Layout, lifestyle go hand in hand

Interior designers make inroads in balancing functionality with style in seniors housing.

By Jeff Shaw

Seniors housing operators have a narrow line to walk. A community’s interiors — furniture, layout and design — must serve the needs of a wide range of people, from seniors still capable of independent living to those who are wheelchair-bound with assistance needs. At the same time, the community must still function as a residence rather than a clinical setting. 

Seniors housing communities have traditionally leaned too far toward a hospital-style setting, according to Jane Rohde, founder and principal at Maryland-based senior living consulting firm JSR Associates.

“Many facilities treat aging as a disease,” says Rohde. “They treat the clinical part, but they don’t create a home.”

Rohde chairs the Residential Document Group — a subset of the Health Guidelines Revision Committee — which published a book in July to help facilities understand design and construct seniors housing in accordance with licensing and regulations. She says there’s nothing about adhering to state and federal regulations that prevents designers from creating a “person-centered environment.”

“We’re seeing it in healthcare in general, too,” says Rohde. “It’s not looking nearly as institutional.”

Austin-based studioSIX5, an interior design firm specializing in seniors housing, is one of the companies leading the charge toward a style closer to the hospitality industry, according to company president Dean Maddalena.

“It’s just beginning to change, but [a clinical look] has been the modus operandi for everybody,” says Maddalena. “Before they could get away with it, but with the expectations we have now the importance of design is critical.”

One of studioSIX5’s clients — Atlanta-based Thrive Senior Living, an owner and operator with a portfolio of over a dozen communities throughout the South — believes that emulating the styles of hotels and resorts is key to moving away from the clinical nature of seniors housing.

“We take an approach to create an atmosphere more akin to a hospitality rather than home-like atmosphere,” says Jeramy Ragsdale, who founded Thrive in 2008 and still serves as principal. “We really tout the product that we offer being more of a resort-quality experience. We’re a substitute for living at home, but we’re not home. We’re aware of that.”

Functionally, this means creating a light and airy environment with stylish design and lots of comfortable communal areas both indoors and out.

“We try to create spaces that are attractive to people, that make them want to spend more time there and socialize there,” says Ragsdale.

One of the keys to this shift in the industry, says Maddalena, is that developers realize that it’s not just prospective residents that they have to please. Their target customer also includes the middle-aged children of seniors.

“We’re designing for the 57-year-old daughter who’s helping her parents with these decisions,” says Maddalena. “All levels of care have to be appealing to that population and the residents.”

Michael Zusman, CEO of Kwalu, a seniors housing specialty furniture company, says part of the key to making the adult children happy is to minimize the difference between the visual appearance of independent living, assisted living and memory care.

“You can’t lump specialty environments together, but you want to design them to flow together,” says Zusman. “You want an integrated look. People don’t want to see a difference in the furniture.”

Adult children want their parents to use the same style and quality of furniture, even as acuity potentially increases and the parent moves to assisted living, skilled nursing or memory care, explains Zusman.

This need for consistency leads to a complicated balance. How can a design work for people who need the furniture to be used in such different ways?


Balancing function and style

“Community design has become something of a multigenerational thing now,” says JSR’s Rohde. “We’re seeing a push toward more multiple generations living in the same community. It’s not just older people or just frail people.”

Sometimes the end result is furniture that’s not appropriate for everyone in the building.

“What limits furniture is incorrect dimensions — way too high, way too low, too soft,” says Rohde. “We’ve seen residents have to pull other residents out of chairs because the cushion was too soft.”

Kwalu tries to design around this issue by having furniture match stylistically, but with subtle differences depending on the intended use. Changes can include more rounded edges on furniture in memory care facilities, firm chair cushions and arm rests at the appropriate height to help lift oneself out of a chair.

“There are distinct differences, but maybe not to somebody walking through a campus,” says Kwalu’s Zusman. “We try to be patient-centered in our design.”

studioSIX5, which occasionally uses Kwalu furniture in its designs, says keeping a consistent look is key, particularly in continuing care retirement communities.

“Our philosophy is that the aesthetic carries through to all levels of care,” says Maddalena. “If a resident one day is in independent living and the next day goes to assisted living, we believe that senior should be sitting in the same dining chair. If a family member visits a memory care unit, he or she doesn’t want to see that a parent is getting anything less.”

Styles can run the gamut, ranging from modern to classic to transitional. There are also Asian-inspired styles and Western styles. Ultimately, the style chosen is based on the location and cost of each individual community.

Even in skilled nursing, the design can still carry through into specialized equipment for seniors with the highest acuity levels, says Maddalena.

Furniture design has to take into account more than just the residents themselves. In high-traffic areas, furniture is exposed to abuse from wheelchairs, walkers, vacuum cleaners and harsh handling in general.

Maddalena says the way to prepare for abuse is to build around the expected use of the furniture. Preparations can include anything from the strategic placement of a handle on the back of a chair to reinforcing sofas in places where they often are bumped by residents or staff. 


Advanced materials pave the way

The most important part of making facilities look less clinical, according to JSR’s Rohde, is the advancement of the furniture materials. Furniture can now look attractive, but still be washable and stand up to abuse.

“The finishes have come a long way in being able to be very durable but less institutional,” says Rohde. “The technology has gotten so much better, providing printed vinyls and Crypton for upholstery solutions.”

In regard to furniture, Kwalu’s Zusman says it was initially difficult convincing some high-end communities to switch from using wood to a more durable faux-wood material. The perception was that wood conferred a sense of upscale living. But that quickly changed following the recession. Once both the average age and acuity levels of their residents increased, providers had to contend with the reality of more walkers and wheelchairs, which put a heavier load on the furniture. 

“Providers constantly complain to us that their wood furniture is getting beaten up too quickly,” says Zusman. “I am glad we can offer them a better solution.”


Fitting within a budget

The new furniture materials can be found for any budget, says studioSIX5’s Maddalena, and developers need to decide the budget beforehand to be cautious. Fabric for upholstered furniture can range anywhere from $16 per yard to over $100 depending on the style and quality.

“When you’re dealing with 18 to 20 yards (of fabric) on a sofa, that has a huge price swing on the cost of that furniture,” says Maddalena.

The average cost of furniture and other interior design elements for a 90-unit community ranges from $550,000 to $700,000, and increases between 3 percent and 5 percent each year due to the rising cost of materials, says Maddalena.

Thrive always considers longevity when choosing materials, often finding that more durable materials will make up for higher costs by lasting longer.

Technological advancements help improve the lighting and flooring of seniors communities, too. Long-lasting, easily maintained carpeting is available. So too are non-slip hard surfaces.

A variety of styles enable any seniors housing community to take advantage of new technology regardless of budget, particularly for lighting fixtures, says Thrive’s Ragsdale. “There are a lot of great products out there, even what’s considered lower-end.”

LED lighting has allowed for a compromise between the dangerous shadows and low light associated with incandescent bulbs and the institutional brightness of fluorescent bulbs. 

“By far the most important aspect of aesthetics is lighting,” says Ragsdale. “We have to balance not wanting an overly bright, clinical atmosphere, but wanting sufficient light to see things, not cast shadows, not create dark spots and trip hazards. Striking that fine line without an institutional look is really an art.” 


The layout can be liberating

Interior design is about a lot more than what fills a space, of course. The space itself is part of the overall mission, and possibly the most important.

Layout can be the key to improving residents’ lives, says JSR’s Rohde, because it can encourage them to use all the community’s amenities. From welcoming outdoor spaces to simple additions like more handrails, layout can “multiply someone’s independence.”

“You can design something that either supports independence or limits independence,” says Rohde. “You want to design toward allowing people to have as much independence as possible.”

Ragsdale says Thrive designs everything around driving residents into socialization areas using strategically placed walking trails, benches and heaters. The company’s designs often start with the outdoor space because that’s a place that encourages both healthy living and socialization.

“Like most providers, one of our programming goals is to have our residents spend as little time in their rooms alone as possible,” says Ragsdale.

Both Ragsdale and Rohde observe that it’s important to work with architects who understand the nuances in the seniors housing industry so that their construction plans mesh with the design elements. 

“It’s absolutely crucial to have an interior design firm that’s very experienced in this space, and an interior design firm that plays well with architects. There’s always a lot of friction there,” says Ragsdale, noting the common clash between tactical architects and artsy designers.

“We often partner with local architects who are familiar with the local code requirements,” says Rohde. “Providing knowledgeable senior living consulting and interior design services fills the knowledge gap of understanding the needs of seniors.”

Maddalena of studioSIX5 is an architect himself, and he says his company always seeks designers who specialize in seniors housing for exactly that reason. “There is a premium to hire a designer with seniors experience, but the payback is many fold on the back side.”