Amy Carpenter, AIA, LEED AP, BD+C, may have started out as a residential architect, but when she got her first senior living project fifteen years ago, she never looked back. The dementia care-centered project was being adapted for three different states, just the kind of challenge she loves. “I had to figure out how to make this building work under three different sets of building codes,” she says. “Then, the more I researched and learned about designing for dementia and the microsocial aspects required of the design, I saw how the design could improve the quality of life or make people miserable. When I realized the type of carpet or wallpaper you choose can drastically alter someone’s life—that’s the moment I was hooked.”
In 2004, she attended a conference session presented by the Society for the Advancement of Gerontological Environments (SAGE), a group she promptly joined and has been a member of ever since—including serving at different times as its vice president and secretary. Now a senior designer and project manager at SFCS in the firm’s new Philadelphia office, Carpenter is firmly ensconced in groundbreaking designs for senior living. “I love it all, but I gravitate toward the end of the care spectrum—end-of-life care and skilled nursing.”
Carpenter isn't shy about her other passion—She's crazy about building codes and has spent the past four years changing some of them for senior living communities.
Her work with the Life Safety Task Force, an initiative launched by the Pioneer Network and funded by Hulda B. and Maurice L. Rothschild Foundation, resulted in important code changes for kitchens and dining spaces in buildings with less than 30 residents. The changes helped pave the way for open-view cooking, a model where residents can order a meal and have it prepared to order right there, like a restaurant. “It’s a big part of person-centered care—to have meals that you can see and smell being prepared.”
The changes were approved by the 2012 edition of the 101 Life Safety Code under the National Fire Protection Association (NFPA), and the Centers for Medicare & Medicaid Services followed suit by approving the code for Medicare-funded communities. Later, the code changes also were adopted for the 2015 edition of the International Building Code.
The new codes opened up a host of possibilities for residents and dining staff, including more creative menus, time-flexible dining and exhibition cooking. The model also provides new activity opportunities for residents, where food smells could entice appetites or a cooking class might create greater interest in nutrition, she adds. “We’re even seeing some families bringing in a resident’s favorite recipes to share.”
From the business side, the person-centered dining model isn't as convenient or as economical as preparing dozens of identical meals and serving them all during a designated meal time, she says. “The challenge for communities will be, how will they staff that kitchen? How do you designate the jobs of cooking? Who on your staff has the desire and aptitude to prepare the food under this model?” The new model may have communities seeking gourmet chef skills and experts in preparing menus with plenty of choice, she adds.
DESIGNING FOR DIGNITY
As the national demographics change, design that supports memory care is moving beyond skilled nursing and into all levels of long-term living, including independent living, she says. "We have to think about every design decision and filter it through the lens of what works for those with cognitive decline. That doesn't mean there isn't a place for dedicated memory care centers, since many people benefit from being in those specific, controlled environments. But we need to think about design for supporting memory like the way we think about how lighting affects the elder eye and how the type of furniture chosen can support accessibility," she says. “All design for senior living spaces needs to be about designing for resident dignity.”