This concept holds considerable promise for developing age-integrated, comprehensive village communities that can serve the special housing needs of older persons. Its success will depend on experience and evaluation of its affordability and responsiveness to users' needs.
Marriott Corporation's "Kit of Parts"
Another example of a housing solution for older people is the "Kit of Parts" for designing buildings, as developed by Marriott Senior Living Services for its new residential developments for retirees. This design approach, described by William K. Glass at the conference, could provide a model for other providers. In laying the groundwork for the evolution of the Marriott approach, Glass notes that designers need long time periods to carry out projects because many layers of government regulation and zoning restrictions cause delays. Most multi-unit residential projects proceed one at a time, resulting in high project design fees.
Standardization Feature of Kit
The idea of the Kit of Parts is to make building components that are as interchangeable as a set of Lego blocks. With the use of computer-aided design, the residential complexes can be adapted to different sites and to variances in building exteriors, roofing materials, and other elements required from one region to another. In this manner, fitting the site to the building (i.e., the "site-adapt" approach) is as much a factor as fitting the building to the site. Glass says the strength of the Kit of Parts lies in the repeated use of the same basic architectural design, operating procedures, and management concepts, all of which serve to reduce construction costs. The Kit of Parts approach is based on standardization of operations, processes, and budgets. As a profit-making venture, Marriott Corporation developed this strategy in response to the constraints of the "development triangle": cost, time, and quality. Regulatory processes are woven into the procedures, although these factors are the least controllable in terms of time and cost.
The Kit of Parts uses a "prototypical" method that includes:
The type of standardized but adaptable processes embodied in the Kit of Parts allows for more competitive pricing, including opportunities for national contracts. The computer-aided design permits meticulous calculation of material quantities per part and per site. Moreover, the Kit of Parts concept does not greatly restrict site selection, largely due to the inherent flexibility of the design process.
The overall concept, which has been used in Marriott Corporation's first assisted-living retirement complexes, may not fully address all the residential needs within the older population especially as the original residents age. Marriott's experiences may lead to more components in the kit that will respond to this wide variety of design and service needs.
It will be important to monitor the progress and evolution of the Swensson and Marriott projects. The outcomes could be compared with those of Ten Kerselaere. Post-occupancy evaluations of the Synergenial Suburban Village and Kit of Parts approaches to elderly housing development will provide data on how those concepts meet the varied needs of a heterogeneous older population.
The cost-saving features of the Synergenial Suburban Village and the Kit of Parts were of keen interest to conference participants. They expressed concern about escalating costs attributable to federal and local regulations and declining federal subsidies and loans for construction of low- to middle-income housing units.
The most pressing needs are to build low income housing that incorporates new technologies and to retrofit existing housing-especially single family units. Swensson believes that savings could be realized through the use of modular units in construction. Glass advocates the Kit of Parts as a cost effective concept for housing elderly persons. Conference participants' recommendations included:
Health and social service professionals, designers, architects, and national and local officials must focus on the growing number of older people who will need housing in all price ranges, especially low-priced housing. The fundamental need is for efficient and reasonably priced products and designs that can retrofit existing homes to allow people to age in place.
Housing Codes and Regulations
Several speakers discussed the problems created by a lack of common standards for housing codes and regulations in the United States. Codes and regulations vary from state to state and develop over a period of years, with new codes and regulations added on to existing ones. So many exceptions are made, they say, that the design professional must spend excessive amounts of time trying to accommodate all the changes.
Geddis notes a resistance in the housing industry toward innovation in building design, because testing new materials and building components can be time consuming and costly. Even if a major innovation works, it usually cannot be used in a building until local codes have been reviewed and revised to include the changes. The process from initial conception and development to final code adoption is time consuming. Accessibility codes currently require extra space and contradict maximum allowable space standards. This situation will be changing with new regulations under the Americans with Disabilities Act, now being implemented.
Contrasts with Scandinavian Countries
Geddis points out that the Danish Commission on Aging promotes research on product design, encourages appropriate codes, and coordinates housing alternatives for older citizens. The Danish Social Welfare Board's main purposes are to provide 1) general help chore services, 2) home nursing services, 3) day nursing homes, 4) day care centers, 5) modification of homes, and 6) information dissemination.
In Sweden, the National Swedish Institute of Building Research performs quantitative and qualitative investigations in all phases of housing development and design. Also, most Swedish universities include a Department of Building Function Analysis, which carries out evaluations of housing and residential products.
Conference speakers and participants contended that work needed to be done in the United States to develop a unified national-building and health-care code system (i.e., minimum standards) to promote appropriate residential design while reducing complexity and cost.
Business and Industry Advocacy
Business and industry must be persuaded to support product research and promote products based on life-safety principles. Information is needed on the cost effectiveness and how technological applications to the residential environment may mitigate the need for support services.
Older people need to express their needs to product designers and manufacturers. No other group in the population is expected to take the initiative to reach manufacturers. However, there is no clear vehicle for such consumer-based input to occur. Rather, manufacturers conduct the research, surveys, and other sources of information about housing design needs. In doing so, they seem largely unaware of -- or only minimally responsive to -- this fast-growing market.
A RESEARCH AGENDA
Conference speakers and participants agreed on an extensive research agenda to lay the groundwork for improved housing design for the elderly.
The first need is for more research on how individuals perform the tasks of daily living. Victor Regnier contends, for example, that designers need to know more about the movement patterns for performing given tasks, so that they can improve the design of residential environments for older people. Regnier calls for more in-depth studies on how individuals perform these tasks of daily living so that the findings could then be integrated into the design process. He suggests using a technique developed by John Ziesel, which calls for "annotating plans with environment-behavior hypotheses in order to test design assumptions through post-occupancy evaluation" (Ziesel, 1981).
Research on Age-Related Changes
Very often the needs of older users are neglected by designers, because many are not adequately aware of changing needs as clients age. This is a relatively new aspect of design, and design professionals largely have not been trained in this area. Nor has there been sufficient research on the detailed aspects of age-related changes in a wide range of functional capabilities. This specialized expertise is being addressed among professionals with training in both design and gerontology.
However, in order to be thorough in these efforts, human performance testing of intended user groups must be part of the design process. As in other countries, the data collected should be studied for application to housing and products used in the performance of activities of daily living.
Researchers also need to evaluate how prosthetic devices and training affect an older person's ability to adjust to the built environment and to different sensory stimuli. The major limitation of existing research is the lack of specific quantitative data and consequent guidelines related both to age and to specific tasks of daily living. "At present, there is little research or information available on the relationships between individual differences and sensory abilities or aptitudes required in various tasks" (Fozard et al.).
Integrating Design and Behavioral Science
According to Regnier, architects face problems in designing for an aging population because behavioral sciences research has not been integrated with design research to provide a set of comprehensive design principles. A solution to the problem may be continuing education that includes such integration.
Sara Czaja also cites the need for more detailed data on the functional requirements of ADLs, the products used to perform the tasks, and which types of environments are preferred for a given task. This is the performance approach to design, and it requires that 1) a determination of the nature of the user's requirements be made as a prerequisite to designing, and 2) buildings be evaluated after occupancy to determine if requirements are met.
Design of residential products and environments also must be integrated with research on the physiological and cognitive aspects of aging. Anthropometric data on older people must be maintained on a par with that of other age groups. As Levy and Malcolm contend, thinking about what older people cannot do is the wrong approach. Instead, they urge that designers begin with the assumption that many older people suffer only minor disabilities, and thus seek to develop products and designs that simplify and enhance what older people can do. Thus, there is a need to educate people that the environment, not the person, is often the major problem. Designers and planners need to establish criteria by which to evaluate new designs. Designers and planners need to enlighten organizations to examine the demonstrable connections among the costs of long term care, an unsafe environment, and functional health problems.
Because improper use of some products can present safety hazards, evaluation should be carried out and education provided to product users. Post occupancy and product evaluation must be integrated in the design process not only for functional assessment but also for life-safety and security reasons.
The development of better design guidelines for products and a better strategy for disseminating information about existing technology to the public are realistic goals if life-span design is to succeed. In Sweden, the government owns and operates outlets for products that emphasize life-span design principles. In the United States, absent of such outlets, better ways are needed to educate health-care professionals, social workers, and family members about what is available for clients' homes, because many professionals and most consumers are unaware of what their Retrofitting options might be.
Many Unanswered Questions
Levy and Malcolm stress a number of unanswered questions that would affect progress in the design and development of housing for older people. Some promising studies are ongoing. For example, Fozard et al. describe studies that provide pertinent data that design professionals should explore and apply to designing and retrofitting housing interiors and products. We need to effectively demonstrate to insurance companies the connection between a safe old age and a safe residential environment. Federal and state governments also need to find ways of encouraging humane and functional residential environments that are true alternatives to nursing homes.SYNOPSIS
This conference focused on the key question being posed by a wide spectrum of professionals concerned with life-span design for an aging population. How can the disciplines of design, engineering, gerontology, human factors, and architecture support aging in place so that independence, freedom of choice, and life safety are promoted?
Professionals in these fields must address the psychosocial aspects of aging including social integration, leisure activities, privacy, safety, and security to determine how to provide the older person with maximum control, choice, convenience, and safety. All these variables must be considered by a designer. Many conference participants believe a considerable gap exists between behavioral science research findings and their application to residential design. As the Scandinavian examples show us, the responsibility to provide answers cannot be left only to the building and engineering disciplines; it should include the behavioral scientist's input on user needs.
Regnier's presentation uses a basic approach and suggests 12 principles to utilize in design. As we recognize the psychosocial and economic needs of residential environments for elderly people, however, we become aware of the complexity of the problem. An important approach, emphasized in this conference, is to apply system and/or task performance analysis to design issues.
Conference participants discussed the need for a variety of approaches-and shared a variety of design ideas-to address the housing needs of the elderly, beginning with the importance of addressing personal characteristics and concerns, such as privacy and safety. Housing design must be sensitive to sensory changes and other physical characteristics of the aging process. High-tech and low-tech solutions need to be explored for ways they can assist persons to age in place.
Conference participants discussed how corporations, insurance companies, government agencies, and health care organizations all need to contribute ideas and solutions to help older Americans live independently. One outcome of designing an accessible, adaptable environment is that it can benefit to varying degrees of people of all ages. Furthermore, designing products that enable all members of society to function more efficiently saves human energy, an important consideration for caregivers as the aging disabled population increases.
Clearly, manufacturers need to be encouraged to provide products that enable persons to perform a variety of tasks of daily living more efficiently. This in turn will provide designers an opportunity to incorporate these products and design features into both existing and new buildings. If the concept of "life-span design" is encouraged at all levels, products could be mass produced and costs lowered. The idea is similar to car design, in which new models reflect new knowledge, improved technologies, and higher quality. The lack of this developmental approach and awareness among most product designers and manufacturers is reflected in their limited ability to relate future products to the demographics of an aging society. If their vision is thus narrowed, they miss tremendous opportunities to contribute to improving the lives of millions of older Americans.
Architects, interior designers, and graphic, industrial, and product designers must become alert and responsive to technological and Gerontological research that provides new data on the changing needs of a heterogeneous older population. These data must be incorporated into future housing designs for older persons.
Design professionals are challenged now to provide housing and products for a growing elderly-and sometimes disabled-population. The challenge is great because the new designs need to be adaptable, encourage flexibility, be accessible, provide for security and life safety, be easily maintained, and be aesthetically pleasing to individual users and those around them.
As Stewart and Kaufman wisely observe, "The goal of both adaptive, accessible design and healthcare technology is to achieve a higher level of functioning, and the realization that it must be affordable is the challenge of the future in housing the elderly."