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Surroundings symposium

July 15, 2011
by root
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Three prominent long-term care designers—one lively discussion. The dos and don'ts of flooring, lighting and furniture


It's not every day you can lock down three of the field's most intriguing and expert sources on aging environments and design to debate best practices in long-term care installations. When you get that opportunity, you make the best of it.

The editors of Long-Term Living proudly present this designer roundtable, featuring:

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.

Lisa M. Cini, ASID, IIDA, is founder and president of Mosaic Design Studio in Columbus, Ohio. Cini's work has been recognized by the American Society of Interior Designers with the First Place designation in its Chapter 32 Design Awards every year since 2007, and she has received several local business awards in her home city of Columbus. Cini regularly participates in national speaking engagements on design and is a blogger for Long-Term Living (

And without further ado…


Elliott: The functional and programmatic expectations of the space should drive the floor selection. We begin with the question, “What is best for the resident within this space?” Considerations include safety, aesthetics, acoustical control, comfort and the level of self-ambulation by the residents. Second to the needs of the resident are the needs of the caregiving staff. You also have to look at the initial and long-term maintenance costs of the material, and we can't be specifying materials without gathering input from the environmental workers taking care of these surfaces. And in our organization, if the material that is better for the staff compromises quality care or quality life for the residents, the residents always win.

Brawley: With the advancements in technology and construction methods in soft surface floorcovering, there are more options today for LTC and senior living environments. The color palettes are greater than ever and are aesthetically pleasing.

Carpet is an excellent choice for senior living dining rooms, social rooms, corridors and resident rooms. Not only does it control the number of transitions, but it also helps with acoustics by softening floor noise generated on hard surfaces. Because many elders in these settings have vision issues, using a mid-range color palette for flooring makes the color more visible. Lighter hues show stains, requiring diligent cleaning. If excessive maintenance is needed, carpet would not be a good choice.

I would also like to see tasteful monochromatic patterns developed—it's one solution for providing pattern and interest without introducing multiple colors and confusion underfoot. Large patterns incorporating multiple high contrast and bright colors are confusing, disorienting and dangerous for older adults with vision impairment or dementia.

Tasteful wood flooring adds character to this bistro at the querencia retirement community in austin, texas. design by d2 architecture, dallas, texas.
© James F. Wilson, Photographer
Tasteful wood flooring adds character to this bistro at the Querencia retirement community in Austin, Texas. Design by D2 Architecture, Dallas, Texas.

Cini: I completely agree with Betsy regarding the importance of selecting the right hue of color for flooring, which in high traffic areas should have a varied pattern with multiple complementary colors to add visual interest, hide difficult stains and reduce the appearance of traffic patterns. Betsy mentions monochromatic colors, but I find that if the colors are complementary and of the same value, the intensity is lessened but stain and soil hiding are increased.