Town Hall at Providence Point (64k jpeg)The thinking that goes into a move at this time is crucial. If this move is made to the right kind of house in the right kind of community it can be the last move, or it can be the first in a series of moves as a person ages, becomes more frail, loses companions or finds health failing. There is a range of ``seniors,'' from the agile active underage retiree of 55, through those who need assistance with some element of living, and finally to individuals who need 24-hour care, and each of these categories have vastly different needs.
Regardless of level of care needed, any move is emotionally traumatic. Thus, the goal in designing retirement age housing should be to provide for the inevitabilities of aging and accommodate these changing needs such that the necessity of a subsequent move is substantially reduced, if not eliminated.
This means designing for a moving target. Design requirements for the active elderly are dramatically different from those of the frail elderly. Yet, if the home is designed carefully, it can accommodate these physical and mental changes, particularly with the advent of home health care.
Complicating the process is the fact that everyone thinks he or she is 10 years younger than they are. Most elderly want to live in a community of people their own age rather than with a bunch of ``old people.'' Until the day you need one, grab bars are offensive.
Also, health care reform and the popularity of home health care services are changing people's perceptions and options. Illustrated in the following examples are the three most common types of retirement-age housing and how they can be designed to be appealing from the onset, but accommodate increasing age.
Independent living
Providence Point is an active elderly retirement community for ``those who refuse to retire'' and are at least 55 years old. The 170-acre new town is divided into villages containing a town hall, a restaurant, meeting rooms and a recreational building with swimming pool and exercise room. All facilities on the sloping site above Lake Sammamish are connected through a series of barrier-free pathways.
Given the choice, virtually everyone in this community would prefer to live in a single family home, which for most people means the owner enters the kitchen area directly through an attached garage and guests pass through a private front yard to enter under a private front porch.
Town Hall at Providence Point (64k jpeg)
In 1983 we designed the first buildings to resemble large single family homes, containing four to seven units each. While the units had individual private front porches, many did not have attached private garages. Market demand taught us a lesson and this year we designed 87 attached ``single family'' homes which do have attached garages.
While this is definitely a community targeted to the active elderly, a large part of the attraction is that it was designed to accommodate aging in place, although not visibly.
Potential buyers may notice the lack of a step between the garage and the home and the lever handles on the doors, but they will probably not be aware that the home was designed to accommodate a wheelchair or walker and that blocking is in place in bathrooms for adding grab bars when the time is right. Early homes had medical call strings in all bathrooms and bedrooms but technology advances have allowed these indicators of aging to be eliminated in favor of subtle, neck worn pagers.
The community takes care of all site and building maintenance but individual gardening is encouraged. The design, layout and management fosters interaction and the formation of new friendships, providing ongoing companionship as friends pass on. For most people, Providence Point has succeeded in being the last move, providing an environment that physically, socially and mentally supports, with the assistance of home health care, even a very frail centurion.
Assisted living
Heritage House at the market in Seattle is the state's first true assisted living facility built from the ground up. Managed by the Sisters of Providence, the facility serves a population that is still somewhat independent, but requires some assistance. With 62 apartments on three floors, the project's location within historic Pike Place Market allowed us to take advantage of the sweeping views to Elliott Bay and beyond, while providing easy access to the market and the many services available.
The sense of community is enhanced on the ground floor by the dining, living and parlor spaces that allow for casual or organized social events. The layout allows for an internal ``wandering path'' that is used heavily by residents suffering from dementia. Day rooms on each of the upper floors provide additional places for activities, helping to strike a balance between shared and private time Ä a necessity in keeping residents active and engaged in day-to-day life.
Each apartment is equipped with a kitchenette with a microwave oven, small refrigerator/freeze, and sink. All rooms are air-conditioned and have views of the city, bay, and the market. Residents are encouraged to bring furnishings and familiar objects from home.
Heritage House at the market is a success because it allows people to stay in their neighborhood when they need to make the move to a place that provides a higher level of care. The waiting list is long but the residents find it worth the wait.
Skilled nursing facility
A decreasing percentage of elderly cannot be accommodated in their homes or in an assisted living facility. Often it is due to advanced Alzheimer's disease. The Bumgardner Architects designs the 60-bed Litvin Pavilion Addition to the Kline Galland home for these individuals. Completed in 1993, the facility required a rezone to allow it to be built in the Seward Park single-family neighborhood from which many residents come.
The facility is blessed with the extended family of the Jewish community from which it is supported and managed. This alone is the most significant factor in providing the overwhelming feel of community and home even within the walls of what is, by law and necessity, an institution. The design and layout sprang from the traditions and patterns of personal, yet efficient, care for the elderly that are a part of the Jewish heritage.
The setting is quiet, serene, subtle and safe. The center's nearly two acres of building is never apparently behind a hedge and path that wind through orchards, ponds and birdhouses. Inside is a village where carefully orchestrated activities provide challenges, interaction and companionship for even the most inform of the elderly.
All surfaces are designed for heavy abuse and maintenance yet subtle nuances like recessed entries to private rooms, custom entry lights, bay windows and home-like colors leave more of a sense of a hotel than a hospital.
This, for the most part, is the last move to a new home, yet the trauma of relocation is relieved tremendously by the community-based nature of the facility and the careful design attempts to emulate home.
Retirement age is promised as the golden years, yet for many it can be a lonely process of decreasing self esteem. Each of these examples, through design and management, have succeeded in keeping the promise.
Mark Simpson is a principal with The Bumgardner Architects, which has been designing retirement age housing for more than 25 years.
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