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	=Considerations in the Design of an Assisted Living Facility: Group 8=		=Considerations in the Design of an Assisted Living Facility: Group 8=
-	*1. Alyssa Marconi	+	*1. Roland Erman
-	*2. Shelby Agnew	+	*2. Alyssa Marconi
-	*3. Roland Erman	+	*3. Shelby Agnew
-		+
	===Physical Layout in Assisted Living Facilities===		===Physical Layout in Assisted Living Facilities===

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Revision as of 07:23, 1 November 2011

Contents 1 Considerations in the Design of an Assisted Living Facility: Group 8 1.1 Physical Layout in Assisted Living Facilities 1.2 Dormitory Style Design 1.3 Social Activity Layout 1.4 Smaller Living Facility 2 Safety in Assisted Living Facilities for the Elderly 2.1 Evacuation Safety 2.2 Fire Safety 2.3 General Safety within the Facility 3 Social Activities in Assisted Living Facilities 3.1 Quality of Life 3.2 Congitive Functions 3.3 Physical Well-Being 3.4 Conclusion 3.5 Notes and References

Considerations in the Design of an Assisted Living Facility: Group 8

• 1. Roland Erman
• 2. Alyssa Marconi
• 3. Shelby Agnew

Physical Layout in Assisted Living Facilities

The physical layouts show many similarities across locations. Residents are set up in large scale, apartment-style homes to accommodate many different people. Furthermore, cafeteria cooking, socialized locations and reaching out to neighbours can often be a major difficulty for some individuals ^[1]. Cafeteria cooking does not offer the same feeling as cooking from within the home. Social rooms may be at the end of the hall, or on the first floor. There also might be a lack of space devoted towards social activities. The segregating of neighbours into their own units also present the problem of meeting new people with ease.

There are not many psychological articles that look at how the layout of these assisted living facilities can help add to the overall quality of the residents. Currently, there are many articles that look at the social need of the individuals in retirement homes. However, one major drawback is that these studies only look at the social needs of individuals from a programming standpoint. By building a more social space for those in assisted living facilities, social programs can become easier to run.

Dormitory Style Design

The one key factor would be structuring the assisted living facility in a dormitory style. Instead of having each housing unit built with a kitchen, washroom, bedroom and living room all inclusive, the living facility would be built like a University residence dormitory. Each unit would only include a washroom, bedroom and living room, but outside the unit would be a kitchen. Up to four different units would be attached to this kitchen, allowing for up to eight residents to share a kitchen and the extra space it provides.

By having “dormitory” style rooms, this will ease individuals into a more comfortable, and hence, social atmosphere. Those who are new to a retirement home may be less inclined to become social due to many different reasons, including the loss of a spouse, or embarrassment to have moved into an assisted living facility ^[2]. By structuring these dormitory style units, new residents will be slowly introduced to a limited number of neighbours. This will not become overwhelming, such as meeting everyone at once ^[3]. Nor will this allow for new residences to become isolated and close themselves off from the rest of the facility, which can be a normal outcome ^[3]. With the implementation of dormitories and the four-unit system, new residences will be able to make fast friends and identify with their new home accordingly.

Social Activity Layout

This system will also help in terms of programming for the residents. Unit-mates can make each other meals, teach each other how to cook, or play games or watch tv. This should help provide a key social aspect that, while still present in modern assisted living facilities, can only grow stronger with this new four-unit system. Further, although each resident may not be able to provide the quality care that a health professional would provide, unit-mates could still assist each other to some extent. This would help alleviate stress levels associated with feeling isolated. Additionally, knowing others on a stronger personal level can help foster sympathy and a better understanding of what each person is going through ^[4].

Another benefit from this dormitory system is that it will keep its residents functioning at a higher cognitive level. One major issue with assisted living facilities is that there can be a significant drop in cognitive functioning, especially with those who are living by themselves ^[3]. Further floor plans can also a game space for television, chess, cards, etc, in addition to a kitchen space. This allows each resident to have easy access to games, instead of providing them at the end of the halls or on different floors. The physical health of some residents may not be very strong^[5]), and residents may feel they are unable to travel down a few flights or all the way across the hall to play a board game ^[6]. By providing the space from within the dormitory, residents will be able to pick up and play at almost no physical costs.

Smaller Living Facility

These dormitory units would be built within a smaller living facility. It is important to keep the notion of identity within each assisted living home. This can be lost in a larger space that has up to 4-5 floors of residents ^[3].

()==Notes and References==

1. ↑ Palmer, D. S. (1991). Co-leading a family council in a long-term care facility. Journal of Gerontological Social Work, 16, 121-134.
2. ↑ Mor, V., Branco, K., Fleishman, J., Hawes, C., Phillips, C., Morris, J., & Fries, B. (1995). The structure of social engagement among nursing home residents. ProQuest Nursing & Allied Health Source, 50, P1-P8.
3. ↑ ^{3.0 3.1 3.2 3.3} Hawes, C., Phillips, C., & Rose, M. (2000). High service or high privacy assisted living facilities, their residents and staff: Results from a national survey, 1-69.
4. ↑ Mara, C. M., & Ziegenfuss, J. T. (2000). Creating the strategic future of long-term-care organizations. Care Management Journals, 2, 116-124.
5. ↑ Manji, S. (2008). Aging with dementia and an intellectual disability: A case study of supported empowerment in a community living home. ProQuest Dissertations and Theses, 21-56.
6. ↑ Hawes, C., Morris, J., Phillips, C., Fries, B., Murphy, K., & Mor, V. (1997). Development of the nursing home resident assessment instrument in the USA. Age and Aging, 26, 19-25.

Safety in Assisted Living Facilities for the Elderly

Many residents in assisted living facilities demonstrate declining cognitive functions due to natural causes such as age, and diseases such as dementia. This increases the importance of providing paramount safety in these buildings for tenants. The changing and declining cognitive functions of these residents are not always predictable and make it difficult to assess which residents need more assistance for their optimal safety.^[7] Safety considerations when building the facility needs to be increased in areas such as evacuation, fire safety, and general safety within the facility.

Senior citizen after Hurricane Katrina.	Evacuated after Hurricane Katrina.	Nursing home after Hurricane Katrina, 31 residents died.	34 deaths in a nursing home after Hurricane Katrina.
Fire in Russia nursing home killed 62 people.	Nursing home room after Hurricane Katrina.	Remains of nursing home from Missouri tornado.

Evacuation Safety

Natural disasters, such as hurricanes and earthquakes, may create a need to evacuate residents from their rooms in assisted living facilities. In the past, many people in assisted living facilities have died due to poor evacuation efforts and immobility issues.^[8] During Hurricane Katrina, 139 seniors in assisted living facilities did not survive, which shows that future preparation is imperative.^[8] The fact that cognitive decline impairs a number of these residents from making informed and prompt decisions on what to do in an emergency situation is enough of a reason alone to increase the planning for natural disasters.^[9] With various brain pathways having slower connections to each other, a pre-informed resident will have time to process what is going on and what is going to happen subsequently when a disaster strikes since they have more time to reflect on the information.^[9] If the state regulates disaster planning, aids in making the arrangements, and ensures the staff and residents are aware of the plan, then assisted living facilities will have a greater chance to efficiently get all of the residents to safety like in this Japanese nursing home.^[10]

Fire Safety

Seniors and older adults have the highest risk of death in the case of a fire.^[11] The reasons for this high risk include issues such as lack of fire safety knowledge, hearing problems, building design, and mobility issues.^[11] Many of these issues are a result of cognitive decline in the aging patients. Furthermore, the staff-to-patient ratio (which is magnified in the evenings) does not provide enough assistance for all of the residents to evacuate if there were a fire emergency.^[11] This statistic should be a major concern for assisted living facilities in which high ratios of seniors live together. As most people know, the population of seniors is growing rapidly and they are expected to represent at least twenty percent of the population in the United States by 2050.^[11] Measures need to be taken to reduce these safety risks before the amount of seniors in these facilities expands and it is too late. Educating residents about fire safety and planning safe routes of escape is one way to reduce this threat. However, as many residents have difficulties with memory, this must be done several times which may become costly and time consuming.^[11] In addition to these safety measures, if fire alarms were installed that residents with hearing deficiencies can detect, it would greatly improve their chances of surviving a fire.

General Safety within the Facility

It is beneficial for many senior citizens to engage in physical activity such as walking.^[12] For residents of assisted living facilities to acquire optimal freedom, these living facilities must be built safely. Facilities need to install items such as wider hallways, secure handrails, and chairs in their hallways to provide residents with the option of walking by themselves in the safest way possible.^[12] Not only do wider hallways promote walking, but they also make it safer for an emergency evacuation, which is a concern that was discussed earlier. Carpeted flooring was also shown to make residents of assisted living facilities feel safer since it was easier for them to walk on.^[12] Another way to increase the safety in these facilities is to provide enough staff to take care of the residents in a safe and secure manner.^[7]Staff should be guided to enforce policies that ensure residents stay safe since many are not able to make the appropriate choices for themselves, yet residents should be allowed to make decisions on their own when they are able.^[7]

Hypertension increases with age in a majority of seniors.^[9] If we make certain changes to the assisted living facilities to increase safety, hypertension may not increase as severely because the residents do not need to worry about safety issues. Doors that need a code to open or railings in the bathrooms are just a few minor modifications that should be considered. If facilities have the appropriate amount of staff and the staff are aware of their expected roles, the care in these facilities will be much more beneficial to the aging residents.^[7]

--Sa09ox 13:30, 31 October 2011 (EDT)

Social Activities in Assisted Living Facilities

In designing an assisted living facility, there are many aspects that need to be considered. One specific aspect is the importance of social engagement for the residents living within these facilities. Social engagement refers to the participation in social activities and sustaining social connections. ^[13] Participation in activities and sustaining these social relationships are an important part of a resident’s foundation when living within one of these facilities. ^[14] Social activities can provide them with opportunities that allow them to adjust to their new environment and allow them to connect with others not only in the facility, but outside the facility as well. ^[15] Research has shown there can be many benefits of social engagement can provide older adults when living in an assisted living facility.

Quality of Life

One of the benefits is a better quality of life. When quality of life is defined in terms of overall life satisfaction and general health measures, residents in assisted living facilities showed a substantial increase when they were participating in social events. ^[14] Social involvement is key to improving quality of life in residents. Social events can include simple visits from friends and family and these visits are predictive of improved quality of life. ^[14] The quality of these social connections is more important than the quantity. ^[13] By having meaningful social interactions residents’ quality of life is greatly increased. ^[16] These visitations from family and friends seem to play a large role in a resident’s life and these visitations would need to be incorporated as activities in the facility.

Congitive Functions

Another benefit of social activities is better maintenance of cognitive functions. Social activities have been strongly linked to improved cognitive functions in comparison to those without social activities. ^[17] Some cognitive functions that are better maintained are memory abilities, perception, and visuospatial abilities.^[13] Some of the activities that helped with cognitive function included going to restaurants, playing bingo, and going on day or overnight trips. ^[13] While all these activities help, it can also depend on the type of social activity. Specifically it can depend on if the activities are organized in a group or privately. For example, group activities such as attending arts and crafts and playing cards or bingo provided more social engagement than private activities, such as reading and writing letters. ^[17] The type of activity as had an effect on the social involvement, by allowing the residents an opportunity not just to socialize with friends and family outside the facility but allowed them to socialize with others in the facility. ^[17] It is important for the assisted living facility to schedule activities, specifically group activities because it helps retain cognitive functions, while also building new social relationships.

Physical Well-Being

Physical well-being can also be maintained through social activities. Participation in such activities such as going to walks and exercise can improve physical well-being. ^[15] Conversely, doing nothing can have a negative effect on the resident’s health, leading to a lower quality of life. ^[15] Social activities can also affect the number of chronic health conditions in residents. ^[14] By participating in social activities, residents can maintain or even improve their physical health and such activities should be included when design an assisted living facility.

Conclusion

There is extensive planning when designing an assisted living facility in regards to the social engagement of the residents. Without social engagement, residents can possibly show more depressive signs and experience more chronic health problems. ^{[14] [16]} Social engagement through the use activities such as bingo, family visits, and walks can greatly reverse these effects. ^{[14] [16]} Thus, social activities are curial to incorporate in the overall design of an assisted living facility.

--Am08tl 02:08, 1 November 2011 (EDT)

Notes and References

1. ↑ Palmer, D. S. (1991). Co-leading a family council in a long-term care facility. Journal of Gerontological Social Work, 16, 121-134.
2. ↑ Mor, V., Branco, K., Fleishman, J., Hawes, C., Phillips, C., Morris, J., & Fries, B. (1995). The structure of social engagement among nursing home residents. ProQuest Nursing & Allied Health Source, 50, P1-P8.
3. ↑ ^{3.0 3.1 3.2 3.3} Hawes, C., Phillips, C., & Rose, M. (2000). High service or high privacy assisted living facilities, their residents and staff: Results from a national survey, 1-69.
4. ↑ Mara, C. M., & Ziegenfuss, J. T. (2000). Creating the strategic future of long-term-care organizations. Care Management Journals, 2, 116-124.
5. ↑ Manji, S. (2008). Aging with dementia and an intellectual disability: A case study of supported empowerment in a community living home. ProQuest Dissertations and Theses, 21-56.
6. ↑ Hawes, C., Morris, J., Phillips, C., Fries, B., Murphy, K., & Mor, V. (1997). Development of the nursing home resident assessment instrument in the USA. Age and Aging, 26, 19-25.
7. ↑ ^{7.0 7.1 7.2 7.3} Kissam, S., Gifford, D. R., Mor, V., & Patry, G. (2003). Admission and continued-stay criteria for assisted living facilities. Journal of the American Geriatrics Society, 51(11), 1651-1654.
8. ↑ ^{8.0 8.1} Hyer, K., Polivka-West, L., & Brown, L. M. (2007). Nursing homes and assisted living facilities: Planning and decision making for sheltering in place or evacuation. Generations, 31, 29-33.
9. ↑ ^{9.0 9.1 9.2} Bishop, N. A., Lu, T., & Yankner, B. A. (2010). Neural mechanisms of ageing and cognitive decline. Nature, 464, 529-535.
10. ↑ Brown, L. M., Hyer, K., & Polivka-West, L. (2007). A comparative study of laws, rules, codes and other influences on nursing homes’ disaster preparedness in the gulf coast states. Behavioural Sciences and the Law, 25, 655-675.
11. ↑ ^{11.0 11.1 11.2 11.3 11.4} Jaslow, D., Ufberg, J., Yoon, R., McQueen, C., Zecher, D., & Jakubowski, G. (2005). Fire safety knowledge and practices among residents of an assisted living facility. Prehospital and Disaster Medicine, 20, 134-138.
12. ↑ ^{12.0 12.1 12.2} Lu, Zhipeng., Rodiek, S. D., Shepley, M. M., & Duffy, M. (2011). Influences of physical environment on corridor walking among assisted living residents: Findings from focus group discussions. Journal of Applied Gerontology, 30, 463-484.
13. ↑ ^{13.0 13.1 13.2 13.3} Krueger, K. R., Wilson, R. S., Kamenetsky, J. M., Barnes, L.L., Bienias, J. L., & Bennett, D. A. (2009). Social engagement and cognitive function in old age. Experimental Aging Research, 35, 45-60.
14. ↑ ^{14.0 14.1 14.2 14.3 14.4 14.5} Mitchell, J. M. & Kemp, B. J. (2000). Quality of life in assisted living homes: A multidimensional analysis. Journal of Gerontology, 2, 117-127. Quality of life in assisted living homes: A multidimensional analysis. Journal of Gerontology, 2, 117-127.
15. ↑ ^{15.0 15.1 15.2} Jenkins, K. R., Pienta, A. M., & Horgas, A. L. (2002). Activity and health-related Quality of life in continuing care retirement communities. Research On Aging, 24, 124-149.
16. ↑ ^{16.0 16.1 16.2} The relationship of social engagement to psychological well-being of older adults in assisted living facilities. Journal of Applied Gerontology, 28, 461-481.
17. ↑ ^{17.0 17.1 17.2} Zimmerman, S., Scoot, A. C., Park, N. S., Hall, S. A., Wetherby, M. M. Gruber-Baldini, A. L., & Morgan, L. A. (2003). Social engagement and its relationship to service provision in residential care and assisted living. Social Work Research, 27, 6-18.