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Designing the Nursing Home of the Future

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Designing the Nursing Home of the Future
@Paul Burns, Getty Images

While the desire for most people is to age in place, you don’t need to dig far to find the crippling health statistics that suggest that people will need nursing homes and assisted living facilities. Designing the nursing home of the future with a focus on person-centered care will be crucial. Future residents will demand a different model.

Not Just Green Houses

Much has been made and rightly so of the concept of The Green House. This project creates small, communities by altering facility size, interior design, staffing patterns, and methods of delivering services. Their theme is: Warm, Smart and Green.

The warmth starts with a floor plan that encourages social interaction, as well as comforting décor and furnishings. The smart comes from using cost-effective, smart technology. And green means letting in the natural world, through sunlight, plants and garden areas.

Not every nursing home can afford to transform into a Green House or build one. Does that mean person-centered care cannot thrive? Certainly not.

Designing the Future Nursing Home

Quality of life for a resident is not just about the physical environment. It is about the social and cultural environment and how all work together. It is about hiring the right staff and educating staff on culture change.

It is about having policies that are flexible. Signage, dining options, consistent staffing – all of these contribute to quality of life. But no doubt the physical environment plays a large role in resident satisfaction.

From Hospital-Like to Home-Like

Nursing homes in particular started as offshoots of medical facilities and many retain that appearance. So the entrance plays a large role in first and lasting impressions. Here are easy steps to make it more welcoming.

  • Have clearly marked signage that identifies the entrance.
  • Create reserved parking for visitors.
  • Have wheel-chair accessible curbs and ramps that are easily identifiable.
  • Create landscaping that is colorful and inviting.
  • Decorate for the season.
  • Install decorative but functional solar lighting.
  • Create comfortable seating areas.

A Warm Reception

The first impression continues when you walk into a home. Many times the first thing encountered is a nursing station. For security and other reasons it is important to create a reception area.

  • Create a reception area even if limited in size.
  • Staff it with a volunteer if staff is not assigned.
  • Construct a visitor’s restroom off the lobby/reception area.
  • Set up a coffee/tea bar important for both hospitality and for creating inviting “smells” as you enter the home. The smell of baking bread can be an alternative achieved by buying an inexpensive bread maker.
  • Have soothing and inviting music playing.
  • Have a log-in book and install non-conspicuous video cameras to monitor the space. After all this area needs to be welcoming but also serve a security purpose.

Navigating the Home

Corridors start residents and visitors on their way-finding path. Adequate lighting and signage that makes sense is important here. Corridors can become spaces that tell stories.

  • Create a history of the home through photos.
  • Highlight recent activities.
  • If non-profit, use walls to showcase fundraising initiatives.
  • Showcase local students’ and residents’ artwork.
  • Make sure the corridors are functional too with non-slip flooring, grab bars, etc.

Dining Experiences Key to Satisfaction

Many nursing homes and assisted living facilities maintain one common dining area so it is important to use this space to create great experiences. The dining experience is crucial to the satisfaction of residents and families alike.

  • Many dining areas are cavernous and impersonal. Break up the space. Consider groupings of tables separated with lattice screens or create separate areas throughout the room by varying table coverings and table and chairs.
  • Minimize noise by considering carpets, drapes and table covers that absorb sound.
  • Consider the view outside the window!
  • Consider other uses of the dining space for community functions too.

More Tips to Make a Home for Residents

In their manual, Practical Strategies to Transform Nursing Home Environments, Lois J. Cutler and Rosalie A. Kane offer many suggestions that can transform homes.

  • Create lounge/social spaces, a place where visitors, staff and residents can interact with each other. A coffee shop is a great first step.
  • Install an aviary.
  • Create a library starting with book donations from family and community members.
  • Have a designated room set up as a barber/beauty parlor.
  • If there is not a designated chapel create a small mediation area in a quiet corner of a large room or use a small room.
  • Install an aquarium.
  • Consider a pet policy. Think about possibly borrowing a pet for a trial period. Invite school children to bring their pets for show and tell or encourage staff members to bring their pets to work.
  • Make outdoor areas accessible and safe. Start a planting garden. Recreate the front porch where residents, neighbors, and staff are invited to gather.

Beyond the Physical

Creating a home for residents goes beyond the physical space.

  • Stagger meal times so residents have a choice. This seems so simple but many homes struggle with this.
  • Move activity programs away from measuring how many people attend to the meaning programs have on individuals and their interests.
  • Investigate programs like Second Wind Dreams that help grant wishes for seniors.
  • Create inter-generational programs to involve the community.
  • Imitate the StoryCorps program and start capturing residents’ life stories.

Real Payback

Investing in creating an environment that creates great experiences has its rewards. Word spreads and that leads to new admissions. Process improvements cut down costs. Happier employees stay. Desired employees apply. Overtime costs and agency use decreases.

Changing the environment does not have to be a high cost affair. It starts with leadership wanting to change. By empowering staff to find solutions, you will find innovative, low cost ways to improve care that you might not have otherwise thought about. And involving residents assures buy-in and the confidence that you are proceeding with the best initiatives for all involved.

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