Sunday, March 8, 2015

A Case Study - Part 7: Denouement

Courtyard view of House B, The Lodge (all photos by Leif Photography Studio)
This is the seventh and final post of a series dedicated to a case study of a single project—the VA Roseburg Healthcare System Community Living Center (CLC) Expansion— designed by Robertson/Sherwood/Architects. Click on “A Case Study” in the Labels list at right for the full series. 
I initiated the Case Study series in January of 2012 but the story actually dates back an additional two years to early 2010 when the VA selected Robertson/ Sherwood/Architects to design a new home for Alzheimer’s and dementia patients at the VA Roseburg (Oregon) Medical Center
Nobody expected the project would take more than five full years to reach completion. After all, it was not particularly large or complex; a challenge, yes, but one everyone fully expected to successfully complete within a couple of years. As I’ve recounted in previous posts, numerous twists and turns in the story are to blame for its protracted genesis. Regardless, the strands of the plot never unraveled and today the Community Living Center Expansion project at the Veterans Affairs Medical Center in Roseburg, OR is welcoming its first residents.  

Living Room, Unit A
As I wrote in Part 2 of this series, our design marked a paradigm shift away from achieving machine-like efficiency and maximum staff convenience toward a patient-centric care model. We’re hopeful the experienced staff will embrace this cultural transformation and function effectively within their new environment. Some may initially resist the change, but with time we expect all will appreciate the value of providing those in their care with as dignified, de-institutionalized, and life-enhancing a home as possible.
I’ve no doubt the patients will take to their new quarters well. Despite their diminished abilities, they can still find pleasure and experience satisfaction. The effects of dementia and Alzheimer’s disease do not remove the ability to appreciate, respond to, and experience feelings such as anger, fear, joy, love, or sadness. Those afflicted are individuals who deserve to be treated with respect, integrity, compassion, and concern for their privacy and safety. We designed the CLC Expansion with these considerations in mind. 
Typical patient bedroom & bathroom
To enhance their quality of life, people with mild to moderate cognitive impairment require appropriate social and physical support. This remains true as their disease progresses. The latest research regarding Alzheimer’s disease and related dementias highlights the importance of good design as a treatment factor. Good architecture has the power to provide a highly supportive environment, one that is life-enhancing as well as functionally adaptive.  
Kitchen, Unit B
We definitely wanted to help preserve the quality of life for each resident as long as possible. Our design provides a range of opportunities for the occupants, both inside and out. These are appropriate, stimulating, and experientially supportive places full of diversity and choice. They provide options for imprinting and personalization. At the same time, we focused on creating calm, coherent spaces conducive to the patients’ limited cognitive maps. If research on the topic is any indication, we expect our design will also improve their lives when measured in terms of fewer injuries, less medication required, less sleep disturbances, and reduced wandering.
Dining Room, Unit A
Home is a place of dignity and respect, and the setting most favorable to preserving the patients’ sense of self as their disease inevitably worsens. This is especially important for those who may live out their remaining days in the facility. The comfort, happiness, and dignity of the residents are especially important to their families, who may harbor feelings of guilt for no longer being able to care for their loved ones in their own homes.  
View from the southeast

Along with my colleagues Jim Robertson, FAIA, FCSI, and Jenni Rogers, Assoc. AIA, I attended the facility’s ribbon-cutting ceremony this past February 3rd. It was tremendously gratifying to overhear many positive remarks, particularly from the family members. We’re honored to have helped the VA create a home for those who served their country and now require compassionate care in return. Our duty as architects was to provide these men (and a growing number of female veterans in the future) with as supportive, respectful, non-institutional, and rich a setting as possible in which to live their remaining days. Seeing the finished product, I believe we hit the mark.

That being said, none of us will be able to declare the CLC Expansion (christened “The Lodge” by the VA) a success until at least one and perhaps several more years have passed. It will take time before everyone with a stake in the project can fairly assess its true merit. There are many chapters left to be written in this story, and it will be the caregivers and patients who work and live in “The Lodge” who will write them. As it should be for everybody who cares about a good book, we won’t close the cover on this one quite yet.

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