# Senior Living Design

## Continuum of Care Levels

### Care Types
| Level | Description | Staffing |
|-------|-------------|----------|
| Independent Living (IL) | Active seniors, minimal services | Minimal |
| Assisted Living (AL) | Daily living assistance | 24-hour |
| Memory Care (MC) | Dementia, Alzheimer's | Specialized 24-hour |
| Skilled Nursing (SNF) | Medical care, rehabilitation | Medical staff |
| Continuing Care (CCRC) | All levels on one campus | Varies |

### Typical Resident Profile
| Level | Age | ADL Needs |
|-------|-----|-----------|
| Independent | 70-85 | None to minimal |
| Assisted | 80-90 | 2-3 ADLs |
| Memory Care | 75-95 | Cognitive support |
| Skilled Nursing | 80+ | Extensive medical |

---

## Unit Types and Sizes

### Independent Living
| Unit Type | Size Range |
|-----------|------------|
| Studio | 400-550 SF |
| 1 Bedroom | 600-900 SF |
| 2 Bedroom | 900-1,400 SF |
| 2 BR + Den | 1,200-1,600 SF |
| Cottage/Villa | 1,200-2,000 SF |

### Assisted Living
| Unit Type | Size Range |
|-----------|------------|
| Studio | 300-450 SF |
| Alcove | 350-500 SF |
| 1 Bedroom | 450-650 SF |
| 2 Bedroom | 600-900 SF |
| Companion | 500-700 SF (shared) |

### Memory Care
| Unit Type | Size Range |
|-----------|------------|
| Private room | 250-350 SF |
| Semi-private | 350-450 SF |
| Suite | 400-500 SF |

### Skilled Nursing
| Room Type | Size Range |
|-----------|------------|
| Private | 150-200 SF (room only) |
| Semi-private | 250-300 SF |
| Private + toilet | 250-300 SF |

---

## Unit Design Standards

### Independent Living Units
| Element | Requirement |
|---------|-------------|
| Entry door | 36" minimum |
| Interior doors | 32" clear minimum |
| Hallways | 42" minimum |
| Kitchen | Full, accessible |
| Bathroom | Walk-in shower preferred |
| Washer/dryer | In-unit or nearby |
| Emergency call | Required |
| Balcony/patio | Preferred |

### Assisted Living Units
| Element | Requirement |
|---------|-------------|
| Entry door | 36" minimum |
| Bathroom | Roll-in shower, grab bars |
| Kitchenette | Optional (sink, microwave) |
| Emergency call | Pull cord + pendant |
| Lighting | Adequate task lighting |
| Flooring | Non-slip, low pile |
| Furniture | Resident or provided |

### Memory Care Units
| Element | Requirement |
|---------|-------------|
| Simplified layout | Reduce confusion |
| Bathroom | Visible from bed |
| No kitchenette | Safety |
| Emergency call | Staff alert only |
| Lighting | Circadian rhythm support |
| Windows | Secured, limited opening |
| Doors | Concealed from wandering |

---

## Common Areas

### Dining Venues
| Type | SF per Seat | Seating |
|------|-------------|---------|
| Formal dining | 25-30 SF | Fixed |
| Casual dining | 20-25 SF | Flexible |
| Private dining | 30-35 SF | 8-12 people |
| Bistro/Café | 15-20 SF | Counter/table |
| Memory care | 25-30 SF | Small groups |

### Living/Activity Spaces
| Space | Size Range |
|-------|------------|
| Main lounge | 15-20 SF per resident |
| Activity room | 400-800 SF |
| Craft room | 300-500 SF |
| Library | 300-600 SF |
| Game room | 400-600 SF |
| Theater | 20 SF per seat |
| Fitness center | 800-2,000 SF |
| Pool/spa | 1,500-3,000 SF |
| Salon | 200-400 SF |

### Memory Care Common Areas
| Space | Purpose |
|-------|---------|
| Living room | Residential scale |
| Dining room | In household |
| Activity area | Supervised programs |
| Secured outdoor | Safe wandering |
| Quiet room | De-escalation |
| Family visit | Private meetings |

---

## Circulation Design

### Corridor Standards
| Setting | Width |
|---------|-------|
| Independent living | 5'-6' |
| Assisted living | 6'-8' |
| Memory care | 6'-8' |
| Skilled nursing | 8' minimum |

### Wayfinding
| Element | Purpose |
|---------|---------|
| Color coding | Floor/wing identification |
| Landmarks | Memorable features |
| Memory boxes | Personal items at door |
| Signage | Large, high contrast |
| Lighting | Even, glare-free |
| Flooring | Pattern changes at destinations |

### Memory Care Circulation
| Feature | Purpose |
|---------|---------|
| Looped paths | Continuous walking |
| Secure exits | Delayed egress |
| Disguised doors | Reduce exit-seeking |
| Outdoor path | Safe wandering |
| Rest areas | Seating along route |
| Visual cues | Recognition aids |

---

## Safety and Security

### Emergency Systems
| System | Requirement |
|--------|-------------|
| Nurse call | Every unit, bathrooms |
| Pendant/wristband | Mobile alert |
| Pull cords | Bathrooms, bedside |
| Smoke detection | Per code |
| Sprinklers | Per code |
| Emergency power | Life safety + more |

### Memory Care Security
| Feature | Purpose |
|---------|---------|
| Delayed egress | 15-30 second delay |
| Wander management | RFID/GPS tracking |
| Door alarms | Staff notification |
| Keypad entry | Restrict access |
| Camera monitoring | Common areas |
| Secured courtyard | Outdoor access |

### Fall Prevention
| Feature | Application |
|---------|-------------|
| Grab bars | Bathrooms, corridors |
| Non-slip flooring | Throughout |
| Adequate lighting | 50+ FC task areas |
| Contrast edges | Steps, transitions |
| Handrails | Both sides of corridors |
| No thresholds | Flush transitions |

---

## Accessibility Requirements

### Beyond ADA Minimums
| Element | Enhanced Standard |
|---------|-------------------|
| Doors | 36" throughout |
| Corridors | 6' minimum |
| Turning space | 60" diameter |
| Toilets | Comfort height (17-19") |
| Showers | Curbless, roll-in |
| Grab bars | Reinforced walls throughout |
| Outlets | 18" minimum AFF |
| Switches | 44" maximum AFF |
| Lever hardware | All doors |

### Mobility Aids
| Aid | Space Required |
|-----|----------------|
| Walker | 24" minimum doors |
| Wheelchair | 32" minimum doors |
| Scooter | 36" minimum doors |
| Stretcher | 44" corridors |
| Bed transport | 8' corridors (SNF) |

---

## Dining Services

### Kitchen Requirements
| Setting | Kitchen Type |
|---------|--------------|
| Independent living | Commercial kitchen |
| Assisted living | Commercial kitchen |
| Memory care | Servery + residential |
| Skilled nursing | Commercial + servery |

### Servery Design
| Element | Purpose |
|---------|---------|
| Display cooking | Engagement, aroma |
| Self-service | Choice, independence |
| Staff-assisted | Portion control |
| Beverage station | 24-hour access |

### Dining Room Considerations
| Factor | Design Response |
|--------|-----------------|
| Acoustics | NC-40, absorptive surfaces |
| Lighting | Dimmable, 30-50 FC |
| Seating | Mix of 2-top, 4-top |
| Wheelchair | Space at tables |
| Memory care | Small groups, supervision |

---

## Medical and Support

### Clinic Spaces (AL/SNF)
| Space | Size |
|-------|------|
| Exam room | 120-150 SF |
| Treatment room | 150-200 SF |
| Medication room | 100-150 SF |
| Clean utility | 80-100 SF |
| Soiled utility | 80-100 SF |
| Nurse station | 100-200 SF |

### Therapy Spaces
| Type | Size |
|------|------|
| Physical therapy | 1,000-2,000 SF |
| Occupational therapy | 500-1,000 SF |
| Speech therapy | 150-200 SF |
| Pool therapy | 800-1,200 SF |

### Support Spaces
| Space | Purpose |
|-------|---------|
| Housekeeping | Supplies, equipment |
| Laundry | Commercial or residential |
| Maintenance | Storage, workshop |
| Receiving | Deliveries |
| Staff rooms | Break, lockers |
| Administration | Offices, reception |

---

## Outdoor Spaces

### Garden Design
| Feature | Purpose |
|---------|---------|
| Walking paths | Exercise, mobility |
| Seating areas | Rest, socialization |
| Shade structures | Sun protection |
| Raised beds | Therapeutic gardening |
| Water features | Sensory stimulation |
| Secure perimeter | Memory care safety |

### Memory Care Outdoors
| Feature | Requirement |
|---------|-------------|
| Continuous path | No dead ends |
| Secure fencing | 6' minimum, concealed |
| Shaded areas | Heat protection |
| Visible from inside | Staff supervision |
| Points of interest | Engagement |
| Smooth surfaces | Trip prevention |

---

## MEP Considerations

### HVAC
| Consideration | Requirement |
|---------------|-------------|
| Individual control | Per unit preferred |
| Temperature range | 68-78°F adjustable |
| Humidity | 30-60% RH |
| Air filtration | Enhanced (MERV 13+) |
| Isolation | Infection control capability |

### Electrical
| System | Consideration |
|--------|---------------|
| Emergency power | Generator + UPS |
| Lighting | Dimmable, high CRI |
| Nurse call | Integrated system |
| Data | WiFi throughout |
| TV/cable | Pre-wired units |

### Plumbing
| Feature | Requirement |
|---------|-------------|
| Hot water | 110°F maximum delivery |
| Anti-scald | Thermostatic mixing valves |
| Water heater | Redundant for SNF |
| Backup water | Storage for emergencies |

---

## Regulatory Requirements

### State Licensing (Varies)
| Level | Oversight |
|-------|-----------|
| Independent living | Minimal/none |
| Assisted living | State health agency |
| Memory care | State health + AL license |
| Skilled nursing | CMS, state health |

### Life Safety
| Requirement | Application |
|-------------|-------------|
| Sprinklers | All new construction |
| Smoke compartments | SNF per code |
| Delayed egress | Memory care allowed |
| Evacuation | Defend in place (SNF) |

### Florida-Specific
| Requirement | Details |
|-------------|---------|
| AHCA licensing | Assisted living |
| Emergency management | Hurricane plans |
| Generator | 96-hour capacity (SNF) |
| Staffing ratios | Per license type |

---

## Design Trends

### Household Model
| Feature | Benefit |
|---------|---------|
| Small scale (12-16 residents) | Residential feel |
| Decentralized dining | Flexibility |
| Dedicated staff | Continuity |
| Kitchen in household | Home-like |
| Private rooms | Dignity |

### Biophilic Design
| Element | Application |
|---------|-------------|
| Natural light | Large windows |
| Views | Gardens, nature |
| Plants | Interior, exterior |
| Water | Features, sounds |
| Natural materials | Wood, stone |

### Technology Integration
| Technology | Purpose |
|------------|---------|
| Smart home | Voice control, monitoring |
| Telehealth | Remote medical visits |
| Wander management | GPS/RFID tracking |
| Fall detection | Automatic alerts |
| Social platforms | Family connection |

---

## Staffing Ratios

### Typical Ratios
| Level | Day | Evening | Night |
|-------|-----|---------|-------|
| Independent | 1:30+ | Minimal | On-call |
| Assisted | 1:8-10 | 1:10-12 | 1:15-20 |
| Memory care | 1:5-6 | 1:6-8 | 1:8-10 |
| Skilled nursing | 1:5-8 | 1:8-10 | 1:10-15 |

### Staff Support Spaces
| Space | Size |
|-------|------|
| Nurse station | 100-200 SF |
| Medication room | 80-120 SF |
| Staff lounge | 150-300 SF |
| Lockers | 1 per staff |
| Training room | 300-500 SF |
