Design roundtable: Experts weigh in on senior living trends

Each year, Environments for Aging presents a Design Showcase of notable senior living architectural and design projects from across the country. All projects are reviewed by a jury of LTC architects, designers, educators and providers. This year, the panel convened in January at Devonshire at PGA National, a CCRC located in West Palm Beach Gardens, Fla. After the final judging, the panel of jurors gathered to participate in a lively roundtable discussion, weighing in on the year’s submissions and general trends and issues in senior living design.

In coming weeks we’ll post online the final four Citation of Merit winners where you can judge for yourself the progress our industry has made in elevating environments for aging in this country. Until then, read on for the judges’ frank assessment of the current state of design and architecture.

BUDGET CONSTRAINTS SPUR RESOURCEFULNESS

The Great Recession took its toll the past few years on the senior living industry in the form of anemic project development and slashed budgets for construction and renovation. The one demographic positive has been the burgeoning population of aging baby boomers on track to fill the senior housing pipeline. However, the fallout from the sluggish economy is reflected in this year’s Design Showcase submissions, for better and worse.

Design Showcase judges. Standing (left to right): Lorraine G. Hiatt, PhD, environmental gerontologist, Planning, Research & Design Consultation; Jack L. Bowersox, manager, Life Wellness Communities Development Co., LLC; Kaye Brown, PhD, adjunct associate professor, anthropology, Boston University; Alec Sithong, project manager, VOA Associates, Inc.; Gail Sterling, IIDA, principal, WHR Architects; Jonathan Douglas, managing principal, VOA Associates, Inc.; Melissa C. Pritchard, AIA, LEED, AP, BD+C, associate principal, SFCS, Inc.; Mary Bamborough, senior client relations consultant, interior designer, Haworth; Ed Nettestad, vice president, operations, SHP Senior Living Services; Mitchell S. Elliott, AIA, chief development officer, Vetter Health Services, Inc. Seated (left to right): Russell R. McLaughlin, AIA, senior associate/designer, AG Architecture, Inc.; Andrew Alden, living environment market leader, Eppstein Uhen Architects; Margaret Christenson, occupational therapist, Lifease, Inc.

Overall, the jurors were challenged to discern award-worthy submissions this year. “I was disappointed by a lack of unique solutions,” says Mary Bamborough. “[Some of] the submissions didn’t deliver on the stories they told.”

“This year, interior finishes trumped architectural design,” observes Mitch Elliott. “I get a sense that the interiors are getting better; they’re stronger. “I struggled with evaluating designs based on the interiors but there were some great spaces with great fabrics and finishes. However, the architecture was weak in many areas. The positive is interior design is improving. Vendors are beginning to understand our market.”

“I was happily surprised at the resourcefulness of the applicants considering the issues [relating to] the recession that directly affect them,” says Lorraine Hiatt. “I was struck by their resourcefulness in project conceptualizing and funding to use existing buildings, the ingenuity in putting a project on the map and getting it done even if occupancy was an issue.”

The results are a function of how insecure people are feeling, says Kaye Brown, referring to those who’ve “lost their conceptual edge and are tending toward the tried and true.”

FORCES OF CHANGE

This year’s judges were encouraged by designers who’ve started tweaking the household model, incorporating more technology into their projects and tailoring projects to the region where they’re located.

In general, the judges bemoaned the lack of projects in the U.S. market as new construction and design work has slowed to a crawl. “How many full projects are on the boards?” wonders Jack Bowersox. “I know CCRCs are few and far between.”

“The game plan has changed,” agrees Melissa Pritchard. “From the architectural focus, we’ve gone from going after $15-million jobs and not considering anything under $5 million to [considering] under $1 million [projects]. I’m not sure we’ll ever go back.”

“The new normal is smaller scale, more phasing, renovations and/or repositioning, but not the whole hog,” says Russ McLaughlin.

“The idea of the baby boomers moving to the suburbs to raise their families and now wishing to retire to the city or urban areas is an untapped open market,” says Hiatt. 

REFLECTIONS ON EVOLVING DESIGN

During the roundtable discussion judges reflected on the evolution of senior living design over the past 15 years since the Design Showcase competition started. Andrew Alden says he’s seen a change in the mindset of designers and developers from approaching senior design from a sterile, hospital-like environment to a home and hospitality model.

“I think it’s about the joy of life, wanting to come here [a senior community] for the joy of life, not to die,” says Alden.

“What we’re seeing in the submissions is a distinguishing of story by the locale, from the interiors to the accessorizing and the fabrics. Designers have added a value to the vision for life,” says Hiatt.

“We’re a huge resource,” contends Pritchard. “I spend as much time educating the clients I work with as designing their projects. “We can see there’s this unit type and configuration and [convey] the pluses and negatives.”

“We understand the value of place and how place makes a connection to experience,” says Jonathan Douglas. “Boomers aren’t looking for a replacement for today’s home but a new experience—an aspirational experience.”

The judges acknowledged the effect rising levels of acuity will have on senior design going forward. “We’re seeing sicker persons, less ambulatory residents, but at the same time we want to create a home,” says Elliott. “At times those [forces] can really conflict and those [higher acuities] may require more staff and [more] technology.”

You have to consider “the distance between where you sleep and eat, getting rid of the [long] hallways, shortening that distance,” suggests Bowersox. “Shorter travel distance is great for residents and staff,” adds Elliott.

“I think the destruction of the central dining room has been a huge win-win situation coming out of person-centered care,” says Elliott. “It comes from scale, bringing scale down to something more intimate, where relationships can be built between residents and caregivers. But the clarion call of scale and intimacy has been [the development of] households.”

Bamborough cautions against “institutional creep” when it comes to providers or care teams set in their old ways, despite the integration of newer concepts like the household model. “An institutional mindset can come back and as a culture we have to constantly work on it from an operational as well as a design standpoint,” says Bamborough.

Senior living design has come a long way over the past 15 years but the judges agree that it’s not the easiest career specialty for design professionals. Alden maintains one needs an almost “pathological tenacity in design for aging. We’ve all [worked on] projects where we go in and say ‘why am I in this business?’ It can be a tough path. But then “I have an experience with residents or staff where I’ve [had an impact on] changing this person’s life,” says Alden. “That’s what keeps us going: those experiences where you’ve affected someone’s experience in a positive way.”

Patricia Sheehan

Patricia Sheehan was Editor in Chief of I Advance Senior Care / Long Term Living from 2010-2013. She is now manager, communications at Nestlé USA.