Changing the Traditional Model of Assisted Living Design

Here's the Traditional Assisted Living Design

The traditional design - Apartment Model - long hallways, centralized services.

How did we get here?

Rick and Carol Meier are pioneers and veterans in assisted living. Rick and Carol have developed, owned and operated assisted living/memory care homes and served hundreds of residents. They were also founders of the Wisconsin Assisted Living Association – WALA.

Assisted Living in The 1980’s

In the 1980’s, the vast majority of facilities were converted single family homes that were largely “mom and pop” operations. Over 90% of these homes were 8 beds or less and mostly offered shared bedrooms to their residents.

More sophisticated business participants, such as corporate owners from nursing homes and hospitals were also entering the field in the late 1980’s. The design model reflected their skilled care orientation, utilizing long hospital-like hallways with centralized services. They built what they knew.

Assisted Living from the 1990’s to the Present

Companies specifically organized to develop and operate assisted living residences designed around the apartment model in the early 1990’s. Developers began offering private bedrooms and baths with more space and privacy.  Often the number of residents in the home determined the length of the hallways. As resident capacity increased, the longer the hallways became.

Resident falls and problems with confusion, frustration and getting lost in the hallways were, as a result, far too prevalent.

  • Falls cause broken bones, concussions and other injuries which very often force the resident into more restrictive living conditions, from which they never leave. No other factor contributes as much to serious health problems for seniors than falls.
  • Long and complex confuse and frustrate residents who become lost in them. Residents often live in dread of having to travel in certain (or all) hallways. It then became common for residents to stay in their room in order to eliminate dealing with hallways, reducing their quality of life and increasing their isolation and withdrawal.

Here is Where We Need to Be

IRIS Paradigm - no hallways, distributed services.

In 2011, Rick and Carol decided they wanted to reenter assisted living as developer/owner/operators. The requirement was that the new product and services they offered had to be a major step forward in resident safety and care, employee training and support and management reporting and accountability.

 “Outside the Box” thinking was what was needed – starting with the hallways! The result is Assisted Living 2.0™ and the IRIS design paradigm.

The centerpiece of this new paradigm is that it is created and evaluated from the perspective of the 87-year-old resident who will live there.

Assisted Living 2.0™

  • Resident-centered designs and service provision.
  • Designed to facilitate the IRIS (InReachInSight) philosophy of having residents, caregivers and resident destinations in sight and in reach at all times.
  • Designed to distribute meals, events, activities and services to the resident rather than having residents travel to receive them.
  • Relocates of management staff to the neighborhoods for additional resident and caregiver support, monitoring and supervision.

The essence of Assisted Living 2.0™ revolves around the fact that the resident is in sight of staff the moment they leave their unit. Staff can then continually assist, monitor, redirect and supervise the resident as they go about their day.

The resident can conversely see staff for necessary reassurance and see their destination for mental focus and reduced confusion. In Assisted Living 2.0™ there are no hallways, no frustrations with being lost or confused, no falls with no one to immediately help, no long walks to and from services, and meals. Daily events and activities are always in reach for all residents.

Benefits of Assisted Living 2.0™

For Residents:

  • Reduction in walking and falls.
  • More time with caregivers
  • Close to destinations – reduced walking.
  • Visible destinations – reduced confusion, being lost.
  • Reduced walking distance to activities, events, meals.
  • Immediate assistance from close-by caregivers.
  • Constantly visible caregivers to validate activities.
  • Constant visual observation and supervision by caregivers.
  • Timely redirection and support.

For Caregivers:

  • Buddy system for continual training.
  • Team approach for mutual assistance and support.
  • Better staffing balance during shifts.

For Managers:

  • Constant staffing levels and balance.
  • Increased supervision of employees.
  • Increased supervision of residents.
  • Continual training opportunities.

For Owners:

  • Reduced staff turnover ($7,500/employee lost).
  • Reduced resident turnover.
  • Increased management supervision.
  • Improved margins and valuation.

The mission statement of Assisted Living 2.0™ is to serve the resident at their convenience, increase their safety and improve their health and quality of life.

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