Designing better buildings
Australian Ageing Agenda
November/December 2015
We need a coordinated international approach for good design for an ageing population, Canadian-based architect Rudy Friesen tells Danielle McIntosh.
Residential aged care in Canada is on the cusp of significant change. Like Australia, the number of people living with dementia is increasing and organizations are starting to think smarter about how their buildings can support people to live better lives.
How will this influence good design for the future?
Here, Rudy Friesen, a Canadian-based architect, discusses his vision for change and the future for design, both in Canada and internationally.
Rudy is Partner Emeritus of ft3 Architects, based in Winnipeg, Canada, a firm he started 40 years ago. His aged care design work has produced some innovative changes in Canada. He is a keen advocate for culture change in long-term care towards more buildings that function like households. He has written papers and presented internationally on improving design and care models for older people and people living with dementia.
DM: How did your interest in design for older people and people with dementia develop?
RF: My mother was a major catalyst. For 10 years, she lived in a personal care home in Winnipeg, Manitoba. Every time I visited her, I witnessed her unhappiness, and I felt badly that she didn't feel at home. As an architect, I could see how the institutional environment sucked the life and happiness out of her. That's when I began to reflect on how we as architects and as a society needed to change that. I began to feel the moral and professional obligation to design better buildings.
DM: What did this experience lead to?
RF: A client challenged me to eliminate corridors in the expansion of a personal care home. In that home, we also designed a 10-resident special care unit with a residential scale and feel to it. Our design caught the attention of a group in another community, and inspired them to develop the Chez Nous (our home) concept. This was in early 1990. The next building was three connected 10-resident cottages with many homelike features. In the first year alone, the use of drugs to control the residents dropped sharply. These results spurred me to learn more and I became an advocate for what in Canada is called the household model.
DM: What design challenges exist within Canada?
RF: There is a startling lack of awareness and variation among government authorities across the provinces, and an appalling lack of willingness to change policies and culture, particularly in long-term care. For example, while there seems to be a growing recognition that homelike environments result in happier residents and fewer behavioural issues, there is considerable variation in how to provide this. For example, Saskatchewan calls for no more than 15 single residents rooms per home, with a preference for 10, while in British Columbia, units of 22 to 28 are standard.
DM: What do you think will be the future challenges for aged care design in Canada and around the world?
RF: The rapidly approaching 'silver tsunami' is bound to put a strain on the healthcare system and on the public purse. It's bound to stir up resentment against so-called unproductive elders who are consuming social resources at an alarming rate. We need to think far ahead. What happens after the tsunami has passed? How can we re-purpose or adapt facilities? We need a coordinated approach, nationally and internationally, and we need it now.
DM: What role will climate change and the increasing need for sustainability have on design?
RF: Good design is sustainable and adaptable. That said, people with dementia are more vulnerable and sensitive to change, and we need to be mindful of that, always providing familiar environments for them.
DM: What role could technology play in the future? What factors would need to be considered, both for and against?
RF: If technology is used judiciously and non-invasively, it can be beneficial. We need to keep an elder's life as normal as possible.
DM: What would you like to see included in future design projects?
RF: It's time to stop incarcerating elders. Let's integrate facilities and all levels of care into the community. From a design perspective, a model with 10 to 12 residents living in a self-sufficient house is the first step. Why not take it a step further and incorporate 10 to 12 resident households into multi-use complexes in urban settings, such as student housing, or with shopping centres? The idea is to integrate and maximize resources.
Danielle McIntosh is a senior consultant with the Dementia Centre, HammondCare.
How will this influence good design for the future?
Here, Rudy Friesen, a Canadian-based architect, discusses his vision for change and the future for design, both in Canada and internationally.
Rudy is Partner Emeritus of ft3 Architects, based in Winnipeg, Canada, a firm he started 40 years ago. His aged care design work has produced some innovative changes in Canada. He is a keen advocate for culture change in long-term care towards more buildings that function like households. He has written papers and presented internationally on improving design and care models for older people and people living with dementia.
DM: How did your interest in design for older people and people with dementia develop?
RF: My mother was a major catalyst. For 10 years, she lived in a personal care home in Winnipeg, Manitoba. Every time I visited her, I witnessed her unhappiness, and I felt badly that she didn't feel at home. As an architect, I could see how the institutional environment sucked the life and happiness out of her. That's when I began to reflect on how we as architects and as a society needed to change that. I began to feel the moral and professional obligation to design better buildings.
DM: What did this experience lead to?
RF: A client challenged me to eliminate corridors in the expansion of a personal care home. In that home, we also designed a 10-resident special care unit with a residential scale and feel to it. Our design caught the attention of a group in another community, and inspired them to develop the Chez Nous (our home) concept. This was in early 1990. The next building was three connected 10-resident cottages with many homelike features. In the first year alone, the use of drugs to control the residents dropped sharply. These results spurred me to learn more and I became an advocate for what in Canada is called the household model.
DM: What design challenges exist within Canada?
RF: There is a startling lack of awareness and variation among government authorities across the provinces, and an appalling lack of willingness to change policies and culture, particularly in long-term care. For example, while there seems to be a growing recognition that homelike environments result in happier residents and fewer behavioural issues, there is considerable variation in how to provide this. For example, Saskatchewan calls for no more than 15 single residents rooms per home, with a preference for 10, while in British Columbia, units of 22 to 28 are standard.
DM: What do you think will be the future challenges for aged care design in Canada and around the world?
RF: The rapidly approaching 'silver tsunami' is bound to put a strain on the healthcare system and on the public purse. It's bound to stir up resentment against so-called unproductive elders who are consuming social resources at an alarming rate. We need to think far ahead. What happens after the tsunami has passed? How can we re-purpose or adapt facilities? We need a coordinated approach, nationally and internationally, and we need it now.
DM: What role will climate change and the increasing need for sustainability have on design?
RF: Good design is sustainable and adaptable. That said, people with dementia are more vulnerable and sensitive to change, and we need to be mindful of that, always providing familiar environments for them.
DM: What role could technology play in the future? What factors would need to be considered, both for and against?
RF: If technology is used judiciously and non-invasively, it can be beneficial. We need to keep an elder's life as normal as possible.
DM: What would you like to see included in future design projects?
RF: It's time to stop incarcerating elders. Let's integrate facilities and all levels of care into the community. From a design perspective, a model with 10 to 12 residents living in a self-sufficient house is the first step. Why not take it a step further and incorporate 10 to 12 resident households into multi-use complexes in urban settings, such as student housing, or with shopping centres? The idea is to integrate and maximize resources.
Danielle McIntosh is a senior consultant with the Dementia Centre, HammondCare.
