Enhancing Eldercare Through Built Environment
A Glorious Conversation with Dr. Habib Chaudhury
Junus and I had an incredibly insightful conversation with Dr. Habib Chaudhury, a professor and chair in the Department of Gerontology at Simon Fraser University in Vancouver, Canada.
The topic? How the built environment impacts the well-being and quality of life of seniors in care settings, and the staff who care for them as a result.
It was one of those deep, eye-opening discussions that left us even more passionate about our mission at Glorious to improve eldercare through innovative solutions, and make aging glorious.
Dr. Chaudhury is a professor and chair in the Department of Gerontology at Simon Fraser University in Vancouver, Canada. His work focuses on understanding how the physical environment impacts the quality of life for seniors and staff care practices.
Together with Dr Heather Cooke, Manager of Research & Knowledge Mobilization at the Alzheimer Society of B.C. they have developed a tool graciously called POET: Person Oriented Environment Tool. This tool helps care homes to assess the quality of their facility across several dimensions by putting the seniors at the center. It can then provide improvement suggestions that positively impact the quality of life of the seniors.
Our conversation centered around this theme, and we explored how even small changes in the physical environmental features of care homes can have a meaningful impact on both residents and caregivers.
Understanding the role of the built environment in eldercare
"The physical environment isn't just a backdrop—it's a powerful force that shapes how seniors experience their day-to-day lives." - Dr. Habib Chaudhury:
Dr. Chaudhury started by explaining how the physical environment in eldercare settings is not just a passive backdrop but a dynamic factor that significantly affects the functioning and well-being of residents. He broke down the concept of “physical environment” into three critical dimensions:
Architectural layout
This involves the spatial arrangement and connectivity of different areas, such as dining rooms, bedrooms, and activity spaces. Properly designing these layouts can promote social interaction and reduce feelings of isolation among residents.
Dr. Chaudhury emphasized that the architectural layout must be thoughtfully planned to ensure that spaces serve their intended purposes. For example, the architectural layout of the care home will impact the residents’ ability of wayfinding as they move from their bedrooms to the social spaces.
Interior design
This includes various features of the interior, including furniture, lighting, and floor finishes. Dr. Chaudhury stressed the importance of choosing elements that are both functional and homelike to create a comforting environment.
During our discussion, Dr. Chaudhury shared an insightful observation about how furnishing choices directly impact not just the visual appeal, but also the sensory experience of the space. For example, he mentioned that furniture and flooring materials can significantly influence noise levels, which is crucial in creating a calm environment for residents, especially those with dementia who may be particularly sensitive to sensory overload. Also, in one study, Dr. Chaudhury’s team found that when residents couldn't clearly identify the function of a space due to lack of appropriate environmental cues, a dining room may be perceived as a waiting area in a public space, and thus, residents were less likely to engage in mealtimes. This misunderstanding of space functions can lead to decreased social interaction and a feeling of disconnection among residents.
Sensory qualities
Environmental aspects like noise levels, quantity and quality of lighting, and textural variety directly impact the comfort and mood of residents. Dr. Chaudhury highlighted how sensory-friendly environments could reduce anxiety and agitation among residents , and improve the overall atmosphere in care homes.
He explained that sensory overload, particularly in large communal spaces such as a dining area, can be overwhelming for residents with cognitive impairments. It is important to both regulate the stimulation levels (e.g., lower the sound level) and increase the quality of the stimulation (e.g., having personal and culturally relevant objects in the environment) By carefully managing these sensory characteristics, care homes can create environments that are not only more comfortable but also more conducive to positive social interactions and daily activities.
Practical interventions for a better care environment
Dr. Habib Chaudhury: "Sometimes, the most effective changes are the simplest ones. It's about making the space work for both residents and caregivers."
Dr. Chaudhury shared several practical interventions that care homes can implement low-medium cost interventions without undergoing significant renovations in the facility. These interventions are aimed at enhancing the physical environment to improve reduce stress, increase activity engagement and social interaction for residents and increase caregivers’ quality of care practices and interactions.
Using partitions
Introducing partitions in large communal areas (e.g., large dining or activity room) can help reduce sensory stimulation (e.g., visual and noise stimuli) and reduce the institutional quality of the environment. This is particularly beneficial for residents with dementia, who might experience anxiety or become agitated in overly stimulating environments, as their acceptable stress threshold is lower in the condition of dementia.
We discussed specific examples where simple partitioning helped transform a chaotic, noisy dining area into a less stimulating and distracting space, which also supports staff in being more effective in assistance to feeding. Dr. Chaudhury shared that by using movable and low-height partitions, staff could create smaller, quieter spaces within larger rooms that would create low-stimulation spaces and also allow staff to have visual access to the whole space in a standing position. This flexibility allowed care homes to adapt spaces to the needs of different groups of residents, whether they were engaging in social activities or simply enjoying a quiet meal.
Choosing sound-absorbing furniture and finishes
Selecting materials that absorb rather than reflect sound can create a calmer, quieter environment, which can reduce the noise levels and significantly benefit both residents and staff.
He provided examples of how contemporary finishes (e.g., flooring, furniture upholstery) can offer better acoustic and aesthetic properties, while still meeting the safety and maintenance requirements of healthcare settings, such as being easy to clean and resistant to microbial growth. Dr. Chaudhury emphasized that these choices are not just about comfort, but also about enhancing the overall functionality of the space.
Incorporating familiar elements
Bringing in home-like furnishings and familiar objects can help reduce the institutional feel of care settings and provide opportunities for self-directed activity engagement. Familiar scale of the space and familiar objects can help residents have “environmental comprehension” and provide a feeling of being at home.
This was a particularly resonant point for me. Dr. Chaudhury explained that familiar, homelike environments can evoke positive memories connecting with the intact long-term memory and provide comfort to residents, especially those living with dementia. By incorporating personal items and familiar decor, care homes can create spaces that feel more like a true home rather than a clinical institution.
Creating multi-sensory environments
Incorporating various textures, colors, and even aromas can create a positively stimulating, yet comfortable environment for residents, especially those with cognitive impairments.
We dove into the idea of multi-sensory environments, which can significantly improve residents' engagement and emotional well-being. Dr. Chaudhury mentioned how multi-sensory elements could be integrated into everyday objects and spaces, such as using textured fabrics and objects or introducing soft, warm lighting. These elements not only make the space more welcoming but also cater to the varying sensory needs of different residents.
The POET tool: a new approach to environmental assessment
Dr. Habib Chaudhury: "The POET tool is designed to look at care home environments through a focused lens, identifying specific changes that can make a difference."**
Dr. Chaudhury introduced us to the Person-Oriented Environment Tool (POET), a tool he developed with his colleague Dr. Heather Cooke. The POET tool provides a structured approach to assessing the physical environment of care homes. Unlike other assessment tools, POET focuses on individual spaces (e.g., dining, activity, corridor, bedrooms) within a care setting, allowing for more targeted interventions.
The tool is divided into two modules:
Module One
This module is based on a walkthrough observation that assesses various spaces in a care home to identify general areas needing improvement. It's an efficient way to understand the environment's overall effectiveness.
Dr. Chaudhury explained that Module One allows staff to quickly identify areas that might need attention, whether it’s the dining room, the corridors, or the resident bedrooms. By focusing on these individual spaces, the tool provides clear, actionable insights that can guide improvements.
Module Two
This module associates specific resident behaviors and their environmental context. It helps staff understand what environmental factors might be contributing to certain resident behaviors. This deeper level of analysis allows for more precise, impactful changes.
He shared how Module Two goes beyond simple observation, offering a detailed look at how specific environmental factors might be influencing residents' behaviors. For instance, if a resident is frequently agitated in a particular room, this module helps identify what about the environment (e.g., furniture arrangement, visual access to the unit’s exit) might be causing that reaction and how it can be modified to improve their experience.
A glorious conversation with Dr Habib Chaudhury, Junus Eu and Thibaut
Impact on caregivers and staff
Dr. Habib Chaudhury: "When we improve the environment, we don't just make life better for the residents; we also make the caregivers' jobs more manageable and satisfying."
One of the most compelling parts of our discussion was hearing about the positive impact that a well-designed environment can have on caregivers. Dr. Chaudhury emphasized that creating more manageable, less stressful environments not only benefits residents, but can also significantly reduce stress and burnout among staff.
Dr. Chaudhury shared specific examples of how thoughtful design can reduce caregiver stress. For instance, he talked about how smaller, familiar and positively stimulating dining spaces can help caregivers focus on providing individualized support without the distractions and stressors of a larger, noisier environment. This leads to an improved mealtime experience for the residents with more food intake and social interaction in the residents and more effective support from the caregivers.
How do we adapt this for other cultural contexts?
Dr. Habib Chaudhury: "Cultural context matters. What works in one country may not work in another, and we need to be mindful of these differences when designing care environments."
Dr. Chaudhury pointed out that cultural and geographic factors must be considered when designing and implementing changes in care environments. In Singapore, for example, space is limited, hence, more multi-storied care homes might be needed. Also, there may be different cultural expectations around privacy and communal living compared to North American settings. We discussed the importance of adapting the POET tool for different cultural contexts, ensuring it meets the unique needs of the residents and caregivers in different cultural and social contexts.
He provided insights into how the tool can be adapted for different regions, particularly in Asia. For instance, he mentioned the differences in expectations around privacy in bedrooms and communal living between Western and Asian cultures. In Singapore, where space is at a premium, understanding these cultural nuances is crucial for creating environments that are both functional and culturally appropriate.
Looking ahead: the future of eldercare
Dr. Habib Chaudhury: "We're just scratching the surface in the area of creating communities that support engaged living and caring communities for our elders. There's much more that we can do to improve care environments and support aging adults."
As our conversation wrapped up, I felt a renewed sense of excitement about the future of eldercare. There is incredible potential to enhance the quality of life for seniors through thoughtful design and innovative tools like POET. At Glorious, we are committed to continuing this work, collaborating with experts like Dr. Chaudhury, and pushing the boundaries of what’s possible in eldercare.
We plan to conduct case studies in various care homes in Singapore and Kuala Lumpur to explore how POET can be adapted and applied in different contexts. This will help us learn more about how to create environments that truly support
Key Takeaways
The built environment in eldercare settings significantly affects residents' quality of life and caregivers' job satisfaction.
Practical changes, such as using partitions, choosing sound-absorbing furniture, and creating familiar and multi-sensory environments, can make a big difference.
The POET tool provides a structured way to assess and enhance care environments, focusing on specific spaces and behaviors.
Cultural context is essential in designing and implementing changes in eldercare environments to ensure they meet residents' needs.
Improving the physical environment benefits not only the residents, but also reduces caregiver stress, leading to more effective care practices.
Can we take these insights to heart and continue to build a future where every senior lives in a space that truly feels like home?
If you want to know more please reach out to us or check out our website.
Junus and Thibaut
Let’s make aging glorious 💃!