Senior Living Update: Senior living demands materials with optimal function and elevated aesthetics - March 2021

By Jessica Chevalier

Senior living demands more of its interiors than perhaps any other sector. The functionality of the spaces has a direct impact on the health of residents; good spaces promote independence, both physical and mental, while poor ones inhibit it. Flooring is key in supporting these goals, with the best solutions offering a feel of home, while also performing at the highest levels with regard to safety, moisture resistance, ease of maintenance and durability.

Here, top designers from Perkins Eastman, SWBR and THW share insights on current trends, material preferences and thought strategies behind senior living design, noting that while there are, of course, variations in needs at the different levels of senior living care-independent, assisted living, skilled nursing, memory care-the larger trends generally hold true.

THE NEXT CHAPTER
The transition into senior living can be a matter of need or choice. To attract more from the latter group, these communities have been re-envisioned with an eye on enjoying life rather than awaiting death. With their focus on lifestyle and amenities, modern communities are seeking to attract elders who want to spend their latter years in a community of their peers with ample opportunities for activities, outings and socialization.

This strategy has changed virtually everything about how senior living communities are designed and marketed. While once halls of faded, pale pastels and institutional patterning, today senior living community interiors embrace vibrancy in styling. And in spite of the fact that residents may require medical assistance, the spaces are not hospitals but homes and, as such, are designed to feel home-like.

Amenities spaces, meanwhile, take their cues from hospitality with chef-prepared meals, trendy coffee and cocktail bars, spa services and finishes that communicate a sense of luxury, but still make an effort to convey a sense of home.

Tara Clemens, senior interior designer at Atlanta-based THW, defines the goal of today’s senior living as the creation of “an amenity-rich home that elevates [the residents’] experience and promotes health and wellbeing.” And SWBR’s Amanda Loomis, interior designer, and Leticia Fornataro, senior project manager, focus on the supremely human nature of the work, approaching senior living design with empathy and an eye on using interiors to maintain and support patient dignity.

It is important to note that elders of today are entering senior living at an older age, and that means a higher state of frailty. According to the American Seniors Housing Association, “The average age of senior living residents is about 84 years old. While there are plenty of couples in these communities, most independent living residents are women. There are some who move in close to the minimum age requirement (usually about 65), but most make the move between the ages of 75 and 84. The typical assisted living resident is an 87-year-old woman who needs help with two or three activities of daily living, such as dressing, bathing and medication management.”

FLOORING DESIGN FOR THE CHANGING BODY
When creating homes for older adults, designers are acutely cued in to how age changes the human body. Range of motion becomes increasingly limited. Feet shuffle. Depth perception suffers. Corneas yellow. Hearing fails. Senior living designers aren’t simply creating spaces in which elders can exist, but spaces uniquely suited to the elders’ unique existence.

While flooring design is critical in any location where masses of people will be moving through, in senior living, it is especially crucial because the prevention of falls can avert a spiral of physical problems that can lead to poor quality of life or death. Preventing falls is both a matter of making the proper physical accommodations, such as smooth transitions, as well as eliminating visual barriers, such as significant changes in tone or pattern that might be construed as holes or declines by those with poor vision. For these reasons, flooring specifications in senior living are especially critical.

“For us, it all goes back to safety,” explains Loomis. “Does the material provide proper traction? Do the aesthetics tie into safety, such as patterning that is not too busy? Does it have a glare or a shiny topcoat that can create a trip and fall hazard?”

Carpet, both broadloom and carpet tile, LVT and hardwood are the go-to materials for the residential zones of senior living today, with porcelain also used in bathrooms and public spaces. All of these materials have the ability to withstand the demands of institutional space while also providing a residential aesthetic.

While hard surface flooring, particularly LVT, is frequently used in senior living settings, Loomis and Fornataro prefer broadloom for resident rooms, as it conveys a sense of home that many seniors are accustomed to and also assists with acoustics. “We see a shift toward carpet tile for ease of maintenance,” says Loomis. “That way, if there is an incontinence issue, you don’t have to cut a chunk of broadloom out or take up the whole room.” Broadloom is often used in the public areas of residential units.

Due to the fact that hard and soft surface materials are often used in tandem, collections of different materials with the same profile height are highly prized, as these minimize trip-and-fall hazards.

While cleanability has always been a central consideration in senior living design due to issues of incontinence, it has risen in importance amid Covid to some degree, as the crisis has created a situation in which floors must withstand more frequent cleaning, sometimes with new chemical agents. While Loomis has concerns about already installed products withstanding the new protocols, as of yet she has not seen any failures.

And durability is always a significant consideration, as many communities don’t have the funds to replace finishes frequently.

Ultimately, “when it comes to achieving balance, design and selection of materials has to be very intentional,” notes Loomis. “We need to create a safe environment with the ability to care for universal needs at all acuity levels, and we have to pay attention to visual contrast, cleanability, durability, even visual cues in the flooring in that selection process. Once you figure out all the functional characteristics, you have to take into consideration aesthetics.”

TRANSITION TO LVT
While the transition from VCT to LVT has moved aesthetics away from that institutional feel, designers report that this hasn’t been without its hiccups and requires a degree of re-education for the facilities department. “LVT isn’t necessarily as easy to maintain as VCT,” says Fornataro. “You can’t just wax it and expect it to be fine again. It is easier to scratch and dent.”

SENIOR LIVING STYLE
The designers with whom we spoke work hard to make each project unique and reflective of the community and its goals. There are no cookie cutter designs from one community to the next, so they are always looking for something unique. In addition, they strive to make each space within a community distinct.

“Part of elevating a design is making spaces unique within communities,” explains Jenn McDermott, associate principal with Perkins Eastman. “These are destinations that residents go to every day. We strive to differentiate between areas. In a dining room, on one project, we might use carpet tile. Another could be broadloom. Sometimes it’s a mix of porcelain and carpet at a higher level of care or LVT due to the need for increased cleanability. We use almost every kind of flooring on every project.”

To that end, designers report that while they are generally getting what they need from the flooring industry with regard to function, they often find the styling on senior living specified collections is too bland or traditional. “There are good options on the market,” says Loomis, “but there is also space for new, innovative products. A lot of the time, the senior living selection of products (carpet and LVT) tends to be pigeonholed into the traditional style with large, abstract motifs. It would be nice to see something more transitional. Those larger motifs can work in an independent living hospitality setting but not in memory care.”

Another interviewee notes, “When manufacturer reps come in with a senior living collection, I hesitate to get excited. They are often really limiting and comprised of super traditional looks that don’t align with our vision.”

“There still seems to be a stereotype that senior living uses the same flooring types and design range of products as hospitals and other medical facilities,” explains Clemens. “We do use the same types of products in certain areas and levels of care but look for more hospitality-driven designs, patterns and textures that create a welcoming home environment while still performing with all the technical requirements.”

Sometimes senior living designers are forced to take styling matters into their own hands. “When I started designing senior living projects 17 years ago,” recalls McDermott, “I found that the senior living library was full of products that looked super institutional. I started talking to manufacturers and asked, ‘What makes senior living products more durable and effective at managing moisture?’ So we began looking for products [outside of senior living collections] that we could put moisture backing on to achieve the same quality with a better look.” In addition, McDermott and other designers note that custom coloring is an option they frequently utilize, but that can be a time-consuming endeavor.

McDermott adds that she has seen styling improvements in the ensuing years and especially appreciates manufacturers that seek designer feedback on their collections.

Since manufacturers often release a hefty number of corporate workplace introductions, McDermott scans those collections for more residential looks that make a good fit in senior living. While slip resistance and ease of maintenance are high priorities for materials used in her designs, McDermott reports that “aesthetics are high up there. It’s a win-win if you have something that looks good and can be easily cleaned.”

Clemens recalls a design challenge she faced on her Atlanta-based Village Park Milton project. “The inspiration of the farmhouse vernacular with the urban aesthetic drove the design and selection of materials,” she says. “The challenge was to find flooring materials that expressed this aesthetic with electric, artsy and natural patterns and textures while still meeting all the required technical requirements.”

McDermott notes that Shaw Contract offers a good mix of products for senior living use and that J+J does a great job with patterning. She also calls out Altro’s slip-resistant wood-look products as a great boon in her designs and wishes there were more of such products on the market.

Fornataro and Loomis opt to use materials from a wide variety of manufacturers. “We go with whoever has the right product for the right application,” says Loomis, noting that sometimes the customer will drive the specification based on a positive experience they have had with a manufacturer’s material previously.

THE COVID CRISIS IN SENIOR LIVING
The National Center for Assisted Living reports that there are nearly one million (996,100) licensed assisted living beds in the U.S. with 811,500 residents, which are “the ‘oldest old,’ or age 85 and older, female, and non-Hispanic white.”

The Covid pandemic hit senior living communities disproportionately hard. AARP reports that, as of February 4, “almost 162,000 residents and staff of long-term care facilities have died from Covid-19, according to the Covid Tracking Project, accounting for roughly 36% of all U.S. Covid-19 fatalities.” And designers in the field report that the struggles wrought by Covid, the loss of life and the media scrutiny has been demoralizing for staff.

If it is possible to say there is any silver lining in such a tragedy, it may be this: with the census of senior living lower, facilities now have more flexibility to renovate, without disturbing residents, and create the types of communities that may reduce transmission and minimize the loss of life in the event of crises of a similar nature in the future.

The movement toward neighborhood structures is key to this goal. A neighborhood generally includes a dozen or so residents with shared living and dining space and private bedroom and bath facilities. This type of setting provides an insulated environment that still allows for socialization-in essence, a “quaranteam.” While the movement toward the neighborhood model wasn’t driven by Covid, Fornataro says that “the learning piece is that we are going from a medical model to a household, and infection control is a big plus in that scenario. Having residents in self-contained units that have bedding, eating and kitchen space, rehab space, will be life-saving in some communities.”

McDermott was in the planning phase of a project in Arizona when Covid took hold in the U.S., and she reached out to the owner to ask whether there were any changes they’d like to make to the plan in light of the pandemic developments.

The changes required were small but important. Adjustments were made around the food delivery systems, with increased attention to delivery and take-out options. In the memory care building, doors were added to make it possible to cordon off particular wings, and glass-walled visitation boxes were added. In all of these cases, the changes have no negative or substantial impact on the spaces outside of quarantine times.

For the most part, flooring specifications don’t play a role in these changes. “Everyone wants finishes to be easily cleanable,” says McDermott, “but flooring manufacturers have already done a good job with that.”

Clemens notes that Covid has “adjusted the design approach, in that we are more mindful of creating pockets of seating for gathering rather than one large conversation area and are coming up with creative ways to divide spaces with decorative screening.” Clemens uses flooring material transitions to designate these gathering spots.

SUPPORTING STAFF
Given the stress that senior living staff have had to endure amid Covid, the need for support of their mental and physical well being has never seemed more important. “Sadly,” says Fornataro, “senior living homes have had a horrible go-round with negative press in the pandemic. The institution can take it, but among the staff, there was a loss of a sense of pride. They are the unsung heroes and should not be lumped into the loss. They are doing an amazing piece of work without praise.”

Loomis speaks to how senior living facilities are stepping up to bolster morale and mental well being through this challenging time. “Staff have put their lives on the line and risk exposure to care for those who can’t care for themselves,” she says. “They deserve to go to work in a space that reciprocates that level of care-a space that is inviting, comfortable, uplifting.”

Within those spaces, according to McDermott, using materials that create a feeling of safety and comfort goes a long way. McDermott reports that she likes to specify warm flooring, such as a wood-look LVT, to complement bright, fun décor, which often includes comfortable, lounge-type seating and perhaps a bar-style seating zone for eating. In addition, in recognition of the fact that senior living staff are not paid very high wages, these spaces sometimes include computers and printers for staff use as well as charging stations for electronics.

Some communities also open up amenities, such as the workout facilities, to staff.

Of course, providing staff supportive spaces is not wholly altruistic. Employee retention is a challenge in senior living, especially through difficult times.

As a side note, Clemens reports that “clients are moving away from traditional nurse stations and are encouraging the staff to interact more with residents in an unassuming way, making it less clinical.”

VILLAGE PARK MILTON: THW
With views of Wills Park and access to the bustling urban Alpharetta City Center, Village Park Milton draws inspiration from the farmhouse vernacular of the Atlanta region. Blending contemporary lines with organic materials results in a community where residents can gracefully age-in-place. Milton offers varied opportunities for dining and gatherings such as a coffee bar, chef-led bistro with al-fresco seating and a prefunction space and formal dining room with an enclosed terrace. Entertainment and activities include a great hall, family lounge, movie theater, art room, fitness and rehabilitation center, juice bar, clubroom, and full-service salon, as well as library and function rooms, both with open-air terraces. Many of the resident units and amenities surround an internal courtyard, referred to as the “heart of the community” with an outdoor pool with shading, firepit and locker rooms.

THW opted to use classic materials across the space, including hardwood, broadloom, carpet tile and porcelain, that communicate a sense of timelessness and luxury.

For the reception area, the design team chose an espresso-toned hardwood flooring from BlueSky for the entry that set the tone for the elevated senior environment. In addition, it created a custom feature wall art piece, using a Jamie Beckwith herringbone pattern.

The great hall features 25’ ceilings, hardwood floors, an oversized fireplace and a view to the pool/firepit courtyard. The mix of antiquities, furniture and art create an inviting space for gatherings in pockets of seating. Here, THW continued the espresso hardwood flooring from BlueSky with a J+J Flooring carpet tile inset in a natural pattern. Solution-dyed carpet tile was used across amenity spaces for durability and ease of maintenance.

Nestled between the great hall and bistro, the coffee bar is a gathering spot for residents. In the coffee bar, the design team inset a quirky porcelain plaid tile from Specialty Tile in the espresso hardwood. The tile meets coefficient of friction requirements and has a subtle texture, which adds grip and is easy to clean and maintain.

The prefunction space showcases the industrial farmhouse aesthetic with vintage-inspired lighting and dramatic millwork with Walker Zanger quartzite counters and displays. The space touts floor-to-ceiling tile, chalkboard displays, built-in merchandise display cases with metal barn doors and a banquette. For the space, the design team specified a large-format, linen-look porcelain tile.

The library, overlooking the equestrian park, hosts special events and everyday socializing, For the library, the design team selected a patterned, solution-dyed carpet tile from J+J. Located outside of the salon, fitness and juice bar, the clubroom features the same J+J carpet tile.

Overlooking the park, the dining room features 25’ ceilings and tree-inspired lighting. Residents can enjoy a variety of seating options, including an enclosed terrace and porch. For the formal dining space, the design team selected patterned, solution-dyed carpet tile from J+J that added to the warmth of the space.

For the resident corridor, the THW team designed a custom solution-dyed broadloom transition carpet with bold blue accent lines over the whimsical meandering floral design of the running line product that breaks up the corridor and defines seating areas. It utilized a moisture-resistant backing for added ease of maintenance. The space also features nostalgic entry sconces, furniture and plank ceiling tile reminiscent of tongue and groove. Cozy seating groups are strategically spaced throughout the corridor for small groups or a private reading nook.

MARAVILLA AT THE DOMAIN: PERKINS EASTMAN
Maravilla at The Domain is a senior living community set within a lifestyle center, based in Austin, Texas. Maravilla interiors reflect “relaxed elegance,” using patterns and a color palette rooted in nature, while connecting indoor and outdoor community spaces.

Because the lifestyle center has a plethora of options for dining, Maravilla has only one dining facility for the senior community, as well as a grab-and-go station. (Resources across The Domain are walkable and also accessible via a shuttle system that serves the community.) Because many residents utilize the dining space daily, the Perkins Eastman design team wanted to partition the single space to create three distinctly different feeling venues. For these, the team altered the flooring, lighting and wall finishes to create differentiation and add variety.

The fireplace room features a linear fireplace, wood-paneled walls and recessed wood chevron accents in the ceiling. The broadloom in this area is a custom pattern by Shaw Contract. The second space is adjacent to the fireplace room, separated by a wall with a portal and banquette seating. This area features leather channel wall panels, different decorative lighting pendants and different seating. The third space, around the corner from the prior, features a hexagon-patterned porcelain tile floor and a portal that leads to the private dining room. The artwork in this area varies from the other two spaces in that it features large black and white photographs of the Texas landscape; here, the colors are kept neutral within the floor tile, walls and art.

The client originally requested that Perkins Eastman specify a limestone floor at the entry, leading into the living space and down the corridor to the amenities area. That turned out to be “outrageously expensive,” so Perkins Eastman sourced a large-format porcelain with a limestone look. The team utilized five different formats of the tile to create an ashlar pattern. The lobby is accented with an adjacent bar space.

ST. JOHN’S HOME & ST. ANN’S COMMUNITY: SWBR
SWBR was tasked with renovating two senior living communities in Rochester, New York: St. John’s Home, a skilled nursing community; and St. Ann’s Community, offering independent living, rehabilitation/transitional care and nursing home care. The St. John’s Home project encompassed a whole-campus renovation, which was intended to create a significant shift in culture and space allocation. While the administration offices had previously been located on the ground floor, St. John’s decided to give that space to the residents, moving administration to the upper levels, providing residents access to an enclosed courtyard and natural landscapes. Residential living at St. John’s was transitioned to a small homes model.

Like St. John’s, St. Ann’s transitioned from 42 residents per floor to two residences of 15 elders each. This included a transition to single-resident rooms, many of which include full private bathrooms (the former iteration had centralized bathing).

Fornataro and Loomis created European showers (showers without thresholds) at St. Ann’s Community in Rochester, New York. With the existing concrete deck, there was no way to recess the tile, so the contractors had to chip the concrete away to facilitate the drainage-a cumbersome task.
When the SWBR design team visited St. Ann’s prior to renovation, they made note of stickers on the walls that were used as therapy cues. For the new space, they decided to incorporate those cues into the flooring, changing the carpet pattern at certain intervals to use as therapy distancing measurements.
Each floor of the facility uses a different color palette to create differentiation and assist residents with wayfinding.

SWBR sought to create a barrier-free facility, utilizing carpet insets of the same height with LVT, so as to minimize transitions.

HOMESTYLE
Family-style living provides a host of benefits for elders, providing a network for socialization that potentially staves off loneliness while also reducing exposure to illness and risk.

As senior living spaces have evolved to feel more home-like, an important focus for Loomis and Fornataro is creating differentiation between public and private space. “One of the things we use as design intent is keeping in mind progression from public space to private,” explains Fornataro. “If you enter a home, you walk into a vestibule of sorts, then into the living room, dining room or kitchen. There is a separation from the bedrooms. When we are designing projects, we keep these basic principles in mind and look at the progression of public space, perhaps an elevator lobby, into semi-public, living/dining/kitchen, and into the residential wing.”

Copyright 2021 Floor Focus 


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