“They are neither neglected nor abandoned. An increasing number of elderly people are moving into old-age homes in search of safety, independence and companionship.” (©https://timesofindia.indiatimes.com)
The Age of Retirement or an Old age results from the kind of environment they live in, choices made, and it is inevitable for any living being. Various factors influence how one will age, like their social, economic and physical environment, health and services, personal lifestyle, mental health and behavioural patterns.
So how does one sail through old age when one loses their loved one with whom they can share and care; or have infirmity making it challenging to do the daily activities; or stay away from their family; or stay with family still they want to live alone? As every person has a right to decent housing, nursing homes have been well developed in the United States, United Kingdom and European countries and are now coming up in India.
Old age homes or better-called Nursing homes are places for the elderly designed to provide them with a conducive environment for stay either on a free or on a paid basis by providing them with shelter, hospital beds, food and catering to basic health needs. As architects, there is a lot we can contribute, be it at a large scale within cities or small-scale dwellings. Apart from providing the essentials, some specific guidelines can be of consideration while designing these homes.
Here are some points you must consider while designing Old age homes/Nursing homes:
1. A Sense of Belonging | Old Age Homes
The nursing homes need to appear friendly and approachable in a style that can instil a sense of belonging, foster independence, interdependence and individuality and support the disabilities by making them into possibilities and be a part of the neighbourhood. It shall provide an emotional and physically safe place, where they feel more at ease. Some nursing homes have daycare centres that take care of senior citizens only during the day.
In the end, it is a place for companionship that does bring positive energy, and the elderly feel comfortable amongst the same age.
2. Better environment – indoor & outdoor
The nursing home structure shall be climate-responsive for a better indoor environment, well cross-ventilated, sufficient natural and artificial lighting, and use of shaded areas. Courtyards or squares can be designed around the room clusters to initiate timely gathering. There can be respite areas for the elderly and the staff along the corridors or on every floor. An open kitchen, dining with living spaces can be provided as the joint facility to initiate interaction and a place of gathering.
Do consider their lifestyle, what they are like, or the particular kind of elderly service.
3. Let them have their space | Old Age Homes
There can be a possibility of choosing the kind of accommodation the elderly wants or staying in, like dormitories, shared rooms or private rooms, on affordable rents. Any room, individual or shared or even dormitory type, can be proposed with space to lounge alone or sit with visitors, dine within, a pantry in the alcove as an option. A wardrobe preferably tucked in a niche can help avoid any hindrance or avoid getting hurt. There shall be a lot of space around for the movement of a wheelchair or caretakers required for assistance.
Provide attached bathrooms keeping the accessibility from bed and its maintenance in mind. Provide a space behind the WC for caretakers to help the elderly in case they required their assistance. Install motion sensors near the bathroom and at the entrance.
4. It doesn’t need to be a conventional nursing home
Whether the nursing home is within a city or a rural town, its design shall be with materials that are durable, easily repairable or replaceable, maintenance-free while meeting the environmental requirements of the location. It shall be suitable for everyone despite any particular medical condition. Consider the material reflectivity or heat transmission factor to create a comfortable environment during all seasons. All floorings shall be anti-slippery and wheelchair & crutches friendly.
One can use bold or vibrant colours instead of plain whitewash walls like children care even the senior care needs to be colourfully nurturing, being old doesn’t mean one need be pale dull. Paints can be with low VOC, odourless, fungus-free to induce a better indoor environment.
5. Keep Accessible easy for everyone | Old Age Homes
Provide all the basic facilities in the home on the ground floor placed near each other. If they have to be on upper floors, then a sloping ramp shall facilitate easy movement of the elderly depending upon their health conditions. Corridors shall be wide enough for unrestricted movement in all rooms and with visible signage. Provide suitable railings for support at passages and at staircases.
Plan an easy egress with ramps and risers shall be lower for an easy climb with sufficient lighting and signage. Externally the paved sidewalks shall be free of obstacles with curbs adapted for ease in stepping. There shall be emergency power backup within premises and emergency lighting within corridors & staircases and rooms during power failure.
6. Their care is of utmost importance
Provide a sterile room for storage of prescribed medicines and medical accessories needed for essential treatment with the help of doctors’ advice. The lift shall be of sufficient size to accommodate a stretcher. Provide adequate parking of ambulances near the entrance in case of emergency. Propose a medical care room with necessary instruments if doctor’s visits are home visits or routine check-ups.
Provide a space for a nutritionist or resident doctor to cater to the individual needs or depending upon their medical conditions and well-balanced meals. Propose a drinking facility with a water fountain within the passage.
7. Helping Staff & their Welfare
A BOH area with administration staff having a manager or warden must run and be responsible for servicing these homes. Housing facility for all staff and supporting staff such as helpers, cooks, attenders, maids, the nursing staff will be required to stay for extended duty hours, so the design of an alternative stay or permanent stay within premises.
8. Maintain Social Connections | Old Age Homes
Provide a small media room with internet facilities, video conferencing that will help the elderly stay mentally engaged and connected with the world outside and keep in touch with distant family & friends. Older people need entertainment so provide a place to laze with TV. Provide a Lounge for the family & friends to gather around during visitation. Create a supermarket for them to shop by themselves. It can help them figure around and even roam around.
9. Reconnecting them with nature
It is good to connect and synchronise with nature to breathe fresh air, clear one’s mind, calm the nerves to relieve stress. Nursing homes design needs clean, open spaces with a well-kept landscape with seats and public toilets for the elderly to gather to establish social connections and feel familiar. There can be healing gardens that provide them with a choice to leave the indoors and step out into a natural setting designed to promote exercise and stimulate all the senses. It also helps to encourage positive reminiscences and stabilises sleep-wake cycles.
10. Let’s keep them going | Old Age Homes
At Okinawa, the blue zone of Japan, every 100,000 inhabitants has 68 centenarians which is almost more than three times the number found in US populations. Even by the standards of Japan, Okinawans are remarkable, having a 40% greater chance of living to the age of 100 than many other Japanese people. Formal research in this regard took place to find out the reasons for the longevity of the people of Okinawa. It resulted in the book Ikigai: The Japanese Secret to a Long and Happy Life in 2016 authored by Hector Garcia and Francesc Miralles.
The principles of Ikigai are pretty rational and applicable to any older person in any part of the world. One of them states that one should never retire and be active doing things that one likes till one can. The idea of taking retirement is like being in a back seat from life engagements and might tend to the beginning of the end.
Provide rooms like a library or a space that can convert into a classroom or a seminar for distant education to support continued learning, which substantiates keeping the mind active and healthy during old age. Provide recreational spaces for activities or hobbies like dance, music, arts & crafts that they can enjoy and keep them engrossed. Propose some sports facilities such as tennis, table tennis, squash, virtual games, indoor games like carrom, chess, and cards to move and groove. Also, propose a few outdoor activities like farming, gardening within the premises.
To keep smiling even in adverse circumstances is vital as it depicts the strength of mind, symbolises youthful vitality and energy, and attitude of resilience, reducing anxiety associated with the advanced age. So, by circumstances or by choice, staying at nursing homes shall never be a burden; rather shall be a place to rejoice without any regrets and be given the same importance as a child.
References
http://www.architecture-student.com/design-guide/guide-to-designing-old-age-homes/
https://www.archdaily.com/900713/how-to-design-for-senior-citizens
https://www.architecturaldigest.com/story/aging-in-place-guide
https://www.slideshare.net/dhirajsalhotra/design-guidelines-home-for-the-elderly
https://www.dementiavillage.com/projects/dva-de-hogeweyk/
https://blog.buildllc.com/2010/03/elderly-housing-design-in-europe/
https://timesofindia.indiatimes.com/home/sunday-times/why-these-seniors-prefer-old-age-homes/articleshow/69028391.cms
https://www.bbc.com/future/article/20190116-a-high-carb-diet-may-explain-why-okinawans-live-so-long
