Inspiration is a necessity in life. Thousands of providers across the United States feel constrained by a physical environment that no longer meets the needs of residents, staff, or family members. Giving inspiration to communities considering embarking on a renovation project was the singular goal of Long-Term Living‘s 2009 Remodel/Renovation Contest. Showcased here are the 15 winners and runners-up of facilities that entered in the common space, dining space, or resident room categories. It was our hope, by showcasing remodel/renovation work, that we could give you some ideas of how colleagues are coping with smaller budgets and doing more with less in general, while still furthering their culture change journey.

During April and May, more than 67 submissions were reviewed by a multidisciplinary group of judges from the Society for the Advancement of Gerontological Environments (SAGE). The submissions covered the complete spectrum of the continuum of care, including independent living, assisted living, skilled nursing, and hospice environments.

The SAGE-appointed judges included architects, researchers, interior designers, educators, providers, and culture change specialists. Each judge viewed the submission according to his or her own area of expertise, assuring the projects were evaluated on a wide range of criteria. Judges rated the submissions and provided a comment or two to help clarify the rationale for the rating. The top five projects in each of the three categories (dining, resident rooms, common spaces) were selected for display and voting on the Long-Term Living Web site. Hundreds of participants viewed and voted on the best projects. The highest rated projects from each category are featured in this section. We have included judges’ comments as well as reader comments next to the entries.

The submissions from all three categories ranged widely in amount of renovation and cost of the project. Some submissions tended to solely address the outdated aesthetics of the space by providing new furnishings and finishes, while others looked at incorporating programming and operational changes as well. The most successful submissions looked at more than one facet of the environment targeting culture change. However, all of the submissions seemed to work toward enhancing the resident, staff, or family experience. In that sense, the resident experience usually received the highest priority.

Common spaces

The definition of a “common space” is not very specific, as can be seen in the variety of different spaces submitted, from outdoor courtyards to reception lobbies. Almost 50% of the submissions concentrated on common spaces. Aside from the differences in space type and the intended user, all of the submissions sought to improve the functionality and experience of the space for their residents. In addition, most of the common space renovations followed a hospitality model, in function and aesthetics.

Dining rooms

The dining room submissions presented the largest range of space sizes from a few hundred to more than one thousand square feet. However, all of the renovations concentrated on enhancing the experience of the resident during mealtimes (environmental comfort, views, acoustics, and olfactory exposure). Many of the submissions concentrated on breaking down the scale of larger dining spaces and eliminating aspects often associated with an institutional setting.

Resident rooms

A majority of the resident room submissions (60%) dealt with renovations that enhanced double-occupancy rooms, especially increasing resident privacy. While a few of the submissions dealt only with updating finishes, this category seemed to express the most creativity, due to both a limited budget and typically the largest number of spaces to renovate.

Enjoy reviewing the winners of the 2009 Remodel/Renovation Contest. As a reader service, we have listed vendors and service providers associated with the project.

We hope the inspiration will encourage you to start thinking of a renovation project to improve the experience of your own communities and advance the culture change that is under way. Please be certain to take a “before” and “after” image so that you can contribute to the momentum of communities undergoing renovations by participating in next year’s Remodel/Renovation Contest.

-Andrew Alden, Associate AIA, Engberg Anderson, for SAGE, and the editors of Long-Term Living

COMMON SPACE – REMODEL/RENOVATION

PRS Cascade Manor-Solarium Eugene, Oregon

Architecture and Interior Design: Ankrom Moisan Associated Architects;

Structural Engineers: Kramer Gehlen & Associates;

Woodwork: Chambers Construction;

Mechanical Engineer: The Carmichael Group;

Window Replacement: Mid-Valley;

Custom Window Treatments: Draperies N Things;

Carpet: Bigelow Commercial; Shaw Contract Group;

Custom Couch: Castellano Custom Furniture;

Custom Lighting: Flux Inc. (c/o HL Stearns);

Wallcovering: Colour & Design/Koroseal

A nonprofit, accredited, continuing care retirement community (CCRC), Cascade Manor was established in 1905. The facility embarked on a remodeling plan to create additional space for independent living units, refurbish the current dining area, and add space for a fitness program to allow residents to remain active. Currently, the facility operates an eight-story independent living facility with a healthcare center located on the fifth floor.

The proposed scope of work includes recladding of the building exterior and revamping of mechanical and electrical systems in addition to the remodel of the main dining and kitchen facilities. Two garden apartments add 52 units to the independent living program. A fitness center with a pool addresses the expanding need for health and vitality for the residents.

Cross Road Retirement Community-Activity Room Asheboro, North Carolina

Architecture and Interior Design: CJMW; Structural Design: City Structure D & P, Inc; Mechanical and Plumbing Design/Electrical Design: Applied Engineering; General Contractor: Frank L. Blum Construction; Carpet: Bigelow; Shaw Contract Group; Luxury Resilient Plank: Metroflor; Cabinetry: Archdale Cabinets; Countertops: Formica; Paint: ICI Paints; Pendant Lighting: Progress Lighting; Ceiling Fans: Thomas Lighting; Fluorescent Lighting: Lithonia.

Constructed as a basic multipurpose room in 1982, the Activity Room of the Cross Road Retirement Community in rural Asheboro, North Carolina, featured concrete block walls with vinyl tile flooring and plastic laminate cabinets. Too small, the room had no real definition of space, making activities difficult to coordinate. A tiny kitchenette tucked into one corner was uninviting and hardly used. To ignite a sense of community, the staff at Cross Road hoped to create a more homelike space in which residents could come together for activities and entertainment.

The design team talked to staff about operational goals as well as resident requests and needs. Addressing the lack of space in the Activity Room, two underutilized porches were enclosed. This enclosure not only increased interior square footage, but created a more dynamic exterior façade. It also allowed the creation of a staff break area, moving vending machines out of the residents’ living space.

The resident kitchen was relocated to become a major focal point. An island with a decorative soffit is the only separation between the new kitchen and the rest of the activity space, encouraging increased resident participation in cooking activities and keeping the space open and bright. Existing concrete block walls were covered with painted gypsum wallboard, and the floor was finished with carpet and faux wood flooring, providing residents with a safe, but beautiful walking surface. These finishes, along with the new cabinetry around the existing fireplace, create a more comfortable and inviting gathering area for residents.

Point Pleasant Heights of Parmly LifePointes-Main Lobby Chisago City, Minnesota

Interior Design: Encompass Interiors; General Contractor: Frana Companies; Architect: KKE Architects, Inc.; Electric/Heating/Cooling: Foremost Mechanical; Carpeting: Bigelow; Wall Finishes: Sherwin Williams; Benjamin Moore; Window Treatment: Encompass Interiors; Window Treatment Fabric: Kasmir; Bench: Flexsteel; Bench and Armchair Fabrics: Robert Allen; Armchairs: American of Martinsville; Console Table: Stanley; Table Lamp: Natural Light; Artificial Plants: Natural Creations

The front lobby was chosen for remodeling because it was dark, uninviting, unused by residents, and did not provide space for social gatherings. The objective was to create a larger main lobby with bright, inviting gathering places to provide more room for socialization and activities. Expansion of the main lobby has created a bright, cheery welcome area that offers a coffee shop, library, and fireside parlor. Plans were developed and made available to residents and staff for their input.

The expanded lobby area has encouraged smaller group gatherings, socialization, and activities. On any given morning, tenants gather in the coffee shop to chat. The library is used regularly for group activities such as playing Wii, watching movies, attending presentations, and so on. Residents, families, and visitors enjoy relaxing in the fireside parlor while they visit or participate in other social gatherings. This design allows private social gatherings by closing the pocket doors to the main lobby.

The integration of the new electrical heating and cooling systems with the existing was challenging. To resolve the integration challenge, additional outlets and heating and cooling vents were installed along with an additional air-conditioning unit.

Presbyterian Homes McGaw Care Center-Spas Evanston, Illinois

Architecture, Interior Design, and Furniture, Artwork & Accessories Procurement: Jensen & Halstead, Ltd.;

General Contractor: W. E. O’Neil Construction Co.;

HVAC: Atomatic Mechanical Systems;

Plumbing: Bates Plumbing;

Fire Protection: F.E. Moran;

Electrical: Rex Electric; “Wood Look”

Sheet Vinyl: Teknoflor;

Resilient Base: Johnsonite;

Solid Surface: Corian;

Wilsonart; Wallcovering: Wolf-Gordon; Koroseal;

Granite: Stone Source;

Plastic Laminate: Pionite;

Toilet/Shower Window: Design Tex-Fusion;

Entrance Door: Skyline Design;

Ceramic Carpet: General Polymers;

Decorative Lighting: Crystorama Lighting Group.

Presbyterian Homes in Evanston, Illinois, is one of the country’s most experienced providers of retirement living. They pride themselves on offering exceptional, individualized care, focusing on the physical and emotional needs of residents. The recently completed spa project at the McGaw Care Center embodies the Presbyterian Homes’ spirit, providing warm and relaxing personal care spaces for bathing, grooming, and massage. Before this renovation, the shower rooms were small and awkward.

The spas were designed with a sense of elegance that has become the Presbyterian Homes trademark. Graceful curves, rich architectural moldings, and soft ambient lighting create an intimate environment. The curved walls also function ergonomically to be wheelchair friendly, avoiding sharp corners and allowing residents to maneuver easily. The new spas are each the size of a skilled care resident room, which presented spatial constraints and required meticulous planning. The design was thoroughly tested by the staff with full-size templates made to evaluate the efficiency of the layout.

One of the most important functional aspects was to keep steam from escaping the shower area of the spa. This was accomplished with high-volume exhaust fans that remove the steam without causing a draft. Radiant floors provide warmth underfoot, adding to the ambience of the space. Residents are enjoying the extensive treatment offerings and a space that provides more dignity and privacy.

Mercy Ridge Retirement Community- AL/Dementia Unit Kitchen, Dublin Court Timonium, Maryland

Interior Design: PLDA, Inc.;

Mechanical/Electrical Engineering: James Posey & Associates;

Countertops: Richlite Corp.; Icestone;

Sustainable Flooring: Capri Cork;

Fireplace: HomeClick;

Casework: KraftMaid (c/o Just Cabinets);

Lighting: Bellacor Lighting;

Tile: Architectural Collections;

Accent Glass Tile: Florida Tile

Mercy Ridge Retirement Community (MRRC) is a Continuing Care Retirement Community (CCRC) in the northern Baltimore area. Its 12-resident Dementia Unit needed an overhaul to keep current with market trends and retain resident and family member appreciation to maintain full occupancy. The retirement community also was starting to undergo a systematic “Green Design”/sustainability upgrade throughout the campus. Working with PLDA, Inc., MRRC implemented a dedicated ecofriendly mini-project as a test case for operational implications and planning methodology.

Being limited to an interior upgrade allowed the project to retrofit isolated building systems, improve and enhance finishes, lighting, controls, and alter casework to best suit the operational needs as well as create a stunning visual element that appealed to all. Harkening back to a style that is familiar to the older residents, an Arts and Crafts architectural motif was used to unify the public spaces. Enhanced with memorabilia from the Maryland Eastern Shore-Boardwalk, vacation images are recalled within Dublin Court’s indoor/outdoor transition spaces.

The central activity kitchen became a feature and visually connects the various activity spaces, supporting programming and quality-of-life amenities. Color was introduced to give suitable energy to the setting. To further complement the sustainable profile of the project, reclaimed materials were used (barn wood siding for the Boardwalk/corridor; rapidly renewable cork plank flooring throughout, and so on) along with Energy Star-rated appliances (Sub-Zero refrigerator and KitchenAid induction cooktop) and low-VOC paints. The glass front refrigerator helps with visual cues and promotes a better nutrition program. Existing kitchen cabinets were donated to Habitat for Humanity for immediate reuse in the greater community, diverting it from the waste-stream. A central hearth is defined by casework and reused stained glass panels atop a faux fireplace.

The selected design motif helps provide a familiar and calming setting to residents with dementia and is a marketing plus for the community, both for internal population and prospective families.

DINING – REMODEL/RENOVATION

Mennonite Home-Wissler Run Dining Room Lancaster, Pennsylvania

Architect/Interior Design: Reese, Lower, Patrick & Scott, Ltd.- RLPS Architects;

General Contractor: Benchmark Construction Company, Inc.; Mechanical, Electrical, and Plumbing Engineer;

Lighting Consultant: Reese Engineering, Inc.;

Common Area Furniture: Benjamin Roberts, Ltd.;

Artwork: Booth Framing Arts, Inc.;

Flooring: Bomberger’s Store;

Cabinetry/Woodwork: Rick’s Custom Wood Design

One of the major dining goals was to eliminate the institutional tray service to residents. A Dining Action team comprised of staff and a former resident’s spouse worked carefully to plan for the implementation of serving meals in the households.

In the “before” picture, the dining room felt closed in, lacked daylight and felt very institutional. The team worked with the architect to create a warm, open, residential-looking dining room. Four skylights were added, allowing natural light to infiltrate the space. Glass windows were removed from the corridor openings. An arch with a half wall and pillars provide separation from the Common Space and add architectural detail.

The facility incorporated steam wells into the countertop in the kitchen. This allows the aroma of the food to fill the Dining Room. Residents’ meals are served on cheerful Fiesta®Ware. The kitchen contains an oven so that staff and residents can bake between meals. The kitchen refrigerator is stocked with a variety of snacks that residents can freely access.

When residents moved into this household, two residents that always ate in their rooms immediately started eating meals in the dining room. Staff note that residents eat better in the new household dining rooms.

Because of a load-bearing wall, the kitchen design is not as open in this household. Therefore, there is less counter space in the front of the kitchen. A residential cart was purchased to provide extra space during meals.

Alexian Brothers Sherbrooke Village St. Louis, MO

General Contractor: McGrath and Associates;

Architect: HKW Architects; Interior Design, Furniture Specification &

Procurement, Artwork Master Planning: Spellman Brady & Company;

Furniture Installation: Manley Furniture Installation;

Wall Coverings: Korogard;

Flooring: Teknoflor;

Stone Fabrication/Granite Countertop: Hallmark Stone;

Tabletops: SurfaceWorks;

Artwork Framing: Arch Framing;

Upholstery: DesignTex Fabrics and Paul Brayton;

Window Treatments: Draper;

Paint: Benjamin Moore;

Lighting: Progress Lighting and Hampton Bay Light Fixtures;

Furniture (chairs): Kwalu

Spellman Brady & Company designed the new Dining Room according to the goal of Sherbrooke Village to have an inviting and noninstitutional dining environment. The previous dining area at Sherbrooke Village was a congested space defined by an out-of-date color palette. Residents and staff agreed the space was limiting, dark, and in need of an update.

The new dining area was designed to feel warm, welcoming, and homelike. The soft nature-inspired color palette is subtly pleasing and calming for residents, and the new, softer paint color allows the natural light to reflect into the room for an uplifting effect. New light fixtures, furniture, and flooring were added according to the new color palate. Durability and maintenance were considered, making the space not only warm and beautiful, but functional.

Other improvements to the space included the removal of dark, decorative columns, which impeded traffic flow and added to the previous closed-in feel. Removing the columns opened the space, which allowed more space for maneuvering walkers and wheelchairs in the dining area. A “bistro” was added where residents can see and smell their food choices before choosing their meals; a lifestyle improvement offering both choice and control as part of their daily routines.

Sherbrooke Village now has a modern, inviting space where residents can enjoy their meals, have more choice and control over their daily routine, and get around easier than before. The new design creates a warm and homey environment where residents can linger and socialize long after dessert is served.

St. Camillus Wauwatosa, Wisconsin

Interior Design: Reese, Lower, Patrick & Scott, Ltd.-RLPS Architects; Mechanical, Electrical, and Plumbing Engineer;

Lighting Consultant: Reese Engineering, Inc.;

Carpeting: Shaw Contract;

Seating: Kwalu;

Vinyl Wallcovering: Wolf-Gordon;

Tables: Falcon Products

In 2003, the Health Center at St. Camillus, located outside of Milwaukee, was a prime candidate for the complete reinvention of its medical-model nursing facility. The result is a progressive concept that includes upscale assisted living accommodations and social-model skilled care neighborhoods.

The design team converted the existing 190-bed medical-model health center into distinct neighborhoods of assisted living, memory care, and skilled care. While each neighborhood has its own identity, elements of home and connections to daylight are evident all around. In addition, renovations and interior finish upgrades are consistent between assisted living and nursing in a deliberate effort to minimize the traditional differences between settings and reduce the trepidation typically associated with transitioning from one to another.

The dining room renovation reflects the dramatic transformation achieved throughout with finish selections that reflect a hospitality focus rather than institutional standards. The addition of columns and ceiling bulkheads define the space and create a more intimate scale for dining. Fluorescent light panels were replaced with multiple light sources to provide a pleasing ambience and comfortable light levels for senior diners.

The primary challenges to updating and repositioning this aging facility centered on the logistics of converting an occupied facility and the uncertainty of market acceptance for a solution that combined skilled care and assisted living in one building. The reinvention of the St. Camillus Health Center is an example of responsible stewardship by improving resident quality of life which, in turn, breathes new life into an existing community.

Arleigh Burke Dining Room McLean, Virginia

Interior Designer: Reese, Lower, Patrick & Scott, Ltd.-RLPS Architects;

General Contractor: The Dietze Construction Group;

Flooring: Sincol Flooring-Surface Materials;

Faux Brick: Glen-Gery;

Paint: ICI;

Silk Plants: Labs, Inc.;

Dining Chairs: Shelby Williams

Following the construction of a new assisted living memory care facility, Vinson Hall Corp. (McLean, Virginia), reinvented a former nursing floor to create assisted living apartments. The renovation transformed the overall ambiance of the former nursing floor from clinical to residential with a soft color palette and residential finishes, highlighted by a two-story atrium dining space with clerestory lighting. The dining space was re-created into an appealing garden courtyard by introducing exterior materials such as a brick façade on the two-story focal wall, complemented and softened by balconies, arches, faux exterior windows, and overflowing flower boxes. Decorative features, such as a wooden trellis and wrought iron railings, further support the desired image while masking existing institutional railings. A luminous ceiling replaces the previous commercial cylindrical ceiling lights and simulates a large overhead skylight.

Challenges to the repositioning process included creating a separate identity for the assisting living floor, transforming the overall ambience from a clinical setting to an upscale residence, and providing marketable apartments and ample amenities within the existing space, while nursing care residents remained in the floors above. The most important consideration was coordinating construction activities to minimize disruption to those residents.

Mennonite Home-Swarr Run Dining Room Lancaster, Pennsylvania

Architect/Interior Design: Reese, Lower, Patrick & Scott, Ltd.-RLPS Architects;

General Contractor: Benchmark Construction Company, Inc.; Mechanical, Electrical, and Plumbing Engineer;

Lighting Consultant: Reese Engineering, Inc.;

Common Area Furniture: Benjamin Roberts, Ltd.;

Artwork: Booth Framing Arts, Inc.;

Flooring: Bomberger’s Store;

Cabinetry/Woodwork: Rick’s Custom Wood Design.

As in the Mennonite Home’s renovation of the Wissler Dining Room, the Dining Action team’s goal was to institute person-centered care by eliminating institutional tray service to its residents with dementia. The Dining Action team, comprised of staff and a former resident’s spouse, worked carefully to plan for the implementation of serving meals in the households.

Prior to the reinvention, the dining room was large and served up to 46 residents. It was crowded and was noisy at meal time. With the architect, the team created a residential feel with a warm, open kitchen and dining room through the use of warm yellow paint colors, rich cherry cabinetry, and a large window. Eighteen residents with dementia are now served in this household and meals are peaceful.

Steam wells were incorporated into the kitchen countertop to allow the cooking and baking aromas to fill the dining room. Because this household serves dementia residents, the staff experienced attempts by residents to enter the kitchen area during serving time when steam wells were hot. To solve the problem, a wall-mounted retractable belt barrier was added to the kitchen entrance to protect residents.

As in other households residents are served their meals on Fiesta®Ware. This kitchen also contains an oven that allows staff and residents to bake between meals if they wish. The kitchen refrigerator is stocked with a variety of snacks that residents can access at any time.

The new kitchen and dining room have been well-received by staff and residents. It has been observed that the residents eat better in the new household dining rooms.

RESIDENT ROOM – REMODEL/RENOVATION

Mennonite Home-Swarr Run Lancaster, Pennsylvania

Architect/Interior Design: Reese, Lower, Patrick & Scott, Ltd.-RLPS Architects;

General Contractor: Benchmark Construction Company, Inc.; Mechanical, Electrical, and Plumbing Engineer;

Lighting Consultant: Reese Engineering, Inc.;

Common Area Furniture: Benjamin Roberts, Ltd.;

Artwork: Booth Framing Arts, Inc.;

Flooring: Bomberger’s Store;

Draperies: Martin’s Draperies & Interiors;

Bedroom Furniture: Phoenix Contract;

Cabinetry/Woodwork: Rick’s Custom Wood Design;

Hospital Beds and Medical Equipment: Hill-Rom

A significant goal in the reinvention project was to create additional privacy options for residents. Much of the existing skilled nursing area was comprised of traditional medical model semi-private rooms. A staff design team worked with the architect to create a number of new fully private or modified private rooms in each household. Each room contains a European shower that allows the resident to bathe in privacy.

The modified private rooms exist in the same space where two traditional semi-private rooms (four residents) lived in the past. Now, two residents live in the space separated by a hard wall providing enhanced privacy for each person. The two residents share the European shower.

A painted accent wall was added to each resident room providing a variety of colors within the household. Wiring/jacks are in place for the facility to mount flat-screen LCD televisions in each room. A headset jack is in place at the head of the bed so residents can watch/listen to their television without disturbing others. The facility purchased new resident room furniture that is residential in nature. The remaining finishes including the lights, chair fabric, bedspread, and draperies were selected to ensure that each resident room is warm and comfortable and feels like home. Staff, residents, and family members have all expressed appreciation for the enhanced privacy options in the resident rooms.

The Abington Glenview, Illinois

Interior Design: Hanna Z. Interiors, Ltd.;

Paint and Wallpaper Installation: Painting and Decorating Services, Inc.;

Millwork: P.W. Construction, Inc.;

Floor Installation: Jerry’s Carpeting;

Bedspreads and Cubical Curtains: Superior Drapery;

Drapery: Tailored Draperies, Inc.;

Electrical: Luko Electric, Inc.;

Carpeting: Lees Carpets;

Wallpaper: MDC Wallcovering;

Furniture: American of Martinsville;

Upholstery Fabrics: Arc-Com Fabrics.

Built in the 1970s, The Abington’s resident rooms were becoming worn and outdated. The current area population was a more upscale, wealthy clientele who demanded a less institutional environment for their parents and loved ones. The renovation provided an opportunity to improve the residents’ quality of life by increasing the warmth, beauty, and functionality of their resident rooms. Creating rooms that mimic the elegance of a 5-star hotel, while adding more functions within the existing square footage, the facility was able to increase their room rates, level of service to the residents and their reputation with the community.

With input from the current families and clients, The Abington created more “single room” options. These former double-bedded rooms resemble small apartments, rather than institutional cold sleeping areas. Use of Unibond carpet, controls moisture penetration into the slab, while stain-resistant yarn keeps cleaning and odors under control. The softness to the residents’ feet and the sound muffling provided by the carpet immediately eliminates the old, hard nursing home room attitude.

Functionally, additional call buttons were positioned in locations (not just a