Moving From The Outside In - teams of graduate students create new geriatric long term care designs

Nursing Homes, June, 2001 by Richard L. Peck

A unique program exposes a variety of graduate students to questions--and some new answers--in senior care design

What if your local college or university invited a variety of professionals from diverse disciplines to study long-term care administration and try to come up with new ways to do the job? You might not always agree with the results-but wouldn't it be fun to see what intelligent outsiders might make of what you do? You might even find that some of the new suggestions actually work.

This almost anarchic concept was brought to life in 1994. When two of the leading names in their respective design fields-architect Stanley Tigerman and interior designer Eva Maddox-shard a car trip from the urban design project they had worked on. They ha dlong known that design involves more than bricks and mortar, or carpeting and chintz--it has an impact on people's lives, and can help make those lives better or worse. Their new idea, dubbed Archeworks, would be an alternative, post-graduate school program based on design for social needs. The mission of Archeworks is to "address social needs by developing and providing alternative design education solutions through a multidisciplinary process."

Each year, multidisciplinary teams of interested students of all ages and from all walks of life are turned loose on the broadest challenges of design, ranging from low-income housing for the homeless; to "change" plans for the offices of the Illinois Department of Human Services; to elementary school design-related curricula and Web site communication to connect students, parents, families and communities; to some of the more pressing issues in senior design.

In 1998, largely because of Maddox's deep interest in Alzheimer's disease, Archeworks turned its unique spotlight on it. A three-student team, including a graphic designer, an architect and an art historian, began to explore facets of the disease where design might have a particular impact. The next year saw two European architects, an industrial designer and a graduate student in biology carry on this work. The results: In the first year, a useful supportive device never before seen, and in the second, a booklet addressing ways to make long-term care facilities more livable for Alzheimer's residents.

In recent interviews with students from the two design teams, as well as with Maddox herself, I learned how this freewheeling approach could stir up new ideas and challenge old ones. Speaking on behalf of Team 1998-99 was Maren Nelson, an art historian turned designer and (according to one colleague) "the best welder in the class," and for Team 1999-2000, Sidsel Just, a Danish architect turned book author and porch builder. The program facilitator for both years was Mike Newman.

Team 1998-99: Car Seat Transfer Device

Mike Newman: "The idea was inspired by site visits and interviews we did at long-term care facilities and adult day care centers, and research on families and caregivers. We saw the difficulty family members and caregivers have in helping Alzheimer's residents get into cars. It takes so much time and effort that often the residents just stay home and miss out on outside activities. And it seemed that no one was addressing this."

Maren Nelson: "This was one of the more difficult projects because there was no way to communicate directly with the residents themselves about the problem. But we thought that if we just broke down the act of getting into a car into individual steps that were simpler and easier to comprehend than trying to do everything at once, the process would go faster. We came up with a device that folds out like an ironing board, with one end resting on the car seat. The resident sits on the board and then slides onto the car seat."

Newman: "Because the prototype was heavy--it's made of steel and wood--we were unable to test it effectively, and we're now working with manufacturers using lighter-weight materials to develop this further and bring it to market."

Nelson: "What was interesting about the process was the diversity of the team involved: The architect brought design and computer skills; the graphic designer brought a design perspective and a great work ethic; and I, as an art historian, have studied anthropology and like to focus on the relationship of the human body to objects that come in contact with it. And we all liked to work in the shop. It was what I call an 'uberteam,' bringing various skills and motivations together into a stronger whole."

Team 1999-2000: Archeworks 2000: Alzheimer's Design

Sidsel Just: "We wanted to further the work of the previous year on the problems of transition for the Alzheimer's resident. How do residents transition from one step to another in, say, making toast or going to the bathroom? One of our team members broke down these activities into separate steps, again, to get some idea of how to simplify things and have the design encourage achievement of each step. We also asked, how do residents transition from private to public and back again? We noted, for example, that many of the nursing homes we visited had lots of activities for Alzheimer's residents, but we wondered what happened between activities. We saw lots of attempts by caregivers and families to individualize room entry-ways because even for someone without Alzheimer's, orienting oneself in these long hallways is difficult enough. We wondered if there were other ways to modify room entrances."