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Design HEALS: Investigating Design Guidelines for Healthy Assisted Living Settings

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Designing assisted-living facilities

A (European Commission report) projected that in 2060 life expectancy for 65-year–olds will be 22.4 years for men and 25.6 years for women. As such, planning for long-term care services is crucial.


'The 2012 Ageing Report: Underlying Assumptions and Projection Methodologies' advocates providing care to people without chronic health conditions but with limitations in activities (such as dressing and bathing). It also supports instrumental activities of daily living (such as shopping) at home and in community-based facilities. With the rising cost of providing care at home, assisted-living facilities will be an increasingly important alternative. At this point, however, there are no established criteria to assess such facilities to see if they contribute to the health and well-being of their residents. An EU-funded project, 'Design heals: Investigating design guidelines for healthy assisted living settings' (DESIGN HEALS), filled this gap by studying the link between the environment of assisted-living facilities and the well-being of cognitively intact elderly adults. The study used a multiple case study methodology. Researchers looked at the size of each facility, plan layout, walking distances between each resident's room and the common areas, accessibility and neighbourhood amenities. The team collected well-being outcomes through structured observations of the residents' uses of common spaces and their social interactions. Geographical information software was used to record the location and behaviour of residents in social areas. Residents were interviewed and asked about their perceptions of the facility and the neighbourhood. Caregivers were asked to provide non-medical information and make behavioural assessments about each resident. Researchers collected 189 surveys and 432 behavioural maps from 18 facilities of different sizes. Findings showed that residents used social areas and the outdoors more in small- and medium-sized facilities. The walking distance between the bedrooms and social areas played a role in whether they were used or not. Residents with roommates were found to be more engaged than those living alone. The study provided evidence-based guidelines for modifying and designing assisted-living facilities. In addition, the assessment instruments were found to be reliable. These results are significant and have the potential to lead to facilities that promote residents' well-being.


Assisted-living facilities, life expectancy, long-term care, care services, ageing, community-based facilities, health, well-being, design guidelines, assisted living, social interactions, behavioural maps, evidence-based guidelines

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