Sustainable Environments For Aging

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/year U.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/year U.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 annually 2004 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) Medicaid 46% Medicare 12.4% Out-of-Pocket 27.9% Private Insurance 7.7% Other 6.1% 2004 Met Life Market Survey

Operating costs are the largest on-going capitol outlay

Sustainable staffing affects design Source: LeaderStat, Inc. 3.05 2.10 .23 .70 32 Beds Hours PPD 2.96 2.00 .46 .50 60 Beds Hours PPD 3.18 97.5 30 45 22.5 Total 2.06 .56 .56 40 Beds Hours PPD 67.5 22.5 30 15 Nsg. Asst. 7.5 7.5 LPNs 22.5 7.5 7.5 7.5 RNs Total Evenings Days Nights

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

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 Per Illuminating Engineering Society of North America (IES), 75 year old eye lets in 25% of the light of a 25 year old. 20 – 30 Footcandles in Corridors 5 Footcandles in Corridors Senior-Friendly Energy Codes

Regulatory Challenges 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 Typical Working / Living Environment Temperature 75 - 78 ° Typical Working / Living Environment Temperature 72 - 75 ° Senior Friendly Energy Efficiency

Regulatory Challenges Difficult Devices for a Layman to Operate; Not as Easily Adjusted to Senior Needs Sophisticated HVAC Systems with Control System Design for Engineers Senior Friendly Energy Efficiency

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, USA Perkins 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 Community North Manchester, Indiana, USA RLPS Architects Foulkeways Gwynedd, 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 Centre Sydney, 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 [email_address] 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

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