ImplicationsVOL. 06 ISSUE 09

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Senior Housing Globalized

Related Research Summaries

Senior Housing GlobalizedJeff Rosenfeld, Ph.D.

The age wave was defined by Dychtwald (1990), as the increasing number of elderly and the influence they would have on society, especially design. This age wave was once the demographic in only the most industrialized societies, but is now occurring worldwide (AARP, 1998). Most nations in the world are “rectangularizing,” which means they are experiencing increased longevity of their citizens along with declines in fertility (Bengston et al., 2003). Because of rectangularizing, Asia must now be as concerned about senior housing as Sweden, Germany, the United States, and other post-industrial societies.

Prior to these demographic shifts, there has never been a tradition of senior housing in China, Japan, India, and elsewhere in the Pacific Rim. Families have always cared for the elderly. West is now meeting East in the design of nursing homes, retirement communities, and assisted-living facilities for Asia’s aging population.

This issue of Implications describes recent developments in senior housing in India, China, and Japan. Data is still preliminary but already suggests two important areas of concern when traditional societies

design senior housing. First, there may be conflict between Western code regulations and cultural belief systems. Second, there may be conflict with spatial norms concerning privacy and intimacy in Eastern cultures.

Official Codes Versus Belief Systems The first conflict arises between implementation of building codes and maintaining the cultural belief systems that govern the care and housing of older people. Buildings designed to pass inspection sometimes challenge occupants’ religious or spiritual beliefs. Building codes set standards for fire safety, air circulation, accessibility, handrail heights, set-backs, exit locations, and much more (Goodman & Smith, 1992). Yet, belief systems impose different, occasionally competing standards. The result can diminish the functionality of sleeping space, kitchen areas, and even traffic-flow in corridors.

In China, for example, some newer, Western-style facilities have been criticized for ignoring principles of Feng shui, which specifies how buildings should be sited, and informs the placement of plants, beds, and mirrors in bedrooms. New retirement housing in India is another example of housing that conforms to building codes but ignores traditional norms segregating men from women, and people of different

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social castes. As a result, some residents make lengthy corridor detours to avoid passing people from other castes. Additionally, the design of kitchens and dining areas must conform to local building codes, but this often conflicts with religious dietary laws that govern kosher, halal, or sattvic cooking.

Western and Non-Western Spatial NormsThe second conflict is the difference between Western and Eastern norms when designing sleeping and toileting areas. Expectations are more about privacy and social distance than codes. Non-Western cultures do not necessarily define privacy for sleeping or toileting the way that Western cultures do; accommodating these needs has required modifications the design process. For example, the Western norm is to design private or semi-private bedrooms. Yet India’s homes for the elderly have a tradition of dormitory-style sleeping arrangements (see Figure 1).

A home for the elderly in India may consist of multiple dormitories. The Sada Sukhi Ashram, for example, consists of 10 rural hut blocks, each with a dormitory where residents sleep on cots (Rosenfeld & Chapman, 2008). The idea of senior housing is still so new in China that residents are open to a variety of

arrangements including dormitory-style housing (Lai, 2004). In short, Western sensibilities have influenced the design of bedrooms, toilets, and showers as senior housing comes to non-Western cultures. But Muslim, Hindu, and Chinese communities sometimes have different ideas about privacy, and cultural values should be acknowledged accordingly.

East Meets West: Other Cultures Respond to Senior HousingIn parts of the world without a tradition of senior housing, there has been no architectural vocabulary to draw upon. Therefore, design of new senior housing in Asia is designed based on Western models. However, there are also cases when the design is deliberately modified to reflect local norms or values, and models of innovation that are distinctly non-Western have emerged. Traditional designs in senior housing are still present in Asia, but have been affected by changes in economics, policy, and innovation.

Economics and PolicyIt was once the norm for older people to live with their married children. Homes for the elderly date back to the 18th-century (Nair, 1989), but were only for indigent elders and for those without nearby support from family members. India’s “Economic Miracle” has transformed much of Indian society. India’s government liberalized the economy by opening it up to more foreign trade and competition which created changes in family support. Many younger people have moved to big cities or immigrated to the United States for more opportunity. They must often leave their elders behind or bring their elders to far away places.

Due to the economic development and urban migration of Indian society, a small but growing number of luxury retirement resorts have evolved, which are essentially Western in form and function. They offer everything from spas to Internet access. Residents live in luxury bungalows, cottages, or elegant apartments. In high-

Fig. 1: Widowed women live and sleep in dormitories.

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tech cities like Bangalore, it is becoming a status-symbol for aging parents or in-laws to live in luxury retirement resorts (see Figure 2).

In China, senior housing is being designed to reflect local belief systems, politics, and vernacular architecture. China is in the midst of a senior-housing boom (Qin, 2005). They have had to plunge into the design and construction of senior housing, in large part because their “one child” policy has been so successful. The current shortage of caregivers for the aging members of many Chinese families has separated older people from the children who could care for them.

An estimated 18% of older people in China are now living in some form of senior housing. An additional 20% of Chinese people surveyed say they would prefer to live independently, or in one of China’s 36,000 nursing homes if only they could afford to do so (Shanghai Daily, 2004).

Traditional and Aesthetic ValuesArchitecturally, China has adapted much of its senior housing by creating the distinctive spaces needed for Chinese exercise, Chinese medicine, and various forms of Chinese recreation. Major architectural decisions, such as the direction in which a building will face, are influenced by the Feng shui of the site.

Interior design is also influenced by Feng shui and includes use of traditionally auspicious color (such as red) and placement of furniture in dining and sleeping areas. More attention is given to doors and gates, which are traditionally an important part of Chinese domestic architecture.

Entry areas have been more carefully modified than any other areas of nursing homes or assisted-living facilities in China. Many new senior care facilities in China have done away with reception areas and information desks. In an attempt to create more auspicious entry areas there might be a fountain, wind chimes, and greenery at the entrance. All of these give a nod to traditional Chinese home design. The result is living space that builds both on Western design and Chinese sensibilities (see Figure 3).

Many Japanese nursing homes and assisted-living facilities set aside space for distinctive Japanese rooms. The Japanese room will be decorated in traditional Japanese style complete with tatami (straw) mats and tokonoma (alcoves to display flower arrangements or art). The form and function of the Japanese room is different from other public rooms. It is a place for contemplation and traditional Japanese activities like flower arranging. Whenever possible, nursing homes maintain Japanese gardens

Fig. 3: An elderly resident looks out at the traditional Chinese garden in the courtyard of the Mingshen Nursing Home in Northern Shanghai.

Fig. 2: This upscale retirement community on the outskirts of Chennai, India has Western style amenities such as Internet access.

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(see Figure 4) and will even add a teahouse if space and budget allow. The goal is to honor Japanese sensibilities even in a Western-style facility.

A small but growing number of modern nursing homes in India pay special attention to their gardens, and maintain traditional, Hindu paths for wandering and meditation. These are essential for Vanaprastha, a type of meditation that older people practice. Residents must have easy access to the garden day and night, which impacts the design of corridors and residential wings, even in India’s newest nursing homes. Japanese Zen gardens, and Indian groves for Vanaprastha might appear unusual to Western visitors; but they are modifications that meet important needs of older people in these countries.

InnovationNew architectural forms and design philosophies have been developed by architects Arakawa and Gins who work in a suburb of Tokyo, Japan. Their innovative approach includes the “Reversible Destiny Loft” that encourages aging-in-place in innovative ways. As the title suggests, the housing itself is meant to reverse, or at least postpone, the physical and cognitive changes that often occur in old age “...by making you defend yourself against them” (Doctorow, 2007, p. 1). The living space has color, texture, and floor plans that keep residents vibrant by challenging them. Floors in some rooms are grainy, textured, and concave; the door leading to the terrace is deliberately so low

that the elderly resident must stoop to go out on the terrace; and electric switches are intentionally placed in unexpected locations, “...so that you have to feel around for them” (Doctorow, 2007, p. 1). Influenced by the growing need for senior housing in Japan, Arakawa and Gins have responded with innovative design and their own ideas about aging. They have created living space that is intended to make life more stimulating (see Figure 5).

West Meets EastGlobalization is also bringing design, technology, and people from many cultures to the United States. The challenge in the U.S. will be to design senior housing for populations that are ethnically diverse. There have already been attempts to create housing for elderly people from particular ethnic groups. For example, in Pawtucket, Rhode Island, there is a housing development for elderly Asian-Americans (Abbott, 2006) and housing for older Jewish adults (Schwarz, 1996). A Web site, “Ethnic Elders Care Network” (www.EthnicEldersCare.net) offers information on places where elderly people can relocate to live with others from the same ethnic group.

Culturally specific design has a new twist in ethnically diverse communities. There are a growing number of facilities that designate an entire floor to one ethnic group and another floor to a different ethnic group. USA Today reported this phenomenon in Chicago

Fig. 4: Japanese rock garden in a Tokyo nursing home.

Fig. 5: Reversible Destiny Lofts in Tokyo Japan

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noting that at the Mid-America Convalescent Center “...Asians live on one floor, Hispanics are on another” (2004, p. 1). At the Alameda Center in Perth Amboy, New Jersey, culturally specific design exists for Hindu residents. The floor contains a Hindu shrine as well as culturally appropriate colors and decorations (see Figure 6). They also have a Latino floor specifically designed for the Latino residents. The floor features a tropical garden and solarium, as well as the sounds, colors, and salsa music that are found in many Latin American communities (see Figure 7).

As we have seen through these examples, East has met West in the design of senior housing across the globe. These projects have demonstrated designers’ abilities to attend to culture as an important part of the residents’ welfare and quality of life. The development of such communities will continue to influence culturally specific design solutions for senior housing in the future.

References—AARP. (1998) Aging everywhere: Global aging report. Washington, DC. —Abbott, E. (2006, November 26). Creative housing ideas for an aging population. The New York Times, pp. 1-4.—Babwin, D. (2004, October 12). Ethnic nursing homes on the rise. The Associated Press, p. 1.—Bakker, W. (2005). Evolution of living. Global Report on Aging: Special Issue: The Promise of Livable Communities. pp. 1-9. AARP.—Bengston, V., & Lowenstein, A. (Eds.). (2003). Global Aging and Challenges to Families. NY: Aldine Transaction.—Clemetson, L. (2006, June 13). U.S. Muslims confront taboo on nursing homes. The New York Times, p. 1.—Day, K., & Cohen, U. (2000). Culturally-specific design supports dementia patients. Environment & Behavior, 23(3), 361-399.—Doctorow, C. (2007, February 13). Tokyo elder-condos demand that you defend yourself against them. Retrieved from http://www.boingboing.net/2007/02/13/tokyo-eldercondos-de.html.—Dychtwald, K. (1990). The age wave. NY: Bantam Books. —Goethe Institute. (2008). The city of the future: A paradise for senior citizens? Town planning for an aging society. Retrieved from http://www.goethe.de/kue/arc/dos/dos/sls/sdz/en1417880.htm.—Goodman, R., & Smith, D. (1992). Retirement facilities: Planning, design and marketing. N Y : Whitney Library of Design. —Goodman, R., & Smith, D. (2004). Nursing homes opening up across the city. Shanghai Daily, p.1. —Lai, C. (2004). More flats to cater for needs of the elderly. South China Morning Post. p. 1. —Lai, C. (2005). More nursing homes in Chicago grouping residents by ethnic groups. The Associated Press, p. 1.

Fig. 6: Dedicated Hindu floor deocrated with the colors, fabrics, melo-dies, and fragrances of India. Perth Amboy, NJ.

Fig. 7: Dedicated Latino floor where residents enjoy salsa music and Latin colors and decorations. Perth Amboy, NJ.

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—Nair, T. (Ed.). (1989). Care of the elderly: Organizations caring for the elderly in India. Madras: Madras Institute on Aging.—Qin, X. (2005, October 24). Facing up to the graying of China. Beijing Times, p. 1.—Sarfaty, C. (2005, November 4). Nursing home focuses on ethnic needs. Home News Tribune Online, p. 1. Retrieved from http://www.alamedacenter.com/docs/HomeNewsTribuneArticle.pdf.—Schwarz, B. (1996). Nursing home design. Garland Publishing, Inc., p. 121. —Schwarz, B. (2004, October 10). More nursing homes in Chicago grouping residents by ethnic origins. USA Today, p. 1.

About the AuthorJeff Rosenfeld, Ph.D., is Director of the Gerontology Program at Hofstra University and an adjunct professor at Parsons School of Design. He writes often on the design and evolution of senior housing and culture. Together with architect Wid Chapman, AIA, Rosenfeld has published Home Design in an Aging World (Fairchild Books, 2008) that looks at the design and evolution of senior housing in seven of the world’s most rapidly aging nations. He is currently working on a subsequent book, Nirvana: The World’s Most Beautiful Retirement Communities.

Related Research Summaries InformeDesign has many Research Summaries about culture and aging, and other, pertinent, related topics. This knowledge will be valuable to you as you consider your next design solution and is worth sharing with your clients and collaborators.

“Religious Symbolism and Place Attachment”—Journal of Environmental Psychology

“Design of Sacred Space” —Journal of Interior Design

“Socialization in Elder Communities”—Ageing & Society

“Evaluating Nursing Home Environments”—The Gerontologist

“Adjustments to a Retirement Community”—Journal of Housing for the Elderly

“Cultural Perceptions of Aging Affects Retirement Living”—Ageing & Society

Images Courtesy of:Ryan Pyle (RyanPyle.com) (p. 1 and Fig.3)Phoebe Liebig (Fig. 1) The Ashiana Utsav Resort, Bangalore, India (Fig. 2) Green Tokyo Nursing Home (Fig. 4)Shusaku Arakawa and Madeline Gins (Fig. 5)Alterra Care Center (Figs. 6 and 7)