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If I Designed a Nursing Home

September 8, 2008
by Kathleen Mears
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Several years ago I started a long-term care design plan. After fleshing it out, I began considering its cost-effectiveness. Then, I stopped writing my plan. I saw how difficult it is for the long-term care industry to design facilities that are functional and attractive. Number crunchers then would have considered my plan 'blue sky.' Given some facilities I have seen lately, maybe my plan may not have been extreme.

My design would have assisted living, skilled nursing, rehab, and long-term care available on the same site. Residents would not have to move far because their finances or level of care change. For people with disabilities like me, and others with health problems, moving is life altering. I like the idea of aging in place.

Each resident needs private living space. Pod design allows each resident a partitioned space where two share a bathroom. Then pod mates can either visit or be alone. A small sitting area in each pod would improve things. Ideally, each resident should have their own bathroom. Or if cost will not allow, other bathrooms should be available in the hall. In my experience, female residents are territorial about bathrooms.

I think facilities need built-in and modular closets with sliding doors. Changeable shelves and hanging space would allow closets to be adapted for the resident's needs. A built in, locked compartment should be available and accessible in each resident's room.

I think new construction should feature barrier-free design. Wheelchairs or walkers should be able to navigate and pass comfortably. Doors on common areas should be eliminated. People without arm strength cannot open them and are effectively shut out. Outside doors that open automatically would assist residents and visitors alike.

I think older facilities could open up the front lobby and business office area. By removing part of the office wall and replacing it with one-way glass, office staff can see daily activity. Separate space could be allocated for prospective employees and business office visitors, so residents can use the lobby. The front door would be monitored by a security camera and the employee entrance as well. Facilities need to protect wanderers while eliminating alarms at entrances.


Kathleen Mears



Kathleen Mears is a long-time blogger who has been a nursing home resident for 21 years. She is...



As an addition to your comprehensive list of suggestions I would add that all doors residents and family members pass by or go through would have door hinge guards installed to prevent finger-trapping injuries and amputations. In the USA there are 300,000 finger and hand injuries caused by doors every year mainly to children and vunerable adults

I want to work for you! I enjoy reading your articles and am inspired by your ideas....I wish the general public, younger nursing home staff members and other people had access as well. You must be a joy to care for and visit with. I'm sorry I don't know you personally.

WOW This is great modifications of a nursing home and assisted living building. I think a lot of this is great and would occupy the residents as well as family members. thier wouldn't be so much boredum if thier was always something to do or some where to go. and the residents would seem to be very happy and peaceful in this kind of an enviroment setting. love all this ideas . austin

Love this idea! When you build it I want a job lol

Great comments...Much of what you are saying is what is already happening in Continuing Care Retirement Communities...There will be a major change in how LTC is structured in the next 20 + years. Sadly so many of the ideas (all logical) couldn't have been implemented long ago. The problem is that many of the nursing homes are bound by the bottom line...not necessarily logic. And logic coupled with great customer service can often impact the bottom line in a very real, positive fashion.