Environments for Aging - Fall 2016 - 40

Left: Resident rooms at The Terraces at San
Joaquin Gardens are arranged in proximity
to a household-dedicated common room,
pictured here. Part of the continuing care
retirement community of the American Baptist
Homes of the West, the buildings opened in
2014 and were designed by Douglas Pancake
Architects. Below: Resident rooms at The
Terraces at San Joaquin Gardens feature a
wireless charting center, media wall, built-in
personal storage, and wheelchair storage.

expected to open in winter 2020. The
20-story high-rise, designed by Perkins Eastman, will have 11 floors with 22 Green House
homes-two households per floor-to accommodate a total of 264 residents. In each
home, 12 private bedrooms will surround
a great room showcasing a living room, an
open kitchen, and a dining room, the latter
boasting a dining table large enough to seat
all 12 residents plus guests. Five other floors
with a total of 150 beds-90 private and 60
semi-private-will be devoted to short-term
rehabilitation.

Details, details

40

EFAmagazine.com * Fall 2016

doors feature a doorbell, providing a simple
residential association right from the start.
"The exterior door is locked in the household
model," Simonetti says. By comparison, in
a traditional facility, particularly a larger one,
"people walk in and walk the halls; everything is public." That sort of visitation, he
explains, "conveys a sense of entitlement."
Instead, in a household model, "the whole
home becomes [the residents']," he says.
"Visitors act differently: You wait in the foyer
until you are acknowledged. That's perfect."
The up-and-coming residential emphasis
in skilled nursing facilities includes public
spaces filled with natural light and windows
offering strong visual connections to outdoor
settings. But a more obvious example of
the model's person-centered features is an
all-private bedroom layout that includes a
private bathroom. "In all of my experience
over the past decade or more, even in the
medical model, the [private] bathrooms are
being put in the bedroom," says Douglas
Pancake, president of Douglas Pancake
Architects. "It's terribly undignified to be
wheeled down the halls."
Where semi-private bedroom allocation

occurs, half-walls should be used to define
respective sleeping spaces, with each bed
having a resident-dedicated area and direct
window access, Pancake says. In some
scenarios, two residents may express a
desire to have a shared bedroom-spouses, partners, siblings, good friends. Even
so, a patient-centered shared space in this
arrangement consists of two areas: either
two designated bedrooms or one bedroom
and a living room space, with each configuration divided by a solid partition wall with a
door that closes. "From an ideal perspective, everybody deserves the option of a
private room unless you want to share,"
Calkins says.

Striking a balance
Still, a natural tension exists between creating a residential environment and supporting the inherent clinical nature of skilled
nursing. "You have to design for both,"
says Martin Siefering, principal with Perkins
Eastman (Pittsburgh). State requirements
introduce necessary features that are
institutional in aesthetic: mounted boxes to
dispense latex gloves or soap, for example.

PAUL MULLINS

When it comes to interior approaches for
SNF households, the individual needs of
residents come first, says Debbie Wiegand, a
project guide with The Green House Project.
"We ask, 'Would it belong in your home?'"
regarding color, furnishings, and other design
elements. If not, it's excluded from the design
mix. "We want to get rid of institutional cues;
we just want to make sure we're creating
something residential."
Small houses in the Sarah Neuman
campus of The New Jewish Home in Mamaroneck, N.Y., feature a large, open kitchen/
dining room/living room area that includes
a hearth. The combined space conveys
"home," right down to each kitchen's granite
countertops; refrigerators look like residential
models, yet they're commercial grade for durability. Perkins Eastman designed the small
houses; three of which are open and a total
of seven are planned as part of a phased
renovation, from 2014 to 2017.
Residential cues guide interactions at The
Cottages at Garden Grove, a SNF in Cicero,
N.Y., as well. SWBR Architects designed The
Cottages, 12 8,400-square-foot units, each
having 13 private bedrooms and all containing private bathrooms with showers. Front
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