Design Trends

By Debra Eilering

Design tends to be evolutionary, not revolutionary. Progress is typically made in incremental steps, tweaking what “is” to change what “will be.” Occasionally, a revolutionary idea comes along, one that makes us stop and reconsider what we thought we knew. There is now widespread recognition that things will be different as the Baby Boom generation enjoys a longer life expectancy. Many of us are already helping aging grandparents or parents cope with later life changes. We all hope that things will be different when we get to that stage. I can barely even think about the phrase, “nursing home”. It is so hypocritical, as ever one that I have seen has been unpleasant.

For the sake of maintaining my sanity and to learn about improvements to how we treat our aging population, I opt to research some new trends in design as it relates to “senior care”. I have found that we are beginning to see a strong commitment in changes to nursing homes. People are increasingly unsatisfied with what we have allowed nursing homes to evolve into-staff-centric institutions that cared more for the body than the soul. Here are a few examples:
1. ELIMINATING THE MEDICATION CART
2. BETTER BATHROOMS: The passage of the ADA in 1990 dramatically increased the size of bathrooms requiring a 5′ turning radius. However, the ADA Accessibility Guidelines recommended designers put the toilet with the center line 18″ from a side wall. The goal was to make sure the grab bar was in reach of the person using the commode. However, many residents require a one- or two-person assisted transfer, and only having 18″ significantly increases the risk of injuries to the staff. Some states will now allow a variance that permits the use of fold-down grab bars adjacent to the toilet. This puts grab bars within easy reach on both sides of the toilet, a better option for someone with 1-side neglect or weakness. It also allows placing the toilet further from the wall to create more room for staff to provide assistance without injury.
3. ELIMINATING THE NURSING STATION
4. LIGHTED GRAB BARS: It is well documented that most falls occur at night, as residents get up to go to the bathroom. When a light is turned on at night, the sudden change of light levels can be physically painful, and the contraction of the pupil is not immediate. If the bathroom light is on, then turning it off before heading back to bed can cause momentary blindness. Both situations put people at high risk for falling. A lighted grab bar provides enough light to find the toilet without having to turn on additional lighting. It also highlights the bar so it is easier to see and use. It is so logical. Debra Eilering

Resources:

• CMS Interpretive Guidelines for Long-Term Care Facilities. Appendix PP -“Interpretive Guidelines for Long-Term Care Facilities,” www.cms.gov/transmittals/downloads/R55SOMA.pdf
• National Association of Home Builders' section on Universal Design. Available at: www.toolbase.org/toolbaseresources/level3aspx?bucketid=2&categoryid=22