When someone enters a room, he or she may take notice of the paint color, the stylish décor, or the accent lighting. If they are in a building designed by SFCS, it is entirely possible they would be scanning over details that have been chosen as a result of endless hours of research. The firm has a strong belief in deeply studying all aspects of senior living environments to create evidence-based designs. In addition to internal research, SFCS collaborates and partners with other industry experts to gather data and feedback. Each investigation brings forward knowledge that is then incorporated into the firm’s architectural planning, design, engineering, and interior design work.
One of the most pressing research topics of late is driven by an effort to find a solution for what SFCS Managing Principal Melissa Pritchard describes as a complete and total societal shift.
“This is not a wave. It’s a reality that is the new normal,” said Pritchard, referring to a notable uptick in the number of senior-aged people and their inability to afford community living. Only five percent of the population is able to benefit from home and community-based services and aging in place.
Less than 5% of the aging population currently lives in, or is able to afford, Life Plan Communities. Projections indicate that while many of these seniors will likely need the level of care provided in seniors housing, over half of seniors will not have adequate financial resources to pay for it.
SFCS’s research and multiple industry studies shows those who live in shared environments are healthier, happier, and, ultimately, live longer. The other 95% are making their way through the beauty and the challenge of aging on their own or with a much more limited support. Much of the displacement is focused on the middle market, where hundreds of thousands of people are unable to afford senior community living.
“This isn’t just a result of the Baby Boomers rolling in,” said Pritchard. “This is a shift in demographics and society that is here to stay. The incoming generation of aging seniors marks a new standard in community living. This societal cohort have been greatly affected by the recession and have made different choices regarding saving and investing.”
SFCS has made it a personal mission to find headway in the creation of long-term, sustainable solutions that make community living affordable for seniors in the middle market. Working closely with several different groups to find a solution, the firm’s research has examined multiple avenues, exploring everything from environment and housing to business models and operations. The goal is to develop a variety of solutions which help provide the support and benefits found in full-service Life Plan Communities all at a lower price point that meet a much greater portion of the senior population’s financial resources.
SFCS has explored various subjects related to affordable assisted living with Dr. Margaret Calkins, a nationally recognized leader, trainer, and researcher in the field of environments for elders. Additional environmental feedback has come from several small teams who are exploring various aspects of affordability. This includes diving into the possibility of cutting down the costs of independent living homes through prefabricated options, standardized designs, and construction using bulk materials. Another SFCS team has researched beyond the physical building’s design to study business models that explored the costs of building new homes, repurposing existing structures, and everything in between. Pritchard is leading a session at our 35th Annual By Design Conference that focuses on SFCS’s research to date and shares insights and ideas discovered through visiting and interviewing multiple organizations who are attempting to tackle this challenge.
SFCS’s research in affordability was directly incorporated into their Cooperative Living House design at Garden Spot Village in New Holland, Pennsylvania. The award-winning design is just the beginning of a long run in overcoming the affordability challenge.
“Right now, our main focus is to just make progress,” said Pritchard. “This is a multi-faceted issue that affects hundreds of thousands of people in all ranges of need. It’s not just independent living; it’s not just assisted living; it’s not just cottages. There will never be a single answer because there are many answers. The industry just has to start coming up with some.”
Some of the most impactful solutions in memory care designs by SFCS have spawned from the first-hand experiences of the team. Two first-hand experiential research initiatives were conducted by SFCS. In the “Living a Skilled Life” project, a team from the firm conducted multiple 24-hour overnight stays in skilled nursing homes across the country. Each team member was admitted with typical admitting diagnoses, strokes, mobility issues, vision challenges, etc. and lived with those challenges during the stays. In the “Dementia Diaries” project, they again conducted multiple overnight stays in memory care environments with virtually applied dementia.
Enter Dr. Addie Abushousheh, a gerontologist, researcher, and consultant for organizational and environmental development in long-term care. Dr. Abushousheh helped design the experiment where SFCS leaders were living with virtually-applied dementia. Using her expertise in architecture, organizational development, aging, and applied research, Dr. Aboshousheh developed the protocol, the devices, and the observation as well as testing before and after the experiment.
The experiences had a direct impact on some of the firm’s most notable memory care designs, including Brookside at Cross Keys Village in New Oxford, Pennsylvania and Cypress Cove in Ft. Myers, Florida. The projects marked a milestone in memory care as they were designed to specifically improve the lives and to help manage and offset the challenges that residents face who are living with Alzheimer’s disease and other dementia-related conditions.
For instance, residents living with these disorders often find their internal circadian rhythms and wake sleep cycle are disrupted. Research indicates that the exposure to a supplemental lighting system can help residents maintain synchronization with the solar day. SFCS worked that concept into the lighting of common areas at Cypress Cove’s memory support building, “The Cottage”. It’s the first purpose-built dementia environment in the world to utilize the technology. The use of circadian lighting schemes are specifically designed to help residents sleep through the night. The results have been astounding.
“It’s making a difference,” said Pritchard. “In the first two years, there were no nighttime bathroom falls with cognitively-impaired residents. So, it’s really improved their quality of life and, frankly, the care provided by the staff.”
Overcoming Staffing Challenges
Staffing challenges may not fall directly under the umbrella of architecture, engineering, and interior design, but SFCS finds a great deal of their senior living clients need help with recruiting and retaining employees. The firm is answering the call by researching what it takes to find and keep adequate staffing.
The firm has conducted ongoing research in the area of employment by pulling together teams that are known for developing unique approaches to improve the status of staffing, consulting with Donna Cutting, an organizational coach who focuses on recruiting and retention, and conducting explorations internally by combing through both recent data and long-standing literature.
SFCS also spends a great amount of time exploring the use of technology aimed at seniors living both at home and in a community setting. The senior technology industry is bifurcated with a significant portion of the product development focused on in-home use, and a smaller but growing portion focused on enterprise level options appropriate for incorporation into larger scale senior living communities. These technologies can either be a differentiator and competitive edge to senior living providers, or it can be perceived as a competitor and a disruptor, with solutions that are rapidly developing and new products which are aimed at supporting seniors staying at home rather than moving to senior living communities.
“Things like fall sensors, accessibility apps, social support networks, smart home and other technologies are marketed to seniors constantly,” said Pritchard. “While that’s something senior living providers can be apprehensive about incorporating, it’s something we try to look at as an opportunity. Technology may be intimidating at times, but it’s a part of today’s fabric of life and is an expectation of all society, including seniors.”
From a research perspective, SFCS believes every project is an opportunity to learn and grow. Even after a building or community is completed, the firm conducts post-occupancy evaluations (POE) to garner feedback from residents and staff. The responses give the team at SFCS new perspectives that could potentially benefit clients moving forward.
On one project, the client asked SFCS to design designated areas for staff members in the bedroom and living areas. The idea was to decrease travel time between rooms and overlapping care by having one staff member stationed within reach of 8-10 adjacent residents. As a result, SFCS incorporated specialty “staff touchdown stations” designed around the specific workflows of the caregivers. During the POE process, SFCS learned the employees weren’t utilizing the spaces. The feedback served as new perspective and a discussion point for future projects.
“Every project we do begins with extensive research,” said Pritchard. “And in most cases, the project itself becomes a learning experience. We love designing buildings, and for us, creating them is an art. But it’s not finite. It’s constantly evolving, and we will always seek the opportunity to improve.”
“Our goal is to deeply understand our client’s business,” said Pritchard. “We work with each organization to thoroughly understand their foundation: their goals, vision, mission, operations, processes, and their challenges. This broad-based understanding gives us a starting point to address not only their environmental needs, but to also improve the overall organization and communities. This also allows us to share insights and research findings with the greater senior living industry, helping to contribute to improvements industry-wide which enrich the lives of seniors.”