A new kind of rest home: relaxing in the dementia ward

Before the renovation, Marlene Rotering’s 98-year-old resident never slept through the night. That changed after the resident stayed one night in the new Cognitively Impaired Unit (CIU) of Edgewood Retirement Community.

“She slept peacefully,” recalls Rotering, executive director of the continuing care retirement community in North Andover, MA. “Her appetite has increased. For somebody to have those kind of physical responses to such an environmental change was worth [the work]. That made my day.”

Altering Edgewood’s environment to provide more intimate areas and more natural light was a goal of the design of the 12-year-old facility. The three-year project, which was completed at the end of May, involved a 20,000-square-foot addition and a 20,000-square-foot-expansion. The long-term care unit, which now has 60 beds, includes the new CIU.

“Our skilled nursing facility center, which was 45 beds originally, was very nice,” Rotering says. “There were no glaring issues with it, but we didn’t feel it really served the entire population we care for. That included people with different types of dementia and short-term rehab.”

The CIU, with its open outdoor courtyard, is one of the most impressive aspects of the new construction, says Marc Margulies, principal of Margulies Perruzzi Architects, which undertook the design. The glass surrounding the courtyard allows for transparency so staff can keep an eye on residents. Also, it gives residents a sense of open space.

“It allows them to maintain the kind of security they need, but it also is a sort of homelike atmosphere,” Margulies notes.

Another source of pride for the architects is the new bistro, which seats 80. The informal dining area allows views of the outside and directly connects to the living room, main corridor and billiards room.

Allowing for seamless transitions between smaller and larger spaces is one of the most appealing parts of the new facility, says John Pearson, senior associate and architect of the Edgewood project.  

“You can find a place that is more of a living room size or a cozier kind of environment but still be open to the larger spaces,” he explains.

One of the challenges was renovating and building in an existing space. At one point, the existing long-term care residents moved into the newly built CIU unit to accommodate the renovation of the existing long-term care unit. They later moved back once the renovation was completed. (The rehabbed resident rooms are more spacious and have flat-screen TVs, wireless connections and they open to communal spaces.)

During the project, the architects and facility learned that they had to allow for a certain amount of flexibility. The renovation grew because of their decision to redo systems that were nearing the end of their useful life. For example, they ended up installing a larger cooling tower.  

Involving the residents in the project also turned out to be a smart move. Because of feedback, the bistro has wait staff. The residents said they wanted to be served.

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Lessons Learned:-Mixing up scale, so that smaller spaces open into larger spaces, can make a facility feel more like home

-Building some flexibility into a project allows you to repair or replace old equipment

-Involving the residents makes a project more rewarding for everyone involved