Impact of interior design on the dining abilities of the elderly residents in assisted living and nursing homes

The purposes of this two-phase study were to identify and describe the problems in assisted living and nursing home dining areas, identify solutions, and offer design recommendations or guidelines that would be useful to those involved in creating the dining environment for the elderly. The study was completed in North Carolina, and was limited to facilities with a minimum of 40 beds.

Phase I consisted of a mailed questionnaire to a random sample of 288 of the total 576 administrators of assisted living and nursing homes. The response rate was 32.6%, or 94 questionnaires completed and returned. Frequencies and percentages were examined to determine the most commonly occurring problems in dining areas. Findings of Phase I revealed the major problems and gave direction for the in-depth case studies of Phase II. The problems occurring most frequently were glare from windows, maintenance of walls and floors, noise, size of room, and instability of tables. From the 34 respondents who gave permission for further research, six facilities were selected for in-depth exploration of the target problems identified in Phase I. Methods used in Phase II included: (1) observation of the dining room, photographing the area, preparing sketches of the floor plan and furniture layout, and verifying the information submitted on the mailed questionnaires of Phase I; (2) interviews with staff members; and (3) interviews with residents. The participants of Phase II were a convenience sample of five on-duty staff members and five lucid elderly residents at each facility.

The findings of Phase II revealed that staff and residents made adjustments to avoid glare. Maintenance problems concerning repair of walls and floors were, however, overlooked by staff and residents. Sound levels in the dining room were disturbing and confusing, causing irritation and loss of appetite among resident diners. Noise was often generated by both residents and employees. Restricted size of the dining space hindered staff from providing service, while residents accepted the given size. Many residents preferred separate eating areas for those who could feed themselves and those who required assistance in eating. Finally, the unlevel tables and instability of table bases were constant irritations to residents and staff.

There were implications for designers of various disciplines as well as furniture manufacturers, administration personnel, and educators of design students. Design recommendations included suggestions that would be useful to the four groups listed above.

Recommendations for further study include researching opinions of family members on design of facilities; exploring areas other than dining rooms of assisted living and nursing home interiors; and studying the comparison of assisted living and nursing home environments for satisfaction level of residents.