For well over 30 years, design professionals have been aware of the growing proportion of the general adult assisted living facilities, for those who are challenged with different forms of dementia. The most common of these geriatric dementias is Alzheimer’s disease (AD). A current estimate maintains that AD is affecting 5% of the population between the ages of 65 and 74 (Hebert, Scherr, Bienias, Bennett, & Evans, 2003). Incredible strides have been made in the knowledgebase for treatment and care of the residents challenged with AD. Empathetic and positive treatment guidelines have been developed for adult-living facilities as well as guidelines for shoring up the fragmented families stretched and stressed by this disease (Manepalli, Desai, & Sharma, 2009). The care facilities and operators are now retooling the construction guidelines to embrace this notion of care (Facilities Guidelines Institute, 2010). Multilayered efforts are being made by a cross section of professionals to create a new place: a place called home. The song ‘‘Forever Young,’’ written by Bob Dylan in 1974, poignantly expresses this aging pandemic in its call for society to be ‘‘forever young.’’ Perhaps at 33, Dylan was beginning to see the shift in the cohort he was very much a part of, the aging of the ‘‘baby boomer’’ generation. It was a demographic he was right in the middle of when he penned the lyric for the song, a clarion prayer for strength, community, and honesty in the inevitable face of aging and death. His lyrics speak to the dignity of human condition when faced with change and death, the ultimate transition. Whether one is a physician, operator, builder, architect, or interior designer, we are all tasked by future generations to get it right before this generation passes. How will we know whether our assumptions are correct and the decisions we made in implementing new design, business, and care models were correct? One of the primary tools available to the senior care and design professionals is critical participant observation. This type of reflective scrutiny is based on the observer embedding himself into the AD culture in an attempt to experience what the resident is experiencing. With empathetic, methodical, and consistent cyclical review, new models of treatment, management, and design will be developed and evaluated over time. It is time that is creating is the growing pressure to find solutions for the population shift from individuals who have been independently productive to those who require around-the-clock supervision and care. The demographic bubble is reaching critical mass. Bob Dylan is now 71 years old. He along with his burgeoning cohort of baby boomers may well overwhelm our health care and adult care infrastructure (Wahl, Rick, Paul, & Warner, 2004). It is time to develop a flexible, affordable model that will address the current needs of the baby boomer as well as anticipate the needs of future generations. It will be a model that will facilitate compassionate care for the individual and recognize the value of the nuclear family as it knits its disparate parts into a place called home.
Read full abstract