2018 LeadingAge OK Memory Care Presentation

ADDING MEMORY
SUPPORT to YOUR
EXISTING CAMPUS

The Impact of the Built Environment on Memory Care

Presenters

Daniel Schindhelm Jeffrey Anderzhon, FAIA
Project Manager Senior Planner/Design Architect

Agenda

• An Aging World
• The Evolution of Senior Care Environments
• Environments we Need to Design for our

Residents to Thrive
• Memory Care Environment Case Studies
• Questions/Discussions

AN AGING WORLD

An Aging World (2015)

United States Europe
12.9% 16%

Italy Japan
20% 21%

Sub – Saharan
Africa 3.1%

Percent 65+ in 2010 as estimated by the United Nations.

World Life Expectancy : 65 Years Old

Declining fertility rates and population aging.

An Aging World (2030)

United States Europe
20.0% 24.3%

Italy Japan
28.1% 28.3%

Sub-Saharan Source: US Census Bureau
Africa 3.7%

Percent 65+ in 2030 as estimated by the United Nations.

World Life Expectancy : 70 Years Old

Aging Population: Oldest Old

The number of seniors 85+ is Source: US Census Bureau
estimated to exceed 20,000,000 25
by 2050
20 20.9
§ This is the fastest growing senior 2050
population segment 15

§ The 85+ segment increased 274% 10 0.6 4.3
from 1960 to 1994 1950 2000
5
§ compared to 100% for persons 0.1
65+
0
§ and only 45% for the total 1900
population

§ 40% of those over 85 have cognitive
impairment

Dementia Statistics

Dementia in Oklahoma

THE EVOLUTION OF
SENIOR LIVING CARE

ENVIRONMENTS

(or how we USED to care for the elderly)

St. Simeon’s – 13th Century

Senior Care Prior to 1860 (& into the 20th Century)

Prior  to  1880

• Extended  
Families  Provide  
Physical  Care  /  
Economic  &  
Emotional  
Support

1863-Civil War Hospital

1940-County Homes

1940’s

1950-County Homes

1960-Nursing Home

1970/1980-Nursing Home

• Traditional  “Holdover”

§ Shared  Occupancy  Rooms/2-­piece  Toilet  Rooms
§ Structured  Dining  &  Activities  to  Suit  Staff
§ Loneliness,  Lack  of  Independence  &  Dignity

1E9N9V0IsR-OCoNrMrinEeNDTSoFlOanRCOeLnDteErR ADULTS

1E9N9V0IsR-OCoNrMrinEeNDTSoFlOanRCOeLnDteErR ADULTS

Divided Floor Plan
1990s

1E9N9V0IsR-OCoNrMrinEeNDTSoFlOanRCOeLnDteErR ADULTS

2E0N0V4I-RGOreNeMnhEoNuTsSeF®OR OLDER ADULTS

EEnNvVirIRoOnmNeMnEtsNfToSrFOOldReOr ALDdEuRltsADULTS

REALITY IS CHANGING… AVERAGE AGE
IN THE PAST 10 YEARS FOR RESIDENTS ENTERING CONTINUUM*
65 AND OLDER
Ø Nursing Homes 79 yrs
Ø 58% Increase in College or
Above Educational Ø CCRCs 81 yrs
Attainment past 10 years
Ø Independent Living 85 yrs
Ø 85% Increase in this segment
of aged workforce Ø Assisted Living 87 yrs

(67% with males, 120% with females) *per data from CDC, American Health Care
Association, LeadingAge & Senior Housing News
Ø 482% Increase in poverty level // US Census Bureau

ENVIRONMENTS WE
NEED TO DESIGN FOR

OUR RESIDENTS TO
THRIVE



Physical Environment Comparisons Between Models of Care

TRADITIONAL CONTEMPORARY
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
(2, 3, or 4 people) Shared 2 Piece Bathrooms. Limited Number of Companion
Bathrooms. Limited Private Rooms Rooms, “Smart Doubles”

Monochromatic Interior Colors & Variety of Interior Colors &
Lack of Textures Mixture of Textures

Limited Outdoor Access and Garden Outdoor Access with a Variety of Spaces

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
Maximization of Staff Efficiency Routines

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
Plating of Food Behind Closed Door Food at Decentralized Dining Spaces In
View of Residents

WENhVatIRisOaNHMoEuNsTeShoFOldR OLDER ADULTS

…a household is a place where a small group of
residents live that is their home.

It includes a kitchen (with a wide variety of food
accessible to residents 24/7), a dining room and a living
room. It encompasses households within a building or
single households in the form of cottages, houses and
similar structures.

IEnNtuVitIiRvOeNHMouEsNeThSoFldODR eOsiLgDnER ADULTS

“Unless  the  spaces  in  a  building  are  arranged  
in  a  sequence  that  corresponds  to  their  

degrees  of  privateness,  the  visits  made  by  
strangers,  friends,  guests  and  family  will  always  

be  a  little  awkward.”

(Christopher  Alexander:  A  Pattern  Language)

Porch Foyer Living Kitchen Bedroom
Room/Dining

Room

Public Domain Public/Private Private Domain
Domain

HoENusVeIhRoOldNSMtyENleTsS FOR OLDER ADULTS

Hybrid Household Styles

HoENusVeIhRoOldNLMaEyNoTuSt FCOoRmOpaLrDisEoRnADULTS

Household Layout Comparison Hybrid
Household
Short
Corridor
Household

Hearth
Household

Renovation
Household

HoENusVeIhRoOldN/NMeEiNgThSboFOrhRooOdLDER ADULTS

MEMORY CARE
ENVIRONMENT CASE

STUDIES

HENouVsIeROofNHMoEpNeT-OS FmOaRhaO, NLDEER ADULTS

House of Hope-Omaha, NE



Park Homes @ Parkside, Hillsboro, KS

Park Homes @ Parkside, Hillsboro, KS



Luther Manor, Asbury, IA

Luther Manor, Asbury, IA



HarborChase, Shorewood, WI

HarborChase, Shorewood, WI





Forest Side, Washington, DC





Brookside Care Center, Kenosha, WI

Brookside Care Center, Kenosha, WI