Homelike environments in eldercare deliver a comfortable ‘stealth health’

October 9, 2018 Thomas Grden

How social-driven design is replacing—and improving upon—the medical model for eldercare facilities


For the past decade, expectations have been steadily rising in the design of eldercare facilities. From assisted living and skilled nursing, to senior living, these facilities have been shaking off the sterile, hospital-inspired designs of the past to create a more resident-centric, homelike environment. Studies confirm the benefits of living in a social setting on the physical and emotional well-being of seniors. The standard for eldercare is changing.

In my nearly 30 years designing facilities for the elderly, I’ve been especially excited by this rising chapter in senior living design. These social-centric designs encourage residents to be more active and communal, provide families peace of mind that their loved ones are in settings reminiscent of home, and help eldercare providers remain competitive in an ever-expanding market.


At RoseCrest, a homelike feel is created throughout the property as part of the operator’s mission to create “Abundant Life.”


How can we design eldercare facilities that are more homelike, while still providing the necessary accommodations for medical functions? There are several key tactics that can be incorporated, both in a new facility as well as a renovation, to enhance the feeling of home. These strategies don’t just feel good, they promote overall well-being and offer an antidote to loneliness. Researchers have identified loneliness as one of today’s prime health risk factors.

With the “stealth health” approach, the design concept centers on resident comfort in a setting that also supports uncompromising care in an inconspicuous way. 


Homestyle dining

Just as kitchens are the heart of the traditional home, dining areas play an important role in the elder care environment. To meet the demand for a more elevated, communal dining experience, providers are doing away with the cafeteria-style tray line to create a setting that feels more like eating at home or in a restaurant. The result is a “country kitchen” where residents can enjoy a meal in a dining room, in some cases being served at a table with from a selection of menu items. Through thoughtful design choices, these dining rooms can serve as a thriving social setting for residents—very much like a Panera or Starbucks.


Kitchens at RoseCrest provide residents space to interact over a meal in a setting that feels like home.


During the design of the new RoseCrest, an assisted-living project from Lutheran Senior Life in Pennsylvania, our team advised our client to forego a larger building scheme in favor of two 15-bed “households” incorporating a homelike feel. The property includes features like country kitchens and hallways that encircle outdoor courtyards for added light and openness to the whole environment. This design scheme resonated with the client’s mission of creating “Abundant Life.”

This design proved popular with residents, allowing Lutheran Senior Life to rapidly fill the RoseCrest facility and subsequently support a second project, an independent living facility embracing similar design tactics called Overbrook Pointe. In fact, the dining space in Overbrook Pointe has become so popular that residents are eager to invite friends from outside of the facility, expanding their social community.


_q_tweetable:With the “stealth health” approach, the design concept centers on resident comfort in a setting that also supports uncompromising care in an inconspicuous way._q_

Private living

For decades, the prevalent model in nursing home and assisted living design was inspired by hospital settings. It revolved around a scheme with long corridors lined along each side with shared or semi-private rooms. The overall feel was institutional, efficient, and easy to maintain. With the elder care approach evolving from “patient” care to “resident” care, facilities are trending toward private rooms with full bathrooms. Even with property renovations, where a major changeover may not be realistic, there has been a clear move toward a more homelike environment for resident rooms.

We can enhance this environment through a more discerning level of finishes and fixtures with the character of home. Details such as more intimate lighting, residential-style bathroom vanities, decorative mirrors, attractive accessories, and the like, make these residences feel more like home.


Welcoming common areas

The feeling of home doesn’t just stop at a resident’s door. Hallways are moving away from institutional design. Aspects like the nurse’s stations and medical support areas are now strategically hidden from sight, while still giving nurses a clear view to deliver patient care when needed, hence the nickname “stealth health.”


Hallways at RoseCrest are bright, airy, and welcoming, with medical areas out of sight but in easy reach when needed.


Common areas are also being designed with an eye toward hospitality to create spaces where residents want to linger, relax, and interact. At RoseCrest, for example, the central great room is cozy and inviting with exposed wood trusses, extensive woodwork, and clerestory windows.

Today’s eldercare providers are challenged not only to deliver quality care for the eldest members of our society but increasingly to provide for a higher quality of life demanded by loved ones and the residents themselves. Providers would do well to incorporate design features such as those above that build community and feel like home as today’s best practice.

About the Author

Thomas Grden

Tom Grden has more than 30 years of experience in architecture, and has served as principal, project manager, and lead architect on a variety of projects. His experience encompasses a wide spectrum of building types and construction systems including commercial, residential, institutional, higher education, and renovation projects.

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