DESIGN HEALS

Design HEALS: Investigating Design Guidelines for Healthy Assisted Living Settings

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 Obiettivo del progetto (Objective)

'Recent European Commission (2008) report on “Long-term care in the European Union” announced that demands for quality and quantity of long-term care services bound to rise. As current models for healthy ageing define institutional care as the last resort, assisted living settings fill a big gap between home and institutions. Varying in scale and design, the overall concept of assisted living facilities is to provide home-like physical environment and social support for those who require help in performing their activities of daily living. The aim of this research is to study the link between environmental qualities of assisted living facilities and well being of cognitively intact elderly. Multiple case study methodology will be followed by selecting facilities varying in size and plan layout configurations. The size of facility, plan layout configuration, walking distances between resident’s room and common areas, accessibility and presence of neighborhood amenities will be the independent variables of this study. Well-being outcomes (dependent variables) will be collected by structured observation of resident’s use of common spaces and their social interactions. Personal digital assistants that run geographical information software will be used to record location and behaviors of residents in social areas. Residents will be asked about their perceptions of facility and neighborhood in an interview. Caregivers will be asked to provide non-medical information and make behavioral assessments about each resident. Research findings will be transformed into design guidelines and an assessment tool for assisted living settings. Currently, no tool exists that links well-being of elderly and physical environment of assisted living, with the potential of affecting policy. Results will be communicated to network of decision-makers, architects, planners, caregivers, and residents of these facilities within European Union.'

Descrizione progetto (Article)

'The 2012 Ageing Report: Underlying Assumptions and Projection Methodologies' advocates providing care to people without chronic health conditions but with limitations in activities (such as dressing and bathing). It also supports instrumental activities of daily living (such as shopping) at home and in community-based facilities.

With the rising cost of providing care at home, assisted-living facilities will be an increasingly important alternative. At this point, however, there are no established criteria to assess such facilities to see if they contribute to the health and well-being of their residents.

An EU-funded project, 'Design heals: Investigating design guidelines for healthy assisted living settings' (DESIGN HEALS), filled this gap by studying the link between the environment of assisted-living facilities and the well-being of cognitively intact elderly adults.

The study used a multiple case study methodology. Researchers looked at the size of each facility, plan layout, walking distances between each resident's room and the common areas, accessibility and neighbourhood amenities. The team collected well-being outcomes through structured observations of the residents' uses of common spaces and their social interactions. Geographical information software was used to record the location and behaviour of residents in social areas.

Residents were interviewed and asked about their perceptions of the facility and the neighbourhood. Caregivers were asked to provide non-medical information and make behavioural assessments about each resident. Researchers collected 189 surveys and 432 behavioural maps from 18 facilities of different sizes.

Findings showed that residents used social areas and the outdoors more in small- and medium-sized facilities. The walking distance between the bedrooms and social areas played a role in whether they were used or not. Residents with roommates were found to be more engaged than those living alone.

The study provided evidence-based guidelines for modifying and designing assisted-living facilities. In addition, the assessment instruments were found to be reliable. These results are significant and have the potential to lead to facilities that promote residents' well-being.