A common mistake with furnishings in a communal environment is to purchase beds, chairs, tables and couches in one universal size. Residents in congregate care facilities are individuals and some have special needs when it comes to furniture dimension, comfort, safety and ergonomics, furniture designers and manufacturers say.
“There are two critical questions to ask when selecting furnishings for a senior living community’s spaces,” said Paula Plotkin, furnishings consultant for Direct Supply. “The first is, ‘How will this room be used?’ The second is, ‘Who are the people using this room for the defined purpose?’ The customer really needs to know who their guests are going to be to make the correct furnishings choices.”
Nancy Kirchhoff, the owner of Medtek Resources, asserts that providers’ top considerations for furniture should be the dimensions and materials in a home-like environment.
“Healthcare specifications are vital in areas where the resident spends the most time, namely dining, activities and resident rooms,” she said. “The materials and construction can provide both comfort and easy access. Firmness provides support to a resident in rising from the chair.”
Because Medtek Resources provides products that are manufactured solely for seniors, Kirchhoff says special attention is placed on structure, durability, fabric and comfort without losing style.
Style considerations
“Style can be achieved by the lines of the furniture, incorporating wood and texture,” she said. “Furniture styling along with fabric selections sets the decor for the rooms. Fabric lines give the durability and ease of cleaning. We have seen wonderful fabrics developed in the years that can transform the design of a room.”
Assessing furniture needs for each room requires several considerations, says Michael Zusman, CEO of Kwalu.
“You want to select furniture that is easily maintained, durable, yet desirable,” he said. “Can the furniture handle high-traffic, high-maintenance areas? The furniture company you choose should offer a complementary range of designs, styles and finishes across their product lines, so that you have a cohesive look from your entrance and lobby, through common areas, dining and activity rooms to resident rooms.”
Choose the ‘right’ fit
The importance of selecting appropriate furnishings for all residents is due to several factors, Plotkin said.
“The most significant negative consequences of ill-fitting furniture are the possibility of discomfort and even injury, and that the furniture will go unused because it is uncomfortable,” she said. “The idea of attractive, comfortable furnishings is to draw the residents out of their rooms to enjoy the atmosphere and company of other residents or family. Unusable furniture defeats the purpose. As for casegoods, purchasing something too small or too large for the space affects the entire environment by making the resident feel lost or closed in.”
To avoid getting too standardized with furniture selections, Plotkin repeated this advice in triplicate: “Measure, measure, measure.” It takes only a little time to make sure the furnishings will fit the resident, she reminds.
“For seating, make sure the backs of upholstery don’t lean back too far, cushions aren’t too soft or too low, and that there are good handgrips on the arms,” Plotkin said. “If you aren’t sure, ask for assistance from the experts. We suggest having several furniture size options so you’ll be sure to have the right ‘fit’ for everyone. We suggest customers measure the favorite chairs of their residents to make sure they continue to offer that same size and comfort.”
Some larger-framed residents need bariatric seating and long-term care communities should have some models available for them, recommends interior designer Melinda P. Avila-Torio of THW Design.
Think, request big
“Though a few companies may standardize on certain models, a furniture company should always be asked if they are willing to create a bariatric model,” Avila-Torio said. “There may be instances where the resident is wheelchair-bound and cannot transfer easily into the bariatric seat. It is a sensitive issue with residents when there is a larger seating option designated for them. It all depends on how the bariatric seating is presented and offered to the resident.”
The need for smaller chair sizes is a topic that Avila-Torio recommends be discussed with the actual caregivers.
“This conversation goes beyond just a mere glance of what will be presented or the assurance that it will showcase well for high public areas,” she said. “An easy way to accommodate the smaller human body measurements in a senior-designed chair would be with kidney pillows. Again, those options for customizing seating dimensions for individual needs should be explored. It is not a matter of size, but of comfort and proper back support.”
Rooms and dimensions
For resident rooms, Zusman suggests products that are designed specifically for long-term care and commercial applications and that are “comfortable and appropriate” for the environment.
“Aesthetic considerations will be the major contributing factor to potential residents’ and their families’ first impressions,” he said. “It will also influence ongoing satisfaction with existing staff, residents and their families.
Evidence-based design has demonstrated that home-like furnishings and style offer the most soothing environments, decreasing the need for certain medications, helping patients remain calm and providing a general sense of well being.”
Variations in both the height and weight of residents play a key role in determining furniture dimensions.
Kirchhoff maintains that the “ideal” seat height for a chair should be 19 inches, or within an 18 1/2-inch to 20-inch range. A resident should be comfortably seated in a chair with a seat depth of 17 1/2 inches to 18 1/2 inches with an arm height of 24 1/2 inches to 26 inches to provide added standing support.
“Usually you will find that if the dimensions of the table and chair are not in those ranges that the residents, along with staff, have a difficult time maneuvering their sitting movements to and from the chair,” she said.
The same dimensions apply to common areas for ease of movement, she said: 19-inch seat height, 19-inch seat depth and 24-inch arm height.
“Firmness is important for easy access and fabrics can make a big statement,” Kirchhoff added. “Styles can run the gamut from traditional to transitional to contemporary. Adding softness in styling with wood frames and beautiful fabrics make the area most welcoming. And casegoods pieces for storage have become important in every project.”
Resident rooms are featuring more and more custom casegoods to incorporate the modern technology into the resident room, Kirchhoff said.
Wall units that span the length of a wall are being installed to include space for flat screen TVs, VCRs, DVD players, refrigerators and computers along with the resident’s wardrobe. This can create a personal and more modern look to the room.
Durability important
Furnishings take a beating in the congregate care environment, so endurance is an essential quality of room features, Plotkin said.
“The durability, stain-resistant and antimicrobial features needed in furnishings depend on what services the community offers,” she said. “Certainly, this is very important to skilled nursing and assisted living communities. In addition, our senior living customers expect durability and stain-resistant properties in their furnishings.”
To be sure, “infection control protocols are critical,” Zusman added. “Find furniture that will support your efforts in limiting healthcare-associated infections with antimicrobial, water-resistant and easy-to-clean features. Keep in mind products need to tolerate the harshest cleaning substances without damaging the finish.”
Zusman also recommends looking for furniture that will not crack, swell, split or chip too quickly as a result of normal usage and wear and tear.
“Look for furniture with limited grooves, nooks and crannies, where debris and spill-related soil can lodge without being easily disinfected and cleaned,” he said. “When paired with high-performance fabrics — some of which have antimicrobial treatments and are bleach-cleanable — these products deliver the ultimate in easy maintenance and minimal-fuss housekeeping.”
When buying furniture, operators should consider these points:
— There should be an honest conversation of aesthetics versus durability. In an environment that may have a high wheelchair-bound resident population, every consideration should be made to explore highly durable furnishings with abuse-resistant surfaces and steel-reinforced frame construction.
— Whenever there are large quantities to be selected, always ask for furniture samples that the end users can see and test.
— If specific frame styles are favored, always ask about being able to customize dimensions and features.
— Identify the proper amount and type of casters for chairs. Allow the end user to test the chairs with casters for at least a week in an actual residential setting.
— Do not make seating selections without having sat in the chair models that represent the final specified dimensions.
— Specifying the appropriate furniture specifications begins with truly understanding how spaces will be used and anticipating any change that may happen in program activity. For example, an arts and crafts room might accommodate needlepoint and painting as well. The team should consider the residents’ comfort level with sitting for extended periods of time, and the cleanability of the fabric and frame.
— The ability to clean is important for both the fabric and furniture. It is critical that the facility operator be informed of necessary care procedures recommended by the manufacturer. Furniture is a crucial factor in helping to mitigate healthcare-acquired infections.
— Learn about the various fabric protection technologies available and why a certain application would be used over the other in the different levels of care.
— Identify incontinence levels, especially in higher-acuity resident care settings. This will help determine the performance specifications of the furniture being investigated.
— Include in the furniture selection process a parallel review of the specified interior finishes. For example, there are floor manufacturers who recommend certain chair glides for luxury vinyl flooring.
Source: Melinda P. Avila-Torio, THW Design, 2011
From the July 01, 2011 Issue of McKnight's Long-Term Care News
