Interior Design Considerations for Retirement Homes

Annie Rose H. Nicholson

Stephen F. Austin State University, Spring 2002

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At the Waterford, you'll find the freedom to create the lifestyle you've always wanted. Each morning you'll awake to a colorful palette of possibilities from which to paint your day. Enjoy the quiet, muted tones of solitude in your spacious apartment, knowing friends and an attentive staff are close by. You'll always have a wealth of things to do right at your fingertips keeping you as active as you want to be. The Waterford proudly presents a staff of experienced, detail-oriented professionals at your service. From our executive director to our culinary chef, to our housekeepers and wait staff, you'll find warm and friendly people truly concerned about you. TheWaterford offers you flexibility and options so you can paint your days with the colors of life (A Place for Mom, 2002).

With an environment that seems so appealing, why is there such a negative stigma placed on retirement homes/communities or nursing homes? The idea of spending our retirement in a nursing home is perceived by our society as the most undesirable of options. Three out of one hundred Americans over the age of 65 suffer from depression (National Institute of Mental Health, 2000). A study done at the University of Rhode Island reported that 11% of the residents in the nursing homes examined were suffering from depression (Brown, Lapane, & Luisi, 2002). Another study done at Columbia Universityreported that 44.2% of the nursing home residents tested showed somesymptom of depression with 14.4% of the residents experiencing serious depression (Teresi, Abrams, Holmes, Ramirez, & Eimicke, 2001). Why is the depression rate among the elderly almost four times greater among those living in nursing homes? It could be the work of chance in that many of the residents in nursing homes already have a mental health problem that has made them unable to provide for themselves. Having prior difficulties could make these residents more susceptible to the normal adjustment problems that come along with relocating to a new living environment. Or perhaps it is because the environments nursing homes create are not specifically geared towards the needs of the elderly. With about 5% of people over 65 living in nursing homes this is a serious problem, whether the resident is healthy or not, that should be demanding more attention (Hoyer, Rybash, & Roodin, 1999).

There are many factors that could contribute to depression among the aging including illness, loss of close family members, or financial problems. Unfortunately these are problems that are uncontrollable, but there are things that we can control that may provide a more agreeable environment for those living in nursing homes or retirement communities. Perhaps if we did more to accommodate the aging with an environment that is aesthetically pleasing and functional through color change, lighting, and spatial arrangement, the number of depression diagnoses would decrease among the elderly residing in retirement homes.

Through motion pictures and photographs we have some idea of what it might be like to live in a world that is colored in shades ofgray. However, it would be much more difficult to imagine a world where there were colors, but they were indistinguishable in many cases and shades of certain colors were nonexistent. It would be similar to wearing glasses with yellow lenses. This is the type of colored world that many people progressively experience after the age of forty caused by a condition called presbyopia. Presbyopia is an age-related illness caused by the hardening of the variable lens, which decreases the eyes' ability to accommodate (Goldstein, 2002). This hardening of the variable lens is caused by the death of cells inside the lens with age. These dead cells cause visual images to be seen as if through a yellow lens. The process occurs so gradually that most people do not notice the colors and lights getting dimmer. This could be an explanation of why nursing homes are thought to be so drab by the elderly yet so pleasant to us (those unaffected yet). Rooms decorated in pastels or blues may seem to be just shades of dirty gray to the aging. It has been shown in several studies that the colors in our surroundings affect our moods. A study done at the University of Texas Division of Interior Design found that office colors definitely influenced mood. Females indicated more depression in white, gray, and beige offices while males reported more depression in offices colored orange or purple (Kwallek, Lewis, Lin-Hsiao, and Woodson, 1996). Therefore, it would be safe to assume that the drab colors seen by the aging in nursing homes might negatively affect their mental state. An effort should be made to decorate the interior in colors more suitable to the presbyopic eye, even though the combinations may not be as pleasing to the younger eye. Using colors that the residents actually see might increase positive feelings towards the atmosphere and the home altogether.

Another factor in the retirement home environment that may contribute to unhappiness among the elderly is illumination levels. Soft glowing lights create a pleasant atmosphere for those of us unaffected by vision deterioration, but for most of the residents, the low level of light can lead to a frustrating battle for clarity. Due to the normal aging process, the lens in our eye becomes less able to accommodate and focus on objects in dimly lit surroundings. This makes it more difficult to do everyday tasks like read the newspaper, watch television, or write a letter. Problems with lighting can cause anything from discomfort glare, which is a distracting glare that interferes with the physiological processes used in perception, to veiling reflections, which occurs when the light partially or totally interferes with details by reducing contrast (Hughes & Neer, 1981). Often, problems with vision are a constant reminder of an aging body, and in many adults this is not a smooth or joyful process and can lead to depressive feelings. By providing appropriately lit surroundings, we might lessen the awareness of vision problems and aid in a decrease of depressive feelings about old age. The best type of lighting to use would be a full-spectrum light that is able to resemble natural sunlight (Hughes & Neer, 1981). Not only would this type of lighting aid those residents suffering from presbyopic symptoms but it also has been found to help regulate several physiological processes like Vitamin D3 synthesis and cardiovascular regulation (Hughes & Neer, 1981). Hopefully, having an adequate light source would help the aging to feel younger and lessen the negative feelings about growing old. Additionally, brighter lights make bright colors even brighter which could bring some color back into their world.

Along with specific color choices and lighting, spatial arrangement can improve the living environment in nursing homes for the residents. Age-related vision problems can affect more than color vision or illumination levels. There are several diseases that can also affect peripheral vision, depth perception, and object size (Bennett & Eklund, 1983). For example, cataracts are caused byc louding in the variable lens and this influences how well the eye is able to measure depths in the environment. Cataracts occur in people over 65 almost 75 percent of the time (Goldstein, 2002). Another example could be senile macular degeneration. This occurs when the macular area of the retina (contains the focusing element used indirect line of sight) begins to degenerate and your central vision is seriously impaired. This means that anything that you looked at in your direct line of sight would not be there when you focused on it and could dramatically affect object size and depth perception. Because of these changes in vision it is important to arrange a room, especially the private rooms, in a way that is most comfortable and suitable for the specific needs of the individual. Also because of visual problems, daily tasks may become more difficult, so the room should be arranged to make these tasks easier. By making these difficult tasks more manageable, it could give residents their feelings of independence back and help to curb emotions stemming from their inability to be self-sufficient that might cause depression. Gerontechnology is an area of science aimed at managing these types of problems. By developing technological devices that are specifically designed for the home environment of an elderly person, they hope to provide a safer and more comfortable environment for the elderly (Pinto, De Medici, Van Sant, Bianchi, Zlotnicki, and Napoli, 2000).

Current research explores the many areas included in color vision, illumination and spatial arrangement, but each on their own. There does not seem to be any research regarding the specific needs of the elderly regarding environmental difficulties and whether these difficulties do in fact contribute significantly to their negative mental states. Perhaps if we were to explore deeper into the perceptive side of the nursing home stigma, we might be able to help a greater portion of the aging in our community adapt to their new environment. With the percentage of people over 65 increasing every year and the life expectancy age increasing, more should be done to accommodate them and make their retirement more enjoyable. Nursing homes are made to appear appealing to the families of the potentialr esident in order to solicit the families' approval. But it is in this appeal that the problem lies. The arrangement of color and lighting in these communities does not take into consideration the effects aging has on the perceptual processes. To take into account these perceptual problems would diminish the appeal to the younger generations trying to provide what they think is the best and most comfortable environment for their loved ones. In order for changes to be made in these environments that would satisfy the needs of the elderly, the younger generations should be educated as to the effects of aging. This education might lead to the changes in nursing homes that are necessary to make the elderly more comfortable.





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