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166 In Pursuit of the Sunbeam: A Practical Guide to Transformation from Institution to Household
patterns of residential lifestyles. When thinking about privacy in nursing homes, we have focused on procedures, staff efficiency and resident movement. Public hallways pass by bedrooms – spaces considered among the most private in a residential home.
Nursing home designs have not focused on patterns of home life that support intuitive behaviors of privacy and individual pursuits. Therefore the experience of privacy for nursing home residents is often non-existent. Since the goal of the Household Model is to replace the institutional experience with one of home, you need to support residential privacy through the architectural design. Simply adding familiar residential imagery may create a home-like setting, but will not address the deeper issues. “Home” means, “This is where you live,” not “Pretend this is your home.”
To reach this point, we must focus on the essential details that capture the fundamental meaning of home. We can do so by understanding how the spaces of nursing homes can be designed and arranged to support attitudes and behaviors that are natural within a family and home setting.
To effectively create a home experience, attention to the arrangement of spaces and the sequential nature of circulation between rooms must be carefully considered. The cueing we receive from features in a building sends a powerful message. A front door implies, for example, that we should request permission to enter. To barge into someone’s house unannounced and uninvited would typically be met with a negative reaction from the homeowner. Inside the home there are additional signals for behavior through the placement of walls, doors, lighting, cabinetry, appliances and furnishings.
Scale – Small Versus Large Spaces: What Are the Impacts on Perception?
Another challenge is the size of space and deciding how to use it effectively. Most traditional nursing homes have one large room where a majority of activities occur including meals, crafts, television, worship services and other large group activities. Staff may be open to adding residential touches to these rooms, but are often reluctant to exchange these spaces for smaller ones because the multipurpose room is a major component in the life of the nursing home. Staff often say, “Oh, we can’t make that smaller, we won’t be able to get everyone in here for the holiday program!”
Should we design the spaces around one or two days of the year, or