| Acknowledgments |
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xix | |
| Foreword |
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xxiii | |
| About the Companion Website |
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xxxiii | |
| 1 What Do Older People Want? |
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1 | (12) |
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What Possibilities Would Frail Older People Prefer in a Housing Solution? |
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1 | (1) |
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How We Age Is Often Unpredictable |
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1 | (1) |
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Strategy One: Stay in the House and See What Happens |
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2 | (3) |
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Strategy Two: Plan the Move and Explore Other Scenarios |
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5 | (4) |
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What Aspects of Housing and Services Best Serve the Older Frail? |
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9 | (1) |
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10 | (3) |
| 2 What Are the Major Aging Changes that Affect Independence? |
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13 | (12) |
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Changes in Sensory Modalities |
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13 | (4) |
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Chronic Conditions and Disability that Limit Independence |
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17 | (1) |
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Will Chronic Disease Continue to Decrease? |
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18 | (4) |
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22 | (3) |
| 3 Demographics and Living Arrangements |
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25 | (12) |
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Mortality and Fertility on the World Stage |
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25 | (1) |
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Longevity Is a Primary Driver of Aging Population Growth |
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26 | (1) |
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World Population Growth: 65+, 85+, 100+ |
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26 | (1) |
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China Is the Most Rapidly Aging Country in the World |
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27 | (1) |
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European Aging Experience: Been There, Done That |
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28 | (1) |
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The Triple Whammy of the Aging of Japan: Longevity, Low Fertility, and Low In-migration |
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29 | (1) |
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What About the Growth Rate of the 65+ and 85+ Population in the US? |
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29 | (2) |
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The Centenarians and Near Centenarians: 100- and 90-Year-Olds in the US |
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31 | (1) |
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Impacts of Demographic Growth |
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31 | (2) |
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What Other Demographic Issues Will Affect the Future? |
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33 | (1) |
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34 | (3) |
| 4 How Is Long-Term Care Defined? What Are the Choices? |
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37 | (16) |
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What Are the Major LTC Alternatives? |
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37 | (1) |
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Nursing Home Facts and Figures |
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38 | (1) |
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What Are the Problems of Traditional Nursing Homes? |
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38 | (3) |
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Will Green House© and Small House Models Replace Traditional Nursing Homes? |
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41 | (1) |
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What Attributes Should We Strive to Include in New Nursing Homes? |
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42 | (1) |
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How Do Assisted Living (AL) and Residential Care Settings Differ? |
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43 | (1) |
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Assisted Living, Problem One: Care for More Dependent Residents |
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44 | (1) |
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Assisted Living, Problem Two: Cost of Care and Lack of Reimbursement |
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44 | (1) |
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How Do Assisted Living Residents Differ from Nursing Home Residents? |
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45 | (1) |
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What Can We Learn from Hospice Models? |
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45 | (2) |
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Home Care Through Family Members and Formal Sources |
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47 | (1) |
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Reformulating Home Care to Work at the Margin of Need |
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48 | (2) |
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50 | (3) |
| 5 Concepts and Objectives for Housing the Frail |
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53 | (4) |
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53 | (1) |
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53 | (1) |
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Environmental Docility Hypothesis |
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54 | (1) |
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55 | (2) |
| 6 20 Design Ideas and Concepts that Can Make a Difference |
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57 | (34) |
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The Neighborhood, Site Issues, and Outdoor Space |
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57 | (7) |
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One: Defining A Good Accessible Site |
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57 | (1) |
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Two: Orientation To The Outdoors And The Natural World |
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58 | (2) |
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Three: Courtyards For Density, Views, And Social Exchange |
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60 | (1) |
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Four: Interstitial Spaces On The Building's Edge |
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60 | (2) |
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Five: Atriums For Social Interaction And Exercise |
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62 | (2) |
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Refining Design Attributes And Considerations |
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64 | (10) |
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Six: Making The Building Approachable, Friendly, And Noninstitutional |
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64 | (1) |
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Seven: Create A Building That Is Accommodating And Adaptable |
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65 | (1) |
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Eight: The Building Design Should Encourage Walking |
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66 | (2) |
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Nine: Invite Natural Light |
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68 | (1) |
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Ten: Embrace The Open Plan |
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69 | (1) |
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Eleven: The Impact Of Interior Design On The Senses |
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70 | (2) |
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Twelve: Special Considerations For Designing For Dementia |
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72 | (2) |
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Stimulating Social Interaction |
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74 | (9) |
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Thirteen: Places That Welcome Family And Friends |
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74 | (2) |
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Fourteen: The 100% Corner Or Community Table |
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76 | (2) |
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Fifteen: Places For Unobtrusive Observation And Previewing |
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78 | (2) |
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80 | (1) |
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Seventeen: The Primary Path |
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81 | (1) |
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82 | (1) |
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Planning The Dwelling Unit |
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83 | (5) |
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Nineteen: Personalization That Makes The Unit Your Own |
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83 | (2) |
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Twenty: Dwelling Unit Design |
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85 | (3) |
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88 | (3) |
| 7 12 Caregiving And Management Practices That Avoid An Institutional Lifestyle |
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91 | (20) |
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Effective Caregiving Strategies |
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91 | (8) |
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One: Accommodating Independence Through A Home Care Model |
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91 | (2) |
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Two: Primary, Secondary, And Designated Caregivers And The Computer |
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93 | (1) |
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Three: Activity Of Daily Living (ADL) Therapy |
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94 | (3) |
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Four: Maintain A Commitment To Serve The Surrounding Neighborhood |
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97 | (2) |
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Full Participation In The Life Of The Place |
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99 | (5) |
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99 | (1) |
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Six: Commitment To Physical Therapy And Exercise |
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100 | (1) |
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Seven: Clubs, Entertainment, And Purposeful Activity |
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101 | (1) |
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Eight: The Dining Experience And Nutrition |
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101 | (3) |
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104 | (6) |
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Nine: Encouraging Cheerfulness And Positive Affect |
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104 | (2) |
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Ten: Avoid An Institutional Lifestyle |
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106 | (1) |
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Eleven: Plants, Pets, Kids, And The Creative Arts |
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107 | (2) |
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Twelve: Treating The Staff With Respect And Dignity |
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109 | (1) |
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110 | (1) |
| 8 21 Building Case Studies |
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111 | (118) |
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European History Of Home-Care Serviced Buildings |
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111 | (1) |
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Service House Model Emerges |
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112 | (1) |
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113 | (5) |
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The Continuing Care Retirement Community (CCRC) Or Life Plan Community (LPC): A Us Invention |
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118 | (39) |
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CS One: Humanitas Bergweg, Rotterdam, The Netherlands |
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120 | (5) |
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CS Two: Rundgraafpark, Veldhoven, The Netherlands |
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125 | (4) |
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CS Three: La Valance, Maastricht, The Netherlands |
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129 | (5) |
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CS Four: Neptuna, Malmo, Sweden |
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134 | (4) |
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CS Five: De Plussenburgh, Rotterdam, The Netherlands |
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138 | (6) |
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CS Six: De Kristal (Crystal), Rotterdam, The Netherlands |
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144 | (2) |
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CS Seven: Woodlands Condo For Life Prototype, Woodlands, Texas |
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146 | (5) |
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CS Eight: Newbridge On The Charles, Dedham, Massachusetts |
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151 | (6) |
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Small Group Living Cluster Case Studies |
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157 | (38) |
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CS Nine: Mount San Antonio Gardens Green House©, Claremont, California |
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161 | (4) |
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CS Ten: Leonard Florence Center For Living, Chelsea, Massachusetts |
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165 | (5) |
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CS Eleven: The New Jewish Lifecare Manhattan Living Center, Manhattan, New York |
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170 | (5) |
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CS Twelve: Hogeweyk Dementia Village, Weesp, The Netherlands |
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175 | (9) |
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CS Thirteen: Krtebjerghaven, Odense, Denmark |
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184 | (6) |
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CS Fourteen: Herluf Trolle, Odense, Denmark |
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190 | (5) |
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Smaller-Scale Assisted Living Buildings (25 To 40 Units) And Other Options |
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195 | (32) |
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CS Fifteen: Vigs Angar Assisted Living, Kopingebro, Sweden |
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195 | (6) |
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CS Sixteen: Ulrika Eleonora Service House, Louviisa, Finland |
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201 | (4) |
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CS Seventeen: Irismarken Nursing Center, Virum, Denmark |
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205 | (5) |
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CS Eighteen: Sunrise Of Beverly Hills Dementia Cluster, Beverly Hills, California |
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210 | (4) |
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CS Nineteen: Egebakken Co-Housing, Nobedo, Denmark |
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214 | (5) |
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CS Twenty: Willson Hospice, Albany, Georgia |
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219 | (4) |
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CS Twenty-One: Musholm Bugt Feriecenter, Korsor, Denmark |
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223 | (4) |
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227 | (2) |
| 9 Programs that Encourage Staying at Home with Service Assistance |
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229 | (24) |
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One: Home Modification Programs |
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229 | (3) |
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Two: Danish Home Care System |
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232 | (3) |
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Three: PACE (Program for All-inclusive Care for the Elderly) |
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235 | (3) |
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Four: Home- and Community-Based Care: The 1915c and 1915 Waiver Programs and Long-term Care Insurance |
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238 | (2) |
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Five: Beacon Hill Village (BHV) |
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240 | (3) |
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243 | (2) |
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Seven: Accessory Dwelling Units (ADU) |
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245 | (2) |
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Eight: GenSmart House and Next Gen House |
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247 | (2) |
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Nine: Naturally Occurring Retirement Communities (NORC's) |
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249 | (2) |
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251 | (2) |
| 10 Therapeutic Use of Outdoor Spaces and Plant Materials |
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253 | (14) |
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How Does the Landscape Make a Difference? |
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253 | (1) |
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253 | (1) |
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254 | (1) |
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255 | (1) |
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Design Considerations for Gardens and Outdoor Spaces |
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256 | (4) |
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260 | (1) |
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European Atrium Buildings |
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261 | (4) |
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265 | (2) |
| 11 How Will Technology Help People Stay Independent and Avoid Institutionalization? |
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267 | (14) |
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Transportation Is a Major Barrier Today |
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267 | (1) |
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Internet Service Utilization |
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268 | (1) |
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269 | (2) |
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271 | (1) |
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271 | (2) |
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Functional Electromechanical Robots |
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273 | (1) |
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Transfer and Lifting Devices |
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274 | (1) |
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275 | (1) |
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276 | (1) |
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Scooters (Personal Operating Vehicles) and Mobility Aides |
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276 | (1) |
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277 | (1) |
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278 | (1) |
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DNA-based Medicines and Therapies |
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278 | (1) |
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279 | (2) |
| 12 Primary Themes, Takeaways, and Conclusions |
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281 | (8) |
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The US and the World Will Experience a Much Older Population |
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281 | (1) |
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Home Care Models and Integrated Health Care Models Are Needed |
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281 | (1) |
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Assisted Living (AL) Is a Viable Alternative but Comes with Restrictions in the US |
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282 | (1) |
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The Apartment for Life (AFL) Model Provides Personal and Medical Care in Independent Housing |
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282 | (1) |
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Small Group Housing Clusters for the Extremely Mentally and Physically Frail Is Likely to Continue, Even with Other Options Available |
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283 | (1) |
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Most Existing US Nursing Homes Are of Poor Quality and Need to Be Phased Out or Upgraded |
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283 | (1) |
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How Can We Help Those with Dementia Live a More Satisfying and Meaningful Life? |
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284 | (1) |
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Baby Boomers Have High Expectations for Quality Long-term Care Services but Lack the Means to Purchase Them |
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285 | (1) |
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Supporting Friendships and Increasing Affect Make Places to Live Happier |
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285 | (1) |
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How Will Advances in Technology Make a Difference? |
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286 | (1) |
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An Emphasis on Exercise and Connections to Outdoor Spaces |
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286 | (1) |
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More Comprehensive Approaches at the City and Neighborhood Scale |
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287 | (1) |
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287 | (2) |
| Index |
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289 | |