Senior living is ever changing. The resident experience is often the focus of a well thought out senior living business model. Of the many metrics utilized to assess the success of a community, wellness programs have found a foothold for multiple reasons. From the perspective of an operator, wellness programs cater to and are a differentiator for increasingly discerning interests of the new class of senior living residents. From the perspective of a developer and a finance partner of senior living communities, the evolving research on wellness programs suggests effective programs reduce attrition and operating expenses by managing the costs associated with acute and chronic ailments. For these reasons and others, the trend toward a focus on wellness in senior living is gaining momentum.
Often overlooked is how the built environment can support or, unfortunately in some cases, inhibit a well-intentioned wellness program. Creating spaces that can flex between and accommodate the overlap of the dimensions of wellness builds strong and vibrant communities.
To understand how a building can have either a positive or negative impact on wellness, we must first explore how we define wellness. Wellness is often thought of in terms of one's physical wellbeing. In reality, wellness is a much more robust and interconnected system which embodies many dimensions of human health and experience. The National Wellness Institute (NWI) has identified wellness across six dimensions: Physical, Emotional, Occupational, Spiritual, Intellectual and Social. Focusing on these dimensions of wellness builds resiliency and healthy outcomes for residents and staff alike.
PHYSICAL
The most easily recognizable dimension of wellness is one's physical wellness. Physical activity and nutrition become the cornerstone of the physical wellness dimension. Many communities provide exercise rooms and a nutritious menu for residents. Consider differentiating your community with a more robust exercise program with outside instructors and community membership opportunities which engages the community and boosts income. Some communities have adopted this practice through gym memberships available to the outside community. This practice acts as a new revenue stream but perhaps more importantly these memberships can be outreach for new residents. Providing a grab and go style dining venue outside an exercise space is also a great way to provide nutrition on demand following an exercise class. as well as provide passive participation for exercise classes with the intent of bringing more residents in for active participation.
Marquardt Village | The physical fitness room, centrally located within the larger community, was designed with large glass walls to showcase the wellness programming and break down the barriers to participation.
EMOTIONAL
One's emotional wellness can sometimes be misunderstand as mental wellbeing. As defined by the NWI, emotional wellness is an awareness and acceptance of one's feelings. By definition, this dimension of wellness is inwardly focused. Designing and designating spaces that provide opportunity for inward reflection are sometimes overlooked when programming a community. Having a design focus on the individual as well as the community is conducive to providing a more complete foundation for wellness programming. Intimate, small group and self-reflection spaces, with an appropriate size and scale to allow residents and staff to focus on themselves, create opportunities to strengthen emotional wellness. 
Shady Lane | A quiet reflective space, this conversation room has tall windows and a larger volume to fill the space with light and openness, inspired by the quiet and calm shore of Lake Michigan.
OCCUPATIONAL
We all strive to find meaningful purpose by applying our skills and talents in ways that we find rewarding. This desire does not wane with age and can be harnessed to elevate the occupational wellness of both residents and staff. Providing spaces with outward connections to the local community can be a catalyst for social action projects and other activities which can warrant fulfillment and provide an opportunity for residents to give back. Activity focused spaces such as craft rooms, woodshops and art studios provide residents an occupational outlet for their energy and curiosity. These spaces could also be incorporated as incubator spaces for a new small business for the semi-retired cohort or those who wish to pass their knowledge on to budding young entrepreneurs. Arranging a space to showcase and highlight the products of these activities to the larger community can provide deeper meaning and purpose to the activities themselves. Designing safe spaces for residents to engage in cooking and gardening are also great examples of giving greater purpose to a resident’s life.
Pine Valley | This flexible and transitional gathering space provides a contextual rural backdrop for resident activities. Centrally located at the heart of the building, it serves as a pre-function area for the larger adjacent community room, highlighting the community's dedication to showcase resident arts.
SPIRITUAL
Our search for meaning begins very early in our lives. For some, this curiosity is the thread that strings our life story together. For others, it's an inward journey of meditation and thoughtful contemplation. Whatever the case may be, the built environment can play an integral role in one's spiritual wellness. In many communities, this dimension of wellness manifests itself as a worship space with a focus on a higher power. For communities who want to expand beyond this traditional solution and appeal to a broader audience, these worships spaces may be supplemented by other spaces which focus beyond a religious purpose. Quiet spaces for group meditation or grieving, outdoor spaces for personal reflection or intimate indoor spaces for one on one discussion all facilitate spiritual wellness. Connecting the built environment back to nature through biophilic design strategies also supports spiritual wellness. 
Siena on the Lake | Renovation of the existing chapel provided updates to enhance the acoustic properties and lighting to improve the resident experience and usefulness of the space.
INTELLECTUAL
Brain health is another readily recognizable dimension of wellness and we have recently seen tablet apps and games gain in popularity to promote brain training. Creating spaces and environments which support problem solving activities, creativity and learning will have a bigger impact on a resident’s intellectual health. Flexible multi-purpose rooms offer a unique opportunity to bring people together at all hours of the day for a wide range of activities, from art to games to continuing education. These spaces should be large enough for a large group while offering the ability to scale down activities for a small group setting. When utilized and flexed throughout the day, these spaces can bring activity to the forefront of a community.
School Sisters of St. Francis Sacred Heart |
Located near the main entrance, tying together the existing and new, the library creates a welcoming handshake to the community. Utilizing architectural elements to define the space while minimizing the physical walls allows the space to accommodate larger and smaller groups.
SOCIAL
The corner stone of social wellness is others. Creating points of connections with our peers and environments that foster communication and community build on our interdependence with others and contributes to the elimination of loneliness. Positioning social gathering spaces and group activities appropriately within a building or campus will have a dramatic impact on their use and impact. Communities may provide a bar, craft room, game room, classroom and many other variations of these gathering spaces. When programmed well and located at strategic points of interest, their use and effectiveness is bolstered, and the social wellness of residents and staff is elevated. 
Marquardt Village | This pre-function space was designed as a self-contained party room with a large volume and connections to the adjacent dining and lobby to accommodate larger gatherings of friends and family as well as more private events. The space can accommodate a variety of activities at once, promoting social interaction.
While the dimensions of wellness offer a framework for understanding the wellbeing of an individual, the built environment plays a role in multiple wellness dimensions at any one time.
For example: a properly designed salon space can have positive impacts on many aspects of wellness. The salon may provide physical wellness initiatives such as massage or meditation therapies. This space may also find itself a social center for residents to share in conversation and community, having a positive impact on resident’s social wellness. Salon spaces programmed and designed to allow for some volunteer activities where residents can help assist provide purpose and positively impact one's occupational wellness. Through collaboration between the design team and operations, the built environment can harness the natural cross section between wellness dimensions to provide an environment of support and well-being.
With competition in the senior market being more robust than ever, resident and staff wellness will continue to move to the forefront for communities that want to be top performers. Many communities have looked to their activities programming and food service menu to bolster their wellness programs; but that is only one piece of the puzzle. When designed with purpose, reimagining the built environment can offer unique opportunities to further enrich and support the wellness initiative for residents and staff alike.
Our client Oklahoma Methodist Manor (OMM) has seen firsthand how thoughtful and purposeful design can elevate a wellness program. CEO of OMM, Steve Dickie, remarked, “There will be two types of nursing homes in the future: the excellent and the non-existent. If serious action wasn’t taken, we would have faced extinction.” Read the full case study.
In what ways can your community enhance its focus on wellness?
Dan Schindhelm, AIA
Project Manager
