Design For Assisted Living

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I suspect that in 2030, when we look back at the history of long-term care design during the last third of the twentieth century, we will be amazed at how society could have ever tolerated such an oppressive institutional system of care and support. I am sure we will be amazedat how long-term care was regulated and how little in-fluence residents and their family members had on thesystem. We will have a hard time understanding why peo-ple with dementia were placed in hospital-like settingsand why so little attention was paid to movement ther-apy, exercise, and physical therapy. We will wonder why residents had to live in semiprivate rooms and why so little attention was paid to fostering independence and autonomy. We will wonder why we stayed with a long-term care model that was so clearly based on a short-term hospital template. Today we look back at the 1960s and find it hard to believe that residents were regularlyinstitutionalized because they were incontinenta muscle control problem, not a health care problem. In 2030 I will be 83, and if I am still alive, I suspect that many of my contemporaries and their families will be thinking very seriously about long-term care. The purpose of this book is to stimulate your thinking about what long-term care could be in the future. I hope that in 25 to 30 years, when we contemplate the housing choices available for persons who are growing older and frailer, we will be faced with not just one option but a variety of choices. These should be choices that pay homage to our past experience and are more consistent with our present desires.

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