Our Town comes to the nursing home - unique nursing home interior design concept from Guynes Design Inc

Nursing Homes, Sept, 1994 by Patricia Moore, Kristin Joyce

It's a short elevator ride to the lower level of Ballard, a family-owned health care residence in Des Plains, IL. But when the elevator doors open, you may have to remind yourself that you are, indeed, in a nursing home rather than on the streets of your home town. Rather than hallways and nurses' stations, your view is one of markets, banks, park benches and even a four-door sedan. It's all part of Our Town, one of dozens of innovative rehabilitation environments created by David Guynes, CEO of Guynes Design, Inc. (GDI).

Our Town is a simulated community environment designed specifically for geriatric rehabilitation. Patients relearn every aspect of day-to-day living,from climbing stairs to making banking transactions, all in safe, familiar, noninstitutional surroundings. Our Town provides rehabilitation therapists with a real-life environment in which to assess the effectiveness of their patients' therapy programs before they are discharged. Patients gain confidence in their abilities, learn to identify and accept their limitations and regain the greatest degree of independence possible.

Our Town was the final addition to Ballard's new, fully-integrated rehabilitation suite, called Transitions in Rehabilitation. It includes physical, occupational, speech and hydrotherapy, as well as a model "ADL apartment". The 231-bed skilled nursing facility has a 76-bed geriatric subacute rehabilitation program with two new dedicated subacute units. Our Town officially opened June 16 and is the first of these environments created specifically for long-term care-based rehabilitation. GDI will use the facility for protocol development and research and is under contract to create an additional 17 Our Towns for skilled and intermediate nursing facilities across the country. The free-standing structures, made primarily of wood and laminate, were easily installed in two weeks and meet all building codes and regulations. GDI has created rehabilitation environments in spaces of widely varying sizes.

Ballard's Our Town was funded with conventional financing, and an analysis of the volume of Ballard's therapy clients, including those using the new outpatient services, suggests that the facility will recover its investment in the first year of operation.

For now, Our Town is used primarily by Ballard's geriatric subacute patients recovering from neurologic conditions, such as stroke, and orthopedic procedures, such as hip or knee surgery. Ultimately, Ballard hopes to use the new rehabilitation suite-including Our Town-to provide outpatient rehabilitation services as well. Our Town normalizes routines and helps to keep residents as active and independent as possible for as long as possible.

The Nickle Tour

When accompanied by a therapist, nurse or sometimes a family member, patients can visit the Our Town community daily. Above-ground windows provide plenty of natural light and, if not for the sensation of the elevator ride, you'd be hard-pressed to believe you were on the basement level. Because Our Town is a multi-dimensional, multisensory experience, the following brief tour is an attempt to convey what Ballard patients see, hear, and experience when they enter this unique environment.

Once off the elevator, we walk down what was once a long, empty, rather nondescript corridor which is now transformed by floor-to-ceiling photo murals depicting various Des Plaines-area businesses, residential areas and other familiar points of interest. Mirrors not only make the corridor appear wider, but also provide a place for patients to stop and check their appearance. This, in turn, provides motivation for better personal hygiene.

Everywhere we look, a variety of street signs and store advertisements provide therapists with opportunities to conduct cognitive assessment and training, by having residents identify signs, letters, colors and shapes and do counting exercises.

As we turn to the left, we see an archway with the words, "OUR TOWN MARKET" in raised gold lettering. Inside the market, patients maneuver through the turnstile and fill a grocery cart with a range of simulated, but very realistic, food items of differing sizes, shapes and weights. Patients scoop bulky items from bins, reach up to high shelves, and weigh produce. Pet owners can even test their ability to lift a bag of dog food. At the checkout, the therapist may do some role playing as the cashier, assessing the patient's ability to read and recognize prices, count change, stay within a budget, etc. This also gives the therapist an opportunity to intervene if the patient's limitation might place him or her at risk for being conned or "taken" as a consumer.

Just beyond the market to the left, we come to the gazebo, a home-like structure with multiple entranceways, each with its own rehabilitative challenge. Patients can maneuver up a ramp or low-rise stairway with assistive devices. Once on the porch, they can ring the door bell, retrieve the mail and newspaper, open the screen door and unlock the inner door that leads to the foyer.