If I Designed a Nursing Home

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.

Communal bathing rooms would have showers, bathtubs, and whirlpools in a barrier-free design with enhanced lighting, pastel colors, and larger mirrors. Drop-down shelves would hold bathing items, and hanging bars would keep clothing high and dry. Tissue and toilet paper holders would be recessed or covered. Height-adjustable shower chairs would be great. Today’s privacy curtains could be replaced by fiberglass folding doors. Shower chairs would not contain metals that rust. Extra drains and high powered sprayers would make cleaning easier. Built-in hairdryers and heat lamps would warm bathers quickly. Residents would appreciate their colorful bathing room with an adjacent closet for supplies.

I prefer small dining rooms with a seating capacity of 30. But today, additional space is needed to accommodate larger wheelchairs. Residents should not be transferred from their wheelchairs because of insufficient space. Three smaller dining rooms would allow special-needs residents to dine together. A round table in the lounge, near the television, would enable residents to eat during sporting or other special events. Dining in a separate area may be optimum but occasionally a more casual style is a nice break.

I think counter food service would be easier and staff would no longer need to go to the kitchen. A better meal cart is needed to keep meals hot for residents eating in their rooms. Serving times could be staggered to accommodate residents. A built-in unit juice bar with snack area, refrigerator, and microwave would be inviting to residents and family members, and make the staff’s job easier.

Public restrooms need to be barrier-free. Some visitors use walkers and need more space. If visitor restrooms are locked, keys should be easily available 24/7.

Facilities need resident/visitor rooms. The activity room could have convertible furniture that can be moved out of the way. Cabinets with counter space, a large sink, and microwave would enable staff to prepare food for activities. Residents need a hobby room to work on and store items. A separate media room would provide an area for residents to listen to audio books, CDs, or watch DVDs. A meditation room would allow residents and visitors a quiet place to reflect.

Residents must have computer access. Linkages with businesses could provide affordable older computers with Internet access where residents can surf the net, play cards, games, and write letters. Outdoors secure areas are needed separate from access roads and parking areas, where a resident can roam.

Residents could develop a cottage industry. Since many people today enjoy crafts, it is natural transition. It would help to alleviate boredom. Could you imagine giving up your knitting or scrapbooking? Cottage industry items could be sold and the profits used to purchase more supplies.

Dementia residents would benefit from a small-home type environment. It would provide constant walkers a secure area with a change of scene. All furniture should be scrubable and have higher seats.

Though, nursing home design is evolving and changing, I wonder if residents are ever asked what they would like. In this area of Ohio, the Main Street design is being implemented. I think that it is an interesting concept, but nursing home entry areas have traditionally been grander and more expansive than the back where the residents spend their time. The Main Street plan seems to promise residents places to go and things to do. It also appears that residents will be consumers of services rather than patients, and the design is likely more eye-pleasing to families.

Vocal baby boomers who want more of everything will be coming to long-term care. I would like care homes to be less ‘medical model’ with Blackberries and computers assisting with record-keeping and care. Long-term care facilities’ functionality and adaptability will determine how well care is delivered. Whether the design is Main Street or some other, attention will be given to the care in residents’ rooms … behind all that.

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