Connectivity- The Public and The Private

CONNECTIVITYTHE PUBLIC AND THE PRIVATE EXPLORING SPACIAL CONNECTIONS IN AN URBAN SENIOR LIVING COMMUNITY TO ENHANCE THE LIVES OF DEMENTIA PATIENTS

SITE: SOUTH HUNTINGTON AVE, JAMAICA PLAIN, MA

Meghan Bell Candidate for Master of Architecture Fall 2013 Thesis Proposal

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A. Table of Contents: B. Thesis Summary

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I. Case Studies

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C. Thesis Abstract

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J. Sketch Problem

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D. Thesis Statement

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K. Health and Wellness

..... 81

E. Methods of Inquiry & Terms of Criticism

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L. Thesis Client

..... 83

F. Building Systems

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M. Schedule of Requirements

..... 85

G. Site Statement

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Resume

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N. Annotated Bibliography

..... 88

H. Programming

Existing State

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Citations

..... 92

1. Site Description and Analysis

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Appendix

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2. Zoning and Codes

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3. Cultural Context

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4. Informational Contect

..... 50

5. Precedents

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Future State

..... 60

6. Mission and Goals

..... 61

7. Cost Evaluation

..... 64

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Modern concept of a healing environment is “... a therapeutic environment that has a positive influence on the healing process and can be achieved by incorporating design elements that provide comfort, security, stimulation, opportunities for privacy and control, positive distractions and access to a patient’s social support network.”

- Suite Dreams Project1 “Memories are motionless, and the more securely they are fixed in space, the sounder they are. To localize a memory in time is merely a matter for the biographer and only corresponds to a sort of external history, for external use, to be communicated to others.” -Gaston Bachelard “Poetics of Space”2

“Architecture is a series of successive events...events that the spirit tries to transmute by the creation of relations so precise and so overwhelming that deep physiological sensations result from them, that a real spiritual delectation is felt at reading the solution, that a perception of harmony comes to us from the clear-cut mathematical quality uniting each element of the work.”

- Le Corbusier “ Precisions on the Present State of Architecture and City Planning”3

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We step off the E-Line in front of Grandpa’s memory care facility. It is a sunny fall day and the leaves along the Jamaicaway are turning reds and oranges. As we enter through the front foyer, we can see through the open central living area to the lake and trees in Olmstead Park. This living area is warm and inviting, with several intimate seating areas spread through the gathering space. It not only provides a sweeping view of the park across the street from the building, but it also allows for a visual connection to other parts of the property, including the gardens outside that are integrated into each level of the building. The sweeping gradual ramps that connect the different parts of the building are also visible in parts from this main welcoming area and from this central vantage point at least a part of all sections of the building are visible. After checking in, we head up the gradual, wide ramp that leads to the resident apartments to check in on Grandpa.

We say “hello” and he is happy to have us to visit. While his apartment is a cozy studio for him, it is too small to entertain guests, so we help him into a sweater and cap and meander down the slightly sloped and bending hallway to the nearest outdoor garden. The protected outdoor space is warm in the autumn sunshine and we all sit down on the benches in the outdoor seating area. The space is well protected from street noise and the birds that inhabit the more mature trees on the perimeter of the property chirp frequently in the background.

Several other residents are also out in the garden space on this afternoon and are potting plants in the raised planter along the edge of the pathway.

Grandpa does not like to stay seated for very long and so we amble around the pathway in the garden with him as he shuffles along the smooth stones and then we head back inside to the interior pathway of the building to continue our walk. The afternoon sunshine is softly filtered through the walls and provides an even soft glow to the interior pathway covered in very low pile warm-colored carpet that is easy on his gait.

The pathway continues on its gradual sloping and meander direction and we arrive at the dining area of the building. One of the providers in the dining facility has set out cookies and we help ourselves to coffee with the cookies and sit down again with Grandpa in this family-style gathering area near the main dining room. We are now closer to Olmstead Park within the building and Grandpa notices the bright reds of the trees and a family bicycling by as he points these sights out to us. Skylights above filter the bright sunlight to a soft even light and this area of the building is also warm and inviting.

As Grandpa tires from our visit, we say our goodbyes and continue along the pathway back to the entry of the building where we catch the E-Line after a few minutes wait and head back into the heart of the city.

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B. THESIS SUMMARY Connectivity- The Public and The Private

Exploring Spatial Connections in an Urban Senior Living Community to Enhance the Lives of Dementia Patients by: Meghan Bell Thesis Statement: Can visual connections adjacencies facilitate a greater connection between public and private spaces?

Abstract: Comprehension of both perceived and physical boundaries that delineate private and public spaces defines our understanding of our place in the world. As population increases and cities become denser, public space has eroded the boundaries of private space. I will seek to understand how we can redefine how adjacencies and visual connections can inform our design decisions to bring back a sense of privacy in an ever-increasingly crowded environment.

New strategies to defining public and private space will be tested in a dense urban environment in a building program for the world’s fastest growing population- that of aging adults over 65 years of age suffering from cognitive limitations as a result of dementia. Because privacy and private spaces disappear for this population, in particular due to not only safety and security reasons, but also because of their deteriorating cognitive perception, employing new strategies for connections and adjacencies for this population will be immediately felt on a small and tangible scale.

The proposed site for the project in on South Huntington Avenue in Jamaica Plain, Boston, MA and will allow testing of strategies on a urban site with visual connections not only to a dense residential and institutional neighborhood but also with connections to the Emerald Necklace and natural features.

Methods of Inquiry: 1. Research what defines visual connections and the understanding of public and private space 2. Study the idea of personal space and what it means to individuals of varying ages and cultures 3. Research the cognitive and physical limitations and symptoms of individuals living with dementia 4. Study how privacy defines the spatial attributes of bedrooms, corridors, and living spaces 5. Understand through sketch and model the types of transition between indoor and outdoor spaces that can preserves privacy and allow for visual connection

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Terms of Criticism: 1. Were visual connections important in establishing public and private space?

2. Were the spatial attributes of bedrooms, corridors, and living spaces clearly defined by zones of privacy?

3. Did the transition between indoor and outdoor spaces preserve privacy while allowing for visual connection?

Building Typology: The thesis will be tested in a facility for senior living with a focus on dementia care. A balance between interior and exterior spaces will be important to the flow of the building and the adjacencies of spaces within the program. Total square footage of the project is currently estimated at approximately 30,000 SF. Site and Location: There are several important factors for the site of the proposed project. These factors are southern exposure for daylighting needs, pleasing views that can be accessible be building occupants, opportunity on the site for quiet outdoor space, ease of access to the site for family and community members, and a neighborhood fabric that does not include neighboring buildings in excess of 5-6 stories in height. These factors will allow for integration of circulation space indoors and outdoors, views can be framed and help encourage movement, and daylight can also be incorporated into the spaces.

The proposed site is a vacant lot on South Huntington Avenue with considerable vegetation and a slope downhill from South Huntington Avenue on the east towards the Jamaicaway to the west. The site overlooks a large pond on the Emerald Necklace and has a total SF of 48,625 SF. The site is within 1 mile of the Longwood medical campuses and is in the VA Hospital Administration Neighborhood Institutional Overlay. A neighboring property contains long-term stay units for cancer patients receiving treatment at the Longwood hospitals. In terms of zoning, in addition to being in the Neighborhood Institutional Subdistrict the site is also in the Greenbelt Protection Overlay. The zoning allows for both elderly housing and nursing and convalescent homes. The zoning allows for an FAR of 1.0 and a maximum height of 45 feet. There are no minimum width and frontage requirements for the site.

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Visual Connections

Zones of Privacy

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C. THESIS ABSTRACT Comprehension of both perceived and physical boundaries that delineate private and public spaces defines our understanding of our place in the world. As population increases and cities become denser, public space has eroded the boundaries of private space. I will seek to understand how we can redefine how adjacencies and visual connections can inform our design decisions to bring back a sense of privacy in an ever-increasingly crowded environment.

These ideas and new strategies to defining public and private space will be tested in a dense urban environment in a building program for the world’s fastest growing population- that of aging adults over 65 years of age suffering from cognitive limitations as a result of dementia. Because privacy and private spaces disappear for this population in particular due to not only safety and security reasons but also because of their deteriorating cognitive perception, employing new strategies for connections and adjacencies for this population will be immediately felt on a small and tangible scale.

The proposed site for the project in on South Huntington Avenue in Jamaica Plain, Boston, MA and will allow testing of strategies on a urban site with visual connections not only to a dense residential and institutional neighborhood but also with connections to the Emerald Necklace and nature.

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Exploring Visual Connections

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D. THESIS STATEMENT Comprehension of both perceived and physical boundaries that delineate private and public spaces defines our understanding of our place in the world. As population increases and cities become denser, public space has eroded the boundaries of private space. I will seek to understand how we can redefine how adjacencies and visual connections inform our design decisions to bring back a sense of privacy in an ever-increasingly crowded environment.

As was discussed in psychology class, Maslow’s hierarchy of needs is a theory that creates an order, or hierarchy, for needs of humans in different stages of growth, development, and maturity. Maslow used the terms Physiological, Safety, Social, Esteem, and Self-Actualization. These needs are ordered from the bottom of the pyramid at the most basic needs for human survival up to the highest achievement of being fulfilled when a person reaches their highest potential. This order describes the pattern of human motivations.

This order of needs relates to an individual’s relationship with the world and other individuals around him. On a basic level, private needs of safety and security are required; however, love and respect gained from interactions with others also hold a prominant place in the hierarchy. A balance of public interaction and private space is necessary to reach fulfillment. The eroding edge between public and private space can be seen not only in the physical environment with more dense urbanization but also in noise pollution, the invasion of smells from neighbors, light spillage from adjancent spaces, and an increasing loss of privacy in the digital world. By studying these edges, and focusing on how the physical environment can redefine and protect the varying zones of public and private space, environments can be created where individuals can be fulfilled and reach their potential.

By focusing on a population who have limitations, dementia sufferers, solutions that meet all of their needs on the hierarchy should also be able to be applied to a greater population. New spatial understandings can improve wellbeing. This thesis will seek to create an appropriate balance in the physical environment between the public and the private in which individuals’ needs may be met and exceeded and spatial connections and adjacencies are tested and discovered.

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Maslow’s Hierarchy of Needs:4

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PERSONAL DISTANCE

18” - 48”

SOCIAL DISTANCE

4’ - 12’ 0” - 18”

INTIMATE DISTANCE

PERSONAL SPACE BUBBLES

WHAT IS PRIVACY?

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Image Credits5

Citation6

“It is possible to have privacy on a crowded street, and at the same time, it may prove impossible to attain privacy alone in a room. Privacy exists at many levels, with both physical and spiritual requirements. The activities of our daily lives require periods of spatial separation, as well as a sense of space that transcends physical barriers.”

- R. and S. Kaplan Privacy is the process by which we control access to ourselves or our group and a condition of selected distance or isolation. There are four key questions that can structure the discussion about privacy: 1. what factors cause us to need privacy?, 2. what are the benefits of privacy?, 3. how do our privacy needs vary and why?, and 4. how can the built environment be designed to provide for our diverse privacy needs?

The need for privacy serves a variety of purposes from physical and psychological health to self-identity and emotional release. The advantages of privacy include enhancing feelings of well-being and facilitating the development of self-identity, which top Maslow’s hierarchy of needs. Being able to choose and achieve a level of privacy that is personally desired is important in managing stress and maintaining a healthy sense of wellbeing.

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HOW TO DEFINE VISUAL CONNECTION?9 As the world becomes more densely populated and there is an increase in urbanization, the conflict between private space and connection with the world around us becomes more apparant. Types of spaces that are designed and built are focused on being “architecturally impactful”, many times by providing open spaces that are visual stimulating yet difficult in which to retreat to private space, whether that private space be away from a crowd, away from noise, or away from overwhelming visual stimulation. There has become less focus on human scale and availability of privacy. The perceived need for visual connection and constant stimulation has eroded personal space. The architectural challenge that is faced is how to allow for visual connection to surroundings and a choice of stimuli, which is important in the ever-increasing culture of multi-tasking, while still allowing for, and defining, personal space for relaxation and security.

While the need and availability of community is increasing in business, in urban housing, in recreation, and in daily health, so is the need for personal space and retreat. A balance in these two opposing spatial types must be found to bring balance back to the life of the individual in today’s society.

WHY SENIOR LIVING? The project will deal directly with the exponentially increasing numbers of individuals over the age of 65, particularly as the number of these individuals with some form of dementia increases worldwide. Given the changing family dynamics over time, particularly in the United States, fewer aging individuals have the option of being cared for by family members as they age and need greater amounts of care. As a result, appropriate housing and care will need to be provided in sufficient supply to accommodate the growing numbers of aging individuals.

Understanding key components of the architecture of senior living facilities will push the field forward and positively impact future design of this project type.

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PRIVACY AND VISUAL CONNECTION IN DEMENTIA CARE The elderly population of the world and, especially of the United States, is growing rapidly. In 2004, the population of people ages 65 and older made up 13 percent of the population; by the year 2030 it is projected by the US Census Bureau that this percentage of the population will make up over 20 percent of the population. This will translate to one in five people in the United States in 2030 will be 65 or older, where currently only one in every eight people is 65 and older. Further, the older segment of this 65 and older population is growing as well. In 2004, the number of individuals aged 85 and older was 4.3 million. This number is expected to be 7.3 million by 2020 and 15 million by 2040. This translates to 1 in 20 Americans aged 85 or older in 2050 as compared to 1 in 100 in that age bracket in 2004.10 Accommodating the needs of this growing population in terms of medical care, housing, and other means of support will be a major challenge in the United States.

In order to make accommodations in these areas of medical care, housing, and support, it is necessary to identify the symptoms and behavior associated with dementia. While Alzheimer’s disease and dementia are not inevitable effects of the aging process, age, along with genetics, is the highest risk factor for both. Currently there are more than 5 million Americans with Alzheimer’s disease and the majority of these individuals are part of the senior population.11 The number of individuals with Alzheimer’s disease is projected to increase to 7.7 million people by the year 2030 and to between 11 and 16 million people by 2050, primarily due to the aging of the baby boomer generation.12 Dementia is not a specific disease, but rather it is a term that refers to a wide range of symptoms that are related to memory loss and cognitive difficulties that impair an individual’s ability to accomplish everyday tasks and activities. Alzheimer’s disease is the most common form of dementia and is a chronic neurodegenerative brain disease that often begins gradually, but as it progresses over time it leads to memory loss, confusion, changes in personality and behavior, communication difficulties, impaired judgment, and a loss of the ability to maintain personal care. While there are a variety of symptoms for both Alzheimer’s and dementia, according to the Alzheimer’s Association, at least two of the following cognitive issues must show significant impairment for a dementia diagnosis: “memory, communication and language, ability to focus and pay attention, reasoning and judgment, and visual perception.”13 Most forms of dementia are progressive and individuals need a continued increase in care as the disease advances; therefore, their environment will need to anticipate further accommodations needed.

The ten most common early symptoms of Alzheimer are as follows: “memory loss that disrupts daily life; challenges in planning or solving problems; difficulty completing familiar tasks at home, at work, or at leisure; confusion with time or place; trouble understanding visual images and spatial relationships; new problems with words in speaking and writing; misplacing things and losing the ability to retrace steps; decreased or poor judgment; withdrawal from work or social activities; and changes in mood or personality.”14 While there is no cure for Alzheimer’s disease or other forms of dementia, these diseases can be treated, and the architecture of the environment can be a major influence in this treatment and can help patients live a rich and dignified life.

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Images Citations18

A physical environment that directs cognition becomes treatment for an individual that can no longer make or use a cognitive map; this type of environment can increase the safety and security of an individual. Further, privacy and personalization of the bedrooms and other private spaces of individuals with forms of dementia lessen their agitation, while distinctive and varied social spaces reduce the rates of depression, social withdrawal, and confusion.15 “The physical environment and therapeutic activities become treatment when they are linked to specific brain dysfunctions such as Alzheimer’s disease when they systematically compensate for the functional losses of dementia. When treated consistently in specially planned environments, even those with Alzheimer’s disease can achieve higher emotional levels, developing both a sense of self and a sense of belonging to a larger community of residents. Improved quality of life, a slowed rate of progression of the disease, delayed institutionalization, and a reduced need for medication are the ultimate measures of success of such a treatment approach.”16 Because accepting the Alzheimer’s patient’s frame of reference and definition of “reality” are an essential part of communicating with and treating that patient, tailoring an environment that is sensitive to his or her needs is necessary to treatment. Of the current senior population in the United States, 1 in 3 will die with Alzheimer’s disease or another form of dementia, and this percentage is projected to increase with the projected growth in the senior population over the next 30 years.17 This percentage of the aging population who will have some form of dementia and/or Alzheimer’s disease makes the incorporation of memory care into senior housing essential and is driving a more widespread need for new senior housing to be delivered to market over the next 15 years with a focus on the care of dementia and Alzheimer’s disease patients.

The loss of memory associated with dementia makes visual cues and connections critical in day to day functioning, while at the same time, the need for a higher level of safety and security shrinks the amount of personal space afforded individuals suffering with dementia. There are multiple levels, or zones, of private space within senior living communities (individual room, gathering space, community as a whole, surrounding neighborhood) and it is critical to maintain visual connectivity between these zones while at the same time not eroding the barriers between that allow for individual privacy.

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E. Methods of Inquiry: 1.

2.

3.

4.

5.

Research what defines visual connections and the understanding of public and private space Study the idea of personal space and what it means to individuals of varying ages and cultures Research the cognitive and physical limitations and symptoms of individuals living with dementia Study how privacy defines the spatial attributes of bedrooms, corridors, and living spaces Understand through sketch and model the types of transition between indoor and outdoor spaces that can preserves privacy and allow for visual connection

Terms of Criticism: 1. Were visual connections important in establishing and understanding public and private space?

2. Were the spatial attributes of bedrooms, corridors, and living spaces clearly defined by zones of privacy?

3. Did the transition between indoor and outdoor spaces preserve privacy while allowing for visual connection?

The terms of criticism will be key in focusing my thesis on zones of privacy and the understanding of how visual connections inform public and private spaces. While understanding the needs of the population that will inhabit the project will inform some design decisions, the ultimate goal is not to discuss senior living and dementia at the forefront of this project but to discuss, research, develop, and push forward the spatial adjancencies and visual connections that define public and private spaces in daily life for all user groups.

Only by fully understanding this underlying concept, can any meaningful application of new ideas be possible.

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F. BUILDING SYSTEMS With a population that suffers from cognitive impairment as well as limitations that can be associated with aging, such as deteriorating eyesight, progressive hearing loss, and impaired balance and mobility there are a number of life safety issues that will need to be addressed. Barrier free design will be the underlying approach to design as well as ADA and Massachusetts Guidelines for universal access. Secure access and monitoring of patients, given the tendency for dementia patients to wander, will need to be considered for their safety; this will come with also having an acute awareness of the different zones of risk for the residents of the building. Types of products that are ligature-resistant and tamper-resistant will need to be incorporated into the design.

Consideration of the safety and access needs of the building residents will effect the flow of the circulation of the building and will be a factor in integration of outdoor spaces and the incorporation of natural light into the project. Further, consideration of quiet and efficient mechanical systems will be key for the aging and sensitive population.

The site itself will require a high-functioning drainage system as the site sits on a downward, and a times steep, slope towards wetlands and a lake where good drainage and foundation protection and waterproofing will be considerations.

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G. SITE S. Huntington Avenue, Jamaica Plain, Boston, MA: In choosing a site for this thesis several important factors should be present. These factors are southern exposure for daylighting needs, pleasing views that can be accessible by building occupants, opportunity on the site for quiet outdoor space, ease of access to the site for family and community members, and a neigborhood fabric that does not include neighboring buildings in excess of 5-6 stories in height. These factors will allow for integration of circulation space indoors and outdoors, views can be framed and help encourage movement, and daylight can also be incorporated into a variety of spaces.

The South Huntington Avenue site is a vacant lot overgrown considerable vegetation, sloping downhill from South Huntington Avenue on the east towards the Jamaicaway to the west. The site overlooks a large pond on the Emerald Necklace and has a total SF of 48,625 SF. The site is within 1 mile of the Longwood medical campuses, is in the VA Hospital Administration Neighborhood institutional Overlay, and is characterized as an urban site. A neighboring property contains long-term stay units for cancer patients receiving treatment at the Longwood hospitals. In terms of zoning, in addition to being in the Neighborhood Institutional Subdistrict the site is also in the Greenbelt Protection Overlay. This zoning allows for both elderly housing and nursing and convalecsent homes. The zoning allows for an FAR of 1.0 and a maximum height of 45 feet. There is no minimum width and frontage requirements.19

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Site Visit Sketch Diagram

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Region20

Neighborhood21 SITE

SITE

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Site Plan22

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H. PROGRAMMING EXISTING STATE

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SiteS. Huntington Avenue, Jamaica Plain, Boston, MA

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Views Onto Site

Image Citation23

eet

175 F

259

10 Foot Side Setback

20 Foot Front Setback

Fee t

252 Fee t

20 Foot Rear Setback

t 6 Fee

10 Foot Side Setback

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Site Setbacks24   29

Site Description and Analysis Parcel 1001625010 District: Jamaica Plain SubDistrict: NI Overlays: Greenbelt Protection Owner: Cedar Valley Holdings LLC SF: 48,625 Classification Code: 390 (Vacant Land- Accessory to Commercial Parcel/ Developable Land) FY2013 Land Value: $1,016,70026 25

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LEGEND Path Edge Node District Landmark

SITE

Greenspace

Lynch Diagram  31

10 Minute Walking

5 Minute Walking

SITE

LEGEND Train Line Bus Line Parking Pedestrian Radius

5 and 10 Minute Pedestrian Radii

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Primary Pedestrian Circulation

Public Transit Routes (Bus and T)

Primary Vehicular Circulation

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Wind Direction and Speed

Nolli Map

Base Map Citations27 Wind Rose Citation28

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SITE

Site Topography29

Adjacent Land Use30

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March 21- 8 AM

June 21- 8 AM

March 21- 12 PM

June 21- 12 PM

March 21- 4 PM

Shadow Diagrams June 21- 4 PM

September 21- 8 AM

December 21- 8 AM

September 21- 12 PM

December 21- 12 PM

September 21- 4 PM

September 4 PM

Shadow Diagrams

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Site Observations Site Visit:

Sunday, October 20, 2013. Weather: Sunny, 55 degrees. 12:30 PM.

Traces: The existing site is primarily vacant and overgrown with vegetation. There are remnants of a basketball court in one small part of the site. A concrete stairway leads down from the South Huntington Avenue to the site and discarded folding chairs and a wheelbarrow site at the foot of the stairs on a patch of eroded pavement. On the northeast side of the site, the chain link fence has fallen down and apparantly discarded construction materials are stacked. The site appears to no longer be in use as it was originally intended and primary access points to the site have been fenced off.

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Orientation/Wayfinding: The site is located in a fairly residential neighborhood with a number of medical institutional properties in close proximity. Additionally, there are biking and jogging trails across the Jamaicaway from the site in Olmstead Park. Finding the site is fairly easy as it is located at both a bus stop and a T stop on the public transit lines. The site itself is fenced off from the street on both the South Huntington Avenue side and the Jamaicaway side; however, while the South Huntington fence side is tall and opaque, the fence along the Jamicaway is chain link and a clear view of the site is possible.

Image Citations31

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Density/Crowding: There was moderate traffic flow along Jamicaway at the time of the site visit. There is heavy traffic flow on Jamicaway during rush hours. There was very light traffic flow along South Huntington Avenue, although this traffic flow also intensifies during rush hour. There were a limited number of people in the area at the time of the site visit as the surrounding properties are primarily residential and medical buildings. The site itself is fenced off and not in use.

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Site Conclusions: While there is active usage of the roads and sites surrounding the property for recreational, residential, and institutional uses, the site itself is vacant, overgrown, and unused. Access to the site is convenient on public transportation and by automobile. There is a steep drop of approximately 15 feet from South Huntington Avenue to the main portion of the site that will need to be considered for drainage. The site has nice views across the Jamaicaway to Olmstead Park in the Emerald Necklace and the slope of the site could be advantageous in capitalizing on these views.

Image Citations32

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Codes33, 34, 35 Per Article 55 of the Boston Zoning Code the site is zoned as a Neighborhood Institutional (“NI”) Subdistricts within the Jamaica Plain Neighborhood District. Specifically, the site is in the Veterans Administration Hospital Institutional Subdistrict. “The purpose of the Neighborhood Institutional Subdistricts is to identify major Institutional uses within residential neighborhoods and to provide regulations that will allow small-scale Institutional projects to proceed as of right, while requiring review of larger Institutional projects to ensure that such projects proceed in a manner that is sensitive to and preserves the quality of life of the surrounding residential neighborhoods.”

Within the Neighborhood Institutional Subdistricts the proposed senior living project would be allowed as elderly housing is allowed in NI, and a general healthcare group residence is conditional in NI. No variances should be necessary for the proposed use.

The maxium FAR for the project at the site 1.0. The proposed site is 48,625 SF, with 259 feet of frontage on South Huntington Avenue. The maximum height of the proposed building is 45 feet. There is no minimum lot size, width, or frontage within the zoning district. The minimum front yard setback is 20 feet, the minimum side yard setback is 10 feet, and the minimum rear year setback is 20 feet.

The site also is within the Jamaicaway Greenbelt Protection Overlay (GPOD). The proposed senior living facility will be in excess of 5,000 SF and will therefore be subject to the GPOD limitations which are as follows: “a) provision for adequate vehicular access, off-street parking and loading and shall not have a significant adverse effect on traffic and parking on the Greenbelt Roadway and adjacent streets; (b) provision for landscaping treatment that ensures that the natural and aesthetic quality of the Greenbelt Roadway area will be maintained; (c) provision for the design of all structures that is compatible with surrounding neighborhood.”

Each car space shall be located entirely on the Lot. Fifty percent (50%) of the required spaces may be no less than seven (7) feet in width and eighteen (18) feet in length, and the remainder shall be no less than eight and one half (8-1/2) feet in width and twenty (20) feet in length, in both instances exclusive of maneuvering areas and access drives.

1.0 parking spaces per 1,000 SF of gross floor area for healthcare use.

0.2 spaces per dwelling unit for elderly housing.

1.0 loading bays are required for a project between 15,001 SF and 49,999 SF. Please see the Appendix for further zoning information.

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Per the 2012 International Building Code, as an assisted living facility with memory care, the building falls into the following use groups: I-1, A-3, A-4, A-5, B, and S-1, which encompasses dwelling uses, medical care uses, office use, storage use, and several types of assembly use. The proposed building will be 32,100 SF on one story at 15 feet in height. The Proposed Construction Type is IIA, and considering increases in building area for sprinklers and perimeter access, the proposed 32,100 SF building would be within the 48,625 SF maximum allowed area for the building and an allowed height of 45 feet.

The proposed senior living facility falls under both the Massachusetts Architectural Access Board Regulations Sections 9, 13, 42, 43, 44, 45, 46, and 47.

Please see the Appendix for for section 13 in full.

This building will fully comply with accessibility codes, particularly as its primary users will have physical limitations. All corridors, doorways, restrooms, and other spaces will meet accessibility codes per the Massachusetts Architectural Access Board. Should the building be greater than one story tall, an elevator will be incorporated into the program.

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Cultural Context

The proposed site rests on the border of the Jamaica Plain and Mission Hill neighborhoods in Boston. While the site is located in Jamaica Plain, influences from both neighborhoods effect the site. from the Boston Redevelopment Authority: “Jamaica Plan At a Glance: Originally a summertime resort destination for Bostonians, Jamaica Plain (JP) is a classic streetcar suburb of Boston. Located southwest of Downtown Boston, JP was annexed by the City in 1874. Jamaica Plain has consistently been an important center for residential life, arts, and commerce for the City of Boston.

JP’s residential streets, filled with iconic triple-decker houses in imaginative colors, are home to Latinos, young families, a growing gay community, and young professionals. A real jewel of JP is 68-acre Jamaica Pond. It is popular with local residents for fishing, sailing, and running along its 1.5 mile shore path. The 265-acre Arnold Arboretum, designed by Frederick Law Olmstead, offers a botanical oasis in the heart of the city.

Jamaica Plain is easily accessible by the Southwest Corridor, MBTA trains, and buses. The main transit hub for the area is Forest Hill Station. Since the eighteenth century, Centre Street has been a major retail street for the community in Jamaica Plain. JP’s diversity of residents is reflected in the businesses with a range of ethnic restaurants and stores animating Centre Street. Egleston Square Main Street, Hyde Jackson Square Main Street Program, and JP Centre/South Main Streets support local business owners. Some notable Jamaica Plain businesses include the Samuel Adams brewery and JP Licks.

Recently approved- 105A S. Huntington Ave for a rental residential project.

Mission Hill At a Glance: Acquired by Boston in 1868, Mission Hill (then called Parker Hill) has been a cornerstone in Boston’s long history. Once filled with farms, breweries, and orchards, Mission Hill has grown into a largely residential neighborhood connecting more central neighborhoods of Boston to Jamaica Plain and Roxbury.

Contained within the neighborhood, the Mission Hill Triangle is an architectural landmark district with a combination of single family homes built by early landowners. Elsewhere on Mission Hill, you can find blocks of traditional brick row houses and iconic triple-deckers. Mission Hill’s streets wind up and down the steep hill the neighborhood is named for, and spectacular views of Boston’s skyline can be had from the new Kevin W. Fitzgerald Park.” 36

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Architectural Context

Apartments enVision Hotel Boston

North American Indian Center of Boston Back of the Hill Apartments

Astrazeneca Hope Lodge Center

VA Hospital

Image Citations37

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Historic Context38 Jamaica Plain, a town in the City of Boston, was originally part of Roxbury, MA before becoming indpendent in 1851 and annexed to Boston in 1873. After the railroad, the streetcar, and the parkway connected the suburb to downtown Boston, Jamaica Plain transformed from a farming community to a commuter suburb beginning in the 1850s. By the 1870s, industrialization began to infiltrate the neighborhood in the Stony Brook area of Jamaica Plain with tanneries and breweries taking hold in the area.

The most notable brewery in the area was the Haffenreffer Brewery which was begun in 1877 and remained in operation until the 1960s. The property is now used for industrial and commercial uses.

Jamaica Pond is a kettle hole formed by prehistoric glaciers that has always been a part of Jamaica Plain’s landscape. Originally, the pond was surrounded by private estates and not open to public use.

However, once the Jamaicaway that runs alongside the pond through the Emerald Necklace was transformed from a carriageway to a throughway for automobiles in the early twentieth century and Jamaica Plain became a town for suburban automobile commuters, the private estates began to be sold and a number of residential developments were built in the area. The pond is primarily used by the public today and now has a public boathouse on its banks.

Jamaica Plain has a history of institutional medical care as is seen in the Neighborhood Institutional Overlay that remains part of the zoning of the town today. Beginning in 1880, the Adams-Nervine Asylum opened on Centre Street with a new community living model for its patients. The asylum operated until 1976 and is now condominiums and designated a historic landmark. This property began the trend of properties focused on care for the elderly and infirm, a trend that I hope to continue in a new style with the propesed senior living facility on South Huntington Avenue.

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Demographics39 2007-2011 American Community Survey Information POPULATION Male: 16,925 Female: 19,128

HOUSING Total Housing: 15,945 100% Occupied Units: 15,064 94.5% Vacant Units: 881 5.5%

AGE Total: 36,053 100% Under 5 years: 2,161 6% 5 to 14 years: 2,966 9% 15 to 19 years: 1,771 5% 20 to 29 years: 8,106 23% 30 to 39 years: 7,218 20% 40 to 49 years: 4,836 14% 50 to 59 years: 4,227 13% 60 to 69 years: 1,268 4% Over 70 years: 1,950 5%

INCOME Median household Income (2011) $70,104

EMPLOYMENT (Status for population 16 years and older) Total: 30,541 In labor force: 23,412 In Armed Forces: 10 Civilian:

23,402 Employed: 21,837 Unemployed: 1,565 6.7% Not in labor force: 7,129

EDUCATION (for Population 25 years and older) Male: 11,962 100% Less than a High School Diploma 1,052 9% High School Grad, GED, or alternative 1,820 15% Some college or associates degree 1,444 12% Bachelor's degree or higher 7,346 61% Female: 13,792 100% Less than a High School Diploma 1,524 11% High School Grad, GED, or alternative 1,632 12% Some college or associates degree

2,074 15% Bachelor's degree or higher 8,562 62%

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Social Issues40 “Jamaica Plain, or “JP” as the locals call it, is a classic “streetcar suburb” that has evolved into one of Boston’s most diverse and dynamic neighborhoods. The ethnically diverse area is home to many Latinos, young families, and a growing gay and lesbian community. Hyde and Jackson Squares have significant Spanish-speaking populations. This blend of cultures is reflected in local businesses, such as the many different restaurants which line Centre Street, one of its main thoroughfares. Residents and visitors enjoy walking, biking, and running along Jamaica Pond situated on the Jamaicaway, part of Boston’s Emerald Necklace.“ Overall, the community consists of long-term residents that are both home-owners and renters and community safety as well as education and neighborhood beautification are ongoing social concerns of the Jamaica Plain community.

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Economic Issues41 Unemployment in Massachusetts has remained fairly consistent at 7.0% over the past few years, and this factor as well as the health of local businesses in Jamaica Plain are ongoing economic issues on the forefront of focus.

Jamaica Plain has focused on highlighting businesses and historic site, particularly along Centre Street, as well as its growing diversity.

From Boston.gov “Home to artists, writers, musicians and activists, the JP Centre/South Streets commercial district reflects the many cultures that call this community home. A walk down Centre and South Streets reveals fine and casual dining from around the world. The diversity of food is matched by the shopping: find everything from funky housewares, clothes and jewelry to kitchen goods and allnatural pet supplies.

Part of Frederick Law Olmsted’s Emerald Necklace surrounds the shopping district – visit Jamaica Pond, the Arnold Arboretum, and Franklin Park. Stroll through beautiful residential neighborhoods on either side of the commercial district. Find innovative examples of commercial property reuse, as well as fine residential homes in the Gothic, Victorian, Italianate styles.

Eat your way around the world on Centre and South Streets. Visitors will delight in the great pub scene, and restaurants including Cambodian, Japanese, Thai, Indian, Mexican, Chinese, Greek, Dominican, and Italian. The district boasts one of Boston’s only authentic Asian tea houses and two landmark ice cream shops!”

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Informational Context Client Description: The proposed client for the proposed senior living project is a major operator of assisted living and memory care facilities, such as Benchmark.

“Benchmark Senior Living At Benchmark Senior Living, we celebrate the experience of aging by providing the very best in personalized services to help our residents live well: Mind, Body and Soul. Benchmark provides New England with a variety of Senior living options including Independent Living, Traditional Assisted Living, Assisted Living for the Memory Impaired (including Alzheimer’s and Dementia Care), and Respite Stay programs. Our more than 45 locations span Massachusetts, Connecticut, Rhode Island, New Hampshire, Maine and Vermont — featuring residences in the greater Boston, Hartford, New Haven, Providence, and Cape Cod regions. We cater to our residents’ lifestyles and we are proud to offer a world of opportunities where residents will learn something new, share wonderful experiences with friends, and take part in the activities they enjoy most, every day. At Benchmark, aging is a time filled with laughter and learning. We invite you and your loved one to experience a worry-free lifestyle, while we take care of the rest.”42

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Interviews: Designer: Date: Conclusion:

Soo Im, Architect, DiMella Shaffer Associates July 18, 2013 Lighting and spatial adjacencies are the two design aspects that should be most highly considered when designing a space for dementia care.

Owner: Date: Conclusion:

Christine Sullivan, Retirement Counselor, The Village at Waterman Lake August 8, 2013 Design of community spaces, circulation, and access to the outdoors is very important as these spaces provide the best environments for both residents and caregivers.

Neurology Specialist: Date: Conclusion:

Dorene Rentz, Associate Professor, Harvard Medical School October 15, 2013 Providing sunlight and opportunities for activity are important in moderating behavior in dementia patients. Visual connections between spaces are very important to minimize confusion and agitation for this population.

(Please see the Appendix for text of full interviews)

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Precedents

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Unit Plan

Concept Plan Homes for Senior Citizens in Masans, GraubĂźnden, Switzerland Peter Zumthor, 199343

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Peter Zumthor’s Homes for Senior Citizens in Masans was chosen as a precedent because of the unique approach to blending public and private space. Unlike many senior living facilties, Zumthor lined up the residential units along a corridor so that all the units faced out to the views in the area. Between the units and the “living room” for each unit, runs the corridor of circulation, essentially blending the public and the private space zone as the resident’s space is on both sides of the circulation corridor. This small scale approach to a mixing of public and private zones could be translated into my proposed senior living facility.

Massing

Circulation

Hierarchy

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Bornhuetter Hall Wooster, OH Lewis Tsurumaki Lewis, 200444

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LTL’s dorm project at The College of Wooster provides a balance between private spaces for study and public gathering areas for communal discussion. The hallways are designed to encourage social interaction and widen at the ends to include public lounges and intimate sitting areas. The central outdoor courtyard provides an additional communal gathering space within view of many of the units, given their “L”-shaped alignment. LTL encourages connection visually while allowing for physical boundaries in the small “pop-out” study rooms that protrude into the courtyard. The balance and interaction of public and private spaces that are incorporated into this community living building provide a unique precedent for a senior living facility that also seeks to achieve a balance between public and private spaces.

Massing

Circulation

Hierarchy 57

Leonard Florence Center for Living Chelsea, MA DiMella Shaffer, 201045

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The Leonard Florence Center for Living is an assisted living community modeled after an urban apartment house, which provides housing for 100 residents. The project is the country’s first “Green House” community to be constructed within an urban setting. The Green House model is a trademarked strategy intended to de-institutionalize long-term care by eliminating large nursing facilities and replacing them with independent houses of ten residents each which focus on enhancing the quality of life of each resident and providing an environment closer to a traditional home setting. Each floor of the Leonard Florence Center has two residences (as delineated in the massing diagram) each with their own entrance and central living core. This contained residence strategy to programming a facility is one of the newest strategies and is important to note as a current programming precedent.

Massing

Circulation

Hierarchy 59

FUTURE STATE

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Issues: 1.

Public Space and the Community Connection: The site is currently fenced off and not utilized.

The site is vacant and overgrown; however, it has good views of the open space and lake in Olmstead Park nearby. The proposed senior living facility should provide a community connection between South Huntington Avenue and the views to Olmstead Park. A portion of the proposed site should be maintained for community public space to be able to facilitate a connection between the private spaces on the interior of the building and community spaces on the exterior.

2.

Accessibility: The ease of access to the site for its residents, staff and visitors will be critical in its usability. Because the site will be accessed by residents with cognitive and physical disabilities careful attention will need to be paid to details such as curbs, ramps, stairs, and handrails. Further, the community accessibility of portions of the site will continue to be important.

3.

Safety: The moderate traffic at the rear of the site on the Jamaicaway as well as the frequency of bus and T traffic in front of the site will make securing access to the site for its residents a critical item.

4.

Spatial Adjacencies that Support Public and Private Connections: The availability, size, and ease of access of social support spaces from residents private rooms will be key in programming the senior living facility.

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Mission: The proposed senior living facility is to be a santuary and healing environment for its residents as well as a connection point in the community between the residential and institutional fabric of South Huntington Avenue and the open space of the Emerald Necklace. Creating unique and thoughtful adjacencies between the private spaces of the senior living facility and the public spaces created on the exterior of the property will foster connections between the neighborhood and the residents of the facility. Because healing methods and techniques are always changing and adapting, the facility should be flexible to allow for growth and change in its methods and resources for development.

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GOAL:

The proposed senior living facility and its surrounding site should allow for ease of accessibility for residents, staff, and the community by integrating the residential and community aspects of the site.

GOAL:

The proposed senior living facility should connect the public open spaces adjacent to the site, the surrounding residential and institutional neighborhood and the residents of the facility through spatial adjacencies and visual connections.

GOAL:

The senior living facility should be designed to allow for adaptability and flexibility for future changes.

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COST EVALUATION AND PROGRAM My thesis will be tested in a senior living facility with a focus on memory care for dementia sufferers. This type of facility will allow me to test my thesis of how visual connection can enhance the understanding of public and private space. The concept is that if this study can improve the wellness of an elderly population with cognitive impairment, then this type of design could also be integrated at a later date into other facilities to also improve their overall wellness and delay the onset of dementia.

The facility will house patients, provide community space, both for familiy visitation and for community space. There will be at least one wing of apartments for patients which will house 10-12 individuals. This is a key number is a memory care living facility as this is the largest size that should be grouped together because it is the largest comfortable number that can still feel like “family� and fit around one dining table. The facility will also contain living space, dining space, kitchen space, space for nursing and physical therapy, circulation space, community space, and offfice/administrative space. There will be two types of community spaces; there will be family gathering space that will have a home-like feeling, and there will also be exercise space that is not only for residents but also for members of the community.

To the right are estimated space requirements:

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(in SF) Type of Space Total

SF of each Unit

# of Units

Apartments 9600 400 24 Kitchen 750 750 1 Dining 1500 1500 1 Living 1200 1200 1 Nursing/ PT 4000 2000 2 Family Space 2000 2000 1 Exercise Space 2000 2000 1 Administrative 2000 2000 1 Lobby 1100 1100 1 Multipurpose Rms 1950 650 3

Net Building Area 26,100

Restrooms 1,000 Mechanical/Circulation/Storage 5,000 Total 6,000 0.2

Gross Building Area 32,100

Overall Building Efficiency (Net/Gross) 0.81

Cost Estimate Analysis

A. Building Costs* 32,100 SF*$170/SF B. Fixed Equipment (10% of A) C. Site Development (15% of A)

D. Total Construction (A+B+C)

E. Site Acquisition/Demolition**

F. Movable Equipment (8% of A) G. Professional Fees (7% of D)

H. Contingencies (10% of D) J. Administrative Costs (2% of D)

K. Total Budget Required (D+ E thru J)

$5,457,000 $545,700 $818,550 $6,821,250 $1,016,700 $436,560 $477,488 $682,125 $136,425 $9,570,548

* Location factor for Boston is 118.5 **vacant lot-no demolition needed; cost based on current value

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MASSING STUDIES

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I. CASE STUDIES

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Cambridge Public Library, William Rawn and Associates46, 47 The open floor plan of the new addition to the main branch of the Cambridge Public Library relies on light and views to the exterior to draw the visitor through the space.

Skylights above the main stairs draws the visitor up, and the light penetrating the double skin of the main facade draws the visitor through the stacks to the study areas along the glass wall.

Even the internal conference rooms are transparent to allow for a visual connection with the rest of the floor.

Private spaces are carved out of the main public space by the geometry of the stacks and by the geometry of the building as the more private spaces are along the perimeter of the building. Despite there being few walls within the space the distinction between spaces is clear. Further, although there are visual connections between most all spaces in the library, private spaces are well delineated for meetings and study.

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PARTI

SYMMETRY

REPETITIVE TO UNIQUE

CIRCULATION TO USE

UNIT TO WHOLE

HIERARCHY

STRUCTURE

ADDITIVE & SUBTRACTIVE

GEOMETRY

Graphically, the new addition is ordered and geometrically structured. The main open corridor through the space provides a visual and physical direct connection to the old section of the library

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The Therme Vals, Peter Zumthor48

CIRCULATION

“This space was designed for visitors to luxuriate and rediscover the ancient benefits of bathing. The combinations of light and shade, open and enclosed spaces and linear elements make for a highly sensuous and restorative experience. The underlying informal layout of the internal space is a carefully modelled path of circulation which leads bathers to certain predetermined points but lets them explore other areas for themselves. The perspective is always controlled. It either ensures or denies a view.”

-www.archdaily.com

PARTI

“Between the blocks there is a space that connects everything as it flows throughout the entire building. The meander, as we call it, is the empty space between the fullness of the solid stone blocks; it is a designed negative space between the blocks, a space that connects everything as it flows throughout the entire building, creating a peacefully pulsating rhythm. Moving around this space means making discoveries. You are walking as if in the woods. Everyone there is looking for a path of their own.” (“The Therme Vals,” )- © 2013 Peter Zumthor Thermal Baths Vals Switzerland

NATURAL LIGHT

The geometry of the project directs circulation by creating spaces that are open and closed, illuminated and in shadow, and all a seamless part of a whole. The visitor’s circulation is choreographed but not obviously so. The contrasting spaces within the building direct movement and flow and provide both more public spaces and more private spaces while maintained a flow within the whole.

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The Habitat, Moshe Safdie49 The Habitat is a housing development comprising 158 units from one to four bedrooms, with many small gardens and decks, was planned as a prototype for a system that would streamline the building process and cut costs. It was assembled from 354 reinforced-concrete building modules, stacked so as to give privacy and views to each unit.

The project was Moshe Safdie’s thesis project at McGill University in Montreal and the project was also the major theme exhibition of the 1967 Montreal World Exposition.

A key learning point of The Habitat is that it provides an interconnected community of apartments that also provides the tenants with privacy and seclusion. How geometry plays a key role in this achievement can be utilized in future projects concerning privacy and connection such as the proposed senior living facility.

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The Guggenheim, Frank Lloyd Wright50 “Designed by Frank Lloyd Wright, the cylindrical museum building, wider at the top than the bottom, was conceived as a “temple of the spirit” and is one of the 20th century’s most important architectural landmarks. The building opened on October 21, 1959, replacing rented spaces used by the museum since its founding. Its unique ramp gallery extends from just under the skylight in the ceiling in a long, continuous spiral along the outer edges of the building until it reaches the ground level.”

Wright directs circulation in the building by forcing the visitor to take the elevator up to the top of the sixth story spiral ramp and then meander down the ramp taking in the exhibits on the way down. The predetermined pathway allows for control of the occupants’ sequence of experiences and plays on the visitors’ desire to stroll slowly down the ramp instead of work to move up it.

GEOMETRY

CIRCULATION

HIERARCHY

REPETITIVE TO UNIQUE

PARTI

SYMMETRY AND BALANCE 77

Diagrammatic Plan

J. SKETCH PROBLEM The concept that was investigated during sketch problem was that of “entrance”. Entrance was investigated as related to the physical site location, the program, and the thesis concept of the connection/ separation between public and private zones.

There are multiple entrance types in the proposed senior living project as there is entrance from the street, there is entrance into the public space of the facility, and there is entrance into individual resident rooms; with each type of entrance there is a further retreat into more private space.

Each of the zones were addressed separately but all kept with the underlying idea that views and light would guide the transition between spaces. These common underlying concepts to be applied to each entrance zone are as follows: 1. circulation into and on the site must be sensitive to the site topography as the site drops off approximately 15 feet from South Huntington Avenue before sloping gradually to the Jamaicaway.

2. the entrance should be set back from the main flows of circulation.

3. gradients of natural light should ease the transition between indoor and outdoor spaces as aged individuals eyes are more sensitive to dramatic lighting transitions.

4. views through the building should be used for wayfinding.

The diagrams and conclusion of the sketch problem resulted in each type of entrance having a “transition zone” that incorporated natural lighting and views into each type of entrance (from street, from living ward, and into resident apartment).

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Transition Concept Diagrams

Transition Diagram

Transition Diagram Site Considerations

Transition Diagram Use of Views in Guiding Entrance

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K. HEALTH AND WELLNESS The project will deal directly with the exponentially increasing numbers of individuals over the age of 65, particularly as the number of these individuals with some form of dementia increases worldwide. Given the changing family dynamics over time, particularly in the United States, fewer aging individuals have the option of being cared for by family members as the age and need greater amounts of care. As a result, appropriate housing and care will need to be provided in sufficient supply to accommodate the growing numbers of aging individuals.

Further, as a greater supply of housing will be needed for aging individuals, this housing will need to provide a better quality of life and possibly improve the cognitive wellness of individuals suffering from dementia and dementia related diseases. Providing a therapeutic environment improves the life of the resident but also provides peace of mind for family members.

The project will also engage other design disciplines; exterior spaces that are calming will be important, interior lighting, sensitivity to color and texture, and sustainable design will all play a role in generating a healthy and healing environment.

Understanding key components of the architecture of senior living facilities will push the field forward and positively impact future design of this project type.

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L. THESIS CLIENT Proposed Client: Director of Demetia Operations The Director of Dementia Operations, or Memory Care Operations Manager, is responsible for providing overall leadership and management to staff in the program for dementia care at Benchmark Senior Living. The Director plans, organizes, develops and leads the overall operations of the dementia care program and is familiar with federal, state, and local laws. Because the Director of Dementia Operations interacts with staff and residents, he or she is acutely aware of how the physical environment affects daily care and wellbeing of dementia patients and how the built environment can better serve the residents at Benchmark. The hope is that this individual could provide both staff and resident feedback in the development of a senior living facility.

“Benchmark Senior LivingAt Benchmark Senior Living, we celebrate the experience of aging by providing the very best in personalized services to help our residents live well: Mind, Body and Soul. Benchmark provides New England with a variety of Senior living options including Independent Living, Traditional Assisted Living, Assisted Living for the Memory Impaired (including Alzheimer’s and Dementia Care), and Respite Stay programs. Our more than 45 locations span Massachusetts, Connecticut, Rhode Island, New Hampshire, Maine and Vermont — featuring residences in the greater Boston, Hartford, New Haven, Providence, and Cape Cod regions. We cater to our residents’ lifestyles and we are proud to offer a world of opportunities where residents will learn something new, share wonderful experiences with friends, and take part in the activities they enjoy most, every day. At Benchmark, aging is a time filled with laughter and learning. We invite you and your loved one to experience a worry-free lifestyle, while we take care of the rest.”51

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M. SCHEDULE OF REQUIREMENTS Thesis 1 Reviews:

Introductory Review

Preliminary Review

Schematic Review

Week of February 10, 2014 Week of March 24, 2014 Week of May 5, 2014

Thesis 2 Reviews: Design Development

Final Review

Final Book Due

Week of October 13, 2014 Week of December 1, 2014 December 19, 2014

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N. ANNOTATED BIBLIOGRAPHY Alzheimer’s Association. 2012 Alzheimer’s disease facts and figures. Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association.

March 2012; 8:131–168.

-This is an up to date synopsis of major facts and figures related to dementia and Alzheimer’s disease. This information is important in establishing a need for the research into this area of design as well as outlining key facets of the conditions that must be considered where designing for the target population.

“Alzheimer’s News 3/19/13”, http://www.alz.org/news_and_events.asp, accessed on April 19, 2013.

-This brief article states that 1 in 3 American seniors now dies with Alzheimer’s disease or another dementia; this fact highlights the need for care facilities and treatment options to improve quality of life.

Anderzohn, Jeffrey, David Hughes, Stephen Judd, Emi Kiyota, and Monique Wijnties,

Design for Aging: International Case Studies of Building and Program, New Jersey: John Wiley & Sons, Inc., 2012.

-Jeffrey Anderzohn and colleagues have published several volumes of case studies on senior living and dementia care projects and this is the most recent. The compilation includes images, floor plans, and highlights of observations and comparisons of a wide variety of projects of this property type from around the world. This book provides a good reference of existing projects that will be helpful particularly in relation to programming.

Anderzohn, Jeffrey, Ingrid Fraley, and Mitch Green, editors. Design for Aging Post-Occupancy Evaluations, New Jersey: John Wiley & Sons, Inc., 2007.

-Jeffrey Anderzohn and colleagues not only look at case studies of senior living and dementia care units, but they also published a volume focused on post-occupancy evaluations for a variety of projects of this property type. This is particularly helpful in learning what has not proven successful to date.

Bachelard, Gaston. The Poetics of Space, Boston, MA: Beacon Press, 1969.

-Bachelard provided theoretical background and commentary as inspiration for generative concepts related to movement in space and what defines space.

Brawley, Elizabeth C., Design Innovations for Aging and Alzheimer’s: Creating Caring Environments. New Jersey: John Wiley & Sons, Inc., 2006.

-Elizabeth Brawley is a well-known interior designer in the field of aging and dementia care and this book provides her summary of Alzheimer’s disease and different forms of dementia as well as the most critical symptoms of the conditions that must be considered when designing a senior living facility.

She offers a number of suggested solutions to common issues, such as wandering gardens to calm restless behaviors and provide access to daylight to regulate circadian rhythms.

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Chermayeff, Serge and Christopher Alexander. Community and Privacy, Anchor Books, 1965.

-This small book outlines a research project that was undertaken in the 1960s to define private space, particularly as related to home.

Connell, Betty Rose and Jon A. Sanford. “Difficulty, dependence, and housing accessibility for people aging with a disability.”

Journal of Architectural and Planning Research, Vol. 18 Issue 3 (2001): 234-242.

-This is a journal article describing a research study that examined elderly individuals with compromised mobility. The ability of the individual to complete “tasks for daily living” was evaluated based on age and level of mobility. In terms of my thesis, it is important to understand the limitations that may face the users of my proposed spaces to best be able to encourage movement that is achievable.

Feddersen, Eckhard and Insa Ludtke. A Design Manual for Living for the Elderly. Boston: Birkhauser, 2009.

-This is a collection of essays from a variety of experts in fields relating to senior care and housing. The topics range from Universal Design to the Chinese approach to senior care. This provides an interesting overview of topics and approaches common in senior living and care of the elderly.

Fotuhi, Majid, MD, PhD. The Memory Cure, New York: McGraw-Hill, 2003.

-While the target audience for this book is the population that fear they are aging and want to take steps to prevent memory loss that comes with aging, the book overall address risk factors for being diagnosed with dementia and explains the various types of dementia. The book discusses activities and lifestyle changes that are being studied in their relation to the prevention of dementia; one of these key factors is movement and exercise.

Gesler, Wilbert M. Healing Places, New York: Rowman & Littlefield Publishers, Inc., 2003.

-This short book investigates commonalities between 5 locations that the author considers “healing places”. These locations range from religious centers to public hot spring baths. Given that the underlying focus of my thesis is the power of movement and architecture to be therapeutic, this book offers a unique perspective from which to view the quality of space and place that contributes to healing.

Hoffman, John and Susan Froemke with Susan K. Golant. The Alzheimer’s Project: Momentum in Science, New York: Public Affairs™, 2009.

-This book is particularly useful as it directly addresses the effect of exercise on the delay in the onset of dementia and the improvement of the quality of life once dementia has been diagnosed.

Levine, Robert, MD. Defying Dementia: Understanding and Preventing Alzheimer’s and Related Disorders, Westport, CT:

Praeger, 2006.

-This book provides a thorough overview of the different forms of dementia and Alzheimer’s disease and includes case study examples for each type of cognitive disability. Understanding the various behaviors and symptoms that can present in patients and what types of treatments were beneficial is helpful in thinking about the types and quality of spaces that will be needed to serve this population. This book in particular addresses the role of exercise in delaying onset and improving the quality of life after onset of dementia.

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Lynch, Kevin. The Image of the City, Cambridge, MA: MIT Press, 1960.

-Not only is the source helpful in analyzing the frameworks of a site in helping to choose a site for my thesis project, but he also references paths as lines of movement and a source of information around which an order can be developed. This concept will be helpful in incorporating movement into the architecture of my project and supporting the thought process as to the development of the project.

Perkins, Bradford, with J. David Hoglund, Douglas King, and Eric Cohen. Building Type Basics for Senior Living. New Jersey: John Wiley and Sons, Inc., 2004.

-This was a key programming source as it discusses the various spaces, sizes, and adjacencies typical in existing senior living facilities. The book gives a variety of approaches and discusses successes and failures in senior living projects in terms of programming.

Stewart-Pollack, Julie and Rosemary Menconi. Designing for Privacy and Related Needs. New York: Fairchild Publications, Inc., 2005.

-This source provides a background of theory on what constitutes privacy and how privacy is defined. Discussion of cultural differences in how privacy is perceived is discussed and various examples and studies are presented related to how people interact and respond to varying degrees of personal space. Further, some design concepts on how to encourage privacy in architecture, particularly in interiors, are discussed.

Waite, Linda J. “Introduction: The Demographic Faces of the Elderly.” Population and Development Review, Vol. 30, Supplement: Aging, Health, and Public Policy (2004): 3-16.

-This source provides data to quantify the need for housing for individuals with cognitive impairment.

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CITATIONS 1.

Stewart-Pollack, Julie and Rosemary Menconi. Designing for Privacy and Related Needs. New York: Fairchild Publications, Inc., 2005.

2.

Bachelard, Gaston. The Poetics of Space, Boston, MA: Beacon Press, 1969.

3. Corbusier 4.

Google Images 5.

Google Images 6.

Stewart-Pollack, Julie and Rosemary Menconi. Designing for Privacy and Related Needs. New York: Fairchild Publications, Inc., 2005.

7.

Stewart-Pollack, Julie and Rosemary Menconi. Designing for Privacy and Related Needs. New York: Fairchild Publications, Inc., 2005.

8.

Chermayeff, Serge and Christopher Alexander. Community and Privacy, Anchor Books, 1965 9.

Chermayeff, Serge and Christopher Alexander. Community and Privacy, Anchor Books, 1965 10.

Waite, Linda J. “Introduction: The Demographic Faces of the Elderly.” Population and Development Review, Vol. 30, Supplement: Aging,

Health, and Public Policy (2004): 3-16.

11.

Alzheimer’s Association. 2012 Alzheimer’s disease facts and figures. Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association.

March 2012; 8:131–168.

12.

Brawley, Elizabeth C., Design Innovations for Aging and Alzheimer’s: Creating Caring Environments. New Jersey: John Wiley & Sons, Inc., 2006.

13.

Alzheimer’s Association. 2012 Alzheimer’s disease facts and figures. Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association.

March 2012; 8:131–168.

14. www.alz.org 15.

Brawley, Elizabeth C., Design Innovations for Aging and Alzheimer’s: Creating Caring Environments. New Jersey: John Wiley & Sons, Inc., 2006.

16.

Brawley, Elizabeth C., Design Innovations for Aging and Alzheimer’s: Creating Caring Environments. New Jersey: John Wiley & Sons, Inc., 2006.

17.

“Alzheimer’s News 3/19/13”, http://www.alz.org/news_and_events.asp, accessed on April 19, 2013.

18.

Google Images 19. http://www.bostonredevelopmentauthority.org/research-maps/maps-and-gis/overview 20.

Google Maps 21. http://www.bostonredevelopmentauthority.org/research-maps/maps-and-gis/overview 22. http://www.bostonredevelopmentauthority.org/research-maps/maps-and-gis/overview 23.

Meghan Bell personal photos, October 20, 2013 24. http://www.bostonredevelopmentauthority.org/research-maps/maps-and-gis/overview 25.

Google Maps 26. http://www.bostonredevelopmentauthority.org/research-maps/maps-and-gis/overview 27. http://www.bostonredevelopmentauthority.org 28. www.windfinder.com 92

29. http://www.bostonredevelopmentauthority.org/document-center 30. http://www.bostonredevelopmentauthority.org/research-maps/maps-and-gis/neighborhood-maps 31.

Meghan Bell personal photos, October 20, 2013 32.

Meghan Bell personal photos, October 20, 2013 33. http://www.bostonredevelopmentauthority.org/zoning 34.

International Building Code, http://publicecodes.cyberregs.com/icod/ibc/2012/ 35.

Architectural Access Board, http://www.lawlib.state.ma.us/source/mass/cmr/521cmr.html 36.

“Mission Hill” and “Jamaica Plain”, http://www.bostonredevelopmentauthority.org/neighborhoods 37.

Meghan Bell personal photos, October 20, 2013 38. http://www.cityofboston.gov/images_documents/Jamaica_Plain_brochure_tcm3-19120.pdf 39.

“Jamaica Plain”, American Community Survey, 2007-2011 estimate 40. http://www.cityofboston.gov/neighborhoods/jamaicaplain.asp 41. www.cityofboston.gov 42. www.benchmarkseniorliving.com 43.

Google Images 44. http://ltlarchitects.com/ 45. http://www.dimellashaffer.com/ 46. http://www.rawnarch.com/ 47. http://www.cambridgema.gov/cpl/hoursandlocations/mainlibrary.aspx 48.

Google Images 49. http://www.msafdie.com/ 50.

Google Images 51. www.benchmarkseniorliving.com

93

APPENDIX

94

95

Interviews (Full Text):

96 

Informational Interview: Planner/designerSoo Im DiMella Shaffer Boston Architectural College 1.

What is the relevant historical research on trends in the senior living project type?

There are two major organizations that have shaped recent work in the field- Greenhouse and Planetree.org.

Also, there is a large amount of research on healing environments that delves into daylight, use of color, nature, and scale that is particularly relevant.

2.

What are the key concepts that you focus on at DiMella Shaffer when beginning a senior living project?

DiMella Shaffer focuses on daylighting and scale in senior living designs. The underlying key concept that is a focus is evoking memories through experiences.

3.

When programming senior living spaces what are the most important factors in planning?

Programming factors that are important are first being very focused on adjacencies in the project. Having a continuous pedestrian loop through the building that is interior/ exterior/ and connects the interior and exterior is very important. Changing interior lighting as well as open, light, airy spaces make for an effective project. Skylights in the transitions between interior and exterior transitions are important to make the transition easier on aging eyes. Focusing on ways to personalize individual spaces is also very important.

4.

What is the best size for a grouping of apartments in a senior living facility?

The ideal size of a residential unit is 10-12 individuals because that is the largest size that has been shown to still have a “family” feel to it that allows for group dining and socializing in a unit.

5.

How much of a factor is architecture in effecting quality of life of seniors in dementia care?

Architecture’s contribution to quality of life is approximately 15% of the overall external factors. It is very important for the spaces to be easily usable for staff as well as residents since the staff has the greatest effect on the quality of life of the residents. The most effective type of worker at a facility is a “universal worker”, which is basically a “mom” for the residents that helps with all aspects of daily life as well as their unique individual needs.

6.

What are some good precedents to look at that you would suggest?

The Leonard Florence Center in Chelsea, MA, Rogerson House in Jamaica Plain, as well as adult day care centers such as the Jewish Community Homes for Elderly in Brighton, MA.

97

Informational Interview: Christine Sullivan Retirement Counselor The Village at Waterman Lake Smithfield, RI 1.

What is the difference between assisted living and memory care?

Assisted living residents must be able to maintain a certain level of care for themselves. Memory care has smaller individual rooms and a higher level of care because the individuals no longer meet the standards to be in assisted living. These standards are tested by a 30 point cognitive test that involves memory questions and knowledge of current events, such as who is the current president and what is the season.

2.

Tell me a little bit about the physical layout of the property at the Village at Waterman Lake.

The property is a 38 acre campus that has expanded over time. The original building is now used only for assisted living and has a large dining room as well as a secondary dining room that is a bit smaller. Two additional buildings have been added to the campus since that time. One building is for retired seniors that does not provide nursing services but instead provides a community living situation where services such as cleaning and laundry are provided as well as a pub and restaurant and social events. The other building is for memory care and skilled nursing. This building has four wings, three are for memory care and one is for skilled nursing. Each of these wings has its own dining room and each wing is locked at night for the safety of the residents. The idea is that a senior could retire here and then more through the different levels of care at the property as they age.

3.

How important is the physical layout of the building to the staff that cares for the residents?

The layout is very important and one reason that a new memory care facility was constructed was that the traditional layout of many individual rooms along a long hallway did not facilitate the best level of care for each of the residents. The more communal layout of the memory care facility allows for more social interaction and for a greater level of supervision and care by staff. In the assisted living building there is one worker assigned to each resident (and each worker has about 8 residents that he or she is responsible for). Since many of the residents need to be escorted to meals and activities this low ratio makes that possible. Further, it should be noted that the facility is an F1 Fire Facility, which means that it has 4-hour fire doors and the strategy is to “defend in place� in case of an emergency.

4.

If there is one worker assigned to each resident is gender taken into consideration?

Yes, personal help is a very intimate situation and staff of both genders are available for personal help for the residents to make them feel as comfortable as possible while providing the best level of care.

5.

Is there outdoor space available to the residents and how is security maintained?

All of the buildings have outdoor space available for the residents. The senior living building and assisted living building residents are free to go outside as they wish. The lawn provides great views of the nearby Waterman Lake and actually the property owns a boat that takes residents out on the lake in the summer. The memory care and skilled nursing building has enclosed outdoor areas that include wandering gardens. While the residents are free to go between indoors and outdoors as they choose in the building, cameras and warning chimes alert the workers to the residents whereabouts at all times.

98 

Informational Interview: Dorene M. Rentz, PsyD Associate Professor of Neurology Harvard Medical School Cambridge, MA 1.

What are the primary effects of aging on memory and the brain?

As the brain ages the speed of processing information slows, mental flexibility decreases, and word retrieval diminishes. Aging individuals tend to have a greater amount of disturbed sleep and good sleep is needed for memories to be consolidated. Medications to aid sleep to not help the process of consolidating memories. However, while mental agility decreases, recognition memory tends to be preserved as aging progresses. It is the recognition memory that is affected by dementia.

2.

Are there any habits that have been proven to slow the rate of cognitive decline as people age?

Staying physically active and mentally active has been linked to a lower rate of cognitive decline. The influx of oxygen to the brain that these activities cause is very positive. There are people that are called “Super-Agers” that do not show symptoms of decline; this has been primarily linked to the active lifestyle that these individuals lead.

3.

What are some key symptoms that dementia patients show that should be considered when designing spaces for them?

First, it is the symptoms of other types of dementia other than Alzheimers that usually inform building design. It is also important to note that although dementia sufferers, such as those with frontal lobe dementia, may exhibit confusion and inappropriate behavior that is childlike, unlike children, dementia patients cannot learn so we must accept their reality as our reality when dealing with their issues. Because they can’t learn, they can’t remember what is behind doors and walls in a new environment, so visibility between spaces is very important. It has not been shown that they get overstimulated, so the best solution for their spaces is to have a variety of spaces visible at all times. Similarly, color coding for wayfinding does not work because they cannot learn what the colors represent; visual connections are the most effective means of lower agitation from confusion.

4.

Are there physical symptoms that can be accommodated for in design?

Dementia sufferers tend to have the need to move around, particularly in repetitive motions. Having activities available to them such as picking up sticks, sweeping, walking, or gardening tables can provide solutions for this need to move. However, at the same time many dementia patients also develop a shuffling gait so careful attention to curbs, stairs, ramps, and the texture of the flooring in a facility are very important also in facilitating guided movement.

5.

Are there any other important considerations that need to be addresses in a memory care unit?

“Sundowning” is often a key problem for caregivers when dealing with dementia patients. It has been shown that architectural design has been more effective in control this issue than medications by regulating daylight exposure, de-escalation spaces, and calming community spaces.

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SITE

100

Zoning- Article 55, Jamaica Plain Neighborhood District TABLE I Jamaica Plain Neighborhood District Neighborhood Institutional Subdistricts Dimensional Regulations Veterans Administration

Angell Memorial Hospital

Faulkner Hospital

Maximum Floor Area Ratio

1.0

0.5

0.6

Maximum Building Height

45

45

45

Minimum Lot Size

none

none

none

Minimum Lot Width

none

none

none

Minimum Lot Frontage

none

none

none

Minimum Front Yard

20

20

20

Minimum Side Yard

10

10

10

Minimum Rear Yard

20

20

20

Residential Use(1) Other Use

55 - JAMAICA PLAIN NEIGHBORHOOD DISTRICT - TABLE I

ARTICLE 119

 101

International Building Code 2012 http://publicecodes.cyberregs.com/icod/ibc/2012/icod_ibc_2012_3_sec002.htm

SECTION 302 CLASSIFICATION 302.1 General.

Structures or portions of structures shall be classified with respect to occupancy in one or more of the groups listed in this section. A room or space that is intended to be occupied at different times for different purposes shall comply with all of the requirements that are applicable to each of the purposes for which the room or space will be occupied. Structures with multiple occupancies or uses shall comply with Section 508. Where a structure is proposed for a purpose that is not specifically provided for in this code, such structure shall be classified in the group that the occupancy most nearly resembles, according to the fire safety and relative hazard involved.

1. Assembly (see Section 303): Groups A-1, A-2, A-3, A-4 and A-5 2. Business (see Section 304): Group B 3. Educational (see Section 305): Group E 4. Factory and Industrial (see Section 306): Groups F-1 and F-2 5. High Hazard (see Section 307): Groups H-1, H-2, H-3, H-4 and H-5 6. Institutional (see Section 308): Groups I-1, I-2, I-3 and I-4 7. Mercantile (see Section 309): Group M 8. Residential (see Section 310): Groups R-1, R-2, R-3 and R-4 9. Storage (see Section 311): Groups S-1 and S-2 10. Utility and Miscellaneous (see Section 312): Group U 102 

308.3 Institutional Group I-1.

This occupancy shall include buildings, structures or portions thereof for more than 16 persons who reside on a 24 hour basis in a supervised environment and receive custodial care. The persons receiving care are capable of self preservation. This group shall include, but not be limited to, the following: Alcohol and drug centers Assisted living facilities Congregate care facilities Convalescent facilities Group homes Halfway houses Residential board and custodial care facilities Social rehabilitation facilities 308.4 Institutional Group I-2.

This occupancy shall include buildings and structures used for medical care on a 24-hour basis for more than five persons who are incapable of selfpreservation. This group shall include, but not be limited to, the following: Foster care facilities Detoxification facilities Hospitals Nursing homes Psychiatric hospitals

 103

104  PUBLIC USE AND COMMON USE AREAS All public and common use areas shall be accessible and shall include but are not limited to areas where services are provided to the public, waiting areas, changing rooms, diagnostic and treatment areas, exam rooms, offices and meeting rooms, food services, gift shops, and emergency facilities, and toilet rooms.

Where examining tables are provided in exam rooms, they shall be adjustable in height from 15 inches (381mm) above the floor.

Counters across which transactions are conducted with patients and the public shall comply with the following:

13.2

13.2.1 13.2.2

Hospitals and rehabilitation facilities that specialize in treating conditions that affect mobility, or units within either that specialize in treating conditions that affect mobility, 5% of the patient bedrooms with toilets shall be designed as Group 2B Units and the remainder of the patient bedrooms and toilets shall be designed as Group 1 Units. Said rooms shall be proportionately distributed as to type of room, i.e. private, shared, etc.

13.3.2

521 CMR - 60

In hospitals, general purpose hospitals, psychiatric facilities, and detoxification facilities, a total of at least 10% of the units shall be designed as follows: 5% of the patient bedrooms with toilets shall be designed as Group 2B Units and 5% of patient bedrooms and toilets shall be designed as Group 1 Units.

13.3.1

1/27/06

PATIENT BEDROOMS Shall comply with one or more of the following, as applicable:

13.3

a. Location: The counter shall be on an accessible route. b. Length: A portion of the counter or an auxiliary counter shall be at least 36 inches (36" = 914mm) in length. c. Height: That portion of the counter shall not exceed 36 inches (36" = 914mm) above the finished floor. d. Clear floor space: Shall be provided in front of counter.

GENERAL Medical care facilities shall comply with 521 CMR, except as specified or modified in 521 CMR 13.00. Medical care facilities are buildings in which people receive physical or medical treatment or care and where persons may need assistance in responding to an emergency and where the period of stay may exceed 24 hours. They shall include but not be limited to hospitals, clinics, sanitariums, alcohol and drug detoxification centers, nursing homes, and buildings in which one or more doctors provide health services similar to those provided by any of the above. Doctors' and dentists' offices, counseling offices, offices of chiropractors, psychologists, and psychiatrists and places providing health services that do not require overnight accommodation shall comply with the requirements of 521 CMR 11.00: COMMERCIAL BUILDINGS.

MEDICAL CARE FACILITIES

13.1

521 CMR 13.00:

521 CMR: ARCHITECTURAL ACCESS BOARD

 105

Alterations to Patient Bedrooms: When patient bedrooms are being added or altered as part of a planned renovation of an entire wing, a department, or other discrete area of an existing medical facility, a percentage of the patient bedrooms that are being added or altered shall comply with 521 CMR 13.3.1. The percentage of accessible rooms provided shall be consistent with the percentage of rooms required to be accessible by the applicable requirements of 521 CMR 13.3.1, 13.3.2 and 13.3.3 until the number of accessible patient bedrooms in the facility equals the overall number that would be required if the facility were newly constructed.

ENTRANCES At least one accessible entrance that complies with 521 CMR 25.00: ENTRANCES, shall be protected from the weather by canopy or roof overhang. Such entrances shall incorporate a passenger loading zone that complies with 521 CMR 20.00: ACCESSIBLE ROUTE. DOORWAYS All bedrooms and bathrooms shall comply with the requirements of 521 CMR 26.00: DOORS AND DOORWAYS.

13.3.4

13.4

13.5

TUB AND SHOWER ROOMS Where shower rooms or tub rooms are provided, at least one of each per floor must be accessible.

13.8

521 CMR - 61

PATIENT TOILET ROOMS Where toilet rooms are provided as a part of a patient bedroom, each accessible patient bedroom as defined in 521 CMR 13.3, Patient Bedrooms shall have an accessible toilet room that complies with requirements of 521 CMR 42.00: GROUP 1 BATHROOMS (for Group 1 patient bedrooms) or 521 CMR 44.00: GROUP 2B BATHROOMS, (for Group 2B patient bedrooms). Accessible bathrooms shall be on an accessible route.

13.7

1/27/06

MANEUVERING SPACE IN BEDROOMS Each bedroom shall have adequate wheelchair turning space complying with 521 CMR 6.3, Wheelchair Turning Space. In rooms with 2 beds, it is preferable that this space be located between beds. Each bedroom shall have adequate space to provide a minimum clear floor space of 36 inches (36" = 914mm) along each side of the bed and to provide an accessible route to each side of each bed.

13.6

Exception: Entry doors to acute care hospital bedrooms for inpatients shall be exempted from the requirement in 521 CMR 26.6, Maneuvering Clearance if the door opening is at least 44 inches (44" = 1118mm) wide.

In long term care facilities and nursing homes, 5% of the total number of patient bedrooms with toilets shall be designed as Group 2B Units and 45% of the patient bedrooms with toilets shall be designed as Group 1 Units.

13.3.3

13.00: MEDICAL CARE FACILITIES

521 CMR: ARCHITECTURAL ACCESS BOARD

106  AUXILIARY VISUAL ALARMS Patient bedrooms shall be equipped with one of the following:

13.10

TELEVISIONS Where televisions are provided in patient bedrooms, the facility shall provide, upon request, a television amplifier and a closed caption decoder.

PUBLIC TOILET ROOMS All public toilet rooms shall be accessible.

13.12

13.13

521 CMR - 62

Deaf or hard of hearing patients shall be provided with a decoder and a TTY, on request, on a loaner basis.

13.11.1

1/27/06

TELEPHONES Telephones permanently installed in patient rooms shall have volume controls complying with 521 CMR 37.00: TELEPHONES. An accessible electrical outlet within 48 inches (48" = 1219mm) of a telephone connection shall be provided to facilitate the use of an assistive listening system, which shall be provided by the facility upon request.

13.11

a. A visual alarm connected to the building emergency alarm system; or b. A standard 110-volt electrical receptacle into which such an alarm can be connected and a means by which a signal from the building emergency alarm system can trigger such an auxiliary alarm.

CHANGING ROOMS Shall comply with the requirements of 521 CMR 33.00: DRESSING, FITTING AND CHANGING ROOMS.

13.9

13.00: MEDICAL CARE FACILITIES

521 CMR: ARCHITECTURAL ACCESS BOARD

107

1/27/06

NON-TEXT PAGE

13.00: MEDICAL CARE FACILITIES

521 CMR: ARCHITECTURAL ACCESS BOARD

521 CMR - 63

108

 109

Decks Stages and platforms Warehouses

Basement and grade floor areas Storage, stock, shipping areas Parking garages Residential Skating rinks, swimming pools Rink and pool

Outpatient areas Sleeping areas Kitchens, commercial Library Reading rooms Stack area Locker rooms Mercantile Areas on other floors

Assembly without fixed seats Concentrated (chairs only-not fixed) Standing space Unconcentrated (tables and chairs) Bowling centers, allow 5 persons for each lane including 15 feet of runway, and for additional areas Business areas Courtrooms-other than fixed seating areas Day care Dormitories Educational Classroom area Shops and other vocational room areas Exercise rooms H-5 Fabrication and manufacturing areas Industrial areas Institutional areas Inpatient treatment areas

Gaming floors (keno, slots, etc.)

Assembly with fixed seats

Baggage handling Concourse Waiting areas Assembly

FUNCTION OF SPACE Accessory storage areas, mechanical equipment room Agricultural building Aircraft hangars Airport terminal Baggage claim

15 net 500 gross

50 gross 15 gross

30 gross 300 gross 200 gross 200 gross

60 gross

50 net 100 gross 50 gross

100 gross 120 gross 200 gross

240 gross

20 net 50 net 50 gross 200 gross 100 gross

100 gross 40 net 35 net 50 gross

7 net

7 net 5 net 15 net

11 gross See Section 1004.7

300 gross 100 gross 15 gross

20 gross

FLOOR AREA IN SQ. FT. PER OCCUPANT 300 gross 300 gross 500 gross

TABLE 1004.1.1 MAXIMUM FLOOR AREA ALLOWANCES PER OCCUPANT