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How architectural design affords experiences of freedom in residential care for older people

Originally Published:
2017
Key Point Summary
Key Point Summary Author(s):
Dickey, Andrew
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Key Concepts/Context

As the global population of elderly humans increases, healthcare providers working in long-term care facilities have focused more on how certain social and physical design elements can help promote higher quality care. Previous studies have shown that providing certain degrees of freedom to elderly patients living in long-term care facilities can result in positive health outcomes; however, a deeper understanding of how and why these degrees of freedom influence patient well-being is needed.

Objectives

To understand how degrees of freedom influence overall patient and caregiver well-being in a newly constructed elderly care facility.

Methods

This study took place in a newly constructed elderly care facility. The facility’s designers incorporated modern research recommendations into the overall architecture, including well-lit individual dwelling areas situated around an open patio featuring private bathrooms and sitting areas. Seven patients and seven caregivers were interviewed regarding their perspectives on the facility’s design and their overall experiences with facility usage. After all interviews and field observations were complete, all data were analyzed using NVivo11 software.

Design Implications
Designers might consider how elderly care facilities could be built to emphasize social connectivity and freedom of movement among patients and caregivers while still maintaining necessary safety precautions. Providing private patient rooms and bathrooms (where possible) could provide patients with a balance between privacy and social interaction. Communal kitchens and “hobby areas” can help promote a sense of “hominess” among both patients and caregivers.
Findings

Primary themes derived from data analysis included: overall resident and caregiver experiences, degrees of freedom, elements of co-living, the role of architectural designs, small-scale areas being balanced with generous space, and general levels of accessibility. In relation to architectural designs, residents expressed that freedom of movement within the facility was the most important factor. The newly constructed facility observed in this study featured a more “open” and “accessible” environment which helped residents feel safe and free while allowing caregivers enough room to provide high-quality care. Having access to voluntary social programs within the facility further enhanced the residents’ sense of freedom and overall perception of the facility’s design.

Limitations

This study took place in a single healthcare facility that featured specific, unique designs. While the patient and caregiver perceptions of this facility may help inform design decisions in other facilities, these results may not be universally applicable to all residential care environments. A relatively small group of individuals were interviewed in this study (seven caregivers and seven patients).

Key Point Summary Author(s):
Dickey, Andrew
Primary Author
Van Steenwinkel, I.