Design for adult day care

Nursing Homes, Sept, 1994 by Annemarie Kretschmann

A cult Day Care Centers have become increasingly popular components of contemporary nursing homes. For caregivers, Adult Day Care Centers provide a welcome respite for the periodic care of their loved ones. For the nursing home, they represent an additional income stream. As an "introduction" to the possibility of future long-term skilled nursing care, these facilities can serve as a very powerful marketing tool and also provide a means for the facility to reach out to the community.

The most inviting of these facilities feel, to the greatest degree possible, like a home away from home. They also provide a range of activities and services designed to enrich the guests during the time they spend there. These characteristics are both restorative for the guest and reassuring for the caregiver, who can frequently be anxious about leaving a loved-one behind. Meanwhile, nursing home management is rightfully concerned with the efficiency and functionality of the spaces, the marketability of the facility, and the durability and maintenance of materials, fixtures, and furnishings. The good news is that thoughtful planning and a little creativity can bridge all of these requirements.

Take, for example, the Adult Day Care component of the new Genesis Center for Health and Rehabilitation (GCH&R) in Windsor, Connecticut. The Center is located within a freestanding pavilion at Windsor Hall, a newly renovated, skilled nursing facility, owned by GHV Associates.

Anticipating guests who would have a range of physical and emotional states, Genesis offers three different environments, along with reception and conferencing areas. Since the ideal floor-plan for an Adult Day Care Center consolidates all activities on one level and minimizes corridors to reduce the number of staff required per guest, at GCH&R, all activities revolve around a multi-purpose room located in the center of the facility. We designed this room to be light and airy, although it is fully equipped for the safety and comfort of the elderly and the utility of the staff. Dining and activity tables are wheelchair height, and vinyl-coated fabrics are used that clean up easily, but appear to be elegant chintz. Chairs are equipped with arms and pommel grips; they are also specified with a space between back and seat for easy cleaning. A functional kitchenette, suitable for light snacks and refreshments, does double duty as a backdrop for cooking and arts and crafts I demonstrations.

Both the quiet room and the TV room connect to the multi-purpose room. In order to increase the interaction between guests and facilitate their care by staff, views are provided through clear glass for the multi-purpose room into both the quiet and TV rooms

The quiet room palette draws on traditional furniture and rich jewel tones to impart the feeling of a traditional, cozy study. The room is furnished with bookcases, lounge seating with ottomans, recliners for sleeping, and occasional tables. Cream-colored walls are bordered in a stylized floral pattern. Window treatments provide good sun control, an important design feature for quiet rooms.

The TV room presents a decidedly more casual atmosphere. We dressed up ivory colored walls with a rattan, ribbon-pattern wallcovering border. Queen Anne-style furniture in whitewashed pine is covered with a floral chintz in cooling, pale shades of soft green, blue and lavender. The room is equipped with lounge seating, ottomans, and occasional tables.

Conference and reception areas play an important role in establishing the feel of an Adult Day Care Center. Reception sets the tone for the facility and helps establish the mindset of both quest and caregiver. We prefer that reception areas feel more like a hotel lobby or conceirge desk -- an environment in which guests "check-in" for the day, rather than feel as though they are being "admitted".

Because they are frequently used for meetings with family members during periods of stress, we design conference spaces to be conversational rather than "conference-ational". At GCH&R, for instance, cream walls serve as a backdrop for comfortable chairs and Queen Anne-style coffee tables. Medium cherry wood finishes complement the floral, tapestry-like fabric of the furniture, rich in peaches and greens. A lowboy both serves refreshments and store brochures and other marketing information about the facility.

In designing Adult Day Care Centers, we fully expect guests to bring some "baggage". For some, it will be medications which need to be refrigerated or secured. Others might carry books, a favorite pastime, or a comforting afghan. Many guests will bring a change or "comfort clothes" such as slippers. For this reason, the availability of closets, and preferably lockers, is a critical consideration.

GCH&R also felt it was important to include four special amenities not always found in these facilities: a walk-in shower for therapy and training; a patio equipped with a departure alert system; a physical therapy room; and Physician's Services office.