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Safety by design: Baby boomers


June 15, 2017

Experts weigh facility designs that can help an aging population access hospitals safely

Editor’s note: This is the final part in a series of stories that address the ways that hospitals are using smart design to help increase facility safety and security for different populations of patients.

As hospitals study ways to update their facilities to meet the needs of a variety of patients both now and in the future, there’s one group of people who seem to be the most difficult to please.

That age group is the so-called baby boomers. If you have parents around this age, you know the type: about 65 years old and still pretty healthy for the most part, but beginning to face the realities of aging. But don’t tell them that—they still want to do things their way, and if they don’t like something, they’ll be sure to let you know.

As you’ve heard countless times by now, boomers are set to become more of a presence in your facilities. A study by the National Institute on Aging says that the U.S. senior population will double by 2030, climbing to approximately 70 million, and that Americans age 65 today can expect to live, on average, another 18 years. It stands to reason that this group is going to represent a growing percentage of the occupants of your building—and a growing safety and liability problem.

Essentially, hospital designers are looking to seamlessly integrate safety features into their facilities; they want to include softer features that add safety (perhaps not obvious to an outsider’s eyes) while inviting the patient in. Enter what is being called “universal design,” which is a “new and comprehensive design criteria, applicable to the boomer generation as well as all users of the built environment, including the aged, elderly, handicapped and bariatric patients, as well as persons with special needs,” according to Gary L. Vance, FAIA, FACHA, LEED AP, president of Vance Consulting LLC in Carmel, Indiana. Vance authored a column in the January 2017 issue of Healthcare Facilities Management about some of the more notable safety and design features being worked into hospitals these days to make the aging boomers feel more at home. The following are a few insights from that column:

Site access and entrances. A good first impression is everything. When it comes to how patients enter a facility, hospitals are trying to make those impressions count, while still prioritizing safety.

Access-related problem areas affecting baby boomer populations can include hospital parking facilities, stairwells, ramps, doorways, and elevators. In addition, hospitals should keep in mind any hard-to-reach locations of departments and areas that are visited frequently by seniors and other patients who are less mobile.

Boomers may not want to admit it, but their eyesight and coordination isn’t what it used to be, so hospitals are building straightforward entrances with easily visible features, such as canopies, so that visitors can easily find the front of the building when they pull in. Once they get there, large and prominent front doors and entrances allow for a direct path into the facility, Vance says. Gone are the days of traversing maze-like entryways and multiple elevators before even finding the main entrance of the building.

Keeping entrances and byways safe for foot traffic is also a concern. According to some estimates, some 700,000 falls occur in U.S. hospitals each year; of those, 30%–35% result in patient injury, and up to 11,000 are fatal. A big culprit is uneven walking surfaces, which pose easily overlooked tripping hazards for aging or mobility-challenged patients.

“Mix that with the fact that older folks are sometimes a little unsteady on their feet either because of a medical condition or prescribed medications, as well as weather-related conditions like ice and snow that can play havoc with footing, and you can have a fairly elevated risk of someone injuring themselves in any facility,” says Steven MacArthur, senior consultant and safety expert for The Greeley Company in Danvers, Massachusetts.

Corridors and getting around. Boomers are known as the “me generation,” and they like being able to do things themselves—including finding their ways around hospitals. They don’t want to be in the hospital in the first place (who does?) and during their stay, they expect to be just as comfortable as they would be visiting their doctor’s office, says Vance.

If you’ve ever seen one of your parents try to read the store directory at the mall, you’ll know why hospitals are trying to design calmer, more comfortable wayfinding areas that include lots of natural light and vestibules off to the side where visitors can contemplate where they are going. Also, corridors are being designed with fewer turns and intersections, to avoid confusion.

“Wayfinding maps should be oriented in the exact direction that the person is viewing,” notes Vance. “Additionally, wayfinding signs should not include too much information that may confuse readers. Letter sizes and fonts on signage should be legible to the visually challenged. All wayfinding terms, arrows, and information on directional signage should be simplified.”

Patient rooms. Boomers are used to being comfortable in their home, and if they need to stay over in the hospital, they want the same comforts they’d have in their residences. In addition, boomers are a social bunch, so they want rooms with social spaces. Think of how hotels are starting to build more “residential suites” with sofas, kitchens, and other amenities that remind guests of home. While designers need to keep in mind safety and ease of movement for hospital staff, along with the infection control aspects of making sure upholstered areas are easily cleanable, Vance says hospitals should consider the following to make patient rooms more inviting:

  • Adding space for caregivers to move about and gather in the room
  • Allowing for patient use of computer devices while hospitalized or in ambulatory settings
  • Accommodating the use of earbuds or headphones by making connections available to the TV or entertainment system in the patient’s room
  • Eliminating lighting that shines directly in the eyes of the patient
  • Carefully considering the type of lighting used at night
  • Improving patient comfort and bedside activities while resting and relaxing in both inpatient and outpatient settings

Surfaces and color patterns. Vance says that hospitals are toeing a delicate line here—on the one hand, they want to avoid making the facility look like an institution, but on the other hand, too much color or fancy design work on the walls and floors could be overstimulating to boomers. Research has shown that people 60 and older experience declines in their vision based on a number of factors, and specific colors, textures, and patterns can be disorienting to older patients and visitors—which can lead to avoidable trips and falls.

Most important, Vance says, is to make sure surfaces are installed that keep tripping and falling to a minimum. He suggests the following:

  • Keep color changes of the flooring in main corridors to a minimum, as older visitors can become disoriented.
  • Minimize the amount of level changes in the facility to eliminate the need for patients to step up or down (which could lead to trips) while going from place to place.
  • Use non-skid floor materials that don’t become slippery to avoid a falling hazard.
  • Use recessed floor mats instead of laying down throw mats in slippery conditions.
  • Use patterns and textures with caution. Stick with primary colors and simple patterns that are easier on the eyes.

Technology upgrades. Anyone who has watched their parents play with their newly installed TiVo knows that boomers are a generation who, while relatively tech-savvy, also enjoy the freedom to do what they want.

With this in mind, many hospitals are beginning to add advanced medical technology to their facilities, as well as information technology tools like digital patient education, entertainment systems, and registration kiosks. In addition, since many boomers are taking advantage of home health monitoring devices and virtual visits, some facilities are accommodating telemedicine services by including spaces that contain appropriate lighting and backdrops for videoconferencing with off-site physicians.

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