Description
In response to socio-demographic, cultural and organisational transformations, the spectrum of approaches to living for the elderly has broadened and diversified considerably over the last ten years. Never before have so many people been able to look forward to 15 to 30 years of active and self-determined life after retirement – the time span of an entire generation. The ongoing trend towards individual and diverse lifestyles is also continuing on into old age. Both the housing and the care provision sectors have become more and more aware of the potential of this market segment and are responding to the growing demand for diversity with a variety of different operating concepts.
As a result, the previously separate realms of housing and care concepts are beginning to mesh with one another in a variety of different constellations. The grouping of the projects shown in the following section reflects different variants of such hybrid concepts.
We have identified six key thematic groups, all of which have their own particular formal and design considerations but are nevertheless related to one another: inter-generational living, assisted living and serviced apartments, living concepts for specific user groups, living concepts for people with dementia, residential and nursing homes as well as integrated housing and neighbourhood concepts.
Where ten years ago it was difficult to clearly differentiate between an old people’s home and a nursing home, in recent years a series of new terms such as residential care, serviced apartments, residential care groups, co-housing and others show clearly how the spectrum of care provision has broadened. This new diversity is also reflected in its architectural expression, while at the same time lending new momentum to the cultural exploration of the public face of the elderly in town planning and the city.
Statements such as “old age is colourful and varied” are commonly cited, often with the implication that buildings should also be – but is this necessarily the case? Where existing buildings are adapted to accommodate the needs of the elderly, the focus as a rule will be on urban integration and offering something familiar. But what about a new building in a clearly defined urban environment – should it assert itself or blend as far as possible into the surroundings? Examples from recent years show a much greater tendency towards individual expression than only two decades ago. As long as the architectural quality is coherent and consistent, anything is possible, from a neo-classicist adaptation to a radically modern building; the choice depends only on the client and their budget.
While a more conservative tendency is inherent in old age and in the aesthetic expression of old age, it is by far not the only way. Examples from Switzerland demonstrate in their aesthetic diversity that housing for the elderly has likewise remained open to local as well as international architecture and that appropriate options are available to fit every taste. National typologies such as large-scale residential projects in Holland or the Swiss condominium concept are also to be found. By way of a counter-example, the difficulties experienced by Sunrise after opening senior residences in Germany show that it may not be sufficient to transplant American ways of living and “Laura Ashley style” into a new context, primarily because it neglects to take into account the biographical background. The careful study and adaptation of a region’s architectural language could be a possible way of providing people in old age with an attractive living environment.
The most interesting initiatives of building for the elderly emerge in integrated concepts. Do these projects resist the tendency towards individualisation? Homes for the elderly, regardless of whether they are rich or poor, should no longer be – and often no longer want to be – solitary buildings, but arise in all kinds of urban and functional mixtures: with children’s nurseries, next to schools, sharing buildings with shopping centres, adjacent to swimming pools or health centres. More design possibilities emerge – and while it is up to the designers and decision-maker to opt for more urban unity or for greater variety, it is precisely this approach that in one way or another strengthens the sense of neighbourhood that, in design terms as well, we need to foster in our society. The spectrum ranges from the return to small-scale town life to large expressive and sculptural forms that avoid a tired repetition of standard solutions on the one hand and wilful otherness on the other.
Local small-scale solutions are still the most successful examples: Béguinages, neighbourhoods with a dense pattern of street frontages and private courtyards to the rear, or the European turn-of-the-century type of buildings with shops on the ground floor and living on the upper storeys. In the European city, which typologically may be of interest to other continents, it is not always essential to have a car, an advantage for older people who may no longer feel able to drive. It is along those lines that we should re-examine what has proven itself over thousands of years. Let us use these elements as building blocks to reformulate in architectural terms a new diversity in housing for the elderly.
Inter-generational Living
Many older people would like to live near to their children and grandchildren or among young or younger people – close by but with their own space. Whether in the oldest form of cohabitation, the traditional family unit, or embedded in the context of an extended family – one’s own or, as is becoming increasingly common, one’s family of choice – inter-generational living has the potential to accommodate diverse housing needs and wishes.
Inter-generational concepts offer a variety of flexible housing provisions that allow different generations to live together in different ways and can respond to changing demands as residents grow older. The success of such concepts is, however, very much dependent on the personal commitment of the residents and their degree of interaction.
In addition to providing a range of different sizes and types of residential units as well as flexible floor plan arrangements, such concepts also need to offer opportunities for the residents to come together, for example communal spaces for meetings and festivities, sports, a children’s nursery etc., according to the respective concept.
Assited-living – Serviced apartments
Residents in assisted living schemes and serviced apartments enjoy a way of living that in some ways resembles living in a hotel, with the associated security and comfort it provides at extra cost. This concept comprises a wide range of housing for the elderly with the provision of care services. Typically, a resident will rent an apartment appropriately equipped for the barrier-free needs of the elderly, usually in a special residential complex. The residents subscribe to a series of basic services, for which they pay a flat monthly fee. Basic services typically include consultation and information services and emergency call cover. Residents sign a combined rent and care provision agreement and can purchase additional services such as meals, cleaning and nursing care as required at an additional charge. This form of living for the elderly is not subject to the same regulations as homes and is sometimes also known under other names such as serviced residences and sheltered housing.
Comfort is quite clearly a central aspect of this typology, supplemented by individual personal and health services as required. The notion of aesthetic biography is central to this particular form of living: a concept that describes people’s desire to have continued access to that which they have enjoyed throughout their lifetime. This includes interiors that relate to their familiar locality as well as fellow residents of a similar social class or intellectual milieu.
Following the pattern of a hotel, most projects in this typology also offer communal areas and facilities such as a foyer with concierge, a café and restaurant, meeting and club rooms (for example library, games room), wellness facilities with physiotherapy or a hairdresser and cosmetic salon – the size and standard varying according to the class of the establishment.
Living concepts for specific user groups
Although a longer period of old age represents a chance to embark on new initiatives, it seems that where living in old age is concerned force of habit prevails and most prefer to pursue existing patterns of living. Despite the greater diversity of housing alternatives arising in response to increasing individualisation, one can observe a growing “birds of a feather flock together”-mentality as evidenced by emerging concepts for housing for specific social groups. These in turn are also easier for investors and providers to market.
In addition to long-standing inter-generational projects and women’s housing, housing for gays and lesbians is gradually becoming more widespread, particularly in large metropolitan cities. As is already evident in the kind of lifestyle products targeted towards them, these social groups generally represent a comparatively affluent and aesthetically demanding section of society.
For many homosexuals, the thought of moving into a residential or nursing home has negative associations linked to worries of social exclusion. Accordingly, many have begun – often in the form of self-initiated projects – to club together as clients to find new ways of catering for their housing and living needs in old age and with increasing frailty.
The emergence of housing concepts for specific social groups can also be seen in other constellations: for example, home owners in the outskirts or suburbs whose children have left home may wish to move to a more compact and centrally-located urban apartment as they grower older. Similarly, concepts for people with similar biographical backgrounds, for example from similar professions, are beginning to appear on the market.
Living concepts for people with dementia
For nursing homes, the diagnosis of dementia among its residents – over 70% are affected – already presents a significant challenge. In view of the growing number of people with dementia and their particular need for a sense of security, inpatient facilities have more recently begun to adopt a system of so-called “communal care groups”. These smaller, household-sized units, generally consist of spacious communal areas and individual private rooms for each resident.
This kind of “communal household” gives particular emphasis to places of contact and interaction, such as hallways, the living room or an open kitchen-living area. Experience has shown that a daily routine in which communal activities dominate, is both stimulating as well as reassuring for residents within the group.
The day-to-day routine follows the familiar pattern of family life. The organisation of the floor plan and design of the interiors therefore resembles that of a traditional apartment. Although dementia sufferers have a less pronounced need for peace and solitude, their living environment should nevertheless provide spaces for retreat and privacy – the resident’s own room and secluded niches in communal areas for example – which likewise need appropriate architectural treatment. The relationship between private and communal areas – between distance and closeness – needs to be carefully considered. Ideally, the residents’ rooms are arranged around a central living and dining area with core care facilities and staff close by. This minimises the need for circulation space resulting in cost savings.
Residential and nursing homes
The size and organisational structure of residential and nursing homes often bear typological similarity to those of institutions like hospitals, with the primary difference that they serve a residential function (see also Living concepts for people with dementia).
Most conventional design approaches for institutionalised care facilities exhibit floor plans that are merely rational and often bear similarity to rows of terraced housing. This is largely because 60–70 % of such facilities consist of rooms which in their repetition follow the pattern of a hotel or hospital. Very often, floor plans of this type exhibit an L, H or U-shaped arrangement to keep corridors as short as possible. Winding amorphous arrangements are often regarded as bad for orientation and too long for staff. Although closer inspection shows that this is not necessarily so, competition juries often seem to rule out such arrangements for this reason. Furthermore, the economic constraints on institutionalised nursing homes are so great that their functional character leaves little room for any semblance of beauty. Occasionally, the choice of materials reflects regional influences in a last remaining attempt at aesthetic enhancement.
As the serial repetition of rooms very quickly becomes monotonous and care institutions have limited financial resources, particularly those at the lower end of the social scale, many designs, which we will not consider here, are of a poor quality. Unlike low-cost hotels, which exhibit similar problems, little attempt is made in such cases to find an individual aesthetic expression, and dull and even bleak interiors are the result. More adventurous artistic expression is the exception for institutionalised care facilities.
However, an unmistakable desire for change is afoot, which can be summed up as a need for greater homeliness and comfort: new care facilities are moving away from cold and sterile environments towards a more homely atmosphere in which the specific character of the individual as well as a sense of belonging to a group or a particular biography are accorded equal expression. This includes the design approach whereby a facility should not differ from the houses around it and as such effectively be invisible. While not particularly adventurous, this is nevertheless a better solution than an excessively large and intrusive building. The more successful examples, many of which can be seen in Austria and Germany, exhibit an increasingly free experimentation with window openings and façade proportions more reminiscent of residences in Mediterranean regions. Similarly, a tendency towards better quality materials such as brick façades and wood or natural stone can be observed. In the 1970s, many nursing homes were built with balconies, a feature that disappeared from the 1980s onwards and only made a welcome return more recently.
Special attention should also be given to the continuity of the design outside and inside. Today’s initiatives strive to achieve more than just prettifying the outside, employing deliberate and coordinated design strategies that are met with greater acceptance by society.
Integrated housing and neighbourhood concepts
Integrative approaches often arise in combination with other functions in the neighbourhood, such as a children’s nursery, advisory centre or community centre.
Different social groups live together in larger residential complexes. For the most part, these are initiated by special operators or associations rather than by the residents themselves. The projects aim to strengthen mutual neighbourly assistance and interaction between different generations and residential groups with differing needs – fostering this interaction both internally, within the complex, as well as externally in the surrounding neighbourhood.
Mutual support and assistance helps compensate the personal limitations of individual residents, while at the same time counteracting the risk of isolation and strengthening synergies, both inbound and outbound. To encourage communal living, such concepts should provide spaces for coming together, consultation and services/infrastructure, accompanied in part by trained staff.
Originally published in: Eckhard Feddersen, Insa Lüdtke, Living for the Elderly: A Design Manual, Birkhäuser, 2011.