Senior Living: A Special Design Culture

Jane Rohde discusses what it takes to create both effective and engaging senior living spaces for their inhabitants and surrounding communities.



In recently attending an event sponsored by J+J Carpet in Santa Fe, New Mexico, it was clear from the gathering of senior living designers that there is a special culture around this segment of healthcare. Perhaps it is because of the “living” part of the equation that takes healthcare design into a place that is person-centered, because it reflects how all of us live our lives versus focusing on a person as simply a medical diagnosis. This is the second annual J+J event and the most interesting part for me is the tremendous opportunity of having all the senior living designers who attend, provide a short presentation. Some are on senior living trends, others on specific projects, and others that focus on specifics of interior design and detailing. The rich dialogue that this creates is truly magical, and best of all the intimacy of a smaller group allows the experience to be personal and memorable.  I believe this is partly true, because to work in the senior living sector, you have to be able to hug people – this is just a prerequisite for being part of the design and provider community that provides services to older people. However, don’t be alarmed if you are not a ‘hugger’ and want to work in the senior living space.  Clients who are new to this industry after the third meeting become huggers; so you too may become one.  There is something very special about being a senior living designer; including a lot of heart.  We have the ability to maximize independence, lifestyle, and community living – or not – in the designs that we develop for elders, as well as the general population.  Our job is important and incredibly meaningful to the people we impact; the goal being to maximize everyone’s opportunity for purposeful living.

One presentation that particularly stood out was that of Dean Maddalena and Leslie McVey Hicks from studioSIX5 (see images in the gallery above). Much of the dialogue around their work, as well as universally within the group, was the health and wellness of residents and maximizing socialization and interaction as an ever-growing trend.

At the 2015 Environments for Aging Conference held in Baltimore, Maryland, I included in the Changemaker Keynote Address the “why” of senior living (  For the most part, the “why” is tied to the “who”; the people that we serve and the colleagues that help us achieve a collaborative shift from institutionalized care to person-centered care.  If you look at the Affordable Care Act, it has the potential for having more community-based service, as long as the wrap-around services can occur in the community. If this can happen, then people are likely to be able to stay in their home or in their chosen community. There’s a switch that you’re not just looking at designing something that’s for older people--you’re actually designing community for all people and creating a bigger design perspective.  Designing for senior living is community design that includes sustainable planning components, educational and vocational opportunities, universally designed housing, and access to transportation, services, healthcare, and amenities.

As we see how people desire to live as they age and the resources that are available to them – more and more will be receiving services in outpatient settings and at home.  Based upon statistics from the Center for Disease Control (CDC) in 2010 there were 298.4 million visits to outpatient settings by persons that are age 65 and older.[1]  For the same age cohort, emergency room visits in 2010 were 38,908,000[2] and in-patient hospital stays were numbered at 13,591,000 based upon discharge information provided by the CDC.[3]  This demonstrates that the culture shift for senior living also impacts design for other healthcare and wellness settings. To date, providers of outpatient and acute care settings do not discuss the care population needs, as diagnosis is the main focus.  However, designing for an older population is also beneficial to all people in these settings, particularly when focusing on lighting, reduction of glare, access to nature, acoustics, wayfinding, and furniture selections.

The Facility Guidelines Institute has started the 2018 cycle for updates on the Guidelines for Design and Construction of Residential Health, Care, and Support Facilities. For Hospital and Outpatient settings, there are two books under development for the 2018 cycle.  There will be the Guidelines for Design and Construction of Hospitals and Guidelines for Design and Construction of Outpatient Facilities.  The goal during the proposal process is to work on the overlap of providing guidance from the Residential Document Group for incorporation as an overlay to the other two books on hospitals and outpatient facilities.  At first this was thought of as “geriatric” based information, but it was soon realized during the first in-person meeting in St. Louis that the items to be included are recommendations for “good healthcare design” that will positively impact all healthcare environments – supporting the care populations being served in these different settings.

Jane Rohde is the founding Principal of JSR Associates, Inc. located in Ellicott City, Maryland. She champions a global cultural shift toward de-institutionalizing senior living and healthcare facilities through person-centered principles, research and advocacy, and design of the built environment. Clientele includes non-profit and for-profit developers, government agencies, senior living and health care providers, and design firms. Jane speaks internationally on senior living, aging, healthcare, evidence based design and sustainability. For more information or comments, please contact Jane Rohde at