Life-Span Design of Residential Environments for an Aging Population

Design Principles and Research Issues in Housing for the Elderly

Victor Regnier, A.I.A.,
Associate Professor Schools of Architecture and
Gerontology Andrus Gerontology Center
University of Southern California

Research aging and environments is varied. It ran from theory-based behavioral sickness constructs, which measure the transactional relationships between the person and the environment, to applied design research, which identifies critical attributes of the environment through checklists and illustrations that specify good practice solutions for architects and design decision makers. In a review article, M. Lawton, Altman, and J. Wohlwill describe four "orientations" that characterize the bulk of research concerned with this very broad and diverse set of topics:

orientation to place
orientation to design
orientation to social and psychological processes
orientation to environmental policy.

Implicit in these four constructs is the recognition that research is often formulated to address differing aspects of the person-environment relationship.

Place-oriented research focuses on attributes of group settings, such as retirement communities, nursing homes, congregate housing projects, and senior centers, where the behavior of older individuals is influenced by the social characteristics of a collective group of users as well as by the physical environment. Research here often addresses how the setting influences activities and behavior.

Design-oriented research focuses on the role the built environment plays in supporting, modifying, or denying the social and physical needs of older persons. This includes the "microenvironment," which involves materials, textures, equipment, furnishings, and colors-environmental attributes that make the setting legible and manipulatable. It also can include larger-scale physical design attributes such as a site plan, the location and configuration of common facilities, and unit designs that can encourage social exchange or supply opportunities for privacy.

Research oriented to social and psychological processes involves a fundamental commitment to understanding the theoretical basis for person-environment interactions by extending traditional social and behavioral science constructs to include measures of the physical environment. The best attempts in this arena have been toward creating mega theories that view the environment and its impact on the individual as having a number of interactive components.

Research oriented to environmental policy involves a relatively new way of assessing the environment that implies a relationship between the environment and public policy. Such policy can be imbedded in local zoning codes, state financing and regulatory requirements, guidelines of the Department of Housing and Urban Development, and national fire/life safety codes. This aspect of environmental assessment is becoming more important as we go about establishing local/state/federal requirements to direct the design of purpose-built environments and clarify how social and health service programs for older people can or should be implemented in community housing.

Reviewing the literature in these four domains is a formidable task. Although all four orientations examine the relationships between the person and the environment, they do it in ways that have different and far-reaching impacts on theory and practice in a range of academic and professional disciplines. Literature that has the highest utility for design decision makers is that which reduces the complexity of this topic to a set of preferred practices. Such publications often use empirical research as the basis for practice suggestions, but when empiricism and theory are not adequate to resolve knowledge gaps, problem-solving techniques and reference to traditional, time-tested solutions are used. Together, these information sources define a range of solutions that can be pursued to resolve the problem at hand.

Theory-based Research

Although behavioral science research has moved toward applied environmental assessments, a considerable gap still exists between theory and application. The work of E. Kahana has attempted to link attributes of the environment with personal attributes of the individual to arrive at a fit between the two. Rudolph Moos and S. Lemke have created the multiphasic environmental assessment procedure, which characterizes the attributes of varying environments so that one can understand how residents are affected by the organizational, program, and design differences of these settings.

F.Carp and A. Carp, M. Powell Lawton, and Stephen Golant have embraced the idea of creating mega theories that link a number of different measurement strategies together. These involve multidimensional assessments of the objective environment; personal characteristics of users; and mediating variables such as past personal life events, the social support network, and the perceived competence of the individual.

Design-based Research

Design research, as represented in the writings that provide advice to architects, focuses on issues of relevance to designers who must make decisions in the process of specifying new environments. Rarely do these publications provide a theoretical framework for understanding the relationship between the qualities and characteristics of the older person and the environment. Instead, they are written to conform to various aspects of the design process.

For example, many of these publications choose to organize information by room or type of space. This approach is popular because it links information directly to the architectural programming process. Programming (especially behavior based programming) establishes design and management criteria for specific spaces. In a program, each space is recognized to have differing requirements based on its need to support various types of activities and various user groups (management, residents, maintenance personnel, etc.).

Another information-organizing approach uses a pathological model of decreasing competency to suggest differences in design that are keyed to the changing competencies of the individual. This approach is often directed toward maximizing independence. In the publications that espouse this approach, physiological and anthropometric criteria create the basis for original designs and design adaptations to the environment; design is driven by the need to fit environments to the changing physiological requirements of older people.

In other work, concepts like privacy and community are used to note how design considerations change in different settings. In Low-Rise Housing for Older People, John Zeisel and colleagues partition low-rise housing into 6 domains and 20 subdomains that start with the scale of the unit and end with broader-based site design considerations. In their book, the design of the unit (private) and the domain of community-oriented spaces (public) are arrayed in an order that facilitates a match between specific environmental situations and the most critical design criteria for this setting.

When dealing with service-rich environments where management plays an increasingly important role, some guidelines have conceptualized the environment as having an equally strong social and organizational component. U. Cohen and colleagues have developed their work in this way, recognizing the strong linkages that exist between the physical environment, staff/therapists, and family members which are necessary to create successful settings for Alzheimer's victims. The National Association Of Home Builders, Rosetta E. Parker, M. Powell Lawton, and B. Chambliss have conceptualized design as a component of planning and management. In their writings, the environment is a tool to be creatively managed by staff as well as a supportive setting for older residents. Their work relies on an integrative model that views maintenance, neighborhood orientation, scheduled activities, supportive services, and management philosophy as interrelated aspects of the holistic setting we refer to as "housing for the elderly.

Other researchers have used case studies to establish the conceptual basis for design directives that recognize the relationship between patterns of resident activity and the ability of the environment to support that activity. Sandra Howell has used case study observations to determine the powerful effects of building circulation patterns on the stimulation of social activity. She identifies the concepts of "previewing" and "offensive surveillance" as environment-associated behavioral outcomes that deal with circulation in different ways. Joseph Koncelik has used circulation studies similarly in nursing homes to identify areas that have been over- and underdesigned. His recommendations focus on an array of topics from building organization to furniture design. David Hoglund has used case studies of European housing projects to identify environmental attributes from other cultures that have application to practice in the United States. And Diane Carstens, U. Cohen et al., and this author have used case studies to establish recommendations for practice. In their work, a collection of case studies has become the empirical basis for arriving at a set of comprehensive guidelines.

Still other researchers have compiled guidelines to conform with the process of design and development. This often involves presenting design decisions at various stages of the development process in the set of choices that narrow and specify the direction for the next set of decisions. These choices are often organized in a general-to-specific format that follows a project from initial feasibility to site acquisition to postoccupancy evaluation.

Each of these approaches has its advantages and disadvantages. Most are successful because they conform to the design and development process by providing conceptual guidance and specific information in a timely fashion that supports the decision making process. Yet one of the major problems the publications share is a weak and non-inclusive foundation of theoretical or conceptual considerations. Some guidelines are more successful in articulating the conceptual basis for their organization. Margaret Calkins focuses on "environment and behavior issues" and Cohen et al. cite "therapeutic goals" in their work as it relates to the design of facilities for patients with Alzheimer's disease.

Twelve Environment ans Behavior Principles

Rarely, however, is a set of comprehensive principles provided to justify a research and practice framework. The remainder of this paper attempts to provide just such a framework by identifying 12 principles that characterize a basic set of broad-based conceptual considerations. Such considerations are often of value to theorists interested in identifying the qualities of environments that influence the behavior of older people.

Basic interest in these concepts grew out of a summary chapter written for the book Housing the Aged. That chapter identified six design themes and six policy themes that emerged throughout the book in the work of several different investigators who had conducted independent, unrelated research in the area of aging and environments. More recently, this work has focused on environmental attributes that affect older people in assisted care settings and in their home environment.

The following list of principles originally comprised 20 themes, which were narrowed to a core group of. Again, these seem to capture the range of considerations that characterize person-environment transactions for design decision makers. Some principles are more appropriate for the frail and for those living in settings that have a strong organizational or management component. Others are more timeless and universal in their application, reflecting considerations that many different populations consider relevant in their housing. Many principles overlap and some represent polar opposites; for example, social interaction and privacy can be viewed as two ends of a continuum just as safety/security and challenge can be similarly arrayed. Most important, the list is incomplete: clearly, subdomains exist that are not identified, and many other considerations are not represented on this list. Nevertheless, these principles and the rationales behind them can help order priorities and identify weaknesses in a proposed design. Thus, they might be examined as an integral part of research focused on specific environments.

1.Privacy: To provide for places of seclusion where one can be free from other people, observation, and unauthorized intrusion.

Privacy, such as having one's own bedroom or study where one can be undisturbed, provides a sense of self and separateness from others.

2.Social Interaction: To provide opportunities for social exchange and interaction.

Social interaction can be therapeutic, allowing the older person to share problems, feelings, life experiences, and everyday events with someone who also benefits from the exchange. Retirement communities and housing projects for elderly people have been developed in part on the attractiveness of this single attribute.

3.Control/Choice/Autonomy: To promote opportunities for residents to make choices, control events, and influence outcomes.

Older persons are more alienated, less satisfied, and more task dependent in settings that are highly constrained. On the other hand, older people are enhanced by settings that offer them real or perceived control and promote a sense of competency.

4.Orientation/Wayfinding: To foster a sense of orientation within the environment that reduces confusion and facilitates wayfinding.

Feeling lost or disoriented within an environment is a frustrating and frightening experience that can affect a person's sense of competency and well-being. Larger-scale housing environments often rely on long, winding, double-loaded corridors that can exacerbate feelings of disorientation. Older people who have experienced some memory loss have the greatest need for an environment that is easy to comprehend.

5.Safety/Security: To provide an environment that ensures that each user will sustain no harm, injury, or undue risk.

Elderly people experience not only a high rate of accidents but also more than twice the number of resulting deaths compared with other age groups. The most serious accident related problems result from falls and burns.

6.Accessibility/Manipulation: To consider accessibility and the ability to manipulate as basic requirements for any functional environment.

Reach capacity and muscle strength impairments can affect stooping, bending, sitting, and standing. Thus, older people often have problems manipulating controls (windows,doors, heating, ventilation, air conditioning equipment, and appliances) due in part to chronic disabling diseases such as arthritis. Amputation also becomes a problem for those who have difficulty getting from place to place and may require frequent rest.

7.Stimulation/Challenge: To provide a stimulating environment that is safe but challenging.

A stimulating environment will keep the older person active, alert, and aware. It is especially important for combating boredom, a common problem of persons with mobility impairments.

8. Sensory Aspects: To make environments account for changes in visual, auditory, and olfactory senses.

Older people with normal age-related problems often experience problems with vision and hearing that can place them at a disadvantage in the environment. Environmental conditions that involve high levels of sound and low levels of light hinder older people's socialization and jeopardize their safe manipulation of the environment.

9.Familiarity: To ensure that environment design solutions that are rich in historical reference and influenced by tradition can provide a sense of familiarity and continuing.

For some older people, moving from one setting to another can be disconcerting, especially when there is little continuity between the settings. Bringing personal objects and possessions that constitute a familiar frame of reference is one way to create continuity. The environment should also constitute a familiar frame of reference. provide a sense of familiarity and continuing. Integration For some older people, moving from one setting to another can be disconcerting, especially when there is little continuity between the settings. Bringing personal objects and possessions that constitute a familiar frame of reference is one way to create continuity. The environment should also constitute a familiar frame of reference.

Directions for Future Research

Integration of Research and Design Activities

Although these principles can be used to guide creativity in the design of new and experimental buildings, there is an equal need to promote theory development along with the direct testing of new design ideas. We should develop techniques like those espoused by John Zeisel in his book Inquiry By Design, one of which involves annotating plans with environment-behavior hypotheses to test design assumptions through post-occupancy evaluation. Such techniques allow theory-based researchers with a behavioral science perspective to use the design development process in actively testing ideas. Their results provide feedback on the practical adequacy of the design as well as adding to the general knowledge of human behavior within planned environments.

In addition, we clearly need experimental programs that allow us to control and adjust surroundings and test less expensive forms of supportive housing and nursing environments. Several new ideas and social policies regarding service delivery have already been tested in the last few years in an effort to avoid having to move individuals into institutions, which continue to appear more as places for patients to die than as truly humane places for them to live. Among our greatest obstacles to this, however, are harsh or overly restrictive building codes and regulations that constrain efforts to make housing for the elderly more accommodating. Many of the life/safety and fire codes that currently exist, for example, do so at the expense of providing variety and uniqueness to the setting. In fact, many designers would argue that increasingly restrictive codes and cautious attitudes on the part of local/state/ federal regulatory agencies have reduced or eliminated countless opportunities to humanize supportive environments.

The Museum of Contemporary Art in Los Angeles recently hosted an exhibition of "Arts and Architecture" magazine's Case Study Program, initiated in 1945 by the editor of this forward-thinking 21 This program, fully encouraged 28 houses to be designed during a 22-year period, provided a vehicle for the ideas of 30 designers in three-dimensional test cases. It had a major impact on the development of post-World War II Los Angeles housing stock and, through its example, affected architects and developers throughout the United States. We need a similar type of program today that, through federal and state participation, can unleash the potential for creative application in designed settings.

Universal Design

We should also focus on the issue of universal design as a way to program supportive characteristics into the environment. Not only should the setting be able to change and adjust in relationship to the needs of the resident, but characteristics that make housing safer for all groups (children/physically handicapped/developmentally disabled) should be programmed into the environment as standard features.

Participation and Market Measurements

Another promising aspect of the design process is the participation of older people in the reviewing and critiquing of design ideas. Some of the above mentioned techniques have been extensively tested in the market analysis of upper-income housing for seniors. In these settings, we often have excellent data describing the changing needs and preferences of a newly emerging cohort of older people. Combining this data with participatory design techniques can underscore important attributes of senior housing. We need to explore new methods for eliciting consumer opinions that challenge design decisions and provoke new design ideas. Older people cannot be expected to design a space but can often help in making informed judgments about the utility of various amenities, services, or architectural features or can share their ideas about the meaning of environments.

The Essence of Good Design

Finally, criteria should be established that embrace a broader set of goals when a building is designed. We need to ask questions about how design requirements are being met, but we must also continue to recognize that not all of what is necessary for good design is defined by guidelines that link design to function and activity-based criteria. The Roman architect Vitruvius said it best hundreds of years ago when he defined the essence of architecture as commodity, firmness, and delight. If we follow the appropriate functional criteria, we should master commodity, and firmness is virtually guaranteed through building codes and regulation. Delight, on the other hand, is one of the truly intangible aspects of design that we must not allow ourselves to overlook.

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