Centers for Healthy Living: Providing Whole-Person Wellness to Seniors

85 Pages·2016·7.25 MB·English

Centers for
HEALTHY LIVING
Providing Whole-Person Wellness to Seniors
EMILY CHMIELEWSKI EDAC | CLAIRE DICKEY AIA OCTOBER 2016
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P snik re Enamtsa
Perkni s Eas t nma i s na rca i h t e c ,er ut n i t e r i o r de s i g ,n n da gnpi n l n a f r i m wi t h mlo a s t 01 , 0 0 pem l yo e e s
n da 1 5 of f i c e s rno dau t h e owr l d . Cerat i v i .t y Hinmua .t y Prup o s .e The s e owr d s shp a e rou s f’ r i m c o er
i m s s i o n n da c er a t e a pr ac t i c la f r o m w r e a k of r u s t o lf u f li rou r o l e a s ad v i s e r s , p nl en r a s , rca i h t e c t s , n da
ni t e r i o r de s i g n e r s . B y b r g n i gni rou p r o e f s s i o lna s lk l i s n da a de e p ndu e r s t gnin d a o f rou c i l e n t ’ s i m s s i o ,n
b u s n i e s s mo d e l , n da o p e r a t i o n s , ew c na p r a t n e r t o b en e f i t t h e iul q a t y o f il ef o f t h e p e o p l e wh o il ,ev
o w r k , , pyl a l e r a ,n ga ,e n da h e la w i t nih t h e vroime n e n n t s ew p l na n da d e s i g n . Cerat i ev d e s i g n iud e g d
b y inm u ,a th y pr u p o s ,e n da nv on i a t i o n er l s u t s ni a b e t t e r iul q a t y o f il ef n da er s p o n s b i l e vroime n e n n t la
s wtr e d a .psi h Tih s le ad e r psi h t e ma b r g n i s xe t e n s i ev xe p e r i e n c e t o e ac h prjo e c t n da of c u s e s o n t h e
i s su e s t h a t l e a d t o su c c e s s n da nv on i a t i o n . Th e Prac t i c e Aera s nic u:lde Civi c n da Clurut l ,a Comemr c i la
Mi e x d- U s ,e Hela t h c ,er a Hig he r Eudc a t i o ,n Hospi t i l a ,t y Lrag e Scla e Mi e x d- U s ,e P gninl n a n da U r b na
Desig ,n Prmia y n da Sec on dr a y Eudc a t i o ,n Resid e n t i l ,a Scien c e n da Tecnoh l o g , y Sieno r Livgni , Spor t s
n da Exbiih t i o ,n Trna s p o r t a t i o n n da Infr a s t r u c ,er ut n da Workp l ac .e
P snik re E namtsa Rhc raese
Fro m a logn- s t gnni da c i o m m t m e n t t o ad v n c a gni b e s t p r ac t i c e s ni t h e f i e l d o f rca i h t e c ,er ut
Perkni s Eas t nma ed v l e o p e d a er s e r c a h g r pou t o b e t t e r s er ev rou c i l e n t s n da p emvri o t h e knw o l e gd e
n da bi l a i t i e s o f de s i g n e r s erv e y w h e .er Perkni s Eas t nma Res e r ca h a s s i s t s cil e n t s n da d e s i g n e r s ni
c er a t gni b e t-ter l ib u t vroime n e n n t s b y pu gnsi h t h e b no du r a i e s o f pro e f s s i o lna k nw o l e gd e n da p mv ri o gni
r c a i h t e c r u t la d e s i g n t ro h gu h nv on i a t i ev p r a c t i c e- b a s e d er s e r c a h . B y g a t h e r gni n da p a p l y gni l e s s o n s
l e r a n e d , su c c e s s e s c na b e do cm e u n t e ,d jm o a r xe p e ni d er u t s c na b e uj s t i f i e ,d n da f u erut d e s i g n s c na b e
pemv ri o d t ro hgu h mo re noi f r m e d de c i s i o n- mkg nai n da re c o g g nzii n o p p o r i n u t t i e s of r nv on i a t i o n .
O ru xe p e r i e n c e r gen a s fro m c o n c i s e vroime n e n n t la ui d a t s t h a t g a t h e r jm o a r l e s s o n s l e r a n e d t o mo re
ni- dep t h er s e r c a h s uit d e s t h a t uvl ae a t e lu m t p i l e a s p e c t s o f a f aci l i t s y ’ y p h s i c la v r oi m e n e n n t , op e r a t i o n s
n da nim t a e n c a ,e n da glnibi u d o c c p u n a t ’ s s a t i s f a c t i o n n da u s e p a t t e r n s . W e owr k wi t h rou c i l e n t s t o
edvl e o p t h e er s e r c a h ueq ) s st i o n ( n da a c ro u s e o f ac t i o n t h a t i s nid e v z i i u l da t o me e t t h e iun equ n e e d s
o f t h e ri o r g z i n a a t i o n . Reglr da e s s o f t h e s c o p e o f t h e prjo e c t , ew ly wa a s owr k wi t nih t h e fr omw r e a k o f
pr ac t i c e- b a s e d re s e r c a h t o c re a t e re l s u t s t h a t ev h a re l a-owr l d pap i l c a t i o n s .
CENTERS FOR HEALTHY LIVING: PROVIDING WHOLE-PERSON WELLNESS TO SENIORS
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Table of Contents
5 Defining a Center for Healthy Living
7 Executive Summary
9 The CHL of Today
10 The Development of CHLs
11 Key Findings from the CHL Research Study
17 Case Study: The Center for Healthy Living® at Moorings Park
23 The CHL of Tomorrow
23 Key Concepts for the CHL of Tomorrow
28 Models for the Future
34 Finding Common Ground
35 Appendix A: Forces Driving the Development of CHLs
39 Appendix B: The Evolution of the Center for Healthy Living Concept
43 Appendix C: About the Research Study
47 Appendix D: Research Study Participants
71 Appendix E: Research Study Findings
81 Endnotes
84 Special Thanks
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A center for healthy
living (CHL) is a new
building typology
that supports
seniors through all
the dimensions of
wellness, and may
be one program and
building or a collection
of programs/services
and spaces.
CENTERS FOR HEALTHY LIVING: PROVIDING WHOLE-PERSON WELLNESS TO SENIORS
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Spring Lake Village | Santa Rosa, California
Defning a Center for
Healthy Living
A center for healthy living (CHL) is a new building typology that supports
seniors through all the dimensions of wellness; it may be one program and
building or a collection of programs/services and spaces. A CHL supports the
mind, body, and spirit. A typical CHL provides places for social interactions,
preventative healthcare and medical treatments, wellness education,
counseling, healthy dining, continuing education lectures and discussion
groups, arts programming, fitness training, spa/beauty treatments, and/or
many other activities and services.
CHLs are being developed all over the United States, from Life Plan
Communities (formally known as continuing care retirement communities, or
CCRCs) to stand-alone, neighborhood or regional community centers. CHLs
help bridge the gap between the senior living and healthcare sectors, yet
they go beyond the typical provision of clinic and exercise spaces to address
all eight dimensions of whole-person wellness: emotional, environmental,
intellectual, physical, occupational, spiritual, social, and financial.
6
i
T eh elpitluM D snoisnemi f o
WELLNESS
p
CHL s Sropu t eht elpitluM D snoisnemi fo Wsenle
Emotional Cop gni e f e f c t i e v l y wi t h il ef n da Physical Recog gniz i n t h e ne e d of r yp h s i c la
c re a t g ni s a t i s f y g ni re l a t i o n p s i h s a c t i v i ,t y i d e t , s l e ,ep n da u n t r i t i o n
Financial Sati s f ac t i o n wi t h cr u er n t n da f u erut Intellectual Recog gniz i n c er a t i ev bi l a i t i e s n da
f n i c a i la s i u t a t i o n s f gnni i d y w a s t o xe p n da k nw o l e gd e n da s lk l i s
Social Devleo p gni a s en s e o f c on en c t i o ,n Environmental Goo d he l a t h b y o c cp y u gni
b e l o g n g n i , n da a elwl- edvl e o p e d psu p o r t s y s t e m p l e a s n a t , s lt u a m t i gni v r oi m e n e n n t s t h a t psu p o r t
el wl- b gen i
Spiritual Exp gnin da rou s e n s e o f pr u p o s e n da
mg nei n a ni il e f Cour t e s y o f oe K n k l , K . , J( ul y 82 , .) 4 1 2 0 Adre s s i n g
Spir i t u la i t y an d Hela t h . The Partnership Center
Newsletter . Retr i e v e d f r o m h t t:p w / abw . o h h u s w t / . g / o v /
Occupational Per s o lna s a t i s f a c t i o n n da a g e n c i e s / i p e a r a / t n e / ri n 4 1 d e x 8 s 2 n h i p . e w 7 s s / l 0 e t / t e r
r e n i c m e h n t der i e v d fro m s ’ o n e o w r k h t m l
CENTERS FOR HEALTHY LIVING: PROVIDING WHOLE-PERSON WELLNESS TO SENIORS
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Executive Summary
Centers for healthy living (CHLs) are becoming more common in today’s
senior living industry. By combining various programs/services and spaces
that support whole-person wellness, this new building typology has evolved
to address many issues facing the industry today, including longer life
expectancies and the rapid aging of America; a new definition of health that
considers not just living longer, but living long and well; a changing market
that is interested in greater choice, opportunities for engagement, and
alternatives to traditional healthcare models; the growing costs for care and
changes in reimbursement; seniors aging-in-community; and the need for
care/service providers to offer products that are economically, socially, and
environmentally sustainable.
To better understand the CHL typology, in 2015-16 Perkins Eastman
conducted a design research study that evaluated multiple built and
conceptual (unbuilt) CHLs. The study found that, in addition to supporting
whole-person wellness and encouraging healthy living, CHLs are being
developed to address changing consumer demands, leverage partnerships,
reach a greater cross-section of the community, offer greater choice,
provide better interdepartmental relationships and cross-disciplinary
communications, and to create a differentiator from the competition.
The study also revealed that CHLs are having a positive impact on sense
of community, users’ quality of life and health/wellness, organizational
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f n i c a e s , erm a t k g n i r e e r f r l a s / , s t a f f re c r i u t m e n t / F rou p o t e n t i la m o d e l s of r t h e fu erut era l a s o
er t e n t i o ,n p r o g r ma un q a t i t y n da t y p e s o f of e r f g n i s , p er s e n t e ,d ni c gnui ld ) 1 ( t h e Li ef Pl na Cinuotm m y
p ro g r ma a t t e n d n c a e rp a o t e lp r u a i ,s/ t y n da c p mu a s- b a s e d CHL , ) 2 ( t h e nei g b h o r h o o d
p r a t n e r p sih o p p o r i n u t t i e s . er s r o c u e CHL t shat ’ l ib u t ni t o t h e f b a r i c o f t h e
g re a t e r ci n u ,otm m y ) 3 ( t h e lu m t i- gen e r a t i o lna
Th e go la o f t h e ,s ut d y , erv e wh o w a s t o no t ol n y CHL tha t i s of c u s e d o n p o lp u a t i o n he l a t h n da
n du e r s t n da w h a t xe i s t g ni c e n t e r s of r he l a t yh ps u p o r t s epnv re t a t i ev nele w l s s of r la ag e s , n da
il v gni era d g o n i , bu t t o la s o l o o k t o t h e fu erut ) 4 ( t h e vri u lta CHL tha t bem r a c e s te c n oh l o g i c la
n da xe p l o er h wo CHL s igm h t ovel .ev B a s e d o n ad v n c a e m e n t s t o re d e f n i e who s e r v i c e s rea
t h e s ut sd y ’ f g n n i i d s , s erv e la e yk c o n c e p t s of r dei l e er v d t o s ie no r s , er g lr d a e s s o f wh e t h e r t h e y
t h e CHL o f t h e fu erut ev h a b e e n de f n i e:d Th e era i l v gni o n a Li ef Pl na Cinuotm m y c p mu a s ,
CHL o f t h e fu erut lwli u etzi l i b o t h t h e yp h s i c la w i t nih t h e g er a t e r nei g b h o r h o o d , o r ni a mo er r r u la
v r oi m e n e n n t n da p r so g e r r m a /s v i c e s t o ader d s s n da i s o l a t e d l o c a t i o n .
la e i g h t mie dn s i o n s o f wh o l e- p er s o n nele w l s s ;
i t lwli c er a t e a s el m e a s s t r n a s i t i o n fro m nle l i “ s ” s U l ,t mi a t e l y t h e CHL o f t h e fu erut lwli a c t a s a
t o n“ele w l s ” s , w i t h a of c u s o n e u dc a t i o n n da ci n u o t m m y buh t h a t b r g n i s p e o p l e to ge t h e r ni a
penv er t i o ,n r a t h e r t nha u j s t t er a t m e n t ; i t lwli s u s t bn i a l a e v roime n e n n t t h a t of s t e r s ni t e r p e r s o lna
s e e k b e s t pr ac t i c e s fro m nv on i a t o r s ni t h e de s i g n c on en c t i o n s n da ci n u o t m m y v i t i l a t y — wh e t h e r ni
un i d s t r y n da ac r o s s lu m t p i l e s e c t o r s — c o erv g n gni p e r s o n o r vri . lult a y W e hop e t h a t , t ro h gu h er gniad
s i e n o r il v g n i , he l a t h c ,er a h o s p i t i l a ,t y n da ig h h e r ti h s , p p a e r t h e s ie no r il v gni un i d s t r y er c o g e z i n s
e u dc a t ;io n n da i t lwli d e s i g n ni f l x e bi i l i t y t o psu p o r t t h e uv lea o f de s i g gni n o f r wh o l e- p er s o n nele w l s s
ide rv s e erm a t k s , ov el v gni p r o g r m a s n da ni t e er s t s , n da u s e s t h e noif r m a t i o n n da re c o m e m n d a t i o n s
n da te c n o h l o g i c la ad v n c a e s . Th e CHL o f tom o r wro h e re ni t o edvl e o p th e CHL o f .to m o r w r o
lwli l a s o lerv e ga e p r a t n e r p s i h s n da eg n ga e wi t h
t h e rsug nrino d u n e i g b h o r h o o d t o xe p n da s e r v i c e
dei l e r v , y ps u p o r t ga g n i- ni- cin u ,otm m y n da p r o m o t e
nra u t l l a y o c cr u r g ni ni t e r g e n e r a t i o lna n i t e r a c t i o n s .
Navigating the Paper
I n “Th e CHL o f Toyda ” s e c t i o ,n ew xe p nli a t h e vr a i o u s ofr c e s rd i v gni t h e edvl e o p m e n t o f t h e c en t e r
of r he l a t yh i l v gni glnibi u d t y p o l o g , y s h era e y k f g n in i d s fro m a er c e n t de s i g n er s e r c a h s ut d y t h a t
pvr o i d e s ni s i g h t ni t o wh a t t h e CHL o f to yda l o o k s ekil n da w h a t ou t c o m e s era b geni s e e ,n n da
o f e rf a c a s e s ut d y xpe m l a e o f a er c e n t l y lib u t CHL . I n th e C“ HL o f Tomor wr o ” s e c t i o ,n ew d e s c r b i e
e yk c o n c e p t s of r t h e CHL o f tom o r wro n da o f e rf rofu p o t e n t i la m o d e l s of r h wo t h e s e id e a s yma b e
xe p er s s e d ni f u erut d e s i g n s . Serve la p a p e in d c e s of e rf fr u t h e r ni s i g h t s n da noi f r m a t i o n ba o u t t h e
ofr c e s rd i v gni t h e edvl e o p m e n t o f CHLs , th e ouv el t i o n o f t h e CHL conc e p t , n da t h e er s e r c a h s ut sd y ’
m e t h o d o l o g , y p r a t i c p i n a t s , n da f g n in i d s .
CENTERS FOR HEALTHY LIVING: PROVIDING WHOLE-PERSON WELLNESS TO SENIORS
9
Moorings Park | Naples, Florida
The CHL of Today
In recent years, greater numbers of senior living care/service providers
are using the center for healthy living concept to incorporate an accessible
destination for health and wellness programs/services into the continuum
of care. Some are even developing CHLs that act as neighborhood resource
centers, located in and serving the greater community, as opposed to limiting
services to just Life Plan Community residents. The industry is looking to
use models from the past and couple them with innovations for the future
to provide spaces and programs/services that engage all eight dimensions
of wellness: emotional, environmental, intellectual, physical, occupational,
spiritual, social, and financial. The result of this confluence is that seniors
are increasingly being empowered to live at their maximum capabilities,
rather than simply managing symptoms reactively.
This section of the paper explains the various forces driving the development
of the CHL building typology, shares key findings from a recent design
research study that provides insight into what the CHL of today looks like
and what outcomes are being seen, and offers a case study example of a
recently built CHL.
0 1
THE DEVELOPMENT OF CHLS n da prso g e r r m a /s v i c e s i s fer u eq n t l y s e e n a s a
yMn a f a c t o r s era n i f u l e n c gni t h e s ie no r il v gni i d f e r e f n t i a t o r wh e n c op m r ag ni i d f e r e f n t s ie no r
4
un i d s t r y , to y d a er s h p gnai t h e ywa s p a c e s era i l v g ni ci n u o t m m i e s .
d e s i g n e d n da h wo s e r v i c e s era d e i l e er v d . ƒ Costs for care and changes in reimbursement:
The s e nic u:lde Thogu h a jmoa r i t y o f t h e s ie no r il v gni un i d s t r y i s
ƒ Longer life expectancies and the rapid aging rdie nv b y pr i v a t e- , py a rb ru e m i s e m e n t c genh a s
of America: Wit h t h e bm u e n r o f ol d e r lu ad t s ni s gni tm e m f r o m t h e ni t r o u d c t i o n o f t h e Patien t
t h e .US . ne e gni d l o g n-ter m s er v i c e s n da psu p o r t Prote c t i o n n da Af ofr db a l e C era Ac t A( CA ) ni
p rjo e c t e d t o g wro f r o m 1 5 ilol i nm t o 7 2 il ol i nm 0 1 02 lwli c o n t u eni t o ev h a na p m i a c t o n h wo
b y 02 ,50 t h e er i s a id s t n i c t ne e d t o xe p l o er c era n da s e r v i c e s era b geni d e i l e er v d , a s e lwl
w h e re n da who s i e n o r s er v i c e s rea d ei l e r ev d . 1 a s t h e of c u s o n penv er t i o n n da nel w l s s t h a t
ƒ A new perspective on what “health” means: ynma s i e n o r s er c / er v a i c e pvr o i d e r s era n wo
5
Th e Worl d Hela t h Orgzi n a a t i o n (WHO ) n wo ad o p t g n i . Penvret a t i ev nele w l s s s er v i c e s
de f n i e s he l a t h t o b e a“ s t a t e o f c op m l e t e dei l e er v d t ro h gu h CHL s n da o t h e r p er s e z o i l d n ,a
yp h s i c l ,a m e n t l ,a n da s o c i la el w l- b geni n da n o t lu m t i- miedn s i o lna n ele w l s s p ro g r m a s c na g o
mer l y t h e ba s e n c e o f id s e a s e o r ” nif r i i m . t y 2 a lo gn ywa twr o da b r g n i gni dw o n c o s t s liw eh
Peop l e wn a t t o no t ol n y il ev l o g n , bu t il ev l o gn p r o u d c g ni b e t t e r re l s u t s .
“ w i t h go o d he l a t ,h fn cu t i o ,n p r o u d c t i v i ,t y n da ƒ A need to support (and market to) seniors
nidep” e n d e n c . e 3 CHL s c na he pl nim t a nia n da aging-in-community: A ger a t e r bm u e n r o f
op etzi m i s ’ o n e h e l a t ,h liw eh s t er g n t gnhi e n s i e n o r s c na b e psu p o r t e d t ro h gu h uni d s t r y
o t h e r er a a s o f rou i l e v s t h a t ad d t o rou e rv o la ad v n c a e m e n t s , ekil t e l e m e i d c n i e n da
el wl- b gen i . t h e nic er a s gni b m u e n r o f p r a t n e r p s i h s
ƒ Changing market demands: T soyd a ’ s i e n o r s b e t e w e n he l a t h c rea s y s t e m s , -sieno r f r i e l n d y
era l o o k gni o f r mo er c h o i c e n da vr a i e ,t y s e r v i c e pvr o i d e r s , n da s i e n o r s er c / r e a v i c e
op p o r i n u t t i e s of r il e lf o gn l e gr n i a n , a s en s e pvr o i d e r s — so m e o f iw hc h era f gnin i d a p l ac e
o f p l ac e n da ci n u ,otm m y n da l a t e r n a t i e v s t o wi t nih a CHL . Beyo n d b geni a buh o f r t h e s e
t r i a d t i o ln a h e l a t h c re a m o d e l s — p r a t i c l r u a l y s e r v i c e s , CHL s era l a s o b geni u s e d t o er ac h
snic e ynm a era t k gnai o n a big g e r ro l e ni p o t e n t i la c u s t o m e r s wh o yma n o t ef e l er ad y
nm ga gni t h e ri p e r s o lna h e l a t h n da nele w l s s . , ofr o r wh o yma n o t ye t ne e d , t r i a d t i o lna
I n f ac t , of e r f gni w h o l e- p er s o n nele w l s s sp ac e s s ie no r il v gni p r o u d c t s . A vi si t t o a CHL b y
s om e o n e il v gni ni t h e g er a t e r ci n u ot m m y
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NewBridge on the Charles | Dedham, Massachusetts
CENTERS FOR HEALTHY LIVING: PROVIDING WHOLE-PERSON WELLNESS TO SENIORS