Design with dignity from page 17
spent most of their time in this fixed location, leaving the area to check on residents when a problem arose. Centralized nursing keeps providers and residents separate; culture change stresses decentralized nursing. In the new model, staff and residents work, live, and socialize together. Charting and other tasks take place on a comfortable couch in a household living room instead of at a desk chair behind a behemoth nurse station. In addition, staff are available to one another at all times via text messaging and phone calls, making overhead paging obsolete. Accommodation of visitors. Another important element in design is catering to visiting family and friends. The culture change model takes steps to ensure that visitors are comfortable spending time in the facility. For example, the smells of ammonia and images of stained carpets have cast a dark shadow in the minds of many individuals. Now there are carpet tiles that can be quickly and easily replaced when soiled, and products that eliminate ammonia from fibers to reduce the acrid smell. In addition, many facilities now offer wireless Internet connection and have coffee shops and gift shops that residents and their guests will appreciate.
The goal of the culture change model is to transform nursing homes into comfortable environments that support dignity, self-determination, and a sense of home. Next in the layout are the kitchen, dining room, and living room spaces. They serve as semi-private spaces where residents in the household can come and go as they please and visit with family and friends. In the back of the cottage are the bedrooms. Each resident has his or her own room, offering complete privacy. Residents can decorate their rooms as they wish. This is an area where residents can spend uninterrupted quality time with their family and friends. My research as a resident within a nursing home was invaluable, resulting in a whole new perspective with regard to designing senior communities. Adopting the culture change model is a positive step toward offering seniors the dignity, independence, and overall environment that they deserve. For people who cannot safely stay in their own homes, designers can best support them emotionally and physically by creating a positive, home-like environment. After all, home is where the heart is. Alanna Carter, Assoc. AIA, LEED-AP, is director of senior environments at Mohagen/Hansen Architectural Group and the founder and current president of Sage Minnesota (Society for the Advancements of Gerontological Environments).
Creating a home-like atmosphere Designing for a home-like environment is a key concept in a senior living center layout. In older facilities, everything is shared—even the bedrooms. In contrast, the culture change model includes public, semiprivate, and private places. Mirroring the familiar idea of living in a house, a facility is separated into smaller cottages, each housing 12 to 20 residents. This arrangement supports improved care for residents in many ways: • There is a better staff-to-resident ratio, allowing for efficient, more personalized care.
Leg Pain Study Do your legs hurt when you walk? Does it go away when you rest? Or, have you been diagnosed with PAD? You may have claudication, caused by lack of blood supply to the leg muscles The University of Minnesota is seeking volunteers to take part in an exercise-training program, funded by the National Institutes of Health
• The family-oriented environment encourages stronger social bonds among the residents.
To see if you qualify, contact the EXERT Research Team at
• Residents have more privacy because they are sharing their immediate living space with only a handful of others, rather than with 40 to 80 people on a large, impersonal ward.
or email EXERT@umn.edu or visit EXERTstudy.org
The culture change model notes the importance of normal social patterning and designs in a hierarchical household system. For example, when residents walk into their cottage, they enter a lobby area that brings to mind a household porch or foyer. This is a common area where residents can meet and greet visitors, staff, and other residents, but need not feel obligated to allow them passage further into their home.
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EXERTstudy.org SEPTEMBER 2011 MINNESOTA HEALTH CARE NEWS
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