Inclusive design: comparing models of living environments for older people

Many older adults who are no longer able to live independently due to a combination of impairments need to live in living environments that are adapted to their health conditions. Generally, these are various types of housing, such as nursing or retirement homes, skilled nursing facilities, assisted living facilities, residential care homes, palliative or rehabilitation centres, etc., which can be referred to as long-term care living environments. Although the recent trend in Europe has been to allow older adults to remain living at home as long as possible, the demand for institutionalised forms of long-term care living environments is quite high, and many older adults spend a significant portion of their lives in these settings. In general, the quality of the living environment has a significant impact on the physical and mental health of residents. Therefore, it is important to explore living environments for older adults that not only allow basic existential needs to be met, but also provide humane living conditions. Concepts of long-term care living environments vary from country to country and depend largely on the characteristics of each social and health care system. Among the various concepts of living environments for older adults, nursing homes house a relatively large proportion of the world's population aged 65 and older. The development of nursing home typologies has evolved from traditional to alternative forms which could be illustrated by five-generations model of nursing homes in Europe, whereby alternative types, fourth- and fifth-generation models provide residents with a higher quality of life due to specific architectural features and functional adaptations. The aim of this paper is to introduce some concepts of long-term care living environments in the U.S. and Europe and to analyse models of third-, fourth- and fifth-generation nursing homes, especially the architectural design features that can strongly influence the quality of life of older adults.