0 5 10 15 20 25 30 35 40 45 netherlands ...
ACCLAIMED EUROPEAN DEMENTIA CARE BUILDINGS Environments for Aging 2015 Session E19
Dodd Kattman, AIA, Partner MKM architecture + design Environments for Aging 2015 Baltimore, MD April 20, 2015
Alex Ten Napel Portrait Photography
REMINDERS • Please take the time to fill out the session survey and return it to the room monitor. • To continue the conversation or to provide additional comments for this session, log into the EFA Mobile App and search for this session. Post a comment in the “CHATTER” section. • To access this presentation, log on to the EFA Mobile App, click on the session title under “Agenda” and the presentation will be located under “Collateral”. • If you have CE questions, please refer to the program guide for specific instructions. • If you were not scanned in for this session, please see the room monitor.
Dodd Kattman, AIA, Partner MKM architecture + design Environments for Aging 2015 Baltimore, MD April 20, 2015
SESSION DESCRIPTION This session will compare and contrast leading European facilities serving those with Alzheimer’s disease and other forms of dementia with those found in the U.S. The speaker will present planning principles and visual images compiled from tours of eight acclaimed European models. Building concepts shared vary from small house to hospice wards and dense midrises to the now renowned dementia village. Philosophical approaches include the value of silence, personal freedom, and neighborhood clusters intentionally focused on resident profiling and social “lifestyles.” If you believe that architecture serves as a reflection of societal values, you’ll be challenged to reflect on your own priorities regarding building design and elder service.
Dodd Kattman, AIA, Partner MKM architecture + design Environments for Aging 2015 Baltimore, MD April 20, 2015
ALZHEIMER’S DISEASE PROJECTIONS UNITED STATES AGE 65+ 16,000,000 14,000,000
65-75
75-84
85+
12,000,000 10,000,000 8,000,000 6,000,000 4,000,000 2,000,000 0 2010
2020
2030
2040
Hebert LE, Weuve J, Scherr PA, Evans DA. Alzheimer disease in the United States (2010–2050) estimated using the 2010 Census. Neurology 2013;80(19):1778–83.
2050
CHANGES IN SELECTED CAUSES OF DEATH ALL AGES, BETWEEN 2000 AND 2013
+71%
BREAST CANCER
PROSTATE CANCER
HEART DISEASE
-2%
-11%
-14%
STROKE
H.I.V. ALZHEIMER’S DISEASE
-23% -52%
National Center for Health Statistics. Deaths: Final Data for 2013. National VitalStatistics Report. Volume 64, Number 2. Hyattsville, Md.; 2015. Available at: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. Accessed February 26, 2015.
PERCENT OF POPULATION 65+ RECEIVING L.T.C. 2009
30
Home Institution Combined
25 20
23.9%
19.4% 15
18.2% 12.2%
10
6.5%
5 0 AUSTRIA
NETHERLANDS SWITZERLAND
OECD
USA
Source: Organization for Economic Cooperation and Development (OECD) Health D
SIZE OF L.T.C. WORKFORCE PER 100 AGE 80+ 2008
45 40
40.0%
35 30 25 20
32.1%
26.6%
23.3%
15 10 5 0 NETHERLANDS SWITZERLAND
OECD
USA Source: OECD Health Data, 2011
CAREGIVER SUPPORT RATIO U.S. ADULT CHILDREN CAREGIVERS AGE 46-64 FOR EACH PERSON AGE 80+
7:1
BOOMERS TURNING 45
4:1
BOOMERS TURNING 65
3:1
BOOMERS TURNING 80
D. Redfoot, L. Feinberg, and A. Houser, The Aging of the Baby Boom and the Growing Care Gap: A Look at Future Declines in the Availability of Family Caregivers (Washington, D.C.: AARP Public Policy Institute, August 2013). www.aarp.org/research/ppi.
2
3
4
5
1 6 7
1. 2. 3. 4. 5. 6. 7.
HEAVERS COURT CARE HOME CROYDON, U.K. DEDEI AMSTERDAM, THE NETHERLANDS DE HOGEWEYK WEESP, THE NETHERLANDS SONNWEID WETZIKON, SWITZERLAND SENIORENHEIM BAD SANTIBLICK WALDSTATT, SWITZERLAND HAUS AN DER LUTZ LUDESCH, AUSTRIA HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Photo by Alex MacLean ©2015 MKM | 10
HEAVERS COURT CARE HOME CROYDON, U.K.
Neighborhoods of 10 Dementia Care Large, protected courtyard Very residential Kitchen opens to courtyard ©2015 MKM | 11
HEAVERS COURT CARE HOME CROYDON, U.K.
Location set a block off the main road, within 2 blocks of train. ©2015 MKM | 12
Courtyard
Neighborhood
Neighborhood
Neighborhood Kitchen
Admin./Adult Day Care
HEAVERS COURT CARE HOME CROYDON, U.K.
Living/Dining in middle of household, stairs exit into protected courtyard.
Photo by Alex MacLean ©2015 MKM | 13
HEAVERS COURT CARE HOME CROYDON, U.K.
Nice balcony at corner of households, not used due to poor staff visibility ©2015 MKM | 14
HEAVERS COURT CARE HOME CROYDON, U.K.
Day room overlooking courtyard, central to neighborhood, short walking distances. ©2015 MKM | 15
HEAVERS COURT CARE HOME CROYDON, U.K.
Neighborhood dining across hall from day room, views to perimeter of property. ©2015 MKM | 16
HEAVERS COURT CARE HOME CROYDON, U.K.
Neighborhood kitchen, unprotected. ©2015 MKM | 17
HEAVERS COURT CARE HOME CROYDON, U.K.
Very, very, narrow hallways.
©2015 MKM | 18
HEAVERS COURT CARE HOME CROYDON, U.K.
“European” bathrooms are difficult to control the water, even in Europe. ©2015 MKM | 19
HEAVERS COURT CARE HOME CROYDON, U.K.
Courtyard.
©2015 MKM | 20
HEAVERS COURT CARE HOME CROYDON, U.K.
Courtyard allows for staff and residents to create their own groupings. ©2015 MKM | 21
HEAVERS COURT CARE HOME CROYDON, U.K.
Main kitchen opens up to courtyard, although never serves events. ©2015 MKM | 22
HEAVERS COURT CARE HOME CROYDON, U.K.
Architectural features are meaningless if upper management doesn’t instill culture to use as planned. ©2015 MKM | 23
DEDEI AMSTERDAM, THE NETHERLANDS
Large Campus serves many (4) floors of 6 residents Floor manager, + 2 nurses serving 4 floors Universal care-givers. First floor restaurant and store ©2015 MKM | 24
DEDEI AMSTERDAM, THE NETHERLANDS
Patio
Great Room
Hall
1
2
5
6
Apt.
Support 3
4
Apt. 6-resident household, short distances for staff and residents. ©2015 MKM | 25
DEDEI AMSTERDAM, THE NETHERLANDS
Central outdoor gathering.
©2015 MKM | 26
DEDEI AMSTERDAM, THE NETHERLANDS
Common hallway, storage cabinets, translucent stairs. ©2015 MKM | 27
DEDEI AMSTERDAM, THE NETHERLANDS
Hallway storage.
©2015 MKM | 28
DEDEI AMSTERDAM, THE NETHERLANDS
Great room. Staff just finished grocery shipping. ©2015 MKM | 29
DEDEI AMSTERDAM, THE NETHERLANDS
Common living space.
©2015 MKM | 30
DEDEI AMSTERDAM, THE NETHERLANDS
Common living space.
©2015 MKM | 31
DEDEI AMSTERDAM, THE NETHERLANDS
Integrated cabinetry.
©2015 MKM | 32
DEDEI AMSTERDAM, THE NETHERLANDS
Each level has an outdoor patio connected to the great room. ©2015 MKM | 33
DEDEI AMSTERDAM, THE NETHERLANDS
Resident room.
©2015 MKM | 34
DEDEI AMSTERDAM, THE NETHERLANDS
European bath.
©2015 MKM | 35
DEDEI AMSTERDAM, THE NETHERLANDS
European bath.
©2015 MKM | 36
DE HOGEWEYK WEESP, THE NETHERLANDS
“Dementia Village” includes store, restaurant, theatre, bar, etc. Secure perimeter 7 lifestyles to choose from (homey, upper class, traditional, Christian, indonesian, cultural, urban) Residents cook, laundry, shop, etc. Choose activity for free, pay for extras Motion sensors at common doors, elevators, etc. ©2015 MKM | 37
DE HOGEWEYK WEESP, THE NETHERLANDS
Theater
Admin
Common
Entry Mall
Campus plan.
Household ©2015 MKM | 38
DE HOGEWEYK WEESP, THE NETHERLANDS
Interconnected courtyards, protected. ©2015 MKM | 39
DE HOGEWEYK WEESP, THE NETHERLANDS
Courtyard overview from upper level. ©2015 MKM | 40
DE HOGEWEYK WEESP, THE NETHERLANDS
Courtyard variations.
©2015 MKM | 41
DE HOGEWEYK WEESP, THE NETHERLANDS
Courtyard variations.
©2015 MKM | 42
DE HOGEWEYK WEESP, THE NETHERLANDS
Courtyard variations.
©2015 MKM | 43
DE HOGEWEYK WEESP, THE NETHERLANDS
Civic commons, includes grocery, restaurant, pub, retail. ©2015 MKM | 44
DE HOGEWEYK WEESP, THE NETHERLANDS
Grocery shopping.
©2015 MKM | 45
DE HOGEWEYK WEESP, THE NETHERLANDS
Restaurant.
©2015 MKM | 46
DE HOGEWEYK WEESP, THE NETHERLANDS
Restaurant.
©2015 MKM | 47
DE HOGEWEYK WEESP, THE NETHERLANDS
Household commons.
©2015 MKM | 48
DE HOGEWEYK WEESP, THE NETHERLANDS
Household commons.
©2015 MKM | 49
DE HOGEWEYK WEESP, THE NETHERLANDS
Resident room.
©2015 MKM | 50
DE HOGEWEYK WEESP, THE NETHERLANDS
Shared bathroom serves 3 bedrooms. ©2015 MKM | 51
DE HOGEWEYK WEESP, THE NETHERLANDS
Physical therapy.
©2015 MKM | 52
DE HOGEWEYK WEESP, THE NETHERLANDS
Civic courtyard. Theater entrance. ©2015 MKM | 53
DE HOGEWEYK WEESP, THE NETHERLANDS
Theater Lobby.
©2015 MKM | 54
DE HOGEWEYK WEESP, THE NETHERLANDS
Theater and multi-use room.
©2015 MKM | 55
SONNWEID WETZIKON, SWITZERLAND
Silence important – caregivers trained, sound control in rooms Staffing Ratio – 1:3 daytime, 1:50 night Wrap around porches Circadian lighting (no results) “Care Oasis” – 6-9 resident ward, live longer, less life support, not being alone. Public vs. Private. ©2015 MKM | 56
SONNWEID WETZIKON, SWITZERLAND
Room of silence, each resident creates 2 figures, one stays in building, other to family. ©2015 MKM | 57
SONNWEID WETZIKON, SWITZERLAND
Room of silence, each resident creates 2 figures, one stays in building, other to family. ©2015 MKM | 58
SONNWEID WETZIKON, SWITZERLAND
Central ramp connects floors, sound of water echo’s throughout the building. ©2015 MKM | 59
SONNWEID WETZIKON, SWITZERLAND
Central ramp connects floors, sound of water echo’s throughout the building. ©2015 MKM | 60
SONNWEID WETZIKON, SWITZERLAND
Cozy visiting space allows for private conversations. What happens when others follow? ©2015 MKM | 61
SONNWEID WETZIKON, SWITZERLAND
Shared resident rooms are served by (2) toilet rooms in hallway vestibule. ©2015 MKM | 62
SONNWEID WETZIKON, SWITZERLAND
Shared resident rooms are served by (2) toilet rooms in hallway vestibule. ©2015 MKM | 63
SONNWEID WETZIKON, SWITZERLAND
Shared resident rooms are served by (2) toilet rooms in hallway vestibule. ©2015 MKM | 64
SONNWEID WETZIKON, SWITZERLAND
Common dining, lighting system intended to benefit circadian rhythms (no results). ©2015 MKM | 65
SONNWEID WETZIKON, SWITZERLAND
Wrap-around porch opens to dining room. ©2015 MKM | 66
SONNWEID WETZIKON, SWITZERLAND
Care Oasis: Private bed space with blinds, kitchen, therapeutic space, access to outdoor. ©2015 MKM | 67
SONNWEID WETZIKON, SWITZERLAND
Care Oasis: Improved nutrition. Improved alertness. Increased frequency of interaction. Improved relaxation and sleep. Reduction of challenging behavior. ©2015 MKM | 68
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Adaptive re-use of 200 year old historic hotel Community restaurant Traditional nursing home integrated with dementia Wood part of local culture/reputation Exterior landscape without barriers 3d wander sensors ©2015 MKM | 69
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Adaptive re-use of 200 year old historic hotel Community restaurant Traditional nursing home integrated with dementia Wood part of local culture/reputation Exterior landscape without barriers 3d wander sensors ©2015 MKM | 70
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Floor plan
©2015 MKM | 71
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Entrance lobby divides new from old, frames view of mountains beyond. ©2015 MKM | 72
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Entrance lobby divides new from old, frames view of mountains beyond. ©2015 MKM | 73
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Historic structure becomes village asset, image of restaurant. ©2015 MKM | 74
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Wood structure reflects heritage of village craftsman. Attic local museum. ©2015 MKM | 75
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Wood structure reflects heritage of village craftsman. ©2015 MKM | 76
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Wood structure reflects heritage of village craftsman. ©2015 MKM | 77
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Wood structure reflects heritage of village craftsman. ©2015 MKM | 78
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Borrowed daylight illuminates bathroom. ©2015 MKM | 79
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Borrowed daylight illuminates bathroom. ©2015 MKM | 80
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Wood structure reflects heritage of village craftsman. ©2015 MKM | 81
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Addition with historic structure in background. ©2015 MKM | 82
HAUS AN DER LUTZ LUDESCH, AUSTRIA
Preserved historic building (AL) Administrator change, “tough to staff bldg.” Day care first floor Community Space Public restaurant Motion sensors for lighting, everywhere ©2015 MKM | 83
HAUS AN DER LUTZ LUDESCH, AUSTRIA
2nd floor plan.
©2015 MKM | 84
HAUS AN DER LUTZ LUDESCH, AUSTRIA
Marketplace connection to historic building - converted to assisted living. ©2015 MKM | 85
HAUS AN DER LUTZ LUDESCH, AUSTRIA
First floor child day-care adjacent to front door, community room. ©2015 MKM | 86
HAUS AN DER LUTZ LUDESCH, AUSTRIA
Daylit central core, staff work area provides colorful floor identifier. ©2015 MKM | 87
HAUS AN DER LUTZ LUDESCH, AUSTRIA
“Marketplace provides resident social space and connection to existing building. ©2015 MKM | 88
HAUS AN DER LUTZ LUDESCH, AUSTRIA
“Marketplace provides resident social space and connection to existing building. ©2015 MKM | 89
HAUS AN DER LUTZ LUDESCH, AUSTRIA
View of common courtyard from marketplace. ©2015 MKM | 90
HAUS AN DER LUTZ LUDESCH, AUSTRIA
Elevated water feature mimics plan of area river, allows for residents to get wet. ©2015 MKM | 91
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Serves all ages, severe need for care Day care on first floor Inclusion Individual balconies not used Large, shared balconies used including gardening and sun shades. Transparency Invites levels of social engagement. ©2015 MKM | 92
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Resident room hallway transparency Invites privacy, levels of social engagement. ©2015 MKM | 93
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Transparency Invites levels of social engagement. ©2015 MKM | 94
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Transparency Invites levels of social engagement. ©2015 MKM | 95
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Community physician waiting room. ©2015 MKM | 96
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Exterior, floor, and wall concrete same mix, different texture. ©2015 MKM | 97
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Grand balcony invites resident and activities outside. ©2015 MKM | 98
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Grand balcony invites resident and activities outside, automated sun control. ©2015 MKM | 99
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Expansive patio overlooks school and church yard. ©2015 MKM | 100
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Expansive patio overlooks school and church yard. ©2015 MKM | 101
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Building separation provides protected space for day-care children to play. ©2015 MKM | 102
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Building separation provides protected space for day-care children to play, protected. ©2015 MKM | 103
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Distorted grab bar enables some residents to pull themselves close to mirror. ©2015 MKM | 104
KEY LEARNINGS, PROCESS IMPROVEMENTS AND TAKE-AWAYS It is difficult to compare building models with those common to the United States without considering the different funding strategies. Each facility toured had a distinct “philosophy” of care, and all were different from one another. All buildings presented were integrated socially into the village that they served. Most contained shared community assets. European models were different, not necessarily better. Many of the residents cared for would not meet the requirements of US government support. Dodd Kattman, AIA, Partner MKM architecture + design Environments for Aging 2015 Baltimore, MD April 20, 2015
THANK YOU
Dodd Kattman, AIA, Partner MKM architecture + design Environments for Aging 2015 Baltimore, MD April 20, 2015
Alex Ten Napel Portrait Photography
REMINDERS • Please take the time to fill out the session survey and return it to the room monitor. • To continue the conversation or to provide additional comments for this session, log into the EFA Mobile App and search for this session. Post a comment in the “CHATTER” section. • To access this presentation, log on to the EFA Mobile App, click on the session title under “Agenda” and the presentation will be located under “Collateral”. • If you have CE questions, please refer to the program guide for specific instructions. • If you were not scanned in for this session, please see the room monitor.
Dodd Kattman, AIA, Partner MKM architecture + design Environments for Aging 2015 Baltimore, MD April 20, 2015
SESSION DESCRIPTION This session will compare and contrast leading European facilities serving those with Alzheimer’s disease and other forms of dementia with those found in the U.S. The speaker will present planning principles and visual images compiled from tours of eight acclaimed European models. Building concepts shared vary from small house to hospice wards and dense midrises to the now renowned dementia village. Philosophical approaches include the value of silence, personal freedom, and neighborhood clusters intentionally focused on resident profiling and social “lifestyles.” If you believe that architecture serves as a reflection of societal values, you’ll be challenged to reflect on your own priorities regarding building design and elder service.
Dodd Kattman, AIA, Partner MKM architecture + design Environments for Aging 2015 Baltimore, MD April 20, 2015
ALZHEIMER’S DISEASE PROJECTIONS UNITED STATES AGE 65+ 16,000,000 14,000,000
65-75
75-84
85+
12,000,000 10,000,000 8,000,000 6,000,000 4,000,000 2,000,000 0 2010
2020
2030
2040
Hebert LE, Weuve J, Scherr PA, Evans DA. Alzheimer disease in the United States (2010–2050) estimated using the 2010 Census. Neurology 2013;80(19):1778–83.
2050
CHANGES IN SELECTED CAUSES OF DEATH ALL AGES, BETWEEN 2000 AND 2013
+71%
BREAST CANCER
PROSTATE CANCER
HEART DISEASE
-2%
-11%
-14%
STROKE
H.I.V. ALZHEIMER’S DISEASE
-23% -52%
National Center for Health Statistics. Deaths: Final Data for 2013. National VitalStatistics Report. Volume 64, Number 2. Hyattsville, Md.; 2015. Available at: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. Accessed February 26, 2015.
PERCENT OF POPULATION 65+ RECEIVING L.T.C. 2009
30
Home Institution Combined
25 20
23.9%
19.4% 15
18.2% 12.2%
10
6.5%
5 0 AUSTRIA
NETHERLANDS SWITZERLAND
OECD
USA
Source: Organization for Economic Cooperation and Development (OECD) Health D
SIZE OF L.T.C. WORKFORCE PER 100 AGE 80+ 2008
45 40
40.0%
35 30 25 20
32.1%
26.6%
23.3%
15 10 5 0 NETHERLANDS SWITZERLAND
OECD
USA Source: OECD Health Data, 2011
CAREGIVER SUPPORT RATIO U.S. ADULT CHILDREN CAREGIVERS AGE 46-64 FOR EACH PERSON AGE 80+
7:1
BOOMERS TURNING 45
4:1
BOOMERS TURNING 65
3:1
BOOMERS TURNING 80
D. Redfoot, L. Feinberg, and A. Houser, The Aging of the Baby Boom and the Growing Care Gap: A Look at Future Declines in the Availability of Family Caregivers (Washington, D.C.: AARP Public Policy Institute, August 2013). www.aarp.org/research/ppi.
2
3
4
5
1 6 7
1. 2. 3. 4. 5. 6. 7.
HEAVERS COURT CARE HOME CROYDON, U.K. DEDEI AMSTERDAM, THE NETHERLANDS DE HOGEWEYK WEESP, THE NETHERLANDS SONNWEID WETZIKON, SWITZERLAND SENIORENHEIM BAD SANTIBLICK WALDSTATT, SWITZERLAND HAUS AN DER LUTZ LUDESCH, AUSTRIA HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Photo by Alex MacLean ©2015 MKM | 10
HEAVERS COURT CARE HOME CROYDON, U.K.
Neighborhoods of 10 Dementia Care Large, protected courtyard Very residential Kitchen opens to courtyard ©2015 MKM | 11
HEAVERS COURT CARE HOME CROYDON, U.K.
Location set a block off the main road, within 2 blocks of train. ©2015 MKM | 12
Courtyard
Neighborhood
Neighborhood
Neighborhood Kitchen
Admin./Adult Day Care
HEAVERS COURT CARE HOME CROYDON, U.K.
Living/Dining in middle of household, stairs exit into protected courtyard.
Photo by Alex MacLean ©2015 MKM | 13
HEAVERS COURT CARE HOME CROYDON, U.K.
Nice balcony at corner of households, not used due to poor staff visibility ©2015 MKM | 14
HEAVERS COURT CARE HOME CROYDON, U.K.
Day room overlooking courtyard, central to neighborhood, short walking distances. ©2015 MKM | 15
HEAVERS COURT CARE HOME CROYDON, U.K.
Neighborhood dining across hall from day room, views to perimeter of property. ©2015 MKM | 16
HEAVERS COURT CARE HOME CROYDON, U.K.
Neighborhood kitchen, unprotected. ©2015 MKM | 17
HEAVERS COURT CARE HOME CROYDON, U.K.
Very, very, narrow hallways.
©2015 MKM | 18
HEAVERS COURT CARE HOME CROYDON, U.K.
“European” bathrooms are difficult to control the water, even in Europe. ©2015 MKM | 19
HEAVERS COURT CARE HOME CROYDON, U.K.
Courtyard.
©2015 MKM | 20
HEAVERS COURT CARE HOME CROYDON, U.K.
Courtyard allows for staff and residents to create their own groupings. ©2015 MKM | 21
HEAVERS COURT CARE HOME CROYDON, U.K.
Main kitchen opens up to courtyard, although never serves events. ©2015 MKM | 22
HEAVERS COURT CARE HOME CROYDON, U.K.
Architectural features are meaningless if upper management doesn’t instill culture to use as planned. ©2015 MKM | 23
DEDEI AMSTERDAM, THE NETHERLANDS
Large Campus serves many (4) floors of 6 residents Floor manager, + 2 nurses serving 4 floors Universal care-givers. First floor restaurant and store ©2015 MKM | 24
DEDEI AMSTERDAM, THE NETHERLANDS
Patio
Great Room
Hall
1
2
5
6
Apt.
Support 3
4
Apt. 6-resident household, short distances for staff and residents. ©2015 MKM | 25
DEDEI AMSTERDAM, THE NETHERLANDS
Central outdoor gathering.
©2015 MKM | 26
DEDEI AMSTERDAM, THE NETHERLANDS
Common hallway, storage cabinets, translucent stairs. ©2015 MKM | 27
DEDEI AMSTERDAM, THE NETHERLANDS
Hallway storage.
©2015 MKM | 28
DEDEI AMSTERDAM, THE NETHERLANDS
Great room. Staff just finished grocery shipping. ©2015 MKM | 29
DEDEI AMSTERDAM, THE NETHERLANDS
Common living space.
©2015 MKM | 30
DEDEI AMSTERDAM, THE NETHERLANDS
Common living space.
©2015 MKM | 31
DEDEI AMSTERDAM, THE NETHERLANDS
Integrated cabinetry.
©2015 MKM | 32
DEDEI AMSTERDAM, THE NETHERLANDS
Each level has an outdoor patio connected to the great room. ©2015 MKM | 33
DEDEI AMSTERDAM, THE NETHERLANDS
Resident room.
©2015 MKM | 34
DEDEI AMSTERDAM, THE NETHERLANDS
European bath.
©2015 MKM | 35
DEDEI AMSTERDAM, THE NETHERLANDS
European bath.
©2015 MKM | 36
DE HOGEWEYK WEESP, THE NETHERLANDS
“Dementia Village” includes store, restaurant, theatre, bar, etc. Secure perimeter 7 lifestyles to choose from (homey, upper class, traditional, Christian, indonesian, cultural, urban) Residents cook, laundry, shop, etc. Choose activity for free, pay for extras Motion sensors at common doors, elevators, etc. ©2015 MKM | 37
DE HOGEWEYK WEESP, THE NETHERLANDS
Theater
Admin
Common
Entry Mall
Campus plan.
Household ©2015 MKM | 38
DE HOGEWEYK WEESP, THE NETHERLANDS
Interconnected courtyards, protected. ©2015 MKM | 39
DE HOGEWEYK WEESP, THE NETHERLANDS
Courtyard overview from upper level. ©2015 MKM | 40
DE HOGEWEYK WEESP, THE NETHERLANDS
Courtyard variations.
©2015 MKM | 41
DE HOGEWEYK WEESP, THE NETHERLANDS
Courtyard variations.
©2015 MKM | 42
DE HOGEWEYK WEESP, THE NETHERLANDS
Courtyard variations.
©2015 MKM | 43
DE HOGEWEYK WEESP, THE NETHERLANDS
Civic commons, includes grocery, restaurant, pub, retail. ©2015 MKM | 44
DE HOGEWEYK WEESP, THE NETHERLANDS
Grocery shopping.
©2015 MKM | 45
DE HOGEWEYK WEESP, THE NETHERLANDS
Restaurant.
©2015 MKM | 46
DE HOGEWEYK WEESP, THE NETHERLANDS
Restaurant.
©2015 MKM | 47
DE HOGEWEYK WEESP, THE NETHERLANDS
Household commons.
©2015 MKM | 48
DE HOGEWEYK WEESP, THE NETHERLANDS
Household commons.
©2015 MKM | 49
DE HOGEWEYK WEESP, THE NETHERLANDS
Resident room.
©2015 MKM | 50
DE HOGEWEYK WEESP, THE NETHERLANDS
Shared bathroom serves 3 bedrooms. ©2015 MKM | 51
DE HOGEWEYK WEESP, THE NETHERLANDS
Physical therapy.
©2015 MKM | 52
DE HOGEWEYK WEESP, THE NETHERLANDS
Civic courtyard. Theater entrance. ©2015 MKM | 53
DE HOGEWEYK WEESP, THE NETHERLANDS
Theater Lobby.
©2015 MKM | 54
DE HOGEWEYK WEESP, THE NETHERLANDS
Theater and multi-use room.
©2015 MKM | 55
SONNWEID WETZIKON, SWITZERLAND
Silence important – caregivers trained, sound control in rooms Staffing Ratio – 1:3 daytime, 1:50 night Wrap around porches Circadian lighting (no results) “Care Oasis” – 6-9 resident ward, live longer, less life support, not being alone. Public vs. Private. ©2015 MKM | 56
SONNWEID WETZIKON, SWITZERLAND
Room of silence, each resident creates 2 figures, one stays in building, other to family. ©2015 MKM | 57
SONNWEID WETZIKON, SWITZERLAND
Room of silence, each resident creates 2 figures, one stays in building, other to family. ©2015 MKM | 58
SONNWEID WETZIKON, SWITZERLAND
Central ramp connects floors, sound of water echo’s throughout the building. ©2015 MKM | 59
SONNWEID WETZIKON, SWITZERLAND
Central ramp connects floors, sound of water echo’s throughout the building. ©2015 MKM | 60
SONNWEID WETZIKON, SWITZERLAND
Cozy visiting space allows for private conversations. What happens when others follow? ©2015 MKM | 61
SONNWEID WETZIKON, SWITZERLAND
Shared resident rooms are served by (2) toilet rooms in hallway vestibule. ©2015 MKM | 62
SONNWEID WETZIKON, SWITZERLAND
Shared resident rooms are served by (2) toilet rooms in hallway vestibule. ©2015 MKM | 63
SONNWEID WETZIKON, SWITZERLAND
Shared resident rooms are served by (2) toilet rooms in hallway vestibule. ©2015 MKM | 64
SONNWEID WETZIKON, SWITZERLAND
Common dining, lighting system intended to benefit circadian rhythms (no results). ©2015 MKM | 65
SONNWEID WETZIKON, SWITZERLAND
Wrap-around porch opens to dining room. ©2015 MKM | 66
SONNWEID WETZIKON, SWITZERLAND
Care Oasis: Private bed space with blinds, kitchen, therapeutic space, access to outdoor. ©2015 MKM | 67
SONNWEID WETZIKON, SWITZERLAND
Care Oasis: Improved nutrition. Improved alertness. Increased frequency of interaction. Improved relaxation and sleep. Reduction of challenging behavior. ©2015 MKM | 68
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Adaptive re-use of 200 year old historic hotel Community restaurant Traditional nursing home integrated with dementia Wood part of local culture/reputation Exterior landscape without barriers 3d wander sensors ©2015 MKM | 69
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Adaptive re-use of 200 year old historic hotel Community restaurant Traditional nursing home integrated with dementia Wood part of local culture/reputation Exterior landscape without barriers 3d wander sensors ©2015 MKM | 70
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Floor plan
©2015 MKM | 71
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Entrance lobby divides new from old, frames view of mountains beyond. ©2015 MKM | 72
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Entrance lobby divides new from old, frames view of mountains beyond. ©2015 MKM | 73
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Historic structure becomes village asset, image of restaurant. ©2015 MKM | 74
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Wood structure reflects heritage of village craftsman. Attic local museum. ©2015 MKM | 75
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Wood structure reflects heritage of village craftsman. ©2015 MKM | 76
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Wood structure reflects heritage of village craftsman. ©2015 MKM | 77
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Wood structure reflects heritage of village craftsman. ©2015 MKM | 78
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Borrowed daylight illuminates bathroom. ©2015 MKM | 79
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Borrowed daylight illuminates bathroom. ©2015 MKM | 80
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Wood structure reflects heritage of village craftsman. ©2015 MKM | 81
SENIORENHEIM BAD SANTIBLICK WALDSTAT, SWITZERLAND
Addition with historic structure in background. ©2015 MKM | 82
HAUS AN DER LUTZ LUDESCH, AUSTRIA
Preserved historic building (AL) Administrator change, “tough to staff bldg.” Day care first floor Community Space Public restaurant Motion sensors for lighting, everywhere ©2015 MKM | 83
HAUS AN DER LUTZ LUDESCH, AUSTRIA
2nd floor plan.
©2015 MKM | 84
HAUS AN DER LUTZ LUDESCH, AUSTRIA
Marketplace connection to historic building - converted to assisted living. ©2015 MKM | 85
HAUS AN DER LUTZ LUDESCH, AUSTRIA
First floor child day-care adjacent to front door, community room. ©2015 MKM | 86
HAUS AN DER LUTZ LUDESCH, AUSTRIA
Daylit central core, staff work area provides colorful floor identifier. ©2015 MKM | 87
HAUS AN DER LUTZ LUDESCH, AUSTRIA
“Marketplace provides resident social space and connection to existing building. ©2015 MKM | 88
HAUS AN DER LUTZ LUDESCH, AUSTRIA
“Marketplace provides resident social space and connection to existing building. ©2015 MKM | 89
HAUS AN DER LUTZ LUDESCH, AUSTRIA
View of common courtyard from marketplace. ©2015 MKM | 90
HAUS AN DER LUTZ LUDESCH, AUSTRIA
Elevated water feature mimics plan of area river, allows for residents to get wet. ©2015 MKM | 91
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Serves all ages, severe need for care Day care on first floor Inclusion Individual balconies not used Large, shared balconies used including gardening and sun shades. Transparency Invites levels of social engagement. ©2015 MKM | 92
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Resident room hallway transparency Invites privacy, levels of social engagement. ©2015 MKM | 93
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Transparency Invites levels of social engagement. ©2015 MKM | 94
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Transparency Invites levels of social engagement. ©2015 MKM | 95
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Community physician waiting room. ©2015 MKM | 96
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Exterior, floor, and wall concrete same mix, different texture. ©2015 MKM | 97
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Grand balcony invites resident and activities outside. ©2015 MKM | 98
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Grand balcony invites resident and activities outside, automated sun control. ©2015 MKM | 99
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Expansive patio overlooks school and church yard. ©2015 MKM | 100
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Expansive patio overlooks school and church yard. ©2015 MKM | 101
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Building separation provides protected space for day-care children to play. ©2015 MKM | 102
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Building separation provides protected space for day-care children to play, protected. ©2015 MKM | 103
HAUS DER GENERATIONEN GOTZIS, AUSTRIA
Distorted grab bar enables some residents to pull themselves close to mirror. ©2015 MKM | 104
KEY LEARNINGS, PROCESS IMPROVEMENTS AND TAKE-AWAYS It is difficult to compare building models with those common to the United States without considering the different funding strategies. Each facility toured had a distinct “philosophy” of care, and all were different from one another. All buildings presented were integrated socially into the village that they served. Most contained shared community assets. European models were different, not necessarily better. Many of the residents cared for would not meet the requirements of US government support. Dodd Kattman, AIA, Partner MKM architecture + design Environments for Aging 2015 Baltimore, MD April 20, 2015
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