling and making one plane, we wrapped the beams and decorated them with wood trim. This changes the ceiling atmosphere and the shape of the room and provides the warmth of wood beams-reminiscent of the beautiful parlors and living rooms in turn-of-the-century homes. We added different types of lay-in ceiling tiles in common spaces, using printed tin ceilings in some of the rooms that are also reminiscent of the architecture of the early 20th century.

We accommodated service areas very discreetly throughout the layout of the building. Each wing has areas for staff to gather linens to limit travel distance. Service areas are set up so that they're centrally located without being so noticeable to the residents.

Also, as good stewards of the environment, the carpets and ceiling tiles used are made from recycled materials. In a short amount of time-probably within five to seven years-the facility is going to replace the carpet in most of the common areas. It's important that you provide materials that are recyclable and sustainable.

We truly feel we accomplished our vision of creating a home atmosphere very familiar to the residents while providing an accessible environment and the level of care requested by this great generation.

For more information, phone (610) 444-2900 or visit www.bernardon.com. To send your comments to the editors, e-mail peltier1006@nursinghomesmagazine.com.

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