Greater Compassion Needed in Assisted Living Facility Design
June 2009
The Sleepover Project: Post #1, Sleeper #1

| Sleeper #: |
1 |
| Gender / Age: |
Female / Assigned Age: 85; Actual Age: 31 |
| Medical Condition: |
Recovering from a broken hip |
| Physical Limitations: |
Dependent on using a walker for mobility |
| Sleepover Date: |
5/11 thru 5/12/2009 |
| Assigned Location: |
Cummings Assisted Living in Fort Worth, TX |
| Living Space: |
Studio apartment with a living room, kitchenette, bathroom and walk-in closet |

Our first findings come from Sleeper #1, a normally able-bodied, 31-year-old senior living designer at CSD Architects in Dallas, Texas.
On May 11, Sleeper #1 entered Cummings Assisted Living in Fort Worth, Texas, transforming into the roll of an 85 year-old resident who was recovering from a broken hip. She was mobile by foot through the use of her walker. In her "real" life she wasn't previously aware of how incredibly frustrating and challenging it would be to use a walker. Until now...
Walker Wars
With her sketchpad and pens laying on the seat of her walker (a transportation technique she learned from observing fellow residents), Sleeper #1 set out for her maiden stroll. Paying close attention to the affects of every movement she made with the walker - from going over the smallest bump in the floor to opening a door and crossing its threshold - the struggles of senior living became ever apparent.
Realizing that the walker essentially doubled the surface area that her body took up on the floor, she found her maneuverability quite challenging. In small spaces like showers and bathrooms, her maneuverability became exceedingly challenging since there wasn't always enough room for her and the walker to explore a full range of motion.
In rooms and areas designed to comply with ADA regulations and with seemingly ample space, she found the act of pulling a door open was most difficult. In her studio apartment for example, the narrow width of the corridor inside the unit made it a challenge to exit the apartment with the walker. "It was like dancing with the door," she says. It didn't help matters that some threshold detailing protruded half an inch above the floor, making it difficult to push the walker over the uneven surface.
Sleeper #1 learned that with the walker in the way, she was forced to go back and forth while pivoting her body - practically doing a full circle just to go through a doorway. Also, how the doors operate became an increasing concern for her. She couldn't help to think that while it would be more expensive, automating the door through push button technology would be much safer, simpler, and comfortable for residents. In this particular facility, Sleeper #1 observed that nearly 100% of residents used walkers, which further underscored the need for greater accessibility for disabled or weak seniors passing through doorways.
Pushing the door open was not quite as difficult as pulling. Many resident kick the door a little, which alleviates them from bending their backs. Residents don't worry much about kicking the doors. When asked if she was concerned about scuffing the door, one resident said, "There's a kick plate on the door."
ARGH!!
Once she began to feel the frustrations of senior living, Sleeper #1 quickly noticed how difficult other things became. For instance, she observed only one clock in the facility, and became frustrated with not being able to tell the time of day as she slowly strolled through the hallways or sat around with a group of friends. She theorized that this could be a contributing factor that causes the residents' to lose or change their concepts of time.
Sleeper #1 observed a small vestibule where a beautiful plant stood along with a table and a big comfortable chair, residents passed by slowly and regularly. It was an area of high circulation, yet no one seemed to use the room to sit and chat. They couldn't. Many seniors can't "stand around," especially when they are in walkers. They need to sit comfortably or lay down in order to fully engage in extended conversation. Now, suppose there were two chairs in the vestibule rather than one; how would that have changed the interaction with that otherwise unused space?
Lean On Me
From her mock hip injury, Sleeper #1 quickly noticed that many seniors who suffer from injury or illness could only walk a few steps before they needed to lean on something to support their weight. While ample handrails were placed in her facility, she noticed that in large rooms like public dining rooms, seniors use furniture in place of handrails. Sleeper #1 notes that now, when working on a project and she sees a public space, she thinks more about a seniors' limited mobility and how the type of furniture or its placement may help give seniors something extra to lean on.
Until We Walk In Their Shoes ... We Have No Idea
Within the past few weeks of her 24-hour sleepover, Sleeper #1 has already applied the knowledge she gained from her observations in practical ways. She sees things in construction drawings or in design-development that she instinctively knows could be improved through better and more considerate design practices.
One of the most inspiring things Sleeper #1 and all of our sleepers are reporting about is that they never would have learned the things they learned unless they were walking in the shoes of seniors.
Sleeper #1 says:
"I was using that walker, and really paying attention to how I was affected by even the smallest obstruction, or any impediments. Comparing it with how able bodied I was an hour before. There's no possible way I could have even known to be a better designer in that way, had I not simulated the experiences ... it was frustrating for me to face my own knowledge being so limited. I felt selfish knowing that people live in this manner for 10 years or more. It upset me that there is an entire field of architecture, and we are only scratching the surface [on senior living] now. A lot of this has been ignored by us as architects. We need to show more compassion for seniors in every aspect of our designs."
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