How do you tell a 20- or 30-year-old veteran they have to live in a nursing home for the rest of their life?
This was the challenge Cornelia Hodgson, architect with C.C. Hodgson Architectural Group, faced when designing Community Living Centers for VA centers across the nation. Hodgson and Gary Fischer, senior healthcare architect for the Department of Veteran Affairs, presented Rooted in Planetree: Cultural Transformation to Person-Centered Design at the EFA Conference on Monday in Anaheim, CA.
"You have to change the psychiatry behind telling a young person they have to live in a long-term care facility the rest of their life," Hodgson said. "We changed the name and developed Community Living Centers on VA campuses."
The concept for the new VA homes is rooted in Planetree, which focuses on patient-centered design. Each Community Living Center is built like a small village. There are 10 to 12 homes and each home is connected to a central living area where residents can cook, eat and socialize.
"Our goal in 2009 was to take VA nursing home care and transform it to a residential based model," Fischer said. "(Homes) give residents empowerment and it provides a home environment. We wanted to create an environment that is the home, not 'home-like.'"
In the home, residents can eat whenever they want and partake in activities by going to the great room when they are ready to socialize. They can even participate in the food prep, which is encouraged within these VA homes.
"Creating a healing environment is very important," Fischer said. "We set the standard for homes to be 10 to 12 residents, all in private rooms with private amenities."
The communities are also set up to look something like a gated community, without the gate. Some are set up to have driveways, while others have sidewalks. One common feature is that there is a connector road to the nearby VA hospital in case of emergency.
So now that veterans are moving out of the hospitals and into these communities, what happens to the long-term care facilities in the hospitals, one attendee asked?
The answer: They're repurposed, Hodgson said.
The exterior design of the Community Living Centers is local to the community it is built in. The interiors are designed to look contemporary and inviting. Natural light is key in any of the living spaces, Hodgson said.
"In designing the kitchens, which had to be commercial kitchens, you had all these huge pieces of equipment," Hodgson said. "We insisted on having them covered by cabinet doors to be consistent with the rest of the beautiful home design."
A tricky aspect to designing the CLCs, Hodgson said, is budget.
"When the allocation comes to Congress, that is the budget," Hodgson said. "We're constantly measuring against the budget. We had to figure out a way to be as efficient and as economical as we can without sacrificing standards."
