Louise Aronson

Green architecture is good but silver architecture also needed

Many buildings in the US are ADA-compliant but still difficult to navigate for older adults who have one or more physical, sensory or cognitive challenges, and especially for the frail elderly who have many. -- ST PHOTO: KUA CHEE SIONG
Many buildings in the US are ADA-compliant but still difficult to navigate for older adults who have one or more physical, sensory or cognitive challenges, and especially for the frail elderly who have many. -- ST PHOTO: KUA CHEE SIONG

I heard about the new building for months before I saw it.

Part of a leading medical centre, its green architecture and design were getting a lot of attention, as was its integration of top-notch modern medicine with health and wellness spaces inspired by cultures from around the world.

My father's doctor had moved there, and driving to his appointment we looked forward to experiencing the cutting-edge new building.

Outside, I unloaded the walker and led my 82-year-old father through the sliding glass doors.

Inside, there was a single bench made of recycled materials. I noticed it didn't have the arm supports that a frail elderly person requires to safely sit down and get back up.

It was a long trek to the right clinic and I was double-parked outside. Helping my father onto the bench, I said "Wait here" and hoped he would remember to do so long enough for me to park and return.

He nodded. We were used to this. It happened almost everywhere we went: at restaurants, the bank, the airport, department stores. Many of these places - our historic city hall with its wide steps and renovated dome, the futuristic movie theatre and the new clinic - were gorgeous.

The problem was that not one of them was set up to facilitate access by someone like my father.

Current demographic realities are creating financial and practical reasons to build more homes, businesses, health-care facilities and public buildings that are well suited to older people's needs.

The Americans With Disabilities Act (ADA) guidelines help, but they do not ensure access or safety for this unique and rapidly growing population. Many buildings are ADA-compliant but still difficult to navigate for older adults who have one or more physical, sensory or cognitive challenges, and especially for the frail elderly who have many.

To some, this may sound like a small issue. It's not. More than 40 million Americans are 65 or older, and 11 million - the fastest-growing segment of the older population - are over age 80. Too often, current buildings turn impairments - a bum leg, less-than-perfect hearing, the inability to walk long distances - into handicaps.

Ironically, this includes not just restaurants, multi-level houses and large businesses, but most health-care structures. I hear about this regularly in my role as a doctor who makes house calls. While patients often end up in our Care at Home practice because they can no longer leave their homes, not infrequently the problem is at the other end: the hospital or clinic is too hard to navigate.

Still, it wasn't until I left my father at the much-lauded new green clinic that it occurred to me that the challenges that he and my patients faced navigating medical facilities were symptomatic of a larger societal problem.

Just as green architecture and design came into being in response to the energy crisis of the late 1970s, we in the 21st century have to start creatively building to meet the challenges of our ageing population. We need "silver" architecture and design.

What would a silver building look like? For starters, it would be well-lit, and offer easy, safe access that doesn't require pulling open heavy doors or remembering a key. Building materials would minimise noise, overstimulation, distraction and the risk of falls. Doors, rooms and public areas would accommodate walkers, wheelchairs and a person walking arm in arm with a caregiver. There would be sturdy, regularly spaced chairs where people could rest and regroup.

None of this is novel. These and other strategies are in use in many long-term care facilities and in specialised areas of hospitals, such as geriatric emergency departments or acute care of the elderly units. But they aren't nearly as prevalent as they should be.

Dr Diana Anderson, a resident physician at Columbia University Medical Centre who is also a licensed architect (she calls herself a "dochitect"), says that "despite the growing health-care specialisation in architecture, many spaces in health facilities are ill suited for their actual use". Health care might be the ideal sector to start developing design prototypes that could be applied to homes and even neighbourhoods, so people can stay active and grow older without having to move to retirement homes.

Over the next few years, we should begin to see prizes for excellence in silver design, just as there are awards for green buildings. When local communities review plans for new or improved buildings, they should start by asking questions not only about job creation and traffic flow, and, for green buildings, about sustainability and energy use, but also about how well the design meets the needs of residents and consumers of all ages.

In health care, leaders should examine the considerable data on how facilities harm and hinder older patients, and move forward only with buildings that prioritise equal access, health and safety.

Some might say that buildings can't cater to every group with special needs. But silver architecture and design aren't about indulging a special-interest group. They're about maximising quality of life and independence for a life stage most of us will reach.

Green architecture is good for the environment; silver architecture is good for humans. The best new buildings will be both.

NEW YORK TIMES