Nursing Home Design – The Biggest Mistakes Made Today

One of the biggest mistakes currently being made in the Nursing Home design is the new trend of following the Hospitality Model. It has become popular to abandon the Medical Model and take a literal turn toward designing a Skilled Nursing Facility like a hotel. It is understandable where the roots of this trend come from, as medical buildings have always carried the reputation of having a sterile, cold quality. Making a Nursing Home more like a hotel and mimicking the aesthetics does theoretically create a more inviting atmosphere.

Unfortunately, this approach is a mistake. Even though conceptually, a Nursing Home and a hotel may have similarities in terms of balance between public vs. private space, the hospitality design lacks the underlying medical support that composes the actual function of a Nursing Home. There have been several hospitality companies that have attempted to translate their expertise to nursing homes, and have consequently failed. They created a space that was beautiful, but ultimately dysfunctional.

Hospitality Model vs. Medical Model

The fundamentals of hospitality design are vastly different from those of Nursing Homes. In hotels or resorts, guests voluntarily come to rest and distract themselves from their travels or everyday lives. Most of these visitors tend to be mobile, relatively fit, and healthy. They do not require assistance and are there for a short time. A hotel is a place of entertainment, relaxation, and comfort. Guests leave their rooms for the day and return in the evening. The architectural design for this type of use is based heavily on aesthetics, to be more attractive than the competition. Since people come to hotels by choice, they have the option to choose between thousands of companies. Often, the design aesthetic becomes one of the driving forces hotels used to attract these customers.

The people who occupy nursing homes are typically not there by choice. They are sick, elderly, frail, and weak. They are by definition residents, not guests. The nursing home is in fact their actual home, as they rarely leave the premises, let alone even spend time outside. They need a strong foundation of medically trained staff to support their daily activities. Unlike visitors to hotels, they tend to stay for a longer period of time and have less options of leaving.

A major area that suffers in a Skilled Nursing Facility when it is designed to copy a hotel is the corridor. Guests, residents, staff, clean and dirty linens, medicine, food, and trash are funneled down the same linear path. These competing elements are then forced to co-exist together, all for the sake of a misguided design. In a well run Nursing Home, the corridor is the heart of the facility in terms of being the social center. Residents in wheelchairs travel from their bedrooms to public spaces, interacting with staff and each other. It is a welcome respite from being alone in their rooms, and they feel like a part of the community. In a hotel, a corridor is simply a means of getting from one place to another, and lingering or socializing there warrants suspicion.

The Best of Both Worlds

Our belief at Gregg Maedo + Associates is to design Nursing Homes by using the medical model as the fundamental foundation, and then breathing life into the design by incorporating the best elements pulled from hospitality, restaurant, and residential architecture. It is time for a new paradigm shift in Nursing Home design, as we move beyond the stereotypical medical model but do not seek to mimic that of hospitality. We also provide a unique perspective, pulling experience from the many things we learn by working with Disney. The “Happiest Place on Earth” has a lot to teach all of us about creating pleasant, inspiring environments. Ultimately for us at GM+A, the true measure of excellence is not the accolades that a design receives, but whether it stands the test of time. There is no easy formula to achieve this result, but a combination of experience, talent, knowledge, passion, and a vested interest in the care of our most respected citizens.