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E-raamat: Housing Design for an Increasingly Older Population - Redefining Assisted Living for the Mentally and Physically Frail: Redefining Assisted Living for the Mentally and Physically Frail [Wiley Online]

  • Formaat: 336 pages
  • Ilmumisaeg: 02-Oct-2018
  • Kirjastus: John Wiley & Sons Inc
  • ISBN-10: 111918004X
  • ISBN-13: 9781119180043
  • Wiley Online
  • Hind: 98,28 €*
  • * hind, mis tagab piiramatu üheaegsete kasutajate arvuga ligipääsu piiramatuks ajaks
  • Formaat: 336 pages
  • Ilmumisaeg: 02-Oct-2018
  • Kirjastus: John Wiley & Sons Inc
  • ISBN-10: 111918004X
  • ISBN-13: 9781119180043

“Longer lifespans and the needs of the oldest old are challenging the senior living industry to find bold and compassionate solutions to combine programs and services with housing.  Victor Regnier's latest research provides a thoughtful and insightful roadmap that arrays new ways of thinking from small-scale settings to community based options.  International case studies offer possible solutions with the best thinking from around the globe…all with Vic's unique perspective of extracting themes and concepts that are broadly applicable and essential to addressing the needs of those that live on life's fragile edge.” —David Hoglund, FAIA

“Supporting the independence of the oldest-old is a tough problem Victor Regnier addresses in his latest book on aging and housing. Like previous work, Victor relies on the best practices of northern Europeans to outline a three-prong approach.  First, providing extremely comprehensive home care services in an "apartment for life" setting.  Second, reforming the conventional nursing home by exploring small group style accommodations.  Third, combining new technology with community based services to age in place.  Case studies document the experiences of others in making these programs work here and abroad.  The magnitude of the 90+ and 100+ population increases in the next 50 years make it clear how important it is to address this concern today.” —Edward Steinfeld Darch

“The movement of health care from the institution to the home is a theme that Regnier identifies as one of the most important lessons in rethinking the issue of how to support the ever growing and increasingly aged older population here and abroad.  He examines simple but profound approaches we can take in making long-term care a more humane proposition.  Familiar themes like humanizing technology and optimizing the impact of the natural environment are brought together with clear policy thinking about what we need to do. The timing is good because the impact of this growing segment of society will have major repercussions on health care for the next 50-70 years.” —Stephan Verderber, Ph.D.

A comprehensive guide to designing housing for the world’s aging population

The dilemma of helping older people maintain their independence through better housing with services is growing. This book presents innovative solutions for those who create and provide housing for the world’s increasingly longer-living population. By focusing on three specific housing and service arrangements, it offers alternatives that provide greater freedom of choice than the current living arrangements that exist today. It presents selected examples of housing and service solutions from the US, Sweden, Denmark and the Netherlands to stimulate thinking about the possibilities of community-based service models.

Housing Design for an Increasingly Older Population looks at a trio of options for housing the “oldest-old:” the Dutch Apartment/Condo for Life Model (AFL); decentralized Small/Green Houses; and the provision of enhanced personal and health care for people who want to stay in their own home. It offers unique and eye-opening chapters covering: what older people want; what age changes affect independence; demographics and living arrangements; how long-term care is defined; concepts and objectives for housing the frail; care giving and management practices that avoid an institutional lifestyle; innovative case studies; programs that encourage staying at home with service assistance; therapeutic use of outdoor spaces; how technology will help people stay independent; and more.

  • Based on the author’s numerous conversations with other experts, as well as his examinations of high quality settings from Northern Europe and the US
  • Building case study examples showcase innovative and compassionate solutions
  • In-depth coverage of three major systems that work
  • Examines successful programs such as PACE, Friendly Cities, NORC, and the “Village to Village Network” to demonstrate the progress made in helping older, frail people stay in their own homes for as long as possible

Housing Design for an Increasingly Older Population: Redefining Assisted Living for the Mentally and Physically Frail is an important book for those who create, design, and manage assisted living and skilled nursing facilities, as well as for those who set policies regarding health, and personal care for our world’s aging society.

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