Whether it is a new gray hair or an aging parent, getting old is universal. We all have to deal with it. While people are living longer, healthier lives, the growing older demographic puts pressure on the architectures that support seniors. AN spoke with designers and experts about how cities and buildings can respond to issues around aging.
LIVING OLDER LONGER
Architect Victor Regnier is professor of architecture and gerontology at the University of Southern California. He’s written a number of books on senior housing and community planning.
Courtesy Victor Regnier
Mimi Zeiger: What do you see as the future of aging?
Victor Regnier: When we talk about the future in terms of an aging population we aren’t talking about five or ten years out; 2040 or 2050 is our target. By then we should have a cure for cancer, have cut heart disease in half, and have good insights into dementia. This means incredible increases in longevity and a world with huge numbers of older people. Right now the fastest growing age group is those over 100, and the second fastest growing group is people between 85 and 100.
However, we are seeing very low population growth in the US, Europe, and developing countries. This means that the percentage of oldest old people in the population is going to grow as well. There will be a smaller number of people between 50-65 supporting the young and the very old.
The question is: With all these drugs and all these things that we are going to invent in the next 20 years, are they going to lead to more years of positive, beneficial old age or are they going to lead to more years of impairment in a facility or at home in bed, in a wheelchair, or with a walker?
How do these numbers impact the built environment?
What this means from an urban design perspective is that we need to have cities that are more accommodating and more positively predisposed toward people who are aged and have limited mobility.
Looking at healthy cities that support older people is the most positive thing we can do—to help people lead more independent lives in their own neighborhoods and communities. In doing so, we will keep people from going to institutions or choosing non-independent living arrangements.
Those arrangements, though necessary for some, are also very expensive and there are not that many of them. That’s a problem. They are expensive to build and difficult to develop as subsidized arrangements, since there are service components for recreation and medical which have to be accommodated in the model. So it is difficult to create for affordability.
Ultimately, we want people to live in their own homes as long as possible. We are now seeing more waiver programs that provide help and support at home instead of in a nursing home.
One thing we need to think about is safety and transit. Most public transit isn’t designed for older people. We need to think about paratransit—like a cab or Uber—to help people get to a destination without driving. Transportation is important because we now have a majority of people over 65 living in suburbs and those people are living in settings that have not adapted very well to what their needs will be in the future.
DESIGNING FOR MEMORY
Lisa Morgenroth and architect Curtis Lockwood work on health and wellness projects at Gensler; she’s in the New York office and he’s based in Los Angeles. Morgenroth is also the co-chair of the AIA NYC Design for Aging Committee.
MZ: What trends do you see around design for aging?
Curtis Lockwood: What we are seeing in the aging world is a more active population. In days gone by, once you got beyond a certain stage you were sedentary. People are in better shape. While seniors may have some chronic illness, they are still active.
Lisa Morgenroth: This translates to the senior living common areas we’re designing. It used to be just about receiving care, now these spaces are more diverse in terms of programming.
CL: Senior living facilities break into different levels: independent living, assisted living, and memory care. The overall facility is more like an upscale hospitality project with common rooms, dining rooms, a swimming pool, and even a theater. Today, it is about providing an option to have more freedom.
What is memory care?
CL: There is a big difference between independent living, assisted living, and memory care. Assisted living might be someone who is living independently or with a partner, but may need extra attention after knee or hip surgery, but then returns to living independently after recovery.
Memory care is different. Most of these units are single-occupancy units. People with Alzheimer’s and dementia typically don’t get better. Our goal is to design an atmosphere where they can reflect in the past. Perhaps there’s an outdoor courtyard and blooming plants that put a smell in the air to remind them of something.
LM: Sensory cues are important to memory care. Very often designs will feature a display shelf or recessed pocket outside the unit to allow people to decorate their front door with things that remind them it’s home.
There’s segregation between people with and without memory problems. We could do better.
Can technology help?
CL: There is a lot technology and monitoring behind the design of senior facilities. Often everyone has a wearable: a bed monitor to see if someone has gotten up, and heart rate monitors for vitals while sleeping.
We’ve designed telemedicine suites and areas for senior facilities. Residents can have a one-on-one conversation with their doctor without a trip to the office.
LM: We have to find more ways to address these issues of aging, since there isn’t yet a medical solution to memory-related illnesses. As a profession we need to push ourselves to actively address senior housing as a policy. We need more community-based solutions, such as co-housing, since not a lot of people can afford to go to these places. It’s not just a tech fix, it’s a much more radical idea: People overlapping their lives.
Joel Sanders is a New York City-based architect.
MZ: A few years ago your firm was invited to design The Commons, a senior housing community in Palm Springs as part of BOOM. What does senior or assisted living mean when applied to the LGBT community?
Joel Sanders: Lately I’ve been looking into senior housing as it particularly impacts the LGBT community. As a bit of background information, there’s an organization called SAGE that recently issued a policy brief called Welcome Home: Improving Housing Security for LGBT Older Adults, and they are interested in housing initiatives. It argues that, in a nutshell, the question—not so much of an architectural question—is that there’s been enormous discrimination in the LGBT community, particularly in regards to the needs of people of color and increasingly transgender people, who tend to be even more discriminated against and in the lower-income bracket.
The report notes that despite all the advances that have been made against discrimination, this is an unrepresented constituency that needs to be considered, needs more protections, and needs more funding for LGBT-friendly housing.
In terms of architecture, how did the Palm Springs project address issues of aging?
Our scheme differed from traditional senior housing in that we were thinking about using landscape to link rather than separate the independent and assisted living. My research coincided with my own experience with my parents who, during this process, moved into an independent living facility and I was witnessing these issues firsthand.
We centered our design around a shared outdoor common space flanked by housing: the pool homes that are organized around a long lap pool and the garden homes, each of which have a sunken garden. What’s unique is that the assisted living facility isn’t hidden, it is the head of the project and we programmed it to be a community center and indoor gathering space. We wanted to directly challenge the anxiety and fear that comes with nursing homes.
With the homes, we designed flexible unit types that would accommodate alternative families. The two types were inspired by mainstream media: The TV show Golden Girls, which illustrated people living together as roommates, and the other model was the movie The Birdcage, since increasingly LGBT people have extended families.
It seems that designing for the LGBT community points to new innovations for senior living.
While this was designed with a specifically LGBT community in mind, I’d like to think that the design approach we used could apply to a diverse group of seniors of all different stripes. We were thinking about community within the unit as opposed to thinking about it as a room where you go to die.
It was an LGBT perspective that allowed us to think out of the box about new typologies, but these ideas are universal. All housing should address ecological, social, technological needs. When we really look at the specific needs of what might seem like exceptional demographics, like college kids or seniors, we see something that all of us increasingly want over the course of our whole lives.