Designing for an aging population

AIA/CES + IIDA Program

Altro CEU procedures
Senior living matters – our objective
Our information comes from a variety of sources including but not limited to:

• EFA, Environments for Aging

• Argentum (was ALFA)
• ASHA, American Senior Housing Association
• Regional associations in USA & Canada - BCSLA, ASCHA
• CALTC, Canadian Alliance for Long Term Care
• FGI, Facility Guidelines Institute
• Official U.S. and Canadian Census Data
• U.S. and Canadian Building Codes
• CSA Z8000 – Canadian Healthcare codes
• Dementia Services Development Centre at Stirling University
Designing for an aging population
Learning objectives

Objective 1 – Facility guidelines

Review the 2018 Facilities Guidelines Institute’s standards for construction and renovations of
aging care facilities.

Objective 2 – The effects of aging

Learn about the physical changes to hearing, vision and mobility as people age and how those
changes affect the selection of interior finishes.

Objective 3 – Evidence based design

Learn about the meaning of colors and contrast to create ideal environments for seniors.

Objective 4 – Transitions
Review the design considerations by area type, and transitioning from one area to another.
Types of senior living facilities

Independent living Assisted living Nursing homes CCRC

/ skilled nursing Continuing Care
Retirement Center
Independent living
• Residents do not need
medical care from
within the facility

• Residents want to be
with similar people

• Residents want great

amenities
Assisted living
• Residents need some
type of assistance to
live a quality life. It
could be as simple as
cooking, personal
hygiene or medication
assistance.

• Most facilities have

memory care /
dementia rooms.
Nursing homes / skilled nursing
• Residents need much more
care than their assisted living
counterparts.

• Nurses are on staff 24/7.

• Residents cannot live with

food services alone - more
often than not they need IVs,
wound care, assistance with
walking, eating, dressing and
bathing.
CCRC – Continuing Care Retirement Center
• CCRCs are
facilities/communities that
offer all levels of Senior
Living care.

• The concept is that you

never have to move out of
the community, you just
change the area that you
live in to reflect the care you
need.
Learning objective 1 – Facility guidelines
Building guidelines and requirements
United States and Canada
Building and construction codes

CSA Z8000
Standard for Canadian Health

F.G.I.
Facility Guidelines Institute
Facility Guidelines Institute
Guidelines for floors and walls

Surfaces must be non-absorbent, non-porous and smooth

Flooring surfaces shall provide smooth transitions

between different flooring materials

Scale and type of flooring design patterns should be considered.

Research suggest that flooring with a medium pattern 1” x 6” was
associated with more falls.
Patterns shall be low contrast

Non-glare flooring finishes should be considered

Use of flooring material that is flexible and “gives” should be reviewed

Guidelines for floors and walls (2 of 4)

Flooring should remain intact, safe, and functional in heavy

weight-bearing, high-traffic, and impact-susceptible areas.

Flooring should reduce user fatigue and musculoskeletal injury.

Flooring must be cleanable and water resistant

Slip resistant flooring required in all ramps and entries

All areas subject to wet cleaning methods should have heat-welded

seams with flash-coved flooring
Guidelines for floors and walls (3 of 4)

Slip resistant flooring required in all bathing areas

Water-resistant materials, sealed-seam construction methods, and

moisture-impervious surface selections should be used for any wet areas.

Accessible showers require a transition between flooring and the shower floor that
meets accessibility standards. Although accessibility standards allow varying floor
heights, this has been found to be potentially detrimental to independent and safe
use. Adjacent materials should be evaluated so that transitions are level and even.

Slip resistant flooring required in kitchens with all joints sealed

The floors and wall bases of kitchens, and other areas subject to wet-cleaning
methods shall be constructed of materials that are not physically affected by
germicidal or other types of cleaning solutions.
Guidelines for floors and walls (4 of 4)

Wall finishes near plumbing fixtures shall be washable, smooth,

scrubbable, and moisture-resistant.

Wall surfaces shall have a matte finish. Use of highly polished,

glossy, or shiny wall finishes that create glare shall not be permitted.

Wall protection and corner guards shall be durable and scrubbable.

Sharp, protruding edges shall be avoided.

Appropriate contrasting color/value of wall finishes to distinguish between

floor and wall
Learning objective 2 – The effects of aging
Decline in auditory acuity
Our ears have two jobs,
hearing and balance
As we age, structures inside the ear
change and their functions decline.

• Inability to pick up sounds buried

in ambient noise

• Problems maintaining our

balance as we sit, stand, and
walk
Decline in motor skills and agility
Muscle weakness, joint problems, pain, disease and
neurological difficulties result in:

• Unsteadiness while walking

• Difficulty getting in and out of chairs

• Slips and falls

Decline in motor skills and agility
The effects of falling for an
older person are well known to
be devastating.
• 1/2 who suffer from a hip fracture
never regain mobility

• 1/3 of every serious bone injury

results in death within one year of
incident.
Decline in visual acuity
The effects of poor vision are profound,
causing difficulty for the person to engage with
others, navigate, problem-solve and feel safe.
• loss of peripheral vision

• color vision changes

• changes to night vision

• problems with glare

• nearer images being blurred

• lens and cornea begin to yellow and darken

Healthy eyes
Yellowing of
the eyes
Healthy eyes
Cataracts /
blurry vision
Healthy eyes
Diabetic eye
disease
Healthy eyes
Peripheral field loss
Healthy eyes
Central field loss
Healthy eyes
Hemifield loss
Dementia and Alzheimer’s
Dementia is a spectrum of symptoms that
result from various diseases of the brain

• By the age of 90, approximately 30% of

seniors suffer from dementia.

• Alzheimer’s Disease accounting for about

2/3 of all dementia cases
Dementia and Alzheimer’s continued
Commonly occurring effects of dementia are:
• Forgetfulness, specifically the loss of short term memory
• Disorientation of time and of place
• Disorientation within the physical environment
• Difficulties in comprehending new things
• Difficulty planning ahead, for example, remembering
where the toilet is, or planning a route to the garden, and
back again
• Difficulty in communicating, finding the right word
• Struggling to learn new things, such as how to use
modern-looking taps, or recognising new people
• Confusion, stress, anxiety and mood swings
Objective 3 – Evidence based design
Choosing the right color
The proper use of color can help to
create functional spaces for seniors.
• Color choice is a very personal thing –
no absolute right

• Use bright (saturated) colors, stay away

from pastels

• Easier to distinguish colors in

red/yellow range than blue/green

• Use colors to aid in contrast (more in

upcoming slides)

• Pick colors to enhance the room’s

purpose.
Colors and what they mean
Neutrals – Clean, pure, restful and noninvasive.

Earth tones (Gray, brown, beige) – Stability, approachable, warm and soothing.

Red – Bold releases adrenaline, elevates blood pressure and heart rate.

Pink – Soothing, affectionate, and happiness. Being bright, it can stimulate energy. Used in areas
to reduce erratic behavior.
Orange – Energy, warmth and joy.

Yellow – Alertness and optimism. It can also cause eye fatigue.

Green – Balance, restful, healing and nature.

Turquoise – Refreshing, relaxing and invigorating.

Blue – Calming. Lowers blood pressure and heart rate.

Purple – Promotes creativity, spirituality and perception.

Choosing the right color example installation

Origin at Spring Creek - use of yellow to encourage energy

Yellow - Alertness

Blue - Calming

Earth tone - Warm

Earth tone - Soothing

Earth tone - Warm

Earth tone - Stable

Color considerations

Color can be used to help residents

navigate their environments:

• Aid in orientation

• Use color to design a very clearly

defined space

• Contribute to way-finding

• Stairs
Color considerations continued
Color can encourage and discourage
movement into certain areas

• Encourage correct traffic flow

throughout facility

• Attract residents towards a certain

area

• Discourage movement in areas by

using dark colors
Light reflectance value

• Light Reflectance Values (LRVs)

as close to each other as possible
for different flooring laid adjacent.
• Threshold strips blend with the
flooring.

• Sufficient contrast between

furniture and the floors as well as
the furniture and the walls.

• 30 point variance in LRV between

floors and walls.
LRVs in action
30+ point variance
in floor and wall LRVs
(healthy eyes)
LRVs in action
30+ point variance
in floor and wall LRVs
(poor visual acuity)
LRVs in action
Less than 10 point variance
in floor and wall LRVs
(healthy eyes)
LRVs in action
Less than 10 point variance
in floor and wall LRVs
(poor visual acuity)
Coordinate
Darker
Hand
Door rails
areas
wainscoting and
Chairs
Focus
Encourage
Combine point movement
a non-wood flooring
Walls
Flooring
Discourage
Use contrasting
foot colors
traffic around
to help the
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Use protection
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Darkercolor
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High contrast stair nosings
High contrast stair nosings
High contrast fixtures
High contrast wall panels
Additional considerations

• Ensure that different flooring types laid

adjacent to each other blend as much as
possible to avoid creating the appearance of
a step.

• Any unevenness greater than an eighth of

an inch is a tripping hazard to a shuffling
resident.

• Provide bright lighting while controlling glare.

Glare can be controlled by using as matte a
surface as possible.
Additional considerations continued
• Ensure that a slip-resistant surface is
used, but not so rough as to hurt or be
uncomfortable for bare feet.

• Avoid sparkles or speckling.

• Provide frequent 'cues', such as

familiar objects and pictures

• Use feature walls to make a room look

more three-dimensional

• Commercial performance for both

Floors and Walls
Performance characteristics / survey results

Good looks

Residential feel

Commercial grade

Durability,
cleanability
and safety
Key qualities

Durability Cleanability Safety

Slips and falls
15,000 Americans age 65+ die
annually as a result of slips and
falls

20% of these slip and fall incidents

occur in nursing homes.

Over 2 million will be treated in

emergency rooms each year.

Slip fall statistics

Combined Data from Liberty Mutual Group,
Restaurant Insurance Corp and OSHA
Slips and falls
Falls account for more than 50% of all
injuries among Canadians 65 years
and over.

35% of community-dwelling Canadian

seniors experience a fall each year
and 50% of those will fall more than
once.

Among seniors, 20% of deaths related

to injury can be traced back to a fall.

Slip fall statistics

Combined Data from Public Health Agency of
Canada and OSHA
Slip-resistance testing
Static Coefficient of Friction Ramp Test TRRL Pendulum Test
ASTM D2047 DIN 51130 BS7976
Safety, slip-resistant or smooth flooring?
 “Well done transitions attract no attention. However, a transition that is
done poorly becomes a hazard for the senior living resident. The potential
for injury is very high which is why the issue is so sensitive and requires
perfect installations.”

Nancy Mooney, PDC Midwest

Learning objective 4: Safe transitions

Transitions

Sheet-to-LVT Sheet-to-carpet
Transitions

Sheet-to-sheet
Transitions – wet rooms

Sheet-to-sheet
using a transition strip

Shower Transition with Cove

Support in every environment
Caring for an aging nation
Find more info online altro.com/seniors
Thank you!
Considerations by area type
Entrances and reception areas
Considerations
High traffic durability, water and
snow brought in from shoes,
colors to help hide dirt, home-like
environment
Suggested products
• Altro Symphonia
• Altro Orchestra / Operetta
• Altro Lavencia
• Altro Whiterock
Dining rooms
Considerations
High traffic durability, Rolling carts and
wheel chairs, scratch resistance
Suggested products
• Altro Wood / Comfort
• Altro Symphonia
• Altro Orchestra / Operetta
• Altro Lavencia
• Altro Whiterock
Hallways and corridors
FGI Guidelines
Allow for ease of ambulation and self-propulsion
Allow for easy movement of all wheeled equipment
Shall be stable, firm and slip resistant
Considerations
High traffic durability, rolling carts and wheelchairs
Suggested products

• Altro Symphonia • Altro Lavencia

• Altro Wood • Altro Whiterock
• Altro Orchestra /
Altro Operetta
Resident rooms
Considerations
Shuffling feet, comfort, home-like
environment, cleanability
Suggested products
• Altro Wood / Comfort / Acoustic
• Altro Orchestra / Operetta /
Serenade
• Altro Lavencia
Showers, tubrooms and wet areas
FGI Guidelines
Slip resistant flooring must be used in
bathing and wet areas
Flush transitions between floor and
shower

Considerations
Barefoot and shoe traffic, water and
moisture, slip performance, cleanability
Suggested products
• Altro Aquarius
• Altro Whiterock
Resident bathrooms
FGI Guidelines
Slip resistant flooring must be used in
bathing and wet areas
Flush transitions between floor and shower

Considerations
Contaminants may be present, cleanability
and hygiene
Suggested products
• Altro Walkway 20
• Altro Symphonia
• Altro Wood
• Altro Whiterock
Heavy-duty commercial kitchens
Considerations
Slip resistant flooring must be used
Wall surfaces must be water resistant
Foot traffic, slip and fall accidents, carts
and other rolling loads, comfort underfoot
Suggested products
• Altro Stronghold 30
• Altro Classic 25
• Altro Atlas 40
• Altro Whiterock
Medium and light-duty kitchens
Considerations
Foot traffic, slip and fall accidents, carts
and other rolling loads, comfort underfoot
Suggested products
• Altro Classic 25
• Altro Reliance 25
• Altro Walkway 20
• Altro Puraguard
Residential kitchens and kitchenettes
Considerations
Cleanability and hygiene,
contaminants may be present
Suggested products
• Altro Wood
• Altro Walkway 20
• Altro Symphonia
• Altro Operetta
• Altro Whiterock
Back of house, laundry and service corridors
Considerations
Heavy rolling loads, impact resistant
walls, heavy equipment present,
durability, water and moisture present
Suggested products
• Altro Reliance 25
• Altro Walkway 20
• Altro Whiterock
• Altro Puraguard