10 Homes for older people Ian Smith (updated by David Littlefield) Before his retirement Ian Smith was a partner in Hubbard Ford and Partners KEY POINTS: Because of other available accommodation, the people needing care are increasingly infirm There is a need for activities for residents other than watching TV
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Contents 1 Main elements of the plan 2 Relationship between elements of the plan 3 Planning allowances 4 Planning examples 5 Room data and space requirements 6 Building equipment and fittings 7 Furniture 8 Bibliography
1 MAIN ELEMENTS OF THE PLAN 1.01 The design of homes for old people should create a homely, comfortable and friendly atmosphere. The importance of avoiding an institutional character is stressed in most design guides and instructions to architects.
1.02 This chapter deals with the design of homes in which the residents are in need of special care and attention. The special facilities provided may vary, depending on the degree of infirmity and mobility of the residents, but the basic relationship between the main elements of the plan are common to all homes for old people. Latterly, the concept of very sheltered housing (VSH) has been developed which can provide tenants with a home for life, offering them a choice of different levels of care and support which changes according to need. This removes the need for residents to move to other forms of supported housing. Independence is encouraged; residents can develop a sense of ownership over where they live and can be as self-sufficient as they choose.
CI/SfB 44 Uniclass: F442 UDC: 725.513
Design elements of a VSH development would include: wheelchair standards • Full passing points in circulation areas for wheelchairs and • Adequate scooters of obstructions such as fire compartment doors, which • Removal can be held open on magnetic pads swing door closers to residents’ front doors and other doors • Free regularly used by residents located lift and communal facilities to enable unob• Centrally trusive care delivery and minimise walking distances and
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possible feelings of isolation Centrally located staff facilities away from residential areas Clear separation between areas for residents, staff and visitors Good natural and artificial lighting particularly on circulation routes Good visual access throughout Carefully considered use of tone, colour and tactile materials to assist residents who are partially sighted or disorientated Interesting corridors, ideally naturally lit from windows or rooflights. Avoidance of long, dull vistas Handrails along both sides of circulation routes that are appropriately scored, and snag-free, to assist way-finding for those with visual impairments Appropriate ironmongery, taps, etc. for older people with limited dexterity Protected, sunny, sheltered outdoor spaces with design features appropriate for residents.
2 RELATIONSHIP BETWEEN ELEMENTS OF THE PLAN 2.01 Relationship structures 10.1 shows how the main areas of the building are interrelated. The aim should be to encourage social contact, but at the same time to preserve individual privacy. The residents’ rooms are often grouped
1.03 Elements of VSH A VSH development will likely include the following elements: self-contained flats designed to wheelchair-user • Independent standards. Flats would contain fully fitted kitchens, a shower room, bedroom and lunge
catering kitchen and dining room providing at least one • Main hot meal each day lounge, often linked to the dining room • Communal access to all floors • Lift bathrooms, usually one per floor • Assisted Communal laundry • Wheelchair/scooter • Guest accommodationrecharging store • Non-resident building manager • Separate care team based on site offering 24-h care. Facilities • for staff and carers to include office, rest, meeting, changing and sleepover accommodation
community services, such as hairdressing, chiropody, • Extra shop, etc.
10.1 Relationships between elements of the plan 10-1
10-2
Homes for older people
round a small sitting room and services area containing a bathroom and lavatories. Circulation routes to the communal lounges and dining room should be as short as possible, although routes through the residents’ groups should be avoided. Communal areas may either be centralised or divided between the residential groups, but most homes have a main dining room, which should be close to a sitting area. The administrative offices should be close to the entrance hall, and, if possible, within easy reach of the kitchen. Staff accommodation should be provided in self-contained flats with separate outside entrances.
4 PLANNING EXAMPLES The plans of two typical homes are shown in 10.2 and 10.3.
2.02 Lighting and materials Internally, developments should seek to create an uplifting experience that is welcoming, non-institutional and friendly for both residents and visitors. Particular attention must be paid to the building’s entrance. Careful lighting, colour schemes and use of materials can help create a special environment, although they should remain domestic in character and specified with consideration for the sensory impairments suffered by older people. 2.03 Circulation planning The general arrangement of circulation spaces in a VSH scheme should be clear and ‘rational’ to assist people who are suffering from dementia or memory loss. Complicated planning of circulation routes must be avoided: they will confuse and disorientate. Breaking down the building into identifiable clusters and the provision of visual clues (through pictures and graphics) and signage will greatly assist easy way-finding. Careful planning can reduce the length of corridors, thus reducing the travel distances and minimising an institutional feel. Corridors should have contact with the outside at some points along their length to help people orientate themselves within the overall building and to provide some natural daylight. Windows in the end wall of corridors are not ideal as they create glare, making the corridor appear dark in contrast. A window in the sidewall, near the end of the corridor, will still provide daylight and ventilation while avoiding the glare problem.
10.2 Plan of glebe house, Southbourne
3 PLANNING ALLOWANCES Typical accommodation allowances are given in Table I. Table I Planning allowances Accommodation and facilities Residents
Communal rooms
Kitchen
Administration
Ancillary rooms
Single bedsitting rooms including private WC Double bedsitting rooms Bathrooms and lavatories Sitting areas and tea bars Stores Entrance hall and visitors’ cloakroom Lounges Dining room Handicrafts or sewing room Larder and dry store Food preparation and cooking Washing up Cloakroom and non-resident staff room Matron’s office Doctor’s room Visitors’ room Sluice rooms Laundries Linen storage Cleaners’ stores Box rooms Boiler and plant room Garden store and WC
Staff accommodation Self-contained flat for matron Self-contained flat for assistant matron Two-staff bedsitting rooms Staff bathroom Staff kitchen Two-staff garages Staff lounge NB Room areas on typical 40-person home
9.6–12 m2 15.3 m2 14.8 m2–16 m3 8.8 m2 2.3 m2 per person 1.5 m2 per person 15 m2 12.15 m2 42.50 m2 15 m2 12 m2 11 m2 10 m2 10 m2 6 m2 20 m2 8 m2 4 m2 8 m2 25.30 m2 10 m2 70 m2 60 m2 12 m2 6 m2 12 m2
10.3 Maidment court, Dorset. a ground-floor plan. b plan of first and second floors. c third-floor plan
Homes for older people
5 ROOM DATA AND SPACE REQUIREMENTS Typical layouts are given for single rooms, 10.4, and double rooms, 10.5. These layouts, from DHSS Building Note 2, with rooms of varying proportion, show ways of providing a flexible arrangement within clearly defined sleeping/sitting areas. With narrow rooms, corridor circulation is reduced to a minimum, but other types may well be suitable where a different overall planform is chosen.
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6 BUILDING EQUIPMENT AND FITTINGS 6.01 Some of the information below repeats material in previous chapters. It is also included here because of its importance for this building type.
6.02 Elderly people should be encouraged to do as much as possible for themselves. To facilitate this, the design of the accommodation and appliances should take into account the limitations imposed by age.
6.03 Taps Choose taps that can be manipulated by arthritic fingers. Surgeon’s taps are not recommended, however, as in extreme cases ordinary taps can be modified to provide a similar facility. Within one building, it is sensible to maintain consistency as to the location of hot and cold, e.g. hot always on the right as is now provided in current standards. In addition, the tops should always be boldly colour-coded. It is hoped that in the near future a standard for additional tactile identification will be introduced.
6.04 Washhand basins and baths Washhand basins should be fitted with their rims between 800 and 850 mm high. Bathrooms should be large enough for undressing and dressing, and for someone else to lend a hand. Low-sided baths are available, as the rim, which should be easy to grip, 10.6, should not be higher than 380 mm from the floor. Alternatively, the bath may be set with the trap below floor level. It should have a bottom as flat as possible and should not be longer than 1.5 m; lying down is not encouraged. Grab handles and poles should be provided as in 10.7 to help getting in and out. A seat at rim height is useful for sitting on to wash legs and feet. Bathroom and lavatory doors should open out, with locks operable from the outside in emergencies, 10.8. 10.4 Room data and space requirements for single rooms
10.6 Bath rim adapted for easy gripping
10.5 Double room requirements
10.7 Aids for getting in and out of the bath: pole, handle and rim. Maximum height of rim from floor 380 mm
10-4
Homes for older people
10.8 Plan of bathrooms showing handing to suit people with disability of either right or left leg, and position of pole aid 6.05 Showers Some old people find showers more convenient to use than baths, 10.9. If the floor of the compartment is of smooth non-slip material with a fall to a drain of 1:40, there is no need for a tray with an upstand to be stepped over. The compartment should be well heated, with pegs for clothes on the dry side, divided from the wet with a shower curtain. The water supply should be automatically controlled to supply only between 35 C and 49 C. The shower head should be on the end of a flexible hose, with a variety of positions available for clipping it on. WCs should have a seat height of 380 mm, and handles provided as in 10.10.
10.9 Plan of shower room showing seats and aids
10.10 Inclined rails mounted on walls of WC 6.06 Cupboards Shelves and cupboards should acknowledge the limitations of elderly people. The clothes cupboard rail should be mounted 1.5 m from the floor, and the cupboards should be at least 550 mm deep, 10.11 and 10.12.
10.11 Maximum reach over worktop
10.12 Maximum reach to unobstructed wall-mounted cupboard
7 FURNITURE 7.01 Easy chairs A variety of chair types should be provided in sitting and common rooms, to ensure maximum comfort for all the old people. Seats should not be too low, as this makes the chair difficult to get out of; but if too high, the feet may end up off the floor. A height between 400 and 430 mm is about right, with footstools available for those with extra-short legs. A seat depth between 410 and 470 mm is ideal: any more and cushions become necessary. The back should be angled at 28 to the vertical, and high enough to support the head, for which an adjustable pad is useful. Armrests 230 mm above the seat at the front facilitate getting up, but if lower at the back, make sewing and knitting easier. There should be a gap under the seat to allow the heels to be drawn right back when rising. Generally, the padding should not be too soft and generous, as this can put strain on the tissues rather than allowing the bone structure to support the body.
7.02 Tables and dining chairs Occasional tables in common rooms should not be lower than chair seat height. Dining tables should be 700 mm high and used with chairs having a seat height of 430 mm and a depth of 380 mm. There should be a gap for the thigh between the chair seat and the underside of the table top of at least 190 mm, 10.13.
7.03 Worktops Comfortable reach to worktops are shown in 10.14.
10.13 Table and sitting worktop design, giving height and thigh clearance
Homes for older people
10.14 Standing worktop design, giving height of working surface and reach forward to fittings (scale consistent with 3613)
8 BIBLIOGRAPHY David Robson, Anne M. Nicholson, Neil Barker, Homes for the third age: A design guide for extra care sheltered housing, E & FN Spon, June 1998 David Littlefield, Growing old gracefully. RIBA Journal, July 2003 Sien Winters (ed) Lifetime housing in Europe, Katholieke Universiteit Leuven, 2001
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Sheila Peace and Caroline Holland (eds). Inclusive housing in an ageing society: Innovative approaches. The Policy Press, October 2001 Jeremy Melvin, Stephen Mullin, Peter Stewart. Place & Home; the search for better housing. PRP Architects. Black Dog Publishing, February 2007 Design Guide for Sheltered Schemes. Improving the interior design of the entrance and shared areas. Quattro Design. Bristol City Council Neighbourhood and Housing Services, September 2001 Design Guide for the Development of New build Accommodation for Older People. PRP Architects. The Abbeyfield Society, 2001: ISBN 1 872 380 468 Peter Barker, Jon Barrick, and Rod Wilson, Building Sight. A Handbook of building and interior design solutions to include the needs of visually impaired people. R.N.I.B: ISBN 1 85878 078 4 Accommodating Diversity: Housing design in a multicultural society. Penoyre & Presad Architects, National Housing Federation. ISBN: 978 0 86297 3834 Scheme Development Standards. The Housing Corporation, August 2000: ISBN 1 84111 045 0 Standards in Quality and Development. A good practice guide. National Housing Federation, June 1998: ISBN 0 86297 354 6 S. Thorpe, Wheelchair housing design guide, Construction Research Communications Ltd, 1997: ISBN 1 86081 164 7