Sustainable Community and Architecture for the Aging

Jeffrey Anderzhon, FAIA

Fairfax, Virginia, USA

Sustainability is not simply a design problem

• Sustainability must be based on core business practices

• Sustainability must be integrated with a business strategy

• Sustainability must integrate design with operations

• Sustainability must include continuing education of all building users

Income

$35,825 median for family

households 65+ in the U.S.

$15,193 median for people 65+

reporting income in the U.S.

Percent Distribution by Income:2004

Source: U.S. Census Bureau

Long-term financial stability is an issue of sustainability of aged facilities

Cost of Care

$77,380/year U.S. National

average rate for private

nursing room

$68,985/yearU.S. National average rate

for semi-private nursing room

Avg. Length of Stay: 2.4 Years

2006 Met Life Market Survey

Cost of Care

$36,372/year U.S. National

average rates for assisted living

$51,204/yearU.S. National

average rates for assisted living

Alzheimer’s Care

Average Length of Stay: 21 months

2006 Met Life Market Survey

Income

3.6 million elderly in US were below the

poverty level in 2004

Another 2.3 million were classified as

“near poor”

Source: U.S. Census Bureau

1.6 million people in U.S. are

in 18,000 nursing homes

Nursing Home Care in U.S. is a $111 billion business

annually2004 Met Life Market Survey

Cost of Care

Cost of Care

46% of Nursing Home and Home

Care Costs in U.S. are paid by Medicaid

(U.S. Government reimbursed)

12.4% are paid by Medicare (Partial U.S. Government

reimbursed)

Medicaid46%

Medicare12.4%

Out-of-Pocket27.9%

PrivateInsurance

7.7%

Other 6.1%

2004 Met Life Market Survey

Operating costs are the largest on-going capitol outlay

Sustainable staffing affects design

Nights Days Evenings Total

32 Beds

Hours

PPD

40 Beds

Hours

PPD

60 Beds

Hours

PPD

RNs 7.5 7.5 7.5 22.5 .70 .56 .50

LPNs 7.5 7.5 .23 .56 .46

Nsg. Asst.

15 30 22.5 67.5 2.10 2.06 2.00

Total 22.5 45 30 97.5 3.05 3.18 2.96

Source: LeaderStat, Inc.

•Good design can improve staff efficiency and thus reduce the cost of staff

•This scheme shows close attention to how staffing is utilized in a nursing home with three staffing shifts during a 24 hour period and functions well during each shift

Colorado Veterans Home

Aurora, Colorado, USA

Boulder Associates

Sustainability is holistic

In the U.S. the only sector that has experienced job growth is the healthcare sector

Staffing for aged care in developed countries will come from the younger aged group of undeveloped countries

Regulatory Challenges

Energy Codes Senior-Friendly

5 Footcandles in Corridors

20 – 30 Footcandles in Corridors

• Per Illuminating Engineering Society of North America (IES), 75 year old eye lets in 25% of the light of a 25 year old.

Regulatory Challenges

Energy Efficiency Senior Friendly

Typical Working / Living Environment Temperature

72 - 75°

Typical Working / Living Environment Temperature

75 - 78°

• Air Temperature delivered at a Higher Level for Seniors

• More Challenging to Achieve US Green Building Council (USGBC) Leadership in Energy & Environmental Design (LEED) certification points for Energy Efficiency

Regulatory Challenges

Energy Efficiency Senior Friendly

Sophisticated HVAC Systems with Control

System Design for Engineers

Difficult Devices for a Layman to Operate; Not as Easily Adjusted to Senior

Needs

Forest Side ALF for Dementia

Washington, DC

JSA, Inc. Architects

Sustaining the Aged in an Adaptive Re-use Structure

Avalon Square

Waukesha, Wisconsin, USA

KKE Architects

•Incorporates an historic structure that is a visual and historic icon of the community into the scheme

•Provides commercial space on the street level for both resident and community use

Akasaki-cho Day Centre Ofunato-shi, Japan

•Re-uses an existing home that was scheduled for demolition, with minimal change as a day-care for those with dementia

•Retains cultural connection to the physical environment

St. Monica Trust

Sanford Station, UK

KWL Architects, Ltd.

•Reclaims an old railway station and buildings for an aged community•Retains the character of the community; avoids demolition•Invites the surrounding community onto the campus with walking and biking trails

Felician Sisters Convent Corapolis, Pennsylvania, USAPerkins Eastman Architects

•Combines active sustainability design with adaptive reuse of an old school building

•Reinforces the teaching mission of the client

Westbury Fields Village

Bristol, UK

KWL Architects, Ltd.

Sustaining the Aged in their own Community

•Retaining the aged in their own community retains their wealth and talent as well as providing diversity in the community

•Developing aged communities in city centers reduces the need for automobile use

National Demonstration Home

Roseville, CA, USA

Eskaton

•Retaining the aged in their own homes reduces new construction and the harm to the environment it causes

•Appropriate universal design concepts will allow residents to live in their own homes longer and negate their need to buy new housing thus sustaining their individual resources

Peabody Retirement CommunityNorth Manchester, Indiana, USARLPS Architects

FoulkewaysGwynedd, Pennsylvania, USA

RLPS Architects

The Royal Star & Garter

Solihull, UK

Scurr Architects

Sun City Ginza East

Tokyo, Japan

Perkins Eastman Architects

Goodwin House-Bailey’s Crossroads

Falls Church, Virginia, USA

DHPY Architects

The Mirabella at South Waterfront

Portland, Oregon, USA

Ankrom Moisan Associated Architects

Sustaining the Aged in an Amenity-Rich Community

Marywood Center

Grand Rapids, Michigan, USA

Perkins Eastman Architects

Sustaining the Aged in an Purpose-designed Sustainable Environment

Sydney Aged Care CentreSydney, NSW, Australia

• Fully recycling storm water (gray water)-saves $1,200/month

• Low energy lighting-first cost payback in 18 months-saves $1,477/month

• Low water usage fixtures-first cost payback in 16.5 months

Sustaining the Aged in an Purpose-designed Sustainable Environment

• Environmentally sound storm water management practices

• Use of native plant species to extend wildlife habitat

• Use of permeable surfaces for walks and drives

• Active composting

• Critical attention to use of natural light

• LEED approach to building design

Summerset Village Katikati

Western Bay of Plenty, NZ

Space Architecture Studio

Sustaining the Aged in an Purpose-designed Sustainable Environment

Retirement Home for Priests

Ivory Coast, Africa

HKWN Architects

•Retirement campus replicates typical Ivory Coast town main street with the church as central visual point, a main community street and housing on either side

Sustaining the Aged in an Purpose-designed Sustainable Environment

Retirement Home for Priests

Ivory Coast, Africa

HKWN Architects

•Designed to be built simply by area residents, with green roofs and to be completed on the interior by the residents

•Development includes community soccer field, school, church and community meeting spaces to connect and sustain residents to the surrounding larger community

Nightingale Care Home

Wandsworth, London, UK

Scurr Architects

•Use of active sustainability design techniques:

•PV panels•Natural daylighting•Efficient energy mechanical systems•Efficient energy building envelope•Appropriate site orientation

Sustaining the Aged in an Purpose-designed Sustainable Environment

Thank You

Jeffrey Anderzhon, FAIA

jeffa@crepidoma.com

Resources:Green Globes: www.greenglobes.com

developing an sustainability assessment tool specifically for aged environments

U.S. Green Building Council (USGBC): www.usgbc.org

provides LEED (Leadership in Energy and Environmental Design) certification

Environmental Defense Fund (EDF): www.edf.org

American Institute of Architects sustainable resources web page:

www.aia.org/practicing/groups/kc/AIAS077433?dvid=&recspec=AIAS077433