E-‐42
HOUSEHOLDS-‐Version
2.0:
A
DISCUSSION
ON
THE
INTERACTION
OF
OPERATIONS
&
ARCHITECTURE
Jeffrey
Anderzhon,
FAIA Lorraine
G.
Hiatt,
Ph.D.
Senior
Planner
/
Design
Architect Environmental
Psychologist
/
Gerontologist
Andrew
Alden,
M.Arch
Senior
Planner
/
Designer
Continuing Education Credits
Architects - 22 Credit Hours available
• Have your conference badge scanned by the room monitor at the start of each session you attend.
• Complete the AIA verification form (be sure to check off the sessions you attend) and retain it for your
records.
• CE credits will be uploaded to the AIA transcript system within 4-6 weeks of the close of the conference
and you will receive a certificate of completion via email.
Interior Designers - 22 Credit Hours available
• Have your IDCEC verification form STAMPED by the room monitor at the start of each session you
attend.
• This is the ONLY proof of attendance that will be accepted.
• You will self-submit your credits to the IDCEC system at the conclusion of the conference.
• If you have questions about reporting your credits, contact the interior design association that is
responsible for monitoring mandatory continuing education to fulfill membership requirements.
EDAC - 10 Credit Hours available
• EDAC Approved Sessions: T01, D01, D02, D03, E01, E03, E09, E10, E12, E13, E15, E16, E18, E21,
E22, E23, E24, E25, E27, E30, E34, E35, E36, E38, E39, E40, E41, E42, E43, E44, E47, E49
• Complete the EDAC verification form and retain it for your records
• You will self-submit your CE credits to Castle Worldwide at the time of your EDAC renewal. Renewal
notices with login instructions will be sent from Castle Worldwide six months and three months prior to
the candidate’s renewal date.
• The verification form is your proof of attendance in case of an audit.
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LEARNING
OBJECTIVES
• Understand
how
the
physical
environment
impacts
direct
caregiving,
staffing,
food
service,
and
social
interaction;
• Learn
about
trends
that
are
helping
to
shape
the
physical
environment,
care
program
and
operations;
• Discuss
and
appraise
contemporary
architectural
designs
created
for
older
adult
care
environments
and
the
operational
methodology
assumed
for
those
layouts;
• Gain
knowledge
through
interactive
discussion
focusing
on
participant
experiences
with
their
own
operational
and
environmental
designs.
Jeffrey
Anderzhon,
FAIA Andrew
Alden,
M.Arch Lorraine
G.
Hiatt,
Ph.D.
Senior
Planner
/
Designer Psychologist
/
Environmental
Gerontologist
Senior
Planner
/
Design
Architect
@JeffA_EUA @AndrewA_EUA /lorraine-‐g-‐hiatt-‐ph-‐d-‐83569627
/jeffreyanderzhon/j /andrewalden1 [email protected]
[email protected] [email protected]
THE
AGENDA
• Recap
from
Households
V1.0
• History
• Architecture
• Lessons
Learned
THE
EVOLUTION
OF
SEANIBORRIE
LFIVHINISGT
O CARRYEOF
CONGREGATE SENIOR
CARE HOUSEHOLDS
Civil
War
Hospital
Washington
D.C.
1863
THE
EVOLUTION
OF
SENIOR
LIVING
CARE
Origins
:
Double
Loaded
Corridor
Double
Loaded
Corridor
1980s
Exploded
Corridor
Divided
Floor
Plan
1990s
Household:
Household:
Short
Corridor
Style Hearth
Style
Combination
/
Hybrid
Household
Styles
Household
/
Neighborhood
Household
Layout
Comparison Hybrid
Short
Corridor
Household
Household
Hearth
Renovation
Household Household
Eppstein
Uhen
Architects,
2016
THE
EVOLUTION
OF
SENAIORRC
LHIVIITNEGC
TCUARREE-
LESSONS LEARNED
Physical
Environment
Comparisons
Between
Models
of
Care
TRADITIONAL
CONTEMPORARY
HOUSEHOLD
LONG
TERM
CARE
MODEL RESIDENT
CENTERED
CARE
MODEL
Large
Centralized
Activity
Space Small
Decentralized
Activity
Spaces
Large
Centralized
Dining
Space Small
Decentralized
Dining
Spaces
Centralized
Staff
Space
(Nursing
Station) Small
Decentralized
Staffing
Spaces
Centralized
Care
&
Service
Spaces
Decentralized
Care
&
Service
Spaces
Institutional
Style
Finishes
&
Furnishings Residential
Interior
Finishes
&
Furnishings
Lack
of
Natural
Light
&
Exterior
Views Natural
Light
&
Options
for
Exterior
Views
Majority
of
Multiple Occupant
Rooms
Private
Rooms
with
Private
3
Piece
Bathrooms.
(2,
3,
or
4
people)
Shared
2
Piece
Bathrooms.
Limited
Number
of
Companion
Rooms,
“Smart
Doubles”
Limited
Private
Rooms
Variety
of
Interior
Colors
&
Monochromatic
Interior
Colors
& Mixture
of
Textures
Lack
of
Textures
Outdoor
Access
with
a
Variety
of
Spaces
Limited
Outdoor
Access
and
Garden
Operational
Comparisons
Between
Models
of
Care
TRADITIONAL
CONTEMPORARY
LONG
TERM
CARE
MODEL RESIDENT
CENTERED
CARE
MODEL
Ailment/Disability
Focus Resident
as
Individual
Focus
Staff
Control
of
Daily
Routines Resident
Choice
and
Control
of
Daily
Routines
Maximization
of
Staff
Efficiency Optimize
Resident
Quality
of
Life
&
Independence
Rotated
Staff
Assignments Permanent
Staff
Assignments
Specialized
Job
Tasks
(Hierarchical) Wide
Range
of
Tasks
(Team
Oriented)
Quality
of
Care
Emphasis Quality
of
Care
&
Quality
of
Life
Emphasis
Majority
of
Food
Preparation
& Majority
of
Food
Preparation
&
Serving
of
Food
at
Plating
of
Food
Behind
Closed
Door Decentralized
Dining
Spaces
In
View
of
Residents
THE
EVOLUTION
OF
SENPIORRO
LGIVRINAGM
CAARNED
DESIGN
THE
EVOLUTION
OF
SOEPNEIORRA
TLIIOVINNGS
ACANRDE THE
BUILT ENVIRONMENT
RESIDENT
ROOM
THE
EVOLUTION
OF
SOEPNEIORRA
TLIIOVINNGS
ACANRDE THE
BUILT ENVIRONMENT
RESIDENT
BATHROOM
THE
EVOLUTION
OF
SOEPNEIORRA
TLIIOVINNGS
ACANRDE THE
BUILT ENVIRONMENT
DINING
TOHPEE
ERVAOTLIUOTNIOSNA
ONFD
THE
SBENUIIOLTRE
LNIVVINIRGO
CNAMREENT
SOCIAL
&
ACTIVITY
SPACES
THE
EVOLUTION
OF
SOEPNEIORRA
TLIIOVINNGS
ACANRDE THE
BUILT ENVIRONMENT
SUPPORT
SPACES
INTUITIVE
CAREGIVING
• See,
Hear
• Touch
Downs
and
“Home
Inspired”
Work
Areas
• Share
Care
Partners
Assistance
on
Request
Supplies
clean
and
soiled
where
needed
available
less
visible
• In
Room
Clean/Soiled
• Reach-‐In
Equipment
Alcoves
• Linen/Supplies
in
Residential
“Built-‐ins
• Planned
with
Game
boards
STEALTH
SERVICES:
Single
and
Multi-‐Story
Examples
DESIGNING
TO
STREAMLINE
SUPPORT
AND
GET
BACK
TO
RESIDENTS
Examples:
Rhode
Island
Veterans
Home
SFCS,
Inc.
Mease
Manor
Memory
Care,
Dunedin,
FL,
Slator
Group
Architects
PC
and
Parker
at
Monroe,
Spiezle
Group
Architects.
MULTI-‐STORY
14
14
CONNECTED
FOR
SERVICE
ONLY
• SEPARATE
HOMES
OR
PAIRED
“NEIGHBORHOODS”
• BOTH
CONNECT
FOR
SERVICE
• HOUSES
NOT
SOCIALLY
CONNECTED
• EACH
CONNECTED
TO
COMMUNITY
LIFE
10
10
Right
Above:
Sponsor
Driven
Design.
Levindale
Hebrew
Home,
Hord|Coplan|Mach,
Baltimore,
MD
Above:
Leonard
Florence
Center
for
Living
Greenhouse™
DiMella Shaffer,
“Design
for
Aging-‐International
Case
Studies
of
Building
and
Program,”
Anderzhon,
etal,
2012,
Wiley,
also
in
VA
CLC
DESIGN
GUIDE
2012,www.clcdesignguide.gov
DESIGNING
SERVICES
ARE
Each
INTEGRATED
INTO
RESIDENTIAL
HOUSEHOLD
(
HOUSEHOLD
(12-‐16
Each)
and
Neighborhood
NEIGHBORHOOD
(24-‐32
Each)
√ √
Neighborhood
Services:
“Hub
Staff”*
√ √
Home
Office,
Team
Care,
“Touch
√ √
Downs,”
Medications √ √
Launderette √
Clean Linen;
Soiled
Linen,
Lift
Storage √
Neighborhood Prep
Kitchen Example
with
Home
Style,
Kitchens,
Plating,
Aromas Brenda
Landis,
AIA
SFCS
NNVH
CLC
“Stealth”
Service
“Alley”
Exits,
Janitor,
Mech’l ,
Wheelchair
Wash/Charge
HOUSEHOLD
Porch Entries
Activities/Project
Room /
Therapy
and
Storage
THE
EVOLUTION
OF
SENIOPRU
LTITVIINNGG
CTAHREE
HOUSEHOLD
TOGHETHER
CASE
STUDY:
PARKER
AT
MONROE
SMALL
HOME
LIVING
INTEGRATING
CARE
SOCIAL
CHOICES
MOVEMENT
and
“STEALTH”
SERVICES
Images
with
permission,
Parker
at
Monroe©,
Spiezle
Group
Architects,
LG
Hiatt,
Environmental
Gerontologist,
2016
THE
EVOLUTION
OF
SENIOR
LIVING
CARE
CONCLUSIONS
BENEFITS
OF
CONTINUING
TO
IMPROVE
HOUSEHOLDS
Residents
Caregivers Sponsors
• Freedom,
Dignity • Streamline
• Layouts
supporting
• Exercise
Choices Assistance ADL’s/Memory
are
• Easier
Bathroom
Use Consistent
with
MDS
• Agitation
Reduction • Safety
for
All values
and
$
per
day
• Improved
Memory
• Eases
Personal/
• Images
Improve:
Living
Retention
for
Many Bathroom
Care Rather
than
Sedentary
• Improved
Way
Finding
• Redesigns
Time
for
Social
• Energy
Improved
Person-‐Focused
• Important
to
Roles Stakeholders:
Families,
• It’s
Rewarding! Residents,
Staff
and
Reviewers
Key
Take-‐Aways
• The
physical
environment
can
elevate
or
hinder
the
experience
of
place
from
the
perspective
of
residents,
family,
and
staff
members.
• When
effective,
environments
are
a
24
hour
a
day
partner
in
vitality
and
memory
enhancement…
when
falling
short,
they
render
the
elder
a
“patient”
and
divert
precious
care-‐ and
service
partner
time
to
the
short-‐comings
of
design
rather
than
elders’
potential.
• There
are
lessons
in
the
history
of
design
and
present
progress
suggesting
that
it
is
to
soon
to
fix
one
plan,
size
or
feature
as
the
icon
of
healthy
aging.
Contact
Information
[email protected] Andrew
Alden,
M.Arch.
Mobile:
917.297.8239 [email protected]
@AndrewA_EUA
Jeffrey
Anderzhon,
FAIA Mobile:
414.687.7403
[email protected]
@JeffA_EUA
Mobile:
402.598.3167