ARCHITECTURE
Person-centered care environments New trends in assisted living facilities BY GAIUS NELSON, MA
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hysical or cognitive difficulties often make living at home impractical or unsafe for older adults. Multiple home care options provide support for those wishing to remain in the familiarity of their own home, but this can be an expensive proposition, and one that could limit the social interactions or the sense of community and belonging that are available in congregate long-term care settings. Choosing the right facility can be overwhelming. Several long-term care communities stress their “chef-driven” menus and beautifully appointed entrance lobbies to prospective residents and their loved ones. Architecture clients often wish to present a “Wow” experience for those entering the facility. First impressions are important, but it is even more important to be sure that the same careful design and execution of the physical environment occurs throughout the long-term care facility.
Telephone Equipment Distribution (TED) Program
Whether it is the availability of appropriate types of services, accepted payer sources, or cultural affinity groups, sorting through the various settings and organizations is a difficult task. Decisions can produce even more anxiety during the current pandemic. Some family members may
Guidance for consumers and physicians Minnesota’s Assisted Living Report Card—now under development—may help consumers and physicians sort through a variety of quality measures for long-term care settings (see recent Minnesota Physician article at http:// mppub.com/mp-s4-0320.html). Building on the experience of the state’s Nursing Home Report Card (http://nhreportcard.dhs.mn.gov/), planners have developed a list of nine quality domains based on national literature, reports, and experts. Among the nine domains, Quality of Life; Safety; and Physical and Social Environment most directly correlate to and can be impacted by the architecture and design of long-term care settings. Individuals who have lived within congregate settings rate the quality of the physical and social environment as being more important than those who have not done so, but a review of data from the Nursing Home Report Card shows a discrepancy in satisfaction ratings between residents and their family members. In one cohort of facilities, resident and family ratings on the quality of the environment correlate closely, but in a separate cohort, residents rate the environment much higher, often twice that of family members. This diversity of opinions points to the difficulty that people have in describing which physical attributes of the environment are important, or to a lack of understanding of how these attributes can affect residents, family, and staff.
Physical environment contributes to therapy
Do you have patients with trouble using their telephone due to hearing loss, speech or physical disability? If so…the TED Program provides assistive telephone equipment at NO COST to those who qualify. Please contact us, or have your patients call directly, for more information.
1-800-657-3663 ted.program@state.mn.us mn.gov/dhs/ted-program Duluth • Mankato • Metro Moorhead • St. Cloud The Telephone Equipment Distribution Program is funded through the Department of Commerce Telecommunications Access Minnesota (TAM) and administered by the Minnesota Department of Human Services
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contemplate “rescuing” loved ones from congregate living settings, believing this is the safest alternative—but very few loved ones have the training or ability to practice infection control as effectively as long-term care providers.
JUNE 2020 MINNESOTA PHYSICIAN
The late David Green, former CEO of the Evergreen Retirement Community in Oshkosh, always explained to visitors that the built environment was the most important therapeutic tool available to caregivers. Subsequent research confirms this observation, demonstrating that the environment has a significant impact on the well-being and quality of life experienced by its occupants. These “person-environment” studies led to the development of new types of environments for aging after the passage of the Federal Nursing Home Reform Act, created under the 1987 Omnibus Budget Reconciliation Act. New regulations mandated that quality-of-life measures be integrated into the life of nursing home residents on an equal or greater footing to quality of care. Person-centered care that looked at each person as an individual became the new standard. The proliferation of assisted living centers as an alternative to traditional nursing homes pushed the concept of personalized, non-institutional care environments throughout the longterm care industry. There are a wide variety of care setting typologies available, ranging from independent living, assisted living, memory care, and nursing homes. In many cases it is difficult to distinguish one type of setting from another. For example, assisted living may offer two-bedroom apartments with full-unit kitchens, while nursing home care suites may provide studio-like
