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| THE ARCHITECT'S ANGLE
May 2013 |
Greetings!
This month we are focusing on Long Term Care and Rehabilitation. Our feature article traces the history and evolution of Long Term Care over the last 30 years and discusses trends for the future. Our companion article "Rehab Revisited", centers on one of these trends, discussing the forces shaping current rehab facilitydesign. Please let us know what you think. We welcome your feedback. |
The Evolution of Long Term Care
As a senior care architect with over 30 years in the field, I have experienced the evolution of long term care (LTC) centers from the "other side of the drawing board".
From my perspective, the wave of changes started with the elimination of the old health related facility model (HRF) which was followed by the development of home based and community based alternatives such as long term home healthcare (LTHHC) and adult dayhealth care (ADHC).
These changes, (and a number of other factors such as improved longevity), started to negatively impact the census of the average LTC center and changed the character of the average LTC resident; they were older, sicker, and less ambulatory than in previous decades.
As many LTC centers moved to fill empty beds and deal witha heavier case mix, they did so with a different mindset; residents and families were customers who had a choice as to where they could receive LTC. Although the principals of the Eden alternative were already well known, this new "customer dynamic" seemed to really launch a wave of LTC culture change with a focus on resident centered care.
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Rehab Revisited
As todays Long Term Care (LTC) arena continues to evolve, the specialization and refinement of programs and services seems to be the primarily way in which LTC facilities are attempting to increase their market share. Competition for rehab residents is fierce and "you must have something different to offer residents and families to stay ahead of the game" according to one LTC Administrator I recently interviewed.
To make matters worse, continued cuts in Medicare reimbursement have forced LTC centers and their Architects to "do more with less". We have had to focus on using cost effective materials and finishes in new and interesting ways.
Fortunately, at JWB, we have always used a multi-disciplinary design approach which integrates the aesthetic and technical aspects of a project at the conceptualization stage. In other words we "go with the flow" of existing conditions, designing around them, thereby reducing construction costs. These savings can then be applied to design so our clients don't need to sacrifice the "wow factor" they need to differentiate themselves from the competition.
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We hope you enjoy this months issue. We want to continue to offer content that interests you, our readers. Please drop us a line and let us know what topics you might want to learn more about. As always, we love hearing from you.
Sincerely,
John Baumgarten
John W. Baumgarten Architect, P.C.
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