What We’ve Learned About Making Hospitals Better For Seniors

Today, seniors represent over 25% of the U.S. population. This number is only going up as baby boomers, one of the largest demographic generations to date, age. This means one in every four people entering our healthcare facilities seeking care is a senior. With access to information on how to live healthy, coupled with active lifestyles, these seniors are also living longer. These trends have fueled the rise of orthopaedic facilities nationwide.

According to the American Academy of Orthopaedic Surgeons, as of the first quarter of 2014, there are at least 2.5 million Americans living with an artificial hip and 4.7 million with an artificial knee. This is a 188% increase in knee replacements and 123% increase in hip replacements for patients age 45-64. With advances in technology resulting in quicker stays and faster recovery times, these types of surgeries are on the rise. It is imperative healthcare facilities, not just orthopaedic ones, be designed with seniors in mind.

Rice Fergus Miller is a leading architectural firm in senior living design in Washington State.  Two of our current projects, phase two of Timber Ridge at Talus in Issaquah, Washington and Trillium Woods in Plymouth, Minnesota, are in the final stages of construction. Between these two projects are 1.6 million square feet of independent living, assisted living, skilled nursing, acute rehab, and memory care.

Rice Fergus Miller also designs healthcare settings. We are in the early stages of design of a new stand-alone behavioral health hospital, and are awaiting bids for the construction of Olympic Medical Center’s Medical Office Building and Urgent Care in Port Angeles, Washington. Two years ago, we welcomed the first patients to the FHS-Harrison Medical Center’s new 24-bed orthopaedics specialty hospital.

When designing The Orthopaedic Center at Harrison, our healthcare team relied heavily on lessons they learned while working on the senior living projects. Having over 40 years of cumulative healthcare and senior living design experience and a deep understanding the science behind aging, the team made sure to include the following in the design:

1. Safety of movement for the patient and staff:  Toilet located three steps away. Post-operative patients have a higher risk of slips and falls. This is only heightened for seniors due to their relative lack of strength lessened in both the upper and lower body musculoskeletal systems.   Getting in and out of bed and safe movement within the patient room are critical to patient safety. Locating in the toilet on the head wall allows the patient to be in the toilet room in three easy steps. Continuous hand rails, from bed side into the toilet, provide added support to the patient and further minimizes chances of injury. Zero clearance no step over showers are a priority.  Adequate space at the wall side of the toilet fixture to allow a “two person assist for toileting is also important.  Patient rooms are designed in a way as to allow generous space for equipment, staff, and family.

2. Color palettes, signage and wayfinding that are senior friendly. Eye sight deteriorates with age, and the aging eye lens tends to “yellow,” causing a misperception of colors, especially those in the yellow and reds tones which tend to blur together.   To overcome this, we chose colors using yellow lens glasses to assure the colors in the hospital would not only be pleasing, but also where signage is concerned be readable.   Additionally, we chose larger text for signage that is easily readable to older eyes. Another area of concern for aging eyesight is the misperception of contract in the floor as a potential step, which when perceived, can cause the patient to misstep and potentially fall.  Heavily contracting colors in the floor should be avoided for this reason.  Contrasting colors and textures were used to give patients additional visual cues, such as in flooring transitions. All text for signage and wayfinding are contrasting, larger, of appropriate color as to be seen accurately and quickly.

3. Dexterity is a consideration. Hand grabs, rails, door hardware, and casework pulls were chosen to be easy to grasp, turn, push or pull. This allows the elderly patients, as well as staff, to do fine and gross motor operations even with weak muscles or arthritic joints.  Where possible, sliding doors are preferable to swinging doors as they are safer to transition through during the operating motion.

With the focus on patient care and positive patient experiences, it is important for healthcare designers to consider a wide demographic for their facilities. An understanding of how seniors move, behave, and even see is critical to successful facility design be it new construction or a retrofit.

-Mike Miller is a senior principal at Rice Fergus Miller. He has been active in the design of senior living and healthcare facilities nationwide for the past 35 years. He has written several articles and is a speaker in senior living and healthcare conferences. 

– Ivi Gabales, with a BS Architecture from the University of the Philipines, has worked for several years as an architect. With over 20 years of design, construction, and marketing experience in several markets, she brings this knowledge and experience to the Rice Fergus Miller’s marketing efforts.