Myrtle Grove-Program Book

Table of ContentsProgramming Executive Summary 4 Site Analysis 5 Concept 6 Client Profile 7 Client Issues 8-11 Codes Analysis 12-13

Schematic Ergonomics/Human Factors 14-18 Green Guide for Health care 19-24 Bubble Diagrams 25 Blocking Diagrams 26-27 Schematic Plans 28-29

Design Development Level One Floor Plan 30 Level Two Floor Plan 31 Reflected Ceiling Plan 32-34 Lounge 36-39 Kitchen & Living Room 40-43 Resident Room 44-47 3-D Model 48 Snoezelen Room 50-52 Way finding 54-59

References 60

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Executive Summary

Myrtle Grove is a Senior living facility dedicated to the bond betweeen health and the natural environment. At Myrtle Grove we will provide assistance to elderly in need of skilled nursing and memory care through patience, attentionand knowledgeable care. Creating an environment that engages the mind and promotes healthy healing

Dedicated to the growth of the surrounding environment, Myrtle Grove Senior living will ensure that its construc-tion and operations are fair to the environment. This will be done by sustainable building and designing practices, healthy maintenance and education for all staff and residents.

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Site Analysis

Myrtle Grove Senior Living is an existing 2 story 48,212 square foot building. It will serve as a community for elderly people requiring nursing and memory care. This building will encompass residential living environments, community areas (i.e. theater, restaurants, and gym), nursing care (nursing staff, Snoezelen room, therapy rooms) and Maintenance facilities (laundry, maintenance). It is important that this building caters to the residents who live there while providing maximum functionality for the staff who work there.

The building is constructed of Structurally Insulated Panels called Enviroboard. Enviroboard is comprised of OSB panels that sandwich insulation of compressed straw. This board is manufactured off-site which significantly reduces construction waste. Enviroboard has high insulation ratingsmaking it very energy and resource efficient.

This building is located along the North Carolina coast in Myrtle Grove. Myrtle Grove is a smaller town of only 8 – 9,000 people. It’s residents have an average age of 40 which is slightly higher than North Carolina’s median age of 35. The climate in Myrtle Grove is moderate averaging 80’s in the summer and 40’s in the winter. It holds a higher humidity which increases both highs and lows. This is important to the use of this Senior Residence because residents will want to have access to the outdoors in the summer and also in the winter. Because the winter isn’t as wet as the summer it will still be enjoyable to have windows open or sit outdoors.

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Concept

Myrtle Grove will inspire life and activity in its residents through an environmentally responsible design, concentrating on providing activity and purpose in daily life

Naturally - Timeless

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Client Profile

Senior Citizens who require assistance with daily activities, monitored daily care or suffer from de-mentia. Residents of this facility will be over the age of 60, require skilled nursing care or memory care. The basic resident needs will include house care, personal care and activity care. The residents will need someone to be able to help them perform housekeeping tasks such as washing linens, pre-paring meals and maintaining their apartments. They will need assistance with bathing, medications and physical health. Residents will need someone to assist them with exercising, nutrition and general well-being.

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Client Issues

Issue #1: Resident Quality of Life – Preventing Boredom

Boredom plagues so many senior citizens and has a large impact on their health and quality of life. The specific issues can vary from person to person but some of the main issues are that seniors can no longer do or afford to do the things they used to be able to do. This would cause anyone to go into a sort of depression. When they start to feel down about things they don’t get out and meet others who are in their same situation but most likely they are become solitary people. The goal as designers is to create places of destina-tion that resident’s will feel invited to, so that they can have interaction with other people and nature. One idea is the 100 percent Corner. An area where there is the opportunity to create a social “nexus”. A place that can be connected to interesting activities, food or snacks, major circulation and seating. Often 100 percent area will include, View to the Outside View to a major circulation pathway Access to public rest room Access to snacks Visual/Physical access to mailboxes Good lighting View of staff activities View of Internal Residence activity Comfortable chairs around a table

Case Study: HumlehuseneAlbertslund, Denmark

This Assisted Living facility caters to patients suffering from Dementia. It includes 24 residents with an average age of 82, and 100% of them are cognitively impaired. The campus here is shaped of 3 L-shaped buildings that form a center courtyard. The courtyard can be considered this facilities 100 percent Here, residents can be active, sit and enjoy or do activities. The courtyard is also visible from inside all three buildings in case going outside is not an option. The courtyard includes a hard-scaped walking path around the perimeter, a covered seating area and a pond. Residents have been involved in maintaining a vegetable garden in the courtyard; however, not all residents are able to participate. There are ducks that come to the pond and residents often feed them, which they enjoy doing. This courtyard serves as a great space because it offers so much variety for the residents and staff. An issue however has been sun exposure and wind. But that would be an issue with any outdoor space so it would be important to make sure there is a hubindoors as well.

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Client Issues

Issue #2: Nurses Station/Staff Support Areas

Nurses have traditionally had one common, centrally located area to call home. These traditional nursing stations would house supplies, break areas, paper work & records and be a place for employees to congregate and get caught up. In reaction to issues with these traditional stations such as having a long travel distance and not being close enough to patients; decentralized nursing stations were put into effect. There were issues with these nursing stations as well. For one nurses were finding that a lack of privacy for the staff was causing them to have confidential conversations within earshot of patients. Some stations were far too decentralized and employees weren’t even sure if all staff was showing up for shifts. In an effort to compromise between the two extremes the new trend is to combine a centrally located nursing/staff station with fewer decentralizedstations. The central station will include a break area, supplies and filing, so that staff will naturally be passing by each other and have a chance to converse. This is proving to most effective especially because the new trend in healthcare is to take more of a collaborative approach between all doctors and nurses. A good Nurses station will include, Central Station with common areas Decentralized stations Areas to hold confidential meetings Areas for doctors, nurses and staff to congregate Easily accessible for patients and their families

Case Study: Victor Regnier, Author of Design for Assisted Living, conducted 28 case studies of Nursing Homes that have proven to be successful. He lists Facili-tating Staff Behaviors that Benefit Residents as one of the most important conclusions from all of the case studies done. Important behaviors include,` Private but approachable offices Dutch doors and half walls encourage viewing Small offices located close to circulation areas Single Seating Facilities for Staff Destination Place for Staff

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Client Issues

Issue #3: Snoezelen Room & Rummage Area

What is a Snoezelen Room? A Snoezelen Room is a multi-sensory environment where specialized sensory equipment finishes and furniture is placed to stimulate the minds of its occupants. It is not a threatening room in any way and is meant to cater to the people who occupy it at that time. Patients should be able to roam around and choose to interact with the things that most excite and intrigue them. When talking about Snoezelen Rooms for patients with Dementia, it is most beneficial in the case of “Sundowners Syndrome”. These rooms allow dementia patients the opportunity to escape from their anxieties and relax. When they relax they can become more aware of their surroundings and it’s really peaceful. Sometimes Snoezelen Rooms are so successful the staff also uses them to relax.

Rummage Rooms are places that patients with dementia can go and just look around. Rummaging is a common characteristic of people with de-mentia and the ability to rummage through a box of interesting things is useful and keeps them interested for a good period of time. It serves as an alternative to wandering sometimes. Some Rules of thumb are, Include colors and lights to stimulate eyes Variety of tactile textures Create a non-threatening environment using music Calming fragrances will soothe patients

Case Study: Keswick Pines Life Care CommunityWhiting, New Jersey

At Keswick Pines a Snoezelen Room has been implemented for their residents with Alzheimer’s and other cognitive impairments. The Snoezelen Room is used as an alternative traditional medicine. At Keswick Pines they have created a space where Residents look forward to “a more interac-tive and enriching experience”. The therapy room is set up around the five human senses, smell, sight, touch, hearing and taste. At Keswick they use methods such as aromatherapy, tactile massage, fiber optic spray, familiar music and colorful moving pictures. Debbie Conroy, the activities director of healthcare describes a typical trip,

“First we decide on a particular theme and then put together a program of ex-periences to provide continuity. If the theme centers on the change of seasons, all of the senses would be utilized to experience the theme. To begin, upon entering the room, participants hear the sound of birds singing and chirping to welcome them, while a visual projector would provide colorful, relaxing, abstract images. Residents see the seasons change in front of them as the other senses are stimulated with fragrance, lotion and sound.”

Debbie also says that while this is a more expensive program, it is worth-while because they see a measurable change and improvement in behaviors. The staff at Keswick has noticed that the Snoezelen therapy and its many “props” have helped with anxiousness and repetitive behaviors that are com-mon in all dementia patients. They have seen interest from other patients as well, not just those who suffer from Alzheimer’s.

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Client Issues

Issue #4: Sustainability in Senior Living Environments

Creating Sustainable Senior Care facilities is important for most of the same reasons it is important to design any building sustainably. Natural light and ventilation will help promote positive attitudes, good health and productivity. It will be a better and healthier work environment for the staff. The owner or investor will see lower maintenance and utility costs, greatly reducing the life cycle costs. However one thing that sets apart senior liv-ing from other buildings is the fact that many seniors cannot afford to live in senior care facilities. Sustainable building strategies help this problem. Many government funded senior housing projects are looking at green building strategies for low-income senior housing because they offer the opportunity to greatly reduce the cost of senior living (currently averaging over $100 a day). A sustainable Senior Living Facility will include, Efficient Building Envelope High Indoor Air Quality\Ventilation Water Efficient Plumbing fixtures Alternative Energy sources Energy efficient electrical and mechanical systems Natural Environments accessible to residents Close proximity to public transportation and community

Case Study: Garden PlaceMilwaukee, WI

Garden Place is the first apartment style living facility in Milwaukee to cater to low – moderate income elderly. Many of the residents at Garden Place are receiving funding from Medicaid’s waiver program. Garden Place was developed under the Coming Home Program.

This is an eight-state initiative that was “created to expand the supply of affordable assisted living in rural and underserved communities.” (Garden Place Case Study) The goal of Garden Place and the Coming Home Pro-gram is to provide assisted living centers with private apartments in distinc-tive settings and with 24-hour staffing to seniors who wouldn’t normally have this opportunity. Garden Palace includes 50 licensed Assisted Living Units and 12 Indepen-dent Living units. They have managed to list 57 of their units as “affordable” according to Wisconsin’s Low-Income Housing Tax Credit Program. The design of the building is a 3-story residential building, built in a “U”. It includes a dining room that overlooks the courtyard, family room, fitness center, wellness clinic, library/technology space, barber/beauty shop, medi-cation room, commercial kitchen, laundry facilities that are located on each floor and several sitting rooms. Residents units are a mixture of studios and one and two bedrooms and they range in size from 396 to 1128 square feet. Each room has a full kitchen, walk-in closet, bathroom with roll-in shower, individually controlled heating & air conditioning, cable TV, telephone availability and an emergency response system.According to the staff at Garden Palace the most commonly used areas are the library which overlooks the entry way and the courtyard which is especially popular with residents who enjoy gardening. Garden Palace offers services with meals and housekeeping, daily assistance (dressing, eating, bathing, grooming, toileting, transferring and ambulation or mobility) and also nursing services (health monitoring, medication administering and management). The fee structure at Garden Palace is at a flat rate of $1178 for Medicaid clients and $1350 for private-pay clients. This fee includes weekly house-keeping and linen service, medication administration 3-times a day, 3-hours a week of personal assistance, RN health management and participation in wellness program. Other services are available on an a-la-carte basis and Medicaid clients can get them reimbursed through Wisconsin’s Family Care Program. Also residents whose income is less than 60% of the county median (less than $28,200/year) will have negotiated rental fees which are based on the level their income falls into.

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Codes Analysis

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Codes Analysis

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Ergonomics & Human Factors

Safety & Well-being

Security (Wandering, medications, etc.) Space planning will be critical in the safety of patients in Senior Living. Inherent issues such as wandering, that can’t be stopped can be made safer by space planning in a way that allows patients to wander and explore. Making sure things that the patients can’t get into are locked away and kept out of plain sight. Also creating pathways that a patient would likely follow which lead back to where the patient started or to a safe place.

Using furniture and materials that are not made for seniors is a difficult thing and a safety issue. Seniors need to be able to use with ease things that physically ambulatory people take for granted such as door knobs and bath tubs. It will be important that this is taken into consideration when doing things such as placing light switches, creating suites with showers rather than bath tubs and choosing door levers instead of door knobs that can be hard for seniors to turn.

Lighting Quality (artificial and daylighting)As we age, so do our eyes. When eyes age they are effected by lessened visual acuity, color identification, adaption, peripheral vision, depth perception and tolerance for glare. Presbyopia is the decrease in the eyes ability to change the shape of the lens, affecting the ability of the eye to focus. Because of this it is important to use higher illumination levels, specifically in places where detailed tasks will be performed or where there are safety hazards such as stairs or ramps. The aging eye needs approximately 3 times more light.

Daylighting in Senior Living is especially important. Not only is us-ing daylighting an advantage for financial reasons (making it more efficient so the cost of living is lessened) but it is also important for health reasons. Many seniors do not spend enough time outside. This is especially important for aging because lack of sunlight can contribute to diseases that stem from a lack of Vitamin D. Such as Osteoporosis. Studies have shown that in a healthy human body 80% of Vitamin D is produced in the skin through contact with sunlight. Lack of daylighting can also contribute to mental ailments such as Seasonal Affective Disorder and Depression. Both of which are seri-ous issues within the aging community, especially those who are in need of assistance.

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Comfort & Sense of Choice and Control

Privacy (related to sense of control, interaction and socialization)Noise control is an important factor in privacy. Currently noise level regulations are less than those required in most treatment centers and care units. Noise is an inherent problem in any living situation and I can say from experience it is very uncomfortable to live somewhere that you know you do not have acoustical privacy. Lack of privacy will cause residents to become very introverted and they will retreat into themselves, instead of becoming extroverted where they can enjoy interaction with others and their surroundings.

The idea of vicarious viewing is an important part in senior living design because it incorporates a human’s need for nature while keeping in mind the comfort of being in control. Vicarious Viewing means living through seeing. It can be implemented in many ways. One way would be viewing areas of an outdoor space. A space outdoors can be a wonderful place for lots of activities such as gardening, socializing and playing games. Some seniors may not want to always be involved so there need to be areas where they can watch what is going on without actually doing it. They can live vicariously through others. A more simple way of promoting vicarious viewing is a space where someone can watch a road or community area but not have to be involved. It is allowing the resident to be in control because they are choosing to go to this area but they are under no pres-sure to join.

Skilled NursingResidents in need of skilled nursing assistance need assistance with often very personal aspects of everyday life. Until recently something such as bathing was not typically done in a private area but at the same time as others. Residents would be taken down to a “bath-ing” room where a nurse would help them bathe. There would not be privacy with this and usually it would be an embarrassing time. The option of bathing yourself in the privacy of your own bathroom is very important and will enhance a feeling of self sufficiency. Residents should be able to take a shower in their own rooms or have help in a private area.

There is an issue with choice in many skilled nursing facilities because the residents do require help to do many things. One area that can be helped is the choices residents have for eating. Instead of just one main eating area where there is one meal available, it would be helpful to have options. Perhaps if a resident didn’t feel like having an entire meal they could go to a “café” type place within the facility and have a lighter meal. Even just having different options at different times of the day would allow residents to feel they have a choice in this day to day activity.

Memory CareLooking back at the issue of wandering is also a crucial area where sense of control is desired. Residents with dementia will want to wan-der and if they are not able, this can be frightening and frustrating. They won’t understand why they can’t roam about and therefore it is important to create a space that is conducive to this behavior. Creat-ing a space where residents can wander and won’t run into too many locked doors or dead ends would be very beneficial.

Snoezelen Rooms can be really beneficial in making residents feel comfortable and at ease. The therapeutic properties in Snoezelen rooms make them a great destination place for patients who are con-fused or restless.

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Ease of Use

Mobility and Functional AbilitiesADAUniversal DesignAnthropometrics

The qualities of ADA, Universal Design and Anthropometrics are all guidelines for making day to day tasks more comfortable for seniors and seniors with physical disabilities. They include things such as dimensions for comfortable maneuverability in wheelchairs and comfort standards for a person who is aging. Elderly people have specific limitations when it comes to things such as picking out furniture, not any piece of furniture will work in an assisted living center because things such as chairs with-out arms make it hard for aging bodies to use. The purpose of building an assisted living facility is to make those who inhabit it as comfortable as possible and it can’t be done without understanding their specific physical needs.

A specific design feature related to these three would be a roll in or walk in shower. This is a design element that will benefit all those inhabiting the assisted living facility. A roll in shower would not have a lip on the exterior of it. It would be possible for a person in a wheelchair to roll in without need for assistance. This would also be a beneficial feature for an elderly person not in a wheelchair. They would be able to walk in to the shower without having to lift their legs over a lip, causing instability and making it dangerous. Using this Universal Design feature throughout the facility would allow for any room to be used by any individual and would not limit room availability.

Way finding Strategies

Way finding is crucial in memory care facilities. Many patients dealing with dementia can become confused and get lost very easy. There are different ways of tackling Way finding but a consistent and thorough signage plan is most common and very effective. Many times people will get lost and not know where they are so it is beneficial to include mapping in your signage.

Using things such a color and patterns to act as Way finding is also a more subtle but effective way. Having different color schemes for different areas will help the residents connect the theme to where they are.

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Productivity/Performance

StaffPrivacy is a key factor in the performance of staff in an assisted living center. The staff should be able to have comfortable conversation about patient care without fear of other patients hearing. If one patient is struggling with an aspect of care the staff should be able to warn their co-workers without risking the privacy of the patient. Community staffing areas are key. Places where staff will naturally go that are separate from the living and community areas of the residents. Such as break rooms and supply areas.

Many things that are beneficial to the resident s are also beneficial to the staff. Daylighting, natural ventilation, Viewing areas and functionality are all crucial to a work environment. Staff will be more productive if they are emotionally attached to the success of their work. Getting staff involved in activities and the lives of the residents is very important. Resident daily activities (personal or group

It is important from a mental health point of view for residents to be involved with other residents. It is healthy for the mind and emotion-ally to be involved and interactive with others so that one doesn’t fall too deeply into themselves and become depressed. Planning the As-sisted Living Facility around common areas or areas of activity is one way of promoting resident activity.

Creating inviting and comfortable gathering spaces for residents is one way of promoting interaction. A place such as a fitness center that incorporates a restaurant or social area could contribute to resident interaction. A fitness center would be a good place for residents to concentrate on health in a fun way. They would be surrounded by ac-tive things such as a lap pool and gym equipment with options to do things with each other like take fitness classes or have a smoothie.

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Aesthetics

Color (finishes and furniture)As people age their eyes become unable to distinguish between colors of the same hue. Especially in the blue hue. Colors such as yellow, green and blue can tend to blend together and it is hard for elderly to distinguish. That is why when using patterns there should be a high shift in color hues. Red and browns also become more difficult to distinguish when the eye ages and it becomes muddy. In designing a senior living facility we want the residents to be able to enjoy their surroundings so we should keep these things in mind.

Designing way finding by using color can become tricky because of these color issues with aging eyes. Using very distinct and different colors is one way of helping out and another would be to associate each color with a specific pattern. If all signs include a hint of the same pattern then you can associate that as well as the color. So when residents eyes fail to dis-tinguish color they still have the pattern.

Contrast (finishes, furniture, fixtures)

Having High Contrast between things that seniors need to see is an important design factor. As we age we see things a lot less clearly. It is important to have high contrast between chair seats and flooring, vanity sinks and countertops and Stairs and the floor leading up to them. The aging eye can easily miss these things if contrast isn’t a factor and that can become dangerous.

Contrast in personal furnishings and a public furnishing is also im-portant. If all the public furnishings are somewhat the same or follow a single design scheme and then the personal furnishings are different, it will make the personal furnishings seem even more so. Allowing residents to bring in their own furnishings or accessories will enhance the comfort they have in their own rooms. Even if some furniture is similar or the same in individual rooms the residents won’t necessarily know that they have the same ottoman as their neighbor. Lighting Quality (artificial and natural) to enhance aesthetic appear-ance of personal or shared space.

Creating a different feeling between personal and community spaces can be done using lighting. Community spaces will typically require more and brighter light and therefore daylighting can be used to its fullest. In personal spaces you want the residents to feel comfortable and calm, especially in places such as memory care and daylighting can be controlled by the individual as well as artificial lighting. Per-sonalization of their personal space is very important so that each resident feels comfortable.

Lighting will be beneficial in directing patients. Humans are like bugs and we are drawn to the brightest source of light. A bright sunny area can attract residents. This strategy could be used in memory care fa-cilities to direct wanderers. If they see a bright sunny patio at the end of their hallway they would be likely to go towards it.

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Green Guide for Healthcare

Prerequisite 1: Minimum IAQ Performance

IntentEnhance indoor air quality to maximize health and well-being of occupants

GoalsMeet minimum requirements of ASHRAE 62-2004 or local licensing ventillation requirement (whichever is more stringent) for acceptable indoor air quality

Reference StandardsASHRAE 62-2004 Ventilation for Acceptable Indoor Air Quality

Strategies- Operable Windows where appropriate- Appropriate mechanical ventillation per codes- Zone areas with high levels of contaminants- Keep circulated air clean during construction- Flush with 100% outdoor air prior to occupancy- Reduce or eliminate use of products containing VOCs for all furniture, finishes, equipment and adhesives- Reduce or eliminate toxic chemicals used for cleaning and maintenance - Install sensors for relative humidity, temperature and carbon dioxide- Provide occupant control systems to improve thermal comfort

Prerequisite 2: Environmental Tobacco Smoke (ETS) Control

IntentPrevent exposure of building occupants, indoor surfaces and ventilation air distribution systems to Environmental Tobacco Smoke (ETS)

GoalsProhibit smoking in the building except, 50ft from building openings, air intakes, bus stops, disabled parking and other miscellaneous locations where residents may come in contact with ETS

Suggested DocumentationEstablish and maintain a no-smoking policy on the propertyProvide a site map showing exterior designated smoking areas in compli-ance with the credit goals

StrategiesNon-Smoking BuildingsSet up smoking areas that in compliance with the credit goals

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Credit 1: Outdoor Air Delivery Monitoring

IntentProvide capacity for ventilation system monitoring to help sustain occupant comfort and well-being

GoalsInstall permanent monitoring systems that provide feedback on ventilation system performance to ensure systems are maintaining minimum requirementsSystems to alert maintenance when levels vary by 10%

Reference StandardsUS Code Regulations (CFR) 29 CFR 1910.1000 - Air Contaminants; current 40 CFR 273 - Standards For Universal Waste Management; current

40 CFR 761 - Polychlorinated Biphenyls Manudacturing, Processing, Distribution in commerce and Use Prohibitions; current40 CFR Part 61 - Subpart M - National Emission Standard for Asbestos; current

Strategies- Install CO2 sensors throughout building interior- Provide airflow measurements equipment directly related to HVAC

SystemSuggested Documentation

Use diagrams and calculations to show that the design of the natural ventilation systems meets the recommendations of the CIBSE Applications Manual 10:2005

Credit 2: Natural Ventilation

IntentProvide Natural ventilation systems for improved occupant comfort, well-being and productivity.

GoalsDesign natural ventilation systems for occupied spaces in the building where allowed by relevant building code requirements and where air distri-bution design is not mandated and/or restricted by process requirements

Reference Standards- ANSI/ASHRAE Standard 62.1-2004, Ventilation for Acceptable indoor Air Quality, Chapter 6- The Carbon Trust Good Practices Guide 237- Chartered Institution of Building Services Engineers Applications Manual 10:2005

Strategies- 90% of Rooms will have operable windows for natural ventilation - Use inward tilting windows to offer the highest ventillation capacity

Suggested DocumentationUse diagrams and calculations to show that the design of the natural ventilation systems meets the recommendations set forth in the CIBSE Applications Manual 10: 2005

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Credit 3.1 & 3.2: Construction EG Management Plan During Construction and Before Occupancy

IntentReduce Indoor air quality issues resulting from the construction/renovation process in order to help sustain the comfort and well being of construction workers and building occupants.

GoalsDevelope and Implement a Indoor Air Quality Management plan for the construction and pre-occupancy phase of the building

Reference StandardsCA DHS Standard practice for the Testing of Volatile Organic Emis-sions, CA/DHS/EHLB/R-174, July 15, 2004 including addendum 2004-01; Table 8.1

Strategies- Flush out after construction has ended and prior to occupancy. All inte-rior must be installed. - Air Testing- Integrate air cleaning elements into the design, such as a living wall, to improve the quality of the air after occuppancy

Suggested DocumentationDocument the building flush-out procedures in accordance with credit goals, including actual dates for building flush-out

Credit 4.1 - 4.5: Low-Emitting Materials - Interior Adhesives & Sealants, Wall & Ceiling Finishes, Flooring Systems, Composite Wood & Insulation, Furniture & Medical Furnishings, Exterior Applied ProductsIntent

Minimize Indoor constraints that are odorous, potentially irritating and/or harmful to the comfort and wellbeing of installers and occupants

GoalsUse finishes and fixtures that do not exceed the VOC limits of South Coastal Ar Quality Management District (SCAQMD).

Reference StandardsCalifornia Air Resources Board list of Toxic Air Contaminants (Califor-nia Air Toxics)

Strategies- Using No-VOC and low emitting paints, stains and finishes.

Suggested DocumentationCompile a list of finishes, sealants and stains used in the building and manufacturer verification documenting compliance with the applicable standards

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Credit 5.1 & 5.2: Chemical Pollutant Source Control Indoor & Outdoor

IntentMinimize exposure to chemical pollutants from indoor and outdoor sources

GoalsDesign to minimize pollutant contamination of regularly occupied areas

Reference StandardsNational Ambient Air Quality Standard, US Environmental Protection Agency

Strategies- Place walk off matts at all entrances to capture contaminants on shoes- Pressurized vestibule entrances- Exhaust spaces containing contaminating substances seperately- Place Copiers in spaces with direct ventilation- Landscaping near outdoor air intakes to clean air entering ventilation system

Suggested Documentation - Show strategies such as entry ways on building plan- Perform calculations to ensure quality of air entering system

Credit 6.1 & 6.2: Controllabiltiy of Systems Lighting & Thermal Comfort

IntentProvide controllabiltiy systems for both Lighting and Thermal Control by the individual resident

GoalsProvide Individual lighting and thermal controls to individual residents or groups of residents in common spaces.

Strategies- Each room will have its own lighting and thermal controls- Operable windows will allow residents and staff to control the temperature in any given space

Suggested DocumentationComplete schematic drawing demonstrating the required individual thermal comfort controls are provided

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Credit 7: Thermal Comfort

IntentProvide for the assesment of building thermal comfort over time

GoalsAgree to implement a thermal comfort survery of building occupants within a period of 6 to 18 months after occupancyAgree to develop a plan for corrective action if the survery results indicate that more than 20% of the respondents are dissatisfied

Reference StandardsAHRAE Standard 55-2004

Strategies- Install thermal systems residents monitor themselves - Install thermal systems that correct and maintain the thermal comfort in the environment

Suggested DocumentationDevelop a thermal comfort surveryand a plan for corrective acton in compliance with the credit goalsDocument the facility’s commitment to implement the thermal comfort survery within 6-18 months after occupancy

Credit 8.1-8.3 Daylight and views, Connection to the Natural World, Lighting & Circadium RhythmIntent

Provide residents with a connection to the outdoor environment through daylighting, Indoor places of respite and Natural Circadium Rhythms

GoalsProvide daylighting in all resident rooms and common spaces, offer places indoors to look upon nature and adjust artificial lighting to follow typical sleeping patterns

Strategies- Windows and doors will allow the outdoor environment indoors. Place windows and doors in all resident rooms and common areas- Provide seating near windows to view the outdoors- Manage artificial lighting so that it is not interfering with natural rhythms

Suggested DocumentationCompile floor plans highlighting daylighting, places of respite and views of natureCompile a building program and calculation showing that 90% of these spaces meet the credit goal of havinga direct view to nature

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Credit 9.1 & 9.2: Acoustic Environment Exterior Noise & Sound IsolationIntent

Isolating exterior and interior noises from interferring with the life of residents

GoalsMinimize the impact of site exterior noise on the Building Occupants and on the surrounding community.Sound Isolation performance of constructio

Reference StandardsAIA/AHA Draft Interim Sound and Vibration Design Guidelines for Hospital and Healthcare Facilities

Strategies- Install sound absorbaative wall treatment. Resident Rooms will have acoustical sound seperation- Voice paging and call systems will be designed to achieve a minimum speech transmission index of .5- Clinical alarms will be designed to be audible according to ISO 7731

Suggested DocumentationProvide documentation demonstrating that the acoustic design complies with Credit Goals.

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Bubble Diagrams

Administration Town Center

Skilled Nursing Memory Care

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Blocking Diagram

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Blocking Diagram

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Schematic Design

Level One

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Schematic Design

Level Two

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Floor Plan - Level One

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Floor Plan - Level Two

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Reflected Ceiling Plan

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Lounge

Floor PlanScale= 1/8”

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Reflected Ceiling PlanScale= 1/8”

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Lounge Elevation

Lounge

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Lounge

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Kitchen/Living Room


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Kitchen/Living Room

Living Room

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Kitchen

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Resident Room


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Resident Room

Resident Room

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Resident Bedroom Bathroom Elevation

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3-D Model

Memory Care Room

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Snoezelen Room


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Snoezelen Room

Snoezelen Room

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Way finding

Directional Signage - S1

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Way finding

Directional Signage - S1

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Way finding

S3 S4

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Way finding

S5 S6

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Way finding

Personal Room Signage

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Way finding

S8 S9S7

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References

Client Issues - Page 8“Active Senior | Active Senior Living | Caring.com.” Caring for Aging Parents | Caring for Elderly Parents | Caring.com. Web. 24 Jan. 2010. <http://www.caring.com/articles/active-senior>. Regnier, Victor. Design for Assisted Living Guidelines for Housing the Physically and Mentally Frail. New York: Wiley, 2002. Print. “Senior Tips for Managing Boredom -.” Associated Content - associat-edcontent.com. Web. 24 Jan. 2010. <http://www.associatedcontent.com/article/128205/senior_tips_for_managing_boredom.html?cat=12>.

Client Issues - Page 9“Healthcare Boom: Nursing Stations for the 21st Century - 2005-02-01 07:00:00 | Building Design & Construction.” Building Design and Construction News, Issues and Innovations | Building Design & Construction. Web. 24 Jan. 2010. <http://www.bdcnetwork.com/article/380243-Healthcare_Boom_Nursing_Stations_for_the_21st_Cen-tury.php>. “Help for Nursing Staff from Alzheimer’s Outreach.” Zarcrom Indus-tries Corporation. Web. 24 Jan. 2010. <http://www.zarcrom.com/users/alzheimers/4-index.html>. Regnier, Victor. Design for Assisted Living Guidelines for Housing the Physically and Mentally Frail. New York: Wiley, 2002. Print.

Client Issues - Page 10Kinkead, Gwen. “A Room Comes Alive With Color and Sounds.” The New York Times [New York City] 23 Dec. 2003. Print. “What is Snoezelen MSE?” Snoezelen Multi-Sensory Environment Therapy. Web. 23 Jan. 2010. <http://www.snoezeleninfo.com/whatIsS-noezelen.asp>. “WorldWideSnoezelen.com - A Case Study in Snoezelen as Al-zheimer’s Treatment From the USA.” WorldWideSnoezelen.com - A Case Study in Snoezelen as Alzheimer’s Treatment from the USA. World Wide Snoezelen. Web. 23 Jan. 2010. <http://www.worldwidesnoezelen.com/content/view/70/244/lang,ja/>.

Client Issues - Page 11“Demonstrations.” Wisconsin Affordable Assisted Living. Web. 24 Jan. 2010. <http://www.wiaffordableassistedliving.org/demonstrations/index.html>. “Sustainability in healthcare design gains in importance. | Health Care Health Care Overview from AllBusiness.com.” Business Resources, Advice and Forms for Large and Small Businesses. Web. 24 Jan. 2010. <http://www.allbusiness.com/operations/facilities-commercial-real-es-tate/3897555-1.html>. Turnnock, Judith L. “The Greening of Senior Housing.” The Bi-Month-ly Newspaper of the American Society on Aging Jan. 2008, XXVIIII ed., sec. 1. Web. 23 Jan. 2010. <http://www.asaging.org/publications/dbase/AT/AT-291-Turnock.pdf>.

Myrtle Grove-Program Book

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