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Synopses & Reviews

Publisher Comments

Essential information for the design of senior living facilities

Building Type Basics for Senior Living, Second Edition is your one-stop reference for essential information you need to plan and successfully complete the design of residential care environments for seniors on time and within budget.

Primary authors Bradford Perkins and J. David Hoglund and their Perkins Eastman colleagues—all experts in senior living design—share firsthand knowledge to guide you through all aspects of the design of senior living communities, including independent living and assisted living apartments, and skilled nursing facilities.

This edition features new examples of completed projects and is up to date with the latest developments in senior living design, including coverage of sustainable design, renovation and reinvention, international opportunities, operations, and project financing.

This new edition offers:

  • Numerous photographs, diagrams, and plans
  • A new chapter on issues, trends, and challenges for the senior living industry in the next decade
  • A new chapter devoted to sustainability strategies and considerations
  • Up-to-date coverage of new technologies being implemented in senior living facilities
  • New space programming standards and sample programs

Like every Building Type Basics book, this conveniently organized quick reference provides authoritative, up-to-date information instantly and saves professionals countless hours of research.


Building Type Basics for Senior Living is the definitive guide to the architectural and interior design of senior living homes, including assisted living and skilled nursing facilities. This second edition is thoroughly updated with new examples of projects completed in recent years, and new or updated coverage of a number of topics, including design for the upcoming retiring Baby Boomers, sustainable design, renovations, international opportunities, operations, and project financing.

About the Author

L. BRADFORD PERKINS, FAIA, MRAIC, AICP, is the founder and Chairman of Perkins Eastman, an international architectural, interior design, and planning firm based in New York with eight additional offices in North America and four more around the world. He is author or coauthor of three books published by Wiley: International Practice for Architects; Building Type Basics for Elementary and Secondary Schools, Second Edition; and Architect’s Essentials of Starting, Assessing, and Transitioning a Design Firm.

J. DAVID HOGLUND, FAIA, LEED AP, is the President of Perkins Eastman and the firm’s National Practice Leader for Senior Living. Over a dozen Perkins Eastman principals and senior staff contributed to this book.

Table of Contents

Preface xvii

Acknowledgments xix

1. Senior Living Today 1

State of the Industry 1

Demographics 2

Accessibility 3

Solutions 4

Design and the Aging Process 5

Biological Aging 6

Social Passage 10

2. Programming & Planning Guidelines 13

Understanding the Marketplace 13

Programming Space Guidelines 14

Community Based Options 14

Typical users 14

Sponsors, Settings, Payments, and Reimbursements 17

Geriatric Outpatient Clinic 17

Adult Day Care 24

Long-Term Care 33

Typical Users and Care 33

Sponsors and Owners 34

Settings 34

Program and Design 37

Housing Models 38

Long-Term Care Programs 44

Program and Design 47

Hospice 60

Users and Services 60

History of Hospice 61

Sponsors and Owners 61

Purpose-Built Hospice Care Settings 61

Program and Design 62

Payment, Reimbursement, and Regulation 64

Assisted Living Residences 64

Typical Users 64

Sponsors and Owners 66

Settings 66

Program and Design 66

Resident Unit 66

Unit Features 70

Unit Amenities 75

Planning Approaches 75

Payment, Reimbursement, and Regulation 79

Regulation 79

Trends and Innovations 80

Residences for Persons with Alzheimer’s and Dementia 82

Typical Users 82

Sponsors and Owners 83

Settings 83

Program and Design 83

Design Considerations 90

Payment, Reimbursement, and Regulation 95

Trends and Innovations 95

Independent Living with Services 96

Typical Users 96

Sponsors and Owners 98

Settings 98

Program and Design 98

Unit Features 100

Key Planning Issues 105

Payment, Reimbursement and Regulation 105

Trends and Innovations 107

Continuing Care Retirement Communities 107

Typical Users 107

Sponsors and Owners 108

Settings 108

Organization 108

Program and Design 108

Market Considerations 110

Program Components 111

Assisted Living Residences 115

Long?]Term Care 115

Payment, Reimbursement, and Regulation 117

Trends and Innovations 117

Active Adult Communities 119

Typical Users 119

Sponsors 119

Settings 119

Program and Design 120

Payment, Reimbursement, and Regulation 122

Marketing 123

Ownership 123

Summary 123

3. The Future of Senior Living 125

Demographics 125

Population 125

Health and Services 125

Ethnic and Cultural Diversity 126

Consumers’ Expectations 126

Privacy 126

Choice 127

Value 127

Non?]Institutional Environments 127

Security 129

Integration into Existing Communities 129

Lifestyle Changes 129

Future Consumers 129

Fitness and Wellness 133

Lifelong Learning 134

Lifestyle Apartments 135

Service Partnerships 135

Economic Pressures 135

Existing Housing and Care Facilities 136

Evolving Staffing Patterns 137

Sustainable Design 137

Leveraging Assets and Brand 137

New Housing and Care Concepts 139

Green Houses and Small Houses 139

Culture Change 139

Affordability 141

Reducing the Cost of Housing for Seniors 142

4. Project Process and Management 149

Planning, Design, and Implementation Process 149

Strategic Planning and Preliminary Definition of Need 149

Feasibility Analysis 150

Selection and Organization of Project Team 150

Programming and Predesign 153

Schematic Design 155

Obtaining Approval and/or Financing 158

Design Development 159

Construction Documentation 159

Selection of the Construction and FF&E Installation Teams and Purchasing 160

Construction and Installation 162

Occupancy 162

Common Problems and Cautions 162

Failure to Plan 163

Unclear, Timid, or Unrealistic Goals 163

Inadequate Client Leadership 163

Selecting the Wrong Project Team for the Wrong Reasons 163

Ineffective Project Management 164

Tackling Issues Sequentially, not Concurrently 165

Poor Management of the Public Approval Process 165

Not Prioritizing Quality 165

Failure to Plan for Maximal Staffing Efficiency 166

Poor Cost Management 166

Failure to Plan for Maintenance 166

Conclusion 167

5. Site Planning, Parking, and Landscape Design 169

Site Size 169

Relationship to Adjacent Land Uses 171

Vehicular Circulation 171

Parking 173

Landscape Design 173

6. Building Codes 183

Codes and Regulations 184

Federal 184

State 185

Local 186

Reference Standards 186

Energy Codes and Sustainable Design Standards 186

Regulatory Issues 186

Life Safety 187

Space Standards 188

Building Systems and Construction Practices 188

Public Policy 188

Accessibility 189

Enforcement 190

Fiscal and Bidding Controls 190

Land Use Policy 190

Waivers 191

Conclusion 192

7. Sustainability 193

Market Expectations 193

Calculating Cost Benefit 195

Years to Payback 196

Life Cycle Cost 196

Strategies for Sustainability 196

Create Sustainable Sites 197

Save Water 198

Reduce Use of Fossil Fuels 200

Heating, Ventilation, and Air?]Conditioning 200

Lighting and Daylighting 202

Alternative Energy Sources 203

Smart Use of Materials and Resources 203

Adaptive Reuse 204

Indoor Environmental Quality 204

8. Structural Systems 205

Considerations 205

Program and Concept 205

Applicable Codes 205

Potential Code Changes 206

Flexibility 206

Soil Conditions 207

Lateral Forces 207

Impact on Finished Ceiling and Building Height 207

Material Delivery and Construction Timing 208

Local Construction Industry Preferences and Capabilities 208

Ease of Construction and Schedule 208

Life Cycle Cost 208

Cost Impact on Other Systems 208

Appearance and Aesthetics 209

Structural System Types 209

Wood Frame 209

Structural Metal Studs 209

Masonry Bearing Wall 210

Steel Frame and Concrete Plank 211

Composite Steel 211

Precast Concrete 211

Concrete Frame 211

Long?]Span Structures 212

Pre?]Engineered Structures 212

Combined Systems 213

9. Mechanical, Plumbing, Fire-Protection, And Electrical Systems 215

The Interior Environment and Comfort for an Aging Population 215

Mechanical/Hvac 215

Plumbing 215

Fire Protection 216

Electrical 216

Program and Concept 216

Applicable Codes 216

Mechanical and Hvac 216

Plumbing 217

Fire Protection 217

Electrical 217

Program Impact on System Selection 217

Mechanical and Hvac 218

Plumbing 218

Fire Protection 219

Electrical 219

Finished Ceilings and Building Height 219

Mechanical and Hvac 219

Plumbing 219

Fire Protection 220

Electrical 220

Flexibility 220

Construction 220

Materials Delivery and Timing 220

Local Construction Capabilities and Preferences 220

Ease of Construction and Schedule 220

First Cost and Life Cycle Cost 221

Cost Impact on Other Systems 221

Appearance and Aesthetics 221

Noise and Vibration 221

Controls 221

Mechanical and Hvac System Options 222

Packaged Terminal Air?]Conditioning Units 222

Packaged Rooftop Units 223

Air?]To?]Air Heat Pumps 224

Water Source Heat Pumps 224

Variable Refrigerant Volume Systems 226

Fan Coil Systems 226

Dehumidification Systems 226

Ventilation 227

Fresh Air Requirements 227

Filtration 227

General Exhaust 228

Kitchen Exhaust/Grease Ducts 228

Laundry and Lint Traps 228

Plumbing 229

Fixtures and Fittings 229

Hot Water Distribution 229

Metering 229

Rainwater 230

Fire Protection 230

Fire Alarm 230

Fire Pumps and Backflow Preventers 230

Wet Systems 231

Dry Systems 231

Electrical Distribution 231

Transformers 231

Switchgear 232

Metering 232

Emergency Power 232

Lighting 233

10. Communications and Low-Voltage Electrical Systems 235

Systems Proliferation 235

Emergency Response/Nurse Call 236

Movement Alarms 236

Access Control 237

Visual Monitoring 237

Telecommunications 237

Television 238

Internet Access 238

Networks and Intranets 238

Wireless Technology 238

Audiovisual 239

Point?]Of?]Sale Systems 239

Operations Systems 239

Trends 240

11. Special Technologies 241

Remote Biometric Monitoring Systems 241

Personal Locator Systems 241

Fall Detection 242

Telemedicine 242

Web Portals 243

Virtual Reality Therapy 243

Remote Learning 243

Circadian Lighting 244

12. Products And Equipment 245

Medical Equipment 245

Universal Design 245

Mobility Devices 246

Food Service 246

Adult Day Care 246

Long?]Term Care 246

Assisted Living 248

Independent Living 248

Special Care and Dementia 248

Kosher Preparation 248

Bathing Equipment 249

Tubs 249

Showers 251

13. Acoustics 255

Key Acoustical Considerations 255

Noise Reduction Coefficients 257

Sound Transmission Class Values 257

Design Guidelines for Specialized Spaces 258

Lobbies 258

Dining Areas 258

Multipurpose Spaces, Spiritual Areas, Auditoriums, and Media Theaters 260

Bathing Areas and Other Hard?]Surfaced Spaces 260

Indoor Pool Spaces 261

Mechanical and Electrical Systems and Mechanical Rooms 261

Hearing?]Impairment Guidelines and Code Requirements 262

14. Lighting Design 265

Light Levels, Reflectance Values, and Glare 267

Lamping Options 268

Linear Fluorescent Lamps 268

Compact Fluorescent Lamps 268

Halogen Lamps 269

Other Lamp Types 269

Windows and Daylighting 269

Design Guidelines for Specialized Spaces 269

General Guidelines 269

Common Areas 270

Corridors 271

Resident Living Spaces 273

Conclusion 276

15. Interior Design 279

The Design Process 279

Trends 280

Color Theory 286

Wayfinding 287

Materiality 287

Interior Design Guidelines 289

Flooring 290

Other Floor Coverings 292

Wall Coverings 292

Windows and Window Coverings 295

Furniture and Furnishings 295

Definition 295

Trends 295

Specifications 296

Sustainability 297

Process 298

16. Renovation, Restoration, and Adaptive Reuse 299

Long?]Term Care Facilities 299

Assisted Living Facilities 300

Independent Living Facilities 300

Cosmetic Renovation 301

Moderate Renovation 301

Major Renovation 301

Key Questions 304

Integrated Scenario Planning 304

Adaptive Reuse 305

Key Questions 305

17. International Challenges 307

Service Development 309

Programming and Design 310

Service and Socialization 313

Process 313

Aging at Home 314

Country?]Specific Issues 315

China 315

Japan 318

India 318

Thailand 323

The Americas 323

Europe 324

Conclusion 324

18. Operation and Maintenance 325

Introduction 325

Operations Costs 326

Ongoing Operating and Maintenance Costs 327

Durability, Useful Life, and Replacement Costs 329

Operational Efficiency 329

Cleanliness, Operations Quality, and Design 333

19. Cost Management 335

Cost Management Program 335

Relative Costs 336

Value Engineering and Life Cycle Cost Analysis 336

20. Finances and Feasibility 343

Ten Steps to Financing 343

Preliminary Feasibility Planning and Analysis 344

Potential Capital Structures and Sources of Financing and Equity 344

Financing Team and Method 345

Government Approvals 346

Financial and Market Feasibility Study 346

Underwriting 346

Preparing for Closing 348

Closing 348

Project Costs and Covenants 348

Ongoing Reporting of Performance and Covenant Compliance 348

Financing Variations for Senior Settings 349

Assisted Living 349

Skilled Nursing Facilities 349

Independent Living 349

Continuing Care Retirement Communities 350

Appendix A: Unit Types and Sizes for Senior Living 351

Appendix B: Building Net-to-Gross Factors for Senior Living 352

Appendix C: Geriatric Clinic: Typical Program Components 353

Appendix D: Sample Large Outpatient Clinic Program 354

Appendix E: Sample Enhanced Retirement Community Clinic Program 355

Appendix F: Adult Day Care: Sample Program for 50 Participants 356

Appendix G: Long-Term Care Gross Area per Bed Guidelines 358

Appendix H: Typical Long-Term Care Program Components 359

Appendix I: Sample Program: Long-Term Care, 126 Bed, 4-Story (and Basement) Neighborhood/Household Model 360

Appendix J: Freestanding 75-Unit, 3-Story Assisted Living Facility with 20-Bed Memory-Support Neighborhood 366

Appendix K: Sample Program for 40-person Memory-Care Residence 369

Appendix L: Sample Program for Independent Living with Services Building—150 Units, 4 Stories, 2 Wings 371

Appendix M: CCRC Program 375

Appendix N: Enhanced CCRC Therapy Program 383

Glossary 385

Bibliography and References 395

Index 399

Product Details

Publication date:
Series info:
Building Type Basics
Series Number:
Series Volume:
Bradford Perkins
Douglas King
Eric Cohen
J. David Hoglund
Perkins Eastman
building design
ernational opportunities, operations, project financing, assisted living, skilled nursing facilities
Building Type Basics for Senior Living, Bradford Perkins, J. David Hoglund, Douglas King, Eric Cohen, Baby Boomers, sustainable design, renovations, int
Building Type Basics for Senior Living, Bradford Perkins, J. David Hoglund, Douglas King, Eric Cohen, Baby Boomers, sustainable design, renovations, international opportunities, operations, project financing, assisted living, skilled nursing facilities
Architecture-Drawing and Design


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