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  • Benny Kuriakose and Aneeta Cici George

Design for the Elderly

Ageing happens to everyone, and as we get older, we experience a wide array of physical, psychological, and socio-economic changes that can be a challenge for some to adapt to. One experiences physical challenges related to mobility, strength, vision and hearing loss, and tactile and thermal sensitivity as we age. Many live alone, disconnected from family, friends, and the wider community. These changes, coupled with retirement and changing social roles, can lead many to experience loneliness and despair as they try to adapt to contemporary social structures and the alienation that sometimes accompanies them. As designers, we have to consider the impact we have on ameliorating the negative aspects of these changes.


How can we, as designers, help provide the elderly with their desire for independence, choice privacy, and intimacy? These are the kinds of questions we asked when we got the opportunity to design India‘s first holistic retirement community of Alive Life Spaces, "The Rainbow". We endeavored to dig deep and understand the changes and challenges that occur as people age. We tried to develop a design that would improve the living conditions of the elderly while taking into account all of their requirements. A design that nurtures the elderly, who are sometimes physically weak, immobile, and vulnerable, and intends to encourage them to interact by involving them in various activities.



We believe that conscious design can definitely enhance their confidence and well-being. We incorporated and utilized certain design principles and strived to create a functional, safe, and convenient space for the elderly that embraced and encouraged the idea that life can be wonderful as a senior.


List of Contents


1. Understanding the Problems Faced by the Elderly


Visual Problems


Changes in perception, cognition, and expression, especially when the intellect is intact, can have a depressing and debilitating psychological effect in old age.


Cognitive Mapping Difficulties


Older people have an increased difficulty in creating new mental images- known as “cognitive maps” - of unfamiliar settings. Their ability to comprehend complex but familiar situations may be superior to that of less complex but new environments.


Psychological Problems


With ageing comes several of these physical issues that might limit one's ability to do things. Many retirees who have spent their entire lives being active may find this new stage to be quite stressful. Most senior citizens want to engage in a wide array of physical activities, but when their bodies refuse to cooperate, it can lead to withdrawal, resentment, and even depression.


Senile Dementia


Patients with dementia are more likely to misinterpret architectural components or visual cues, resulting in needless distress. For instance, poorly differentiated hallways can lead to needless frustration as wayfinding and orientation become difficult and frustrating.


These are some of the reasons why it has become more common for them to be relocated to retirement homes and communities where the necessary care and affection may be available. Despite the great advantages of community living, making the decision to move is a difficult one for many seniors and their families, and there are some big fears that come to mind while making such a decision.


2. The Biggest Fears About Senior Living


The most common concerns among the elderly are:


1. Living in a community means sacrificing privacy, independence, and freedom.

2. Moving away from family implies there will be no one to assist and they will be neglected by them.

3. Moving to a community means not being able to continue their normal activities, routines, and hobbies, such as gardening.

4. Boredom and alienation

5. Financial costs

6. Afraid to place their trust in strangers and losing control over their daily lives and activities.


These concerns are well-founded in some cases as several retirement homes and old age homes may not consider all the above-mentioned criteria and may be insensitive towards them. In such places, they may feel imprisoned, lonely, and suffocated. As a result, it is vital to consider their issues while designing a retirement home or community. They need to be included right from the initial planning stages.


We attempted to address all of these difficulties when constructing the retirement community in Thiruvananthapuram, and we were looking for the best solution for them to live a healthy, safe, and contented life.


3. Design Objectives


The following are some of the objectives we considered when designing “The Rainbow” by Alive Lifespaces, India’s first holistic retirement community in Thiruvananthapuram, Kerala.


  • Improving orientation and comprehension.

  • Encouraging social interaction.

  • Stimulating participation.

  • Reducing conflict and distraction.

  • Providing a safe space.

  • Making activities and services accessible.

  • Changing the public perception of ageing and reducing ageism.


4. Design Approach


The primary goal of a retirement home would be to create an environment that anyone, regardless of age, size, disability, or ability, could use. Furthermore, the thoughtful design might improve their self-esteem and well-being. It should aim to reduce dependency and promote independence among the elderly.


The planning has focused on providing appropriate forms of physical support and behavioral cues necessary to diminish the sense of disorientation and vulnerability. Also, the design of the retirement home is intended to encourage interaction by involving the occupants in activities.


5. Design Criteria and Factors


Each area needs to be thoughtfully considered.


Landscaping & Outdoor Spaces


Residents benefit from well-designed outdoor common areas, which make them feel less alone in the midst of high-rise buildings. A range of activities, ranging from calm chats to games and swimming, can be planned for the outdoors. Landscape design may help to increase sensory stimulation and intrigue.



Parking


To ensure safety and convenience, vehicle parks and access roads should be carefully located. It will be advantageous if the landing spot is on level terrain. Considering points like including a lowered kerb to make it simpler for those who use wheelchairs or walking aids will be highly advantageous.



Circulation


Indoor and outdoor walkways and corridors must be wheelchair accessible. In the corridors, a clear width of 1800 mm allows individuals to stroll alongside one another and two wheelchair users to pass freely. Furthermore, color-coded hallways with numbers make identification easier. Stairs can be dangerous for people who have vision or movement problems. Passenger lifts can be installed next to stairwells to provide an alternate mode of transportation.


Means of providing access for people with wheelchairs and other mobility aids.
Means of providing access for people with wheelchairs and other mobility aids.

Common Facilities


The administrative area can have direct access to common facilities, with views of critical areas of the site. Comfortable seating and free space are necessary to accommodate all kinds of people. Lounges serve as social centers and, therefore, can be placed near points of higher activity. It can house a variety of activities, such as group programs, social activities, chatting, visiting, or watching television. Introducing a common dining area and linking tables can help to increase conversations among inhabitants and keep them from getting depressed.


Recreational Facilities


Residents can be rejuvenated by providing facilities for a range of activities throughout the night and on weekends. In public spaces, social activities such as fine arts, crafts, and music might be organized. Sports, fitness programs, yoga, meditation, and swimming are all examples of physical activities that may be developed to incorporate the entire community.


Various combination of outdoor seating and greenery can be experimented.
Various combination of outdoor seating and greenery can be experimented.

Medical Resources


Medical necessities such as a doctor's office, nursing stations, and palliative care rooms are to be provided in a single structure in a node that is easily accessible from the rest of the site. To create a more homely feeling, the nursing station might be separated from the main hallways.


The Design of Living Quarters


It is preferable to provide different kinds of accommodation based on the differing needs of the residents. The open floor layout at a retirement home, regardless of the style, allows for maximum personalization, making residents feel at home and not out of place. Balconies, sit-outs, and semi-open areas built within dwellings give visual and audio protection while keeping a connection to nature, resulting in a relaxing ambiance.


Interior Design


Flexible furniture arrangements can allow people to modify the space as per their unique preferences. Choose round-edged furniture to avoid injury during falls. The provision of assistance alarms in all rooms within the user’s reach can help in times of emergency. For the same reason, a minimum of four feet of clearance can be maintained between the bed and all other objects and walls. The selection of beds has to be done carefully to facilitate easy transfer for wheelchairs.


Slip resistance must always be retained irrespective of whether the floor is wet or dry. Floor finishes need to be firm, even, securely fixed, and non-directional. Wall and ceiling finishes need to be thoroughly evaluated alongside floor finishes to optimize the visual, acoustic, and aesthetic qualities of an environment. This is especially important for those with hearing challenges and those with cognitive, mental health, or visual difficulties. Lighting needs to be carefully designed to aid the perception of space, colour, and texture. In addition to natural light, the installation of adjustable artificial lighting that is easy to control and provides good colour rendering is necessary as a majority of the elderly population have problems with their eyesight.


The inclusion of a toilet in each bedroom fosters privacy and hygiene while also making them feel more at home than in an assisted living facility. The provision of clear space on both sides of the door is essential for ease of movement. The toilets can be provided with an outward opening door to make it easy for people in wheelchairs and other mobility issues.


Wayfinding, Colours, and Signage


With age, one's vision deteriorates. Signage may give visual and tactile information to assist all individuals, regardless of their obstacles (physical or psychological). As a result, bigger fonts, greater contrast colours, and stronger lighting levels will need to be addressed in the design. Signs should be placed at wheelchair eye level (48 to 52 inches from the ground) so that they may be seen easily from both a standing and sitting posture.


6. The Rainbow By Alive Lifespaces


We were involved in the design of 'The Rainbow, by Alive Lifespaces', India's first holistic retirement community, which strives to make retirement life magical. Alive Lifespaces first initiative for the elderly is called ‘The Rainbow’. The Rainbow is a community living space for our forward-thinking elderly.


Aerial Views of 'The Rainbow By Alive Lifespaces'
Aerial Views of 'The Rainbow By Alive Lifespaces'

The senior living community is nestled in the lush greenery of Thiruvananthapuram, Kerala, and has been meticulously designed to reflect the local culture. Environmentally friendly architecture and planning concepts are combined with the organic natural rhythms of the land’s terrain and elements. The design minimizes reliance and fosters independence in its inhabitants by taking a uniquely tailored design approach to the topic.


An exterior view of ‘The Rainbow’  by Alive Lifespaces
An exterior view of ‘The Rainbow’ by Alive Lifespaces

7. Important Points Considered in our Design of ‘The Rainbow’


A design developed to provide assistance and care to the elderly :


  • The visual inability is addressed in architectural design through increased illumination levels, increased size for signage, and heightened contrast between elements in all visually presented information.

  • Intellectually and physically stimulating activities like sports, exercise programs, arts and crafts, swimming, and more programs involving community participation spaces are implemented.

  • The project is constructed in accordance with the Americans with Disabilities Act, and any location within the site limits is wheelchair accessible.

  • Built areas are positioned to provide for maximum natural light exposure.

  • Design considerations prioritize the safety and well-being of the occupants.

  • Design to provide a higher degree of care while simultaneously encouraging social interaction.

  • Visual and audible connectivity is maintained to ensure a comfortable and protective environment.

  • The corridors and pathways are wide enough to enable two wheelchairs to cross simultaneously.


corridors  are wide enough to enable two wheel chairs to cross simultaneously.
Corridors are wide enough to enable two wheelchairs to cross simultaneously.

  • Health SPAs and activity spaces, such as yoga, arts and crafts studios, walking zones, gaming, and gyms, promote social interaction.

  • Internal courtyards provide good lighting for the corridors, making them more lively.

  • Wide windows provide enhanced indoor illumination while also reducing glare.

  • Low-sill windows provide a good view from the bed.


Low-sill windows provide a good view from the bed.
Low-sill windows provide a good view from the bed.

  • A green and well-lit environment will aid in the psychological well-being of the elderly.

8. Our Design


Parking


Adequate parking facilities for the expected number of car users have been provided. The position of allocated car parking spaces is convenient in terms of entrances and exits. The route between the car park and the entrance of the building is accessible and easy to understand. The pedestrian environment is simple and easy to comprehend. Roadway marking and wall or post-mounted signs for all designated spaces have been ensured in our design.


The view of the grounds at The Rainbow by Alive Lifespaces
The view of the grounds at The Rainbow by Alive Lifespaces

Landscaping


Major walkways are provided with a minimum width of 1800 mm. Plantings are located at waist height for ease of visibility, touch, and smell. Resting places are included at intervals on long routes. The pavement width must be at least 1200 mm for small restricted stretches of an access route. Some tactile pavement surfaces provide direction, while others indicate the presence of a possible hazard, such as a level shift on the horizon. Litter bins with an overall height of roughly 1300 mm and a bin entrance of 1000 mm above ground level are provided in public areas.

Major walkways are provide with width of 1800 mm
Major walkways are provide with width of 1800 mm

All outdoor environment-associated buildings are accessible to all. Provision of gardens where possible in association with buildings to provide areas for rest, relaxation and informal meetings was provided. In any of the garden areas, plants do not obstruct access pathways, and falling leaves do not provide a tripping hazard. Adequate protection for water features is provided so that they do not present a safety hazard.


The houses are arranged based on the slope of the land.
The houses are arranged based on the slope of the land.

Plantings are located at waist height for ease of visibility, touch, and smell.
Plantings are located at waist height for ease of visibility, touch, and smell.

Exterior Landscaping and provision of gardens provided at the Residences
Exterior Landscaping and provision of gardens provided at the Residences

Outdoor Spaces


Well-planned outdoor common spaces for residents were included in the design. A variety of activity spaces are provided for the outdoors, ranging from quiet conversation to games and swimming. A sense of neighbourhood is recreated while planning outdoor spaces and indoor activity areas that attract people to opportunities for socialization, recreation, and passive rest, and promote participation. Paved terraces with movable seating are provided as seating areas, with a view of circulation arteries and other activity areas. Outdoor private spaces in elderly housing and continuing care retirement communities are differentiated.


Circulation


External steps are used in combination with ramps to provide options and routes that are accessible to all. Step treads and landing surfaces are non-slip and well-drained to avoid water pooling. Each step is visually highlighted. Clear landings are provided at the top and bottom of the stairs. Handrails are provided on both sides of the steps and are continuous around intermediate landings. All dwelling units are facilitated with ramps having a maximum gradient of 1:10. Passenger lifts are located adjacent to stairs in order to offer an alternative means of access.


Handrails are provided on steps and ramps
Handrails are provided on steps and ramps

All Dwellings have ramps to help in easy movement for physically challenged people
All dwellings have ramps to help in the easy movement for physically challenged people

Built Environment


Every building's entrances are clearly visible and distinguishable from the rest of the structure, thanks to architectural features such as a separate traditional Kerala sloping roof. Landscaping features are used to assist in identifying an entrance. Artificial lighting is used to highlight the entrance to a building and make it more obvious at night for everyone. The land is laid out so that the common amenities block is in the center, surrounded by villas and apartments. The villas are found in clusters or groups of row houses. All dwelling units are adaptable with wheelchair-accessible ramps and special features such as lever handles on all doors, larger bathrooms, flexible shower hoses, grounds for grab bars, anti-scald shower controls, front-loading washers, and dryers, Front Range controls casement windows, and loop cabinet hardware.



Every building's entrances are clearly visible and distinguishable from the rest of the structure, through architectural features  such as a separate traditional Kerala sloping roof.
Every building's entrances are clearly visible and distinguishable from the rest of the structure, through architectural features such as a separate traditional Kerala sloping roof

Corridors and Balconies


In the corridors, a clear width of 1800 mm is provided to allow individuals to walk alongside each other and for two wheelchair users or parents with strollers to pass easily. Side lighting provided at the ends of the corridors with windows improves orientation, day lighting, and views. Freestanding handrails along the corridors facilitate independent mobility (with a mounting height of 33-36 inches).


Reception & Waiting Areas :


The reception desk is clearly visible with a direct route from the entrance doors. Well-designed lighting is installed to optimize visual communication and lip-reading. Comfortable seating and free space are provided for wheelchair users, parents with strollers, people with visual difficulties, and those with walking aids. To enable people to sit comfortably and read or sign papers, the lower work surface incorporates a knee recess, 650mm deep.


The balconies provide visual and audible privacy, good views of site activity, and aesthetic amenities to the users. A built-in-ledge for supporting plants and flowers adds to the visual aesthetics.


Provision of seating at the entrance of homes to improve interaction
Provision of seating at the entrance of homes to improve interaction

Administration and Services


The administrative area has an open and welcoming quality with a sense of security without being overbearing. It has direct access to the building’s main floor common facilities, with views of critical areas of the site.


A View of the grounds at The Rainbow. The common amenity standing tall in the centre, surrounded by the residences
A View of the grounds at The Rainbow. The common amenity standing tall in the centre, surrounded by the residences

Reception & Waiting Areas :


The reception desk is easily and clearly visible with a direct route from the entrance doors. Well-designed lighting is installed to optimize visual communication and lip-reading. Comfortable seating and free space are provided for wheelchair users, parents with strollers, people with visual difficulties, and those with walking aids. To enable people to sit comfortably and read or sign papers, the lower work surface incorporates a knee recess, 650mm deep.



Reception and waiting areas
Reception and waiting areas

Lounges & Dining :


Introduced a common dining area and linked tables to increase conversations among inhabitants and keep them from getting depressed. Lounges located near the lobby or reception area provide places for the elderly to watch the daily activities without disruption. This is similar to the congregating on the traditional front porch with rocking chairs overlooking the passing scene.


Common Kitchen :


It is located close to the dining areas. An open-plan arrangement is adopted to facilitate easier circulation between the kitchen and dining areas. Kitchens are provided, with facilities for storage and vehicle access, if meals-on wheels are provided. In dwelling units, kitchens are screened from other living spaces and directly adjacent to the entryway to enable the depositing of packages. Handles that are easy to use and contrast visually with the drawer have been incorporated, and the cupboard doors are hinged at 180 degrees to prevent obstruction of space.


Common Spaces


A patio is provided next to the lounge area where people relaxing can find a vantage point. Public toilets, telephones, and drinking fountains are provided nearby. Physical activities including sports, exercise programs, swimming, and religious programs such as yoga and meditation are planned on the first floor of the common amenities building, while activities involving community participation take place in the auditorium. Views outdoors and visual connections to adjacent spaces are planned. A cafeteria with the provision of table service to help the elderly carry food trays is provided. Meeting rooms are provided for small meetings and discussions.


Amenities & Facilities


We have tried to develop an activity-oriented space so that they do not feel isolated. Activity rooms increase the social relationships among the residents. Indoor and outdoor gaming, and spaces for yoga and meditation are provided. The yoga/meditation zone is well lit with sunlight. indoor game zone equipped with the necessary gaming elements. There are art and craft facilities available. Multipurpose hall which could hold 120 people can be used for large gatherings and also acts as a mini-theatre, and a library with a good collection of books, e-books, and SPA-along with the massage room and ayurvedic treatments, are other facility spaces. A swimming pool is also provided. Exercise zones are equipped with the necessary equipment.


Swimming pool facility provided is also provided
A swimming pool facility is also provided

Shared Area


Sketch showing Courtyards and shaded areas inside dwellings.
Sketch showing courtyards and shaded areas inside dwellings

Bedrooms and Residences


A display space inside the house gives the resident the opportunity for self-expression and personalization. The thresholds of houses can be decorated with plantings and other personal items. There are couple rooms and single occupancy rooms.


Bed location is selected considering the views out of the windows and an apt position for television watching. The number of beds is limited to two per room in order to provide an environment inducing an expression of ownership, of identity and belonging, control of territory and personalization, facilitated with ease of accessibility, maneuvering and transferring to bed from wheelchairs. Four feet of clearance is provided between the bed and all other objects and walls to allow wheelchair access. Alternatives for bed location are planned to allow for personal preference. Ceilings are provided with visually stimulating surfaces, textures, and patterns.


Individual Residences at The Rainbow campus
Individual Residences at The Rainbow campus

Toilets


Public toilets are provided near activity areas and lounges. They are accessible to and usable by the physically challenged. Appropriately placed grab bars and handles are present for getting on and off the fixture. Wall-mounted mirrors illuminated with warm colours, and a shower area provided with movable seats and adequate support are also present in all toilets.


Non-slippery tiles are used on the flooring. Counters are designed to allow knee room underneath. Swing-away or removable grab bars and adjustable-height toilet seats allow flexibility in use. Emergency call systems are provided within reach of users. The standard height of water closets is considered for ease of use. The shower area is provided with movable seats, grab bars, and handles. Showerheads with adjustable height and intensity are provided. Mirrors are located where they will enable the use of the water closest as a seat and as a site for grooming.


Detailed Design Elements


Even the smallest elements are carefully designed and intended to help the elderly. For example, Coat hooks visually contrast with the mounting surface and are easy to access. Grab rails are provided on suitable surfaces to provide a good grip. Handles contrast visually with the door leaf and are easy to reach and locks are positioned above handles. Assistance alarms are provided in all accessible toilets, bathrooms, and shower rooms designed for independent use.


Examples of detailed design elements provided
Examples of detailed design elements provided

Hearing Enhancement System


Hearing enhancement systems are provided where audible communication is an inherent aspect of the space. The presence of a hearing enhancement system is clearly indicated by signage. Permanent systems are installed in bigger spaces. Portable systems are provided for some smaller ones and where flexibility is necessary.


Lighting


All surfaces and elements are evenly lit, and highlighting of components is avoided to the maximum extent possible. The creation of strong shadows on floors and walls is also avoided. Two-way switching for lights is provided where flexibility is required. An adequate visual contrast between all the switch and socket housings and the adjacent wall is provided so that each can be clearly differentiated from the others. Glare is avoided by using controllable light sources. Stairs are lit to a higher intensity than normal, day and night, if enclosed. From the bed, you have easy access to switches and controls for lights, telephones, and television. Adequate lighting is provided, such as task lighting for ironing and sewing areas and reading lamps for the lounge area.


Furniture


The furniture and furnishings provided are residential in nature, to establish a link to the previous living environment. We have mostly used round-edged furniture to prevent injuries during falls.


Finishes


Floor finishes are firm, even, securely fixed, and non-directional. Visual contrasts between floor and wall finishes are optimized. To delineate zones and contribute to a way-finding system, changes in the colour, texture and acoustic properties of floor finishes are incorporated. Wall and ceiling finishes are fully considered alongside floor finishes to optimise the visual, acoustic, and aesthetic qualities of an environment; in particular, concern for people with hearing difficulties and for those who have cognitive or visual difficulties. Shiny and reflective surfaces are avoided.


Outdoor Courtyard Area for each dwellings
Outdoor courtyard Area for each dwellings

Signage


All signage is evident, consistent, and simple to comprehend. The letters and symbols contrast visually with the signboard. For example, interior signs use white symbols on a dark or black background.

Safety Features


Audible, visual, and tactile alarms or alerting devices are incorporated. Visual alarms are positioned so that they can be seen from all areas of a building.