Grant Warner, Senior Designer and Principal at global design firm HKS, knows a lot about the often roller coaster-like experiences of senior living community staff members and residents. He received much of his information first-hand.
Warner has spent several days – and nights – as a senior living resident as part of the Sleepover Project, a 24-hour immersive experience designed to increase understanding of people in those communities. HKS’ Senior Living practice uses insights gained through the Sleepover Project to create environments to improve the lives of elders, their families and care partners.
“The Sleepover Project, at its core, is an empathy-building exercise,” said Warner, who helped launch the Sleepover Project in 2005 while working for another firm.
During a sleepover, participants assume the persona of a senior living resident, for example someone with hearing loss who uses a wheelchair, to more fully comprehend how the environment impacts residents’ everyday lives. Throughout the sleepover, participants record their observations in journals to help track ideas for advancing senior living design.
The goal, Warner said, is for HKS team members to come away from sleepovers “inspired by meeting some of the people that they work for and seeing how their work can impact real lives.”
HKS adopted the Sleepover Project in 2020 when the firm merged with Dallas-based D2 Architecture. D2, specialists in senior living design, had developed sleepovers into a regular practice.
Warner, who joined HKS when it merged with D2, has participated in more than a half dozen of the approximately 30 sleepovers that have taken place across the U.S. Those projects have been conducted at places ranging from brand-new communities designed to support the latest models of care to outmoded legacy buildings constructed before the advent of the Americans with Disabilities Act (ADA).
During some of Warner’s previous sleepover experiences he saw residents languishing in uninspired environments and struggling to maneuver wheelchairs in cramped bathrooms.
“I thought, ‘This is not dignified. This is awful. What else have we missed as a society, as a profession, in architecture and construction? We’ve got to do better,’” he said.
In February, HKS conducted the first Sleepover Project since pausing the project for safety reasons during the Covid-19 pandemic. Warner led a veritable slumber party of 10 people in a sleepover at the new HKS-designed Elevate Safepoint senior living community in Clearwater, Florida.
Participants included HKS design, research and communications professionals; two of Elevate Senior Living’s owners; representatives from the company’s operator, American Healthcare Management Group, headquartered in St. Johns, Florida; Elevate Safepoint Clearwater’s interior design firm, St. Louis-based Spellman Brady & Company; and the community’s management team.
Charlie Dierke, Executive Director, Elevate Safepoint Clearwater, said that he found it fantastic that designers and researchers were willing to spend a full 24 hours in the community. Dierke said that in general at senior living communities, “architects never come through, except for a walk-through. They don’t really look at the flow of the building, how the residents are taken care of.”
Christian MacCarroll, Office Design Leader at HKS Orlando, took part in several activities with residents during the sleepover at Elevate Safepoint Clearwater. He participated in meals, a painting class, a happy hour gathering and Bingo (a game he accidentally kept winning until, he said, “I had to purposefully lose, so the residents wouldn’t get mad at me”).
Spending an extended period with residents helped break down “some of the barriers that you would otherwise have if you were just holding a meeting in a conference room, asking them to answer a couple of questions,” MacCarroll said. “The sleepover was an opportunity to get to know them. There’s no replacement to being there in person and experiencing it first-hand.”
Through his conversations with residents at Elevate Safepoint Clearwater, MacCarroll learned several things that will help guide future designs.
One thing he noticed is how much residents love to recall their past. People talked about where they grew up, the jobs they’d held, their travels, families and children. “To me, that was important,” MacCarroll said. “How can we design things to help reinforce their past?”
Spending 24 hours in an assisted living/memory care environment underscored how much of their time these residents spend in the community. “Very rarely do they ever leave,” MacCarroll said. “We need to create environments that are always stimulating the mind.”
We need to create environments that are always stimulating the mind.
Places for group activities and individual reflection, indoor/outdoor spaces and design features that afford flexibility and customization, such as adjustable lighting, can be helpful in providing needed variety, he noted.
An engaging senior living environment can be the difference between “a place that you go to just to live out the rest of your life or a place that you go to experience the greatest years of your life, and make new friends and memories,” MacCarroll said.
Over the years, the Sleepover Project has led to mind-opening discoveries and innovative design solutions.
For example, Warner said he was not initially a fan of indoor streetscapes in senior living communities because he found them somewhat kitschy. But he realized the benefits of this type of design when he saw these spaces resonate with residents, such as a husband and wife reading the newspaper together at an indoor streetscape coffee shop or a man with dementia who was newly delighted by a streetscape setting every time he stepped out of his room.
Warner said, “It totally changed my thinking. I couldn’t have been more wrong. The environment was so beneficial for those memory support residents.”
Sleepover participants’ use of geriatric simulation equipment helps build empathy for residents who are dealing with the physical effects of aging and helps designers create accessible environments.
According to Warner, eyeglasses that simulate common vision conditions related to age, such as glaucoma or macular degeneration, are especially useful for identifying color patterns, finishes and furnishings that may not be well-suited for an older population.
Another key finding of past Sleepover Projects is the value of distributing spaces to reduce the number of steps staffers must take during a shift.
“Most of them want to spend more time with the residents. They don’t want to spend time walking to a central supply closet that’s 350 feet away or a clean linen closet that’s 200 feet away,” Warner said.
Elevate Safepoint Clearwater features six distinct “households,” each with its own kitchen, clean linen room and laundry room. According to Warner, this layout helps staff “stay in the community, stay in their household with their residents and spend more time with them.”
Joe Jasmon, CEO of American Healthcare Management Group and co-founder of Elevate, said the sleepover at Elevate Safepoint Clearwater provided a nearly unprecedented opportunity to examine the impact of the community’s design in depth.
“You rarely get an opportunity to do that,” Jasmon said. “I can’t put a dollar figure on it, but it’s going to be huge” for current and future Elevate senior living communities. Jasmon noted that senior living residents often can’t or won’t provide feedback, but the Sleepover Project will supply good, solid information for refining design and operations.
“When we think about innovation, the small things count as well,” said Daniela Aguirre Alfaro, HKS Design Researcher. She noted that the Sleepover Project enables HKS to discover through experience small things that can have a large and meaningful impact.
HKS design and research experts see potential for the Sleepover Project to expand beyond its current format, for even broader influence.
Warner envisions a “workover” program in which HKS designers assume the role of a senior living care partner for a day, to learn more about how hard these individuals work, the pressures they are under and how design can make their jobs easier.
HKS Senior Living practice leaders believe the Sleepover Project concept can be applied across practice areas. For example, it can help designers understand what it’s like to get ready for a game at a sports venue or to be a stadium worker on game day.
“Empathy is a tool that can be applied anywhere,” said Aguirre Alfaro.
