Defining ‘non-institutional’ interiors

For the upcoming July 2011 issue of Long-Term Living, we asked three well known senior living designers to debate the pros and cons of various facility installations. The following is a breakout discussion on non-institutional interiors.

LTL: In her January 2011 story for Long-Term Living (“Evidence-based design for dementia”), Margaret Calkins questions the meaning of “non-institutional” when the term is used to describe décor in senior living and long-term care. What does non-institutional mean to you?

Lisa M. Cini: As an individual designer, non-institutional means that I would be comfortable living with the styling of the furniture and fabrics. Margaret does note that there is a huge range of styles from contemporary to traditional. We have found, however, that there are roughly six or so styles that, depending on the geographic part of the country and the background of the residents, are fairly consistent.

Those styles are:

● Midwest, which is semi-traditional with darker woods and patterned fabrics. Colors range in the greens, reds, yellows and some blues.

● Coastal, a collection of lighter and brighter color schemes with large patterns including white, woods and neutrals.

● Small town, featuring antiques, plaids and Midwest color schemes. Not over done on the accent fabrics and artwork.

● Cottage, another light, bright style but with less pattern than that of the Coastal schemes. It is a merge of the Small Town with the casual Coastal wood tones and painted pieces.

● Southwest, full of terra cottas, sage greens and cherry and oak wood tones. More texture in the fabrics than pattern with the exception of “focal pieces.”

● East Coast, a heavy traditional look with jewel tones and mahogany finishes. Carvings on the furniture and accent pieces abound.

This being said, the furniture still needs to meet code, be easy to clean, easy for the resident to use and hold up to the abuse of a multi-resident, 24-hour home. To boil it down, non-institutional means that the resident or family would not know that we had met code, would see the piece was designed for easy maintenance and believe it was sturdy enough to withstand the needs of the home. If we can do this, then we have successfully achieved a non-institutional décor.

Mitchell S. Elliott: I appreciate Lisa's examples of regional styles. I truly believe that as designers, we need to understand the context of the community. Does the community celebrate with wine and cheese or beer and brats? What era represents success and contentment for our elders? For their families? This awareness to community context should really drive our choices for furniture and interior design.

We are opening a new nursing facility this July. The building has an Arts and Crafts theme both inside and out. In reality, the 1930s may bring up memories of the depression and financial struggles for many of our residents. It will be interesting to explore their reaction to this style as they move into their new home. For us designers, it has been extremely fulfilling to put together this concept, but it isn't about us.

Elizabeth C. Brawley: Furniture offers opportunities to add color, pattern and fun to some otherwise pretty staid environments. Informal spaces are often the most used and enjoyed—the colors are brighter, the light levels are higher and the furniture styles less formal, which helps to make up for diminishing vision.

Upholstery fabrics for healthcare have also improved a thousand percent in the past 10 years. Many colors, patterns and designs are now available in stain-resistant finishes, making our job easier. There is a much greater variety in the choice of excellent products today.

Elliott: A piece of furniture that we are constantly evaluating is the recliner and lift recliner. Neither option is appropriate for residents who experience some level of dementia. But for the cognitive residents, they can be a wonderful residential amenity.

In our short-term rehab facilities, the patients/residents love the electric recliners, both lifting and non-lifting. The caregiving staff seems to support recliners in these environments as most residents don't bring in their own furniture for such a short stay. Our therapists, however, don't typically support the use of recliners, especially the lifting variety. They feel we are undoing everything they have done in rehab by providing a lift recliner.

Fortunately, we are working with some furniture companies to design a more residential, less institutional lift recliner. Some of our rehab patients have asked if they could take their recliners home with them, so I think they are well accepted.

Brawley: I use multiple loveseats and an occasional sofa. Three people never sit on a sofa together and the person in the middle has no means of support to get up and out. Two people will sit next to each other on a loveseat and each has an arm for support to help them rise.

Elizabeth C. Brawley, AAHID, IIDA, CID, is president of Design Concepts Unlimited and one of the preeminent authorities on lighting for senior environments. With more than 30 years of experience, Brawley specializes in designing therapeutic environments for Alzheimer’s special care and was awarded the 1998 Polsky Prize for research in this area. She is a founding member of the American Academy of Healthcare Interior Designers and holds an advisory position with the Illuminating Engineering Society of North America.

Mitchell S. Elliott, AIA, is chief development officer at Vetter Health Services, and serves as vice-president of the Society for the Advancement of Gerontological Environments. A 28-year member of the American Institute of Architects, Elliott oversees the planning, design, construction and property management of all 33 Vetter-owned nursing facilities and retirement communities throughout the Midwest. Elliott’s work reinforces resident-centered care, and he has been a member of the American Health Care Association Life Safety Committee since 2009.