Exploring the Function and Use of Common Spaces in Assisted Living for Older Persons

Abstract

OBJECTIVE:

This exploratory study examines the function and use of common spaces in assisted living facilities (ALFs) from the residential and workplace perspectives.

BACKGROUND:

The impact of the physical environment on human activities in healthcare settings has been emphasized in many studies. Few studies, however, have explored the daily use of common spaces and the impact on the usability of ALFs.

METHODS:

Four explorative methods–observation, group interviews, individual interviews, and questionnaires—were used to investigate 14 ALFs in Sweden. The study involves residents, staff, relatives, architects, and people responsible for planning and construction of eldercare. This research strategy combines quantitative and qualitative methods to enhance the validity of the results. Method triangulation and data triangulation were used and the data were analyzed using Qualitative Content Analysis (QCA).

RESULTS:

The results show that residents and staff have different objectives for use and these differences affect usability, although explicit conflicts are rare. The residents, staff, and other stakeholders have different views about the demarcation of home and workplace and the role of common spaces as venues for social interaction.

CONCLUSIONS:

Both the residential and the workplace perspective must be considered when planning assisted living facilities. Otherwise, inherent conflicts between these perspectives will manifest as a result of the physical design. Common spaces have diverse functions that are reflected in their spatial organization. Therefore, ALFs should be designed so the intended function of a specific space is apparent to all users.

Keywords

Built environment elderly planning satisfaction staff

Get full access to this article

View all access options for this article.

References

Alexander

(2006). The application of usability concepts in the built environment. Journal of Facilities Management, 4, 262–270.

Andersson

J. E.

(2011). Architecture and ageing. On the interaction between frail older people and the built environment (Doctoral dissertation). Stockholm, Sweden: Royal Institute of Technology.

Andersson

Lindahl

, & Malmqvist

(2011). Use and usability of assisted living facilities for the elderly: An observation study in Gothenburg, Sweden. Journal of Housing for the Elderly, 25, 380–400.

Ball

M. M.

Lepore

M. L.

Perkins

M. M.

Hollingsworth

, & Sweatman

(2009). They are the reason I come to work: The meaning of resident–staff relationships in assisted living. Journal of Aging Studies, 23, 37–47.

Blakstad

S. H.

(2001). A strategic approach to adaptability in office buildings (Doctoral dissertaion). Trondheim, Norway: Norwegian University of Science and Technology.

Blakstad

S. H.

Hansen

, & Knudsen

(2008). Methods & tools for evaluation of usability in buildings. In Alexander

(Ed.), W111 research report: Usability of workplaces, phase 2, CIB report 316 (pp. 26–37). Rotterdam, The Netherlands: International Council for Research and Innovation in Building and Construction. Retrieved from http://usir.salford.ac.uk/1985/1/CIB8896.pdf.

Bryman

(2008). Social research methods. London, England: Oxford University Press.

Day

Carreon

, & Stump

(2000). The therapeutic design of environments for people with dementia: A review of the empirical research. The Gerontologist, 40, 417–421.

Denzin

N. K.

(1978). The research act: A theoretical introduction to sociological methods (2nd ed.). New York, NY: McGraw Hill.

10.

Dewalt

, & Dewalt

B. R.

(2002). Participant observation, a guide for fieldworkers. Lanham, MD: Rowman & Littlefield.

11.

Dijkstra

Piterse

, & Pruyn

(2006). Physical environmental stimuli that turn healthcare facilities into healing environments through psychologically mediated effects: Systematic review. Journal of Advanced Nursing, 56, 166–181.

12.

Fenker

(2008). Towards a theoretical framework for usability of buildings. In Alexander

(Ed.), W111 research report: Usability of workplaces, phase 2, CIB report 316 (pp. 16–25). Rotterdam, The Netherlands: International Council for Research and Innovation in Building and Construction. Retrieved from http://usir.salford.ac.uk/1985/1/CIB8896.pdf

13.

Frankowski

A. C.

Roth

Eckert

J. K.

, & Harris-Wallace

(2011). The dining room as the locus of ritual in assisted living. Generations, 35, 41–46.

14.

Fänge

A. M.

, & Iwarsson

(2003). Accessibility and usability in housing: Construct validity and implications for research and practice. Disability and Rehabilitation, 25, 1316–1325.

15.

Graneheim

U. H.

, & Lundman

(2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105–112.

16.

Groat

, & Wang

(2002). Architectural research methods. New York, NY: Wiley & Sons.

17.

Gurney

, & Means

(1993). The meaning of home in later life. In Arber

& Evandrou

(Eds.), Ageing independence and the life course (pp. 119–131). London, England: Jessica Kingsley.

18.

Harris

D. K.

(1988). Dictionary of gerontology. Westport, CT: Greenwood Publishing Group.

19.

Hazelwinkel

(Ed.) (2001). Encyclopedia of mathematics: Student test. New York, NY: Springer.

20.

Ice

G. H.

(2002). Daily life in a nursing home: Has it changed in 25 years? Journal of Aging Studies, 16, 345–359.

21.

International Organization for Standardization. (1998). Ergonomic requirements for office work with visual display terminals (VDTs)—Part 11: Guidance on usability. ISO 9241-11:1998. Genève, Switzerland: Author.

22.

Kalymun

(1991). Toward a definition of assisted living. Journal of Housing for the Elderly, 7, 97–132.

23.

Kärnä

Junnonen

J.-M.

, & Nenonen

(2010). Feedback system for developing the usability of workplaces. In Alexander

(Ed.), W111 research report: Usability of workplaces, phase 3, CIB report 330 (pp. 57–58). Rotterdam, The Netherlands: International Council for Research and Innovation in Building and Construction. Retrieved from http://cibworld.xs4all.nl/dl/publications/pub330.pdf

24.

Lawton

M. P.

, & Nahemow

(1973). Ecology and the aging process. In Eisdorfer

& Lawton

M. P.

(Eds.), The Psychology of Adult Development and Aging (pp. 619–674). Washington, DC: American Psychological Association.

25.

Leaman

(2000). Usability in buildings: The Cinderella subject. Building Research & Information, 28, 296–300.

26.

Lorenz

S. G.

(2007). The potential of the patient room to promote healing and well-being in patients and nurses. An integrative review of the research. Holistic Nursing Practice, 21, 263–277.

27.

Lundgren

(2000). Homelike housing for elderly people—Materialized ideology. Housing, Theory and Society, 17, 109–120.

28.

Lutz

Sanderson

, & Scherbov

(2008). The coming acceleration of global population ageing. Nature, 451, 716–719.

29.

McColgan

(2005). A place to sit—resistance strategies used to create privacy and home by people with dementia. Journal of Contemporary Ethnography, 34, 410–433.

30.

McKechnie

L. E. F.

(2008). Unstructured observation. In Given

L. M.

(Ed.), The SAGE encyclopedia of qualitative research methods (pp. 907–908). Thousand Oaks, CA: Sage.

31.

Moore

K. D.

(1999). Dissonance in the dining room: A study of social interaction in a special care Uunit. Quality Health Research, 9, 133–155.

32.

National Board of Health and Welfare. (2007). Demenssjukdomarnas samhällskostnader och antalet dementa i Sverige 2005. Socialstyrelsen.

33.

National Board of Health and Welfare. (2011). Bostad i särskilt boende är den enskildes hem. Socialstyrelsen.

34.

National Board of Health and Welfare. (2013). Vård och omsorg om äldre 2012. Eldercare 2012. Socialstyrelsen.

35.

Nord

(2011a). Individual care and personal space in assisted living in Sweden. Health and Place, 17, 50–56.

36.

Nord

(2011b). Architectural space as a moulding factor of care practices and resident privacy in assisted living. Ageing and Society, 31, 934–52.

37.

Onwuegbuzie

A. J.

& Johnson

(2006). The validity issue in mixed research. Research in the Schools, 13, 48–63.

38.

Pastalan

L. A.

, & Schwarz

(1993). The meaning of home in ecogenic housing: A new concept for elderly women. In Dandekar

H. C.

(Ed.), Shelter, women and development (pp. 402–407). Ann Arbor, MI: Wahr Publishing.

39.

Patton

M. Q.

(2002). Qualitative research & evaluation methods. Thousand Oaks, CA: Sage.

40.

Paulsson

(2002). Det nya äldreboendet. Stockholm, Sweden: Svensk Byggtjänst.

41.

Rasila

Rothe

& Kerosuo

(2010). Dimensions of usability assessment in built environments. Journal of Facilities Management, 8, 143–153.

42.

Rider

P. R.

(1932). On the distribution of the correlation coefficient in small samples. Biometrika, 24, 382–403.

43.

Ryd

& Fristedt

(2007). Transforming strategic briefing into project briefs—a case study about client and contractor collaboration. Facilities, 25, 5/6, 185–202.

44.

Ryvicker

(2011). Staff–resident interaction in the nursing home: An ethnographic study of socio-economic disparities and community contexts. Journal of Aging Studies, 25, 295–304.

45.

SFS 2001:453. Socialtjänstlag. (Social Services Act).

46.

Sixsmith

(1990). The meaning and experience of home in later life. In Bytheway

& Johnson

(Eds.), Welfare and the Ageing Experience (pp. 172–197). Aldershot, England: Avebury.

47.

Swedish Government. (1990). Ädelreformen: Om ansvaret för service och vård till äldre och handikappade med mera. Government proposition 1990/91:14.

48.

Swedish Government. (2008). Bo bra hela livet. Government official reports SOU 2008:113.

49.

Swedish National Board of Housing, Building and Planning. (2012). Boverkets byggregler (Boverket Building Regulations). Karlskrona, Sweden: Author.

50.

Tashakkori

, & Teddlie

(Eds.). (2010). Handbook of mixed methods in social and behavioral research (2nd ed.). Thousand Oaks, CA: Sage.

51.

Twigg

(2000). Bathing—the body and community care. London, England: Routledge.

52.

Uhlenberg

(1988). Aging and the societal significance of cohorts. In Birren

J. E.

& Bengtson

V. L.

(Eds.), Emergent theories of aging (pp. 405–425). New York, NY: Springer.

53.

Ulrich

Zimring

Zhu

DuBose

Seo

H.-B.

Choi

Y.-S.

Joseph

(2008). A review of the research literature on evidence-based healthcare design. Health Environments Research & Design Journal, 1(3), 61–125.

54.

Verbeek

van Rossum

Zwakhalen

S. M. G.

Kempen

G. I. J. M.

, & Hamers

J. P. H.

(2009). Small, homelike care environments for older people with dementia: A literature review. International Psychogeriatrics, 21, 252–264.

55.

Wahl

H. W.

Iwarsson

, & Oswald

(2012). Aging well and the environment: Toward an integrative model and research agenda for the future. The Gerontologist, 52, 306–316.

56.

Warell

(2001). Design syntactics: A functional approach to visual product form. Theory, models and methods (Doctoral dissertation). Gothenburg, Sweden: Chalmers University of Technology.

57.

Williams

K. N.

, & Warren

C. A. B.

(2009). Communication in assisted living. Journal of Aging Studies, 23, 24–36.

58.

Yang

H.-Y.

, & Stark

S. L.

(2010). The role of environmental features in social engagement among residents living in assisted living facilities. Journal of Housing for the Elderly, 24, 28–43.

59.

Zavotka

, & Teaford

M. H.

(1997). The design of shared social spaces in assisted living residences for older adults. Journal of Interior Design, 23, 2–16.

60.

Zimmerman

, & Sloane

P. D.

(2007). Definition and classification of assisted living. The Gerontologist, 47 (suppl 1), 33–39.

61.

Zimmerman

Mitchell

C. M.

Chen

C. K.

Morgan

L. A.

Gruber-Baldini

A. L.

Sloane

P. D.

Eckert

J. K.

, & Munn

(2007). An observation of assisted living environments: Space use and behavior. Journal of Gerontological Social Work, 49, 185–203.

62.

Zimmerman

Scott

A. C.

Park

N. S.

Hall

S. A.

Whetherby

M. M.

Gruber-Baldini

A. L.

, & Morgan

L. A.

(2003). Social engagement and its relationship to service provision in residential care and assisted living. Social Work Research, 27, 6–18.

63.

Andersson

Ryd

& Malmqvist

(2014). Exploring the function and use of common spaces in assisted living for older persons. Health Environments Research & Design Journal, 7(3), 98–119.