Architects Build On Total Wellness

Perkins Eastman was early to apply biophilic design principles to seniors housing, as seen here in The Summit, a new independent living tower in Spokane, Washington, owned by Rockwood Retirement Communities. Biophilic design combines natural materials and copious amounts of natural light to achieve a sense of physical and mental wellness. The curvilinear shape of the main building’s corridor shows the architects were inspired by a river. Perkins Eastman was early to apply biophilic design principles to seniors housing, as seen here in The Summit, a new independent living tower in Spokane, Washington, owned by Rockwood Retirement Communities. Biophilic design combines natural materials and copious amounts of natural light to achieve a sense of physical and mental wellness. The curvilinear shape of the main building’s corridor shows the architects were inspired by a river.

From the use of special lighting in the common areas to spa-like amenities to community gardens, designers are all in on creating a better physical environment for residents.

By Lynn Peisner

Wellness is no longer a buzzword used to promote yoga retreats, organic foods or
cruelty-free beauty products. It’s a big movement, often backed by big money, that evolves every year and permeates every demographic group, including seniors.

Daily headlines reveal just how much wellness is embedded in today’s zeitgeist. Effective October 1, Weight Watchers changed its name after 65 years in business. Henceforth known as “WW,” the company is betting those Ws will cement the brand into the wellness movement, which the company says is more holistic than a singular focus on calories and weight. This move into wellness is expected to raise the company’s revenue from $1.3 billion in 2017 to $2 billion by 2020, according to Fortune magazine. 

The very same way of thinking is influencing seniors housing architectural trends. Healthy living has long been a priority in programming, but today owners and architects are figuring out how to design and deliver communities that showcase wellness from top to bottom.

What exactly is wellness?

Wellness doesn’t mean “not sick.” It’s about habits, products and environments that work together to promote spiritual, social and intellectual fulfillment in equal measure with physical health and fitness.

“The term ‘wellness’ isn’t exactly new to seniors housing,” says Manny Gonzalez, principal with KTGY Architecture + Planning, who is based in the Los Angeles office of the international firm. “But today we are designing for it in a more complete, all-encompassing way, which is why people are now using the term ‘total wellness.’”

What are some of the physical features of wellness-based design? For Baltimore’s BCT Architects, wellness designs are influenced by trends in multifamily developments, namely creating opportunities for interactions and experiences, and even making space for pets. “We are creating dog parks and dog wash stations in senior communities,” says BCT Principal Janet Meyer. “We never did that in communities five years ago.”

Wellness designs and programming aren’t only relegated to age-restricted or independent living. "Staying active and fit contributes to total wellness at any level of senior living,” Gonzalez says. “What’s important to understand is that by living that kind of lifestyle, active adults can stay active longer and not need independent living until later. Independent living residents can be independent longer, not needing to enter assisted living as early, and folks won’t need to move from assisted living to memory care until it’s an absolute necessity."

Gonzalez adds that for as long as there has been research on seniors, the industry has known that the most desired activity to keep this age group healthy is walking and hiking. “Today’s senior developments are not only incorporating workout stations along walking paths, but they are rating the trails like they do at ski resorts for beginner, intermediate, advanced and expert levels.” 

Gonzalez points to companies such as Avid Trails by way of example. The Park City, Utah-based company works alongside developers to design, construct and program rated trails for multifamily developments, cities, hospitals, college and corporate campuses and master-planned communities. 

Jay Hoeschler, director of design at Avid Trails, says the company’s work with age-
targeted communities is on the rise and represents approximately 20 percent of business in the past year.

“It used to be that our trail designs were limited to ADA (Americans With Disabilities Act) standards, but today older users are more healthy and active and want to stay fit,” explains Hoeschler. “So we look to surfaces that are softer and easier on the knees while we shy away from harder surfaces like concrete.” 

Avid Trails recently completed a combination trail and fitness amenity at Trilogy at Ocala Preserve in Ocala, Florida, a community of 55-plus, for-sale homes owned by Shea Homes.

The amenity is called Avid FitPod, which was designed in collaboration with Trilogy’s Afturburn fitness team to provide physical challenges designed for older people along the trails. “It’s like a fun boot camp for active adults and has become one of the most popular amenities at the community,” says Hoeschler. “The homes don’t have stairs, so we built stairs into the fitness circuit to keep that muscle group strong. It’s a fun way for the residents to socialize.”

Community gardens, fitness centers and kitchens are other spaces where architects are turning up the wellness volume. With the emphasis on healthy eating and organic produce, the amount of space devoted to gardening and indoor-outdoor kitchens is increasing throughout the industry. 

Gonzalez says architects are looking to communities such as Serenbe outside Atlanta for inspiration. 

Serenbe is a 1,000-acre community within a 40,000-acre forest where wellness is a way of life. (The development’s name stems from the serenity of the location.) Four clusters of homes each have their own commercial district, and most residents work in the fields of the 25-acre organic farm to grow their own farm-to-table crops.

While “total wellness” is sweeping the industry, “biophilia” is another term that often comes up when architects talk about what wellness looks like in seniors housing. Biophilia is a design methodology that promotes social interaction, mobility and connections to nature. The concept is less concerned with physical materials and energy outputs and more keyed into how residents interact with spaces and how they feel inside a building.

New York-based Perkins Eastman was an early advocate of biophilic design in seniors housing. Associate McCall Wood says that biophilia can be defined as taking the concept of a green building one step further by focusing on the human elements of sustainability. The idea is that connections to nature and interactions with natural materials and patterns lead to a heightened sense of wellness.

“I believe every design needs to have biophilic elements,” says Allie Thompson, senior designer at Ardmore Pennsylvania-based Meyer Design. “It’s smart design for our industry. A biophilic design and a sustainable design need to be mixed together to achieve total wellness.”

Wellness measured

In June 2017, Perkins Eastman completed a memory care addition at Deer Creek at Paradise Valley Estates in Fairfield, California, then tested the effects of biophilic design. The expansion delivered 18 new units of memory care attached to the already existing assisted living residences. It also added new dining, kitchen and activity spaces as well as an outdoor courtyard.

Perkins Eastman rolled out a prototype that hit most of the highlights of biophilic design. The architects increased residents’ access to natural light and installed special lighting in the common areas that shifts through a color spectrum throughout the day to mimic daylight.

In the units, Dutch doors — divided horizontally in two parts — promote safety while encouraging interaction. With the bottom half closed, residents feel safe, but also ready to engage when the top half of the door is open.

The design also incorporated a “Snoezelen room,” a multisensory environment that helps people with dementia or autism. At Deer Creek, the Snoezelen room included a large faux skylight with images of tree branches and a blue sky.

Ease of access helps a biophilic design. Wayfinding, and what Perkins Eastman calls “meaningful wandering” is supported by changes in ceiling heights, lighting and views of the garden from almost anywhere in the building.

Perkins Eastman conducted a pre- and post-occupancy survey of family members and staff to learn more about how this building design may have changed residents’ health. Forty-five percent of residents had previously lived in skilled nursing, 22 percent lived in assisted living and the remaining 33 percent had lived in independent living.

Across the board, the new physical environment delivered significant improvements. One hundred percent of family members said the new living space encouraged meaningful interaction between residents and family, whereas only 40 percent reported meaningful interactions before moving in.

Staff also saw significant improvements in communication, wayfinding, recall and orientation. “Staff members shared with us that the lighting alone was helping residents into a more natural circadian rhythm,” says Leslie Moldow, principal at Perkins Eastman. “They were taking less medications and were less agitated.”

The positive impact of a wellness-centered design is also important for a healthy, happy staff. 

“If your body’s natural biorhythms are supported by the environment, it helps you get attuned to the daylight hours, work through midday slumps and sleep better so that every day you are more refreshed,” says Emily Chmielewski, design researcher and senior associate with Perkins Eastman. 

“This is of value to everyone, but it’s critical that it have a positive effect on staff. Retention, recruitment and burnout are major issues facing the industry. Staff health is a really holistic view of the occupants that we pay attention to,” adds Chmielewski.

Programs, marketing are key

Total wellness is becoming increasingly important to consumers of all ages, so if your community prioritizes wellness, don’t be shy about marketing it.

“I think the most interesting takeaway for owners and operators is that they make sure to use a biophilic design as a marketing technique to bring in future residents,” says Thompson of Meyer Design. 

Thompson cites a 2014 study titled “The Drive Toward Healthier Buildings” by McGraw Hill Construction and the American Institute of Architects (AIA). The study concluded that 88 percent of people ages 60 to 69 are willing to pay a minimum 10 percent higher premium for a healthier home.

“Wellness is so important in everyone’s lives, and promoting your building as a healthy building that enhances the overall mental, physical and social well being of someone’s loved one at this time in their life is the best thing a family member can hear.”

Of course, the best total wellness designs won’t work without successful complementary programming. Boston-based DiMella Shaffer was hired by Hebrew Senior Life to expand Orchard Cove, a life plan community in Canton, Massachusetts. DiMella Shaffer designed the original community in the 1980s. 

In 2012, the firm was hired again to develop a new master plan. The core of that plan provided an extensive expansion of the space designated for “Vitalize 360,” a wellness program Hebrew Senior Life began developing about 10 years ago. 

The physical spaces DiMella Shaffer delivered were designed to focus on complete wellness and include spa-like amenities, large programmatic spaces, alternative therapies and supportive services including a social worker and a life coach.

“At DiMella Shaffer, design is approached holistically, putting an emphasis on creating environments that support well-being of the mind, body and soul,” says Diane Dooley, a principal with DiMella Shaffer. 

“Traditional wellness spaces in senior living communities were often rudimentary, offering residents access to a simple exercise room with machines and sometimes an indoor pool,” explains Dooley. 

“Since then, there’s been an increasing focus on the individual’s experience. Wellness centers now incorporate programmatic spaces for classes and spa-like amenities, such as estheticians, massage therapists and nutritional counseling,” adds Dooley.

Now that the Orchard Cove wellness space has been up and running for a few years, Vitalize 360 master coach Susan Flashner-Fineman says meditation is one of the most popular offerings. Reiki and acupuncture are also popular. Since the program started, approximately 30 other life plan communities around the country have implemented Vitalize 360. Today, 85 percent of Orchard Cove residents participate.

“For Vitalize 360, there is no formula for what physical space you’ll need,” says Flashner-Fineman. “You start with the concept, then you build the space around it. We see the program as a bit of a culture change because it’s all about the resident and what the resident wants.”

The Orchard Cove team took about six months to design Vitalize 360, using assessment tools from the Institute for Aging Research to develop the program. The tools evaluated how residents were
faring in areas such as wellness, pain, fitness and life satisfaction.

Orchard Cove staffs a master coach and six other coaches for the program who meet individually with each resident to listen to what the resident wants, customize a wellness plan and set goals. The meetings are like annual reviews to find out how to better help the resident take advantage of amenities that support the goals they’ve set.

“It’s more of an inside-out approach, rather than an outside-in approach,” says Flashner-Fineman. “If we built the amenities first, that would be an outside-in approach.” 

Consistent communication with coaches helps support residents in their wellness journey as they transition through levels of care, according to Flashner-Fineman. “We know the residents, we know what they want, and we know what matters to them.”

Back to nature

Perkins Eastman designed The Summit, a new independent living tower on Rockwood Retirement Communities’ 90-acre campus called Rockwood South Hill in Spokane, Washington. The 11-story building was completed and opened for business in 2016, followed by a wellness center that opened in fall 2017. Perkins Eastman’s design linked The Summit to The Ridge, a 1960s-era building with four floors of independent living and two floors of assisted living. The Summit is recognized as an early adopter of biophilic design principles in senior living.

“Rockwood was one of the first communities I had come across that understood that it wasn’t only about the exercise classes they were offering,” says Moldow. “Wellness was everything they did.” 

The project kicked off around 2008, but was delayed by the recession. “At that time, as far as I knew, biophilic design principles hadn’t been applied to senior living. The idea to take these principles and consciously formulate them to achieve total wellness was new.”

The Summit’s design promotes a connection to nature through ample natural light through large windows and clerestory openings to frame views of the distant mountains and nearby pine forests from many vantages, including inside the spa and fitness areas. 

Andrew Gorton, executive director of resident services for Rockwood Retirement Communities, says ownership and residents are most impressed by how the community seamlessly flows together.

“If you were to meander between the towers and through the connecting piece, you can’t really tell when you’re going from one tower to the other,” he says. “It all feels like it ties together, which was one of the major design goals.”

Moldow says Perkins Eastman used the metaphor of a river to inspire the design. The building’s winding corridor, called “Riverwalk,” is designed as a curvilinear pathway that connects The Summit and Ridge towers and promotes discovery at every turn through partially hidden amenity spaces, akin to river eddies, according to the firm.

“Total wellness is very important to us,” says Gorton says. “Around the early 2000s, we started to take fitness very seriously as our fitness program began to outgrow our facilities. With that, we also take wellness very seriously, including all the elements: spiritually, mindfully and physically. We don’t just brand that. We live it.”