Enhanced elderly environments
Gerald Weisman's work yields national model for geriatric and dementia care.
When Gerald Weisman first tried explaining how changing a nursing home environment could affect the quality of residents' care, he generally got the same response.
"Basically, people would laugh at me," Weisman says, still wincing at the memory. Yet the UWM professor of architecture would not let go of his vision. More than 25 years ago, long before the first Baby Boomer hit age 60, he realized that America's aging population was growing. (Today, one in four older Americans can expect to spend time in a nursing home.) And he also knew the current system was woefully inadequate to meet the needs of people in the final stages of their lives. Something had to change—and fast.
Weisman was ideally suited to the task. As an architect and environmental psychologist, he has been actively engaged in teaching, research, and service directed toward the design of better environments for older and cognitively impaired people. He has served as a consultant to the National Institute on Aging, and works tirelessly as a member of a national group committed to reforming regulations for nursing home design.
As co-director of the UWM Institute on Aging and Environment, Weisman's work has been funded by such locally well-known groups as the Helen Bader Foundation, as well as the National Endowment for the Arts and the Alzheimer's Association. He has received additional support from a number of architecture research programs.
Perhaps the most tangible representation of his research can be found on the outskirts of Appleton, Wis. This is the site of Brewster Village, an attractive, cutting-edge facility for care of the elderly, the developmentally disabled and the chronically mentally ill. The $24 million facility is owned and operated by Outagamie County. It sits in the figurative shadow of its 100-year-old predecessor, a series of stark, formidable-looking buildings that served as a poor farm and insane asylum. The buildings were demolished to make way for the 21st century ideas contained within Brewster Village.
The 204-bed Brewster Village opened in 2001. Although each area of the complex is connected, the arrangement appears as a cluster of small homes. Through improved building techniques, the costs related to Brewster Village are comparable to those of many other less innovative facilities. Staffing levels also remain about the same. And yet, Brewster Village offers a wide range of amenities not commonly found in nursing homes, from private rooms and bathrooms to upscale dining facilities. Each resident has about twice the living space as was previously offered. The residents are gathered into manageable "households" of 13-14 residents.
Brewster Village's staff is trained to spend less time on certain tasks (such as moving residents between their rooms and the dining and craft rooms) and more time interacting with the residents. Just walking around the place offers a pleasant surprise around every corner. Indoor areas are highlighted by fountains, atriums, and comfortable-looking rocking chairs. There is plenty of access to the outdoors, too, where residents can visit with each other on patios.
Brewster Village is a triumphant collaboration between UWM's Institute on Aging and Environment, the county, the building's architects, future residents, families, and staff. Research data was collected for two years before the first resident moved in. "Everyone involved in this project was committed to making Brewster Village a national model for geriatric and dementia care, especially for a publicly financed facility," Weisman notes.
The lessons learned from Brewster Village are being applied to Weisman's new research projects. In conjunction with UWM's Institute on Aging and Environment, Weisman is developing blueprints for an adult day services center in the heart of Milwaukee's Hispanic community. Weisman also is working with the Oneida Nation to create a combined residential and activity facility on reservation land outside of Green Bay.
His work has gained admiration from within and beyond the UWM community. According to Rhonda Montgomery, UWM's Helen Bader Endowed Chair of Applied Gerontology, "Jerry's work has been a major influence in the field of geriatric care and he has provided cutting-edge insights that are influencing the development of care environments around the country and internationally. He brings the skills and knowledge of architecture together with an important understanding of the direct link between environment and behaviors. As the numbers of people who are in need of supportive environment grows exponentially over the next two decades, his work will continue to improve the quality of long-term care."
In 2005, Weisman received a career award from the Environmental Design Research Association. In addition, the book he co-wrote with former UWM Professor Uriel Cohen, Holding On To Home: Designing Environments for People with Dementia, has received wide recognition. Weisman has been teaching at UWM since 1983, and several of his graduate students are exploring similar themes in their own research.
"Thankfully, today people are more aware of the fact that environments do affect those living within them," Weisman says. "There's more of a willingness to try things out, rather than just produce a duplicate version of what has been done in the past." ♦