Session 1- B The Changing Resident - Eppstein Uhen Architects
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Session 1-‐B The Changing Resident
Jeffrey
Anderzhon,
FAIA Andrew
Alden,
M.Arch
Senior
Planner
/
Design
Architect Senior
Planner
/
Designer
@JeffA_EUA @AndrewA_EUA
/jeffreyanderzhon/j /andrewalden1
jeffa@eua.com andrewa@eua.com
Copyright
Materials
This
presentation
is
protected
by
US
and
International
Copyright
laws.
Reproduction,
distribution,
display
and
use
of
the
presentation
without
written
permission
of
the
speaker
is
prohibited.
©
Eppstein
Uhen
Architects
2016
Eppstein
Uhen
Architects
milwaukee : madison : des
moines
Learning Objectives At the end of the this course, participants will be able to: 1. Learn about the changing demographic which will inform the client of tomorrow’s elderly housing and care needs. 2. Learn about dynamic international care models which can serve to inform innovative care and environmental solutions in the US. 3. Learn about crafting care and environmental models which can adapt to the future needs without expensive modifications.
THE AGENDA • Text • Text • Text
Life
Expectancy
(2015)
Top
5
Countries
where
people
live
the
longest:
– #5:
San
Marino
– 83.24
years;
population
over
65:
18.5%;
2050
projection:
35.5%
(over
60)
– #4:
Macau
– 84.51
years;
population
over
65:
8.8%;
2050
projection:
42.2%
(over
60)
– #3:
Singapore
– 84.68
years;
population
over
65:
8.9%;
2050
projection:
31.0%
(over
60)
– #2:
Japan
– 84.74
years;
population
over
65:
24.8%; 2050
projection:
42.5%
(over
60)
– #1:
Monaco
– 89.52
years;
population
over
65:
28.7%;
2050
projection:
64.6%
(over
60)
– #43:
United
States
– 79.68
years;
population
over
65:
13.9%;
2050
projection:
27.9%
(over
60)
Source:
CIA,
Library,
The
World
Fact
Book;
United
Nations:
World
Population
Prospects;
geoba.se
US
Population
by
Age
&
Sex
2010,
2030
&
2050
65
years
Source:
US
Census
Bureau
US
65
yrs.
+
Projections
(in
thousands
of
people)
100,000
Total
90,000
80,000
70,000
60,000
50,000
Female
40,000
Male
30,000
20,000
10,000
0
1 2 3 4 5 6 7 8 9 10
2015
2020
2025
2030
2040
2035
2055
2045
2050
2060
Source:
US
Census
Bureau-‐2010
Data
• “Of
all
the
people
in
human
history
who
ever
reached
the
age
of
65,
half
are
alive
now.”
*
*
per
The
Shock
of
the
Old:
Welcome
to
the
Elderly
Age,
by
Fred
Pearce,
New
Scientist
Magazine,
April
8,
2010
Percent
65
years
&
older
by
county-‐2010
Source:
US
Census
Bureau,
2010
• There
will
be
some
surprises…as
there
always
are;
however
this
we
do
know
about
the
future
in
general:
– In
the
US,
one
in
three
seniors
is
anticipated
to
die
from
Alzheimer’s
Disease
or
another
dementia*
– In
other
countries
and
the
US,
the
need
for
educational
programming
on
dementia
and
geriatrics
is
being
recognized
and
growing
in
importance
– Higher
levels
of
acuity
shall
take
place
in
alternative
care
settings;
home,
community
&
facility
based
– Changes
in
licensing
&
building
codes
to
provide
opportunities
for
more
creative
models
are
in
process
*2013
Alzheimer’s
Disease
Facts
and
Figures
Alzheimer’s
Association– Purposeful living as a premise is a good basis for re- positioning; examining the changes needed within physical environment to accommodate change – It is the first time in history that we need the wisdom of experience mixed with the technology savvy of a younger generation to create and move forward… – ….as status quo, just isn’t relevant nor acceptable for the future…. – Think strategically and outside comfort zones…creation of interdisciplinary teams to bring about wonderful results…
§ And
Details
on
the
Future….
§ Economics
§ Higher
percentage
of
residents
with
assets
diminishing
§ Need
to
explore
non-‐care
revenue
sources
§ Higher
number
of
residents
remaining
in
the
work-‐force
§ More
pressure
from
government
sources
to
provide
more
service
for
less
money
§ Demographics
§ Older
move
in
age/shorter
ALOS
§ Higher
level
co-‐morbidities
§ Higher
acuity§ What
does
the
future
look
like?
§ Delivery
of
services
§ Going
to
where
the
services
are
needed
§ Utilizing
technology
§ Creating
your
own
professional
staff
§ Location
of
services
§ Destination
long-‐term
care
§ Destination
retirement
§ Collaboration
§ New
collaborative
relationships
with
§ non-‐care
providers
§ Multi/Distance
campuses
§ Creating
your
own
destination
County Home Wisconsin 1955
WHAT IS THE CURRENT DEFINITION OF A HOUSEHOLD?
A small group of residents living within a physically-‐defined environment
that "feels like home" and that has a kitchen (with a wide variety of
food accessible to residents around the clock, including breakfast-‐to-‐
order and on demand), a dining room and a living room.
Staff is consistently assigned so they can develop meaningful
relationships with the residents, work in self-‐led teams and perform a
variety of tasks.
Courtesy
of
:
www.pioneernetwork.netCourtesy of ARI : www.ari.org
Courtesy of ARI : www.ari.org
Brookside
Care
Center
Kenosha,
WIBrookside Care Center (Existing & New) AFTER
Household Renovation Eppstein Uhen Architects, 2016
Household Renovation -‐ Dementia Eppstein Uhen Architects, 2016
Physical
Environment
Comparisons
Between
Models
of
Care
TRADITIONAL
CONTEMPORARY
HOUSEHOLD
LONG
TERM
CARE
MODEL RESIDENT
CENTERED
CARE
MODEL
Large
Centralized
Activity
Space Small
Decentralized
Activity
Spaces
Large
Centralized
Dining
Space Small
Decentralized
Dining
Spaces
Centralized
Staff
Space
(Nursing
Station) Small
Decentralized
Staffing
Spaces
Centralized
Care
&
Service
Spaces
Decentralized
Care
&
Service
Spaces
Institutional
Style
Finishes
&
Furnishings Residential
Interior
Finishes
&
Furnishings
Lack
of
Natural
Light
&
Exterior
Views Natural
Light
&
Options
for
Exterior
Views
Majority
of
Multiple Occupant
Rooms
Private
Rooms
with
Private
3
Piece
Bathrooms.
(2,
3,
or
4
people)
Shared
2
Piece
Bathrooms.
Limited
Number
of
Companion
Rooms,
“Smart
Limited
Private
Rooms
Doubles”
Monochromatic
Interior
Colors
& Variety
of
Interior
Colors
&
Lack
of
Textures Mixture
of
Textures
Limited
Outdoor
Access
and
Garden Outdoor
Access
with
a
Variety
of
SpacesOperational
Comparisons
Between
Models
of
Care
TRADITIONAL
CONTEMPORARY
LONG
TERM
CARE
MODEL RESIDENT
CENTERED
CARE
MODEL
Ailment/Disability
Focus Resident
as
Individual
Focus
Staff
Control
of
Daily
Routines Resident
Choice
and
Control
of
Daily
Routines
Maximization
of
Staff
Efficiency Optimize
Resident
Quality
of
Life
&
Independence
Rotated
Staff
Assignments Permanent
Staff
Assignments
Specialized
Job
Tasks
(Hierarchical) Wide
Range
of
Tasks
(Team
Oriented)
Quality
of
Care
Emphasis Quality
of
Care
&
Quality
of
Life
Emphasis
Majority
of
Food
Preparation
& Majority
of
Food
Preparation
&
Serving
of
Food
at
Plating
of
Food
Behind
Closed
Door Decentralized
Dining
Spaces
In
View
of
ResidentsThe process
Experiential
Design
-‐ Duct
Tape
Masterpieces
by
space
by
functionExperiential Design – On Site Review Flash mock-‐up!
Experiential Design – Full Scale
Experiential Design – Input / Communication
Experiential Design -‐ Virtual
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