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January 2018 — Health Care Properties Quarterly — Page 21
Senior Housing & Care
A nyone care to hazard a
guess about how much
time Americans, on aver-
age, spend indoors? Most
will respond between 60
and 80 percent, however, the actual
number is closer to 90 percent. As
we age, this percentage inevitably
increases. Approximately, 10,000
Americans turn 65 every day and
by the year 2030, one in five Ameri-
cans will be 65 or older. Needless
to say, we are a population that
is increasingly spending its time
indoors, regardless of evidence-
based research supporting the
numerous benefits of the contrary.
These sobering trends have com-
manded the attention of those who
manage, design and invest in senior
living communities. Therefore it is
no surprise that a large majority of
award-winning senior living design
projects are those that encourage
greater outdoor engagement. What
follows is a discussion of the ben-
efits and methods for reversing this
trend and increasing the health and
wellness of our senior population.
• Benefits. The health benefits of
connection and exposure to the
elements is as old as the practice
of medicine. Hundreds of years
ago, medieval hospitals combined
treatment, prayer and access to the
elements for recovering patients.
Today, a wide variety of research
institutions are conducting con-
trolled studies to illustrate specific
benefits. PMC Canada published
a study in 2012 to illustrate the
benefits of sunlight for recovery,
sleep quality and decreased hos-
pitalization for bipolar depression.
Numerous studies have shown that
sunlight increases
Vitamin D, which
fights inflamma-
tion, improves
the immune sys-
tem, increases
bone health and
decreases depres-
sion – all of which
are common in
seniors.
In 2005, the Uni-
versity of Pitts-
burgh conducted
a study of spinal
surgery recovery
times with relation to the outward
views of recovery rooms. Patients
with natural, scenic views recov-
ered more rapidly and required
less medication than those with
views to an alley or brick wall. This
illustrates a particularly important
concept for seniors – even the views
themselves have benefits. Further
studies of outdoor activities by the
University of Michigan in 2014 dem-
onstrated that outdoor nature walks
improved depression and stress lev-
els, both of which are all too com-
mon for seniors.
Aside from local studies, the field
has interested researchers in medi-
cal communities and institutions
all over the globe. A 2014 study
by the Nippon Medical School in
Japan demonstrated increased
white blood cells in subjects after
six hours of exposure to a wooded
environment. Regardless of age,
location or circumstance, the ben-
efits of outdoor engagement remain
a growing interest for research
publications and medical journals
throughout the industry; especially
with regard to senior care.
• Methods. It’s no surprise that
outdoor amenity spaces in senior
living communities must be safe to
enter, occupy and travel through,
however, the appearance of safety
also plays a key role in the success
of encouraging outdoor engage-
ment. Architectural and techno-
logically based security features
incorporated to improve surveil-
lance, lighting, visibility, privacy and
protection from intruders are all
necessary features, but if the ten-
ants don’t perceive the area as safe,
the engagement diminishes. Privacy
fencing, walls and other methods
to visually enclose outdoor space
in aesthetically pleasing ways are
fundamental in getting seniors out-
doors.
Walking surfaces must be
designed to reduce fall risks, and
handrails must be available in cases
where acuity levels require them.
Ideally, indoor public spaces such as
living, dining or activity rooms are
located immediately adjacent, or
open directly, to the outdoor space
with direct visibility throughout the
day. Keeping outdoor spaces visible
from communal indoor spaces not
only reinforces the sense of safety
but also fosters familiarity and
encourages engagement.
Transitions from indoor environ-
ments to outdoor environments
also must be carefully considered.
Spaces immediately adjacent to
the exterior should provide ample
glazing to help equalize light level
differences between natural sun-
light and indoor lighting. Doorways
should include roofs and overhangs
designed to provide shade and
weather protection. In warmer cli-
mates, seniors simply will not leave
cooler, indoor climates for hot, exte-
rior climates unless shade struc-
tures are directly visible and easily
accessible. The same rule applies
for heating elements and sunny
areas in cooler climates.
In addition to climate and transi-
tion considerations, outdoor spaces
designed with specific functions
can drastically improve outdoor
engagement. Walking paths in
senior living communities are ubiq-
uitous and provide numerous ben-
efits to physical, mental and spiri-
tual health – only reinforcing why
walking remains the most common
exercise among seniors. Looping
Colorado’s Leader in Senior Living Quality and Innovation
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12136 W. Bayaud Ave. #200 Lakewood, CO 80228 303.238.3838
VIVAGE SENIOR LIVING
Full Management Services • Consulting Partner • New
Development & Design Collaboration • Market Positioning
We create models that reflect exciting
lifestyle choices for today’s seniors.
Charlie Schmidt
Director of
design, Lantz-
Boggio Architects,
Englewood
We are a population that is increasingly
spending its time indoors, regardless of
evidence-based research supporting the
numerous benefits of the contrary.