The Madison House - nursing home

Nursing Homes, July-August, 1996 by Annemarie Kretschmann

Not long ago, the typical nursing home was little more than a place for the elderly to pass their remaining days. The best of today's long-term care facilities truly resemble a home, where activities and decor encourage residents to keep on living. A recent example is The Madison House, located in Madison, CT., one of the state's premier shoreline towns, and developed by Connecticut Health Facilities, Inc. (CHF), which has a long-standing reputation for leadership in the life care facility market. CHF facilities are designed to meet the prevailing marketplace aesthetics and foster activities as part of patient care.

Understanding the market and recognizing that, if given a choice, families would rather have their loved ones closer to home, Andrew Tarutis, director of development at CHF during the project's design, expressed the following goals: a facility that was upscale, elegant and, above-all residential in feeling. A gracious country inn was the image that came to mind.

There were good business reasons for this, as witness the following results. The facility was fully occupied in nine months, rather than the anticipated 12, has sustained a 100% occupancy rate, and continues to have a long waiting list. Administrator Kathleen Dess reports "exceedingly low" staff turnover and Nursing Director Barbara Slobin says the residents' period of adjustment is unusually short.

Design Overview

One of CHF's goals for the project was that it be totally noninstitutional - a significant challenge in a facility where larger spaces are the norm, and smaller spaces tend to form a repetitive pattern.

Two strategies were needed. The first centered on layout and organization. CHF felt a one-story facility would significantly enhance ambiance. The plan also centralized treatment and administrative spaces in a center core, removed from the residential wings, which then become true havens of rest and relaxation. The second strategy was to "think residential" and strategically apply touches of home in spaces as private as bedrooms and as public as the recreation room.

Walking Through

The residential graciousness begins at the reception area, designed to be reminiscent of an elegant living room. Appointments are homelike in scale and include personal touches such as a writing desk and a sideboard with refreshments. Residents enjoy greeting guests at the front door as if it were their own home. Corniced, draped windows and a chandelier further dress the space.

The wood-trimmed reception desk is unobtrusively built into a wall and resembles a concierge station. Admissions Director Terry Cullen says visitors often equate the ambiance with that of a resort hotel, making it easier to admit their loved ones.

Each residential wing has 45 beds in single and double configurations, shower rooms, clean and soiled workrooms, and, at its center, a nurses station. A focal point of each wing is a three-story atrium.

To reduce the visual scale of the project, and provide a change of pace for residents, we designed each wing with a distinct country ambiance. The Meigs Point wing has an English country theme with plaids in jewel tones, darker chintz florals, and tailored stripes. Artwork is rustic. With its celadon lattice paper, Chippendale furniture and botanical prints, the Meigs Point dining room has an English conservatory feel.

In contrast, the Tuxis Pond wing has a more casual, provincial feeling - tea-stained colors in mauves blues, terra cottas and beiges, and furniture in light oak and maple. The dining room's contemporary pastel plaids, paired with a complimentary stripe and French country floral, offer the ambiance of countryside dining.

Given their size, dining rooms often present intimacy challenges. In health care facilities, tables are not usually set with four chairs in order to accommodate wheelchairs. To help fill the visual gap the table bases are shaped like Grecian urns in a patina finish. Moldings, wallpaper borders, and pilasters further break up the space and help increase a sense of coziness.

In the residents' rooms, several attributes create a feeling of home. The first is the "front door." While standard, oversized fire-rated doors are used throughout, each is transformed into a paneled door through the creative use of molding. Upgraded nameplates literally frame residents' names against a backdrop coordinated to the room.

A centerpiece of every room is a built-in wardrobe with open shelves for personalizing space with cherished pictures and other mementos. Among the other amenities of home: a window seat that affords views of landscaped gardens and an unconventional place to perch, sheer curtains that provide a sense of privacy and soften the outdoor light, and commercial quality candlestick table lamps, bolted for safety and security, and with switches appropriate for the elderly.

A "Change of Place"

Large public spaces require a conscientious effort to create a sense residential ambiance.

As mentioned, the three-story atria are key focal points of each residential wing. Designed as yet another place in which to foster activities, they are equally suited for an English Tea and a "Sunday sundae party" with grandchildren. The bright soaring height adds to the "change of place" feeling but provides another design challenge: while the atrium is only 1,000 square feet, the height, which provides its airiness, also works against its intimacy. Market square umbrellas continue the festive theme and effectively lower the ceiling to human level.