Getting a Sense of the Inside Out of Nursing Homes – Part I

CloseupWhat comes to mind when you think of nursing home care?   It is often stereotyped as an institutional setting populated by helpless elderly residents who are under-served by over-taxed individuals.  While elderly Americans do occupy most of the 1.7 million beds in the 16,000-plus nursing homes around the nation, they’re not the only occupants.

According to NPR, an analysis from the Department of Health and Human Services showed that “young people ages 31 to 64 now make up 14 percent of the nursing home population.”  The Council for Disability Awareness cites “over 37 million Americans are classified as disabled. More than 50% of those disabled Americans are in their working years.” A 24-year-old traumatic brain injured single-leg amputee and four 50-some-year-old’s paralyzed by stroke, are among the young residents where my mother receives nursing home care.

Could erasing stereotypes help prioritize the need for overdue improvements?  Perhaps, if more Americans spent time getting to know the inside out of nursing homes we’d begin to see a radical shift.  According to Steve Orfield, more money is poured into grand entrances than the living spaces. Lessening or eliminating background noise, improving air quality, and providing more daylight are among simple improvements that go a long way, he says. Furthermore, “the relationship between sensory and cognitive activity and decline is affected by such decisions.”

With his team of experts at Orfield Laboratories, he’s delivering a radically new view of design for aging that can enhance life beginning in our mid-40’s. His methods are backed by solid research and have the potential to reduce or even reverse age-related declines.  Steve’s decision to make an environmental impact is deeply rooted. His expertise as an architectural designer spans more than 40 years, some of which was spent loving his father through end-of-life nursing home care.

Steve Orfield is literally building a bridge between design and perception.


From Minnesota to California and Alabama to Florida, Steve and his team are engaged in improving quality of life for seniors, military veterans, and consumers of all ages. He’s known for his renowned redesigning work of the aging process and his outstanding Guinness World Record achievement for the quietest room on earth. Imagine a place so quiet, you can hear your heart beat, your lungs breathe and your stomach digest. That’s what visitors experience inside the anechoic chamber. It’s not just a fun place to visit, though. “Companies use the chamber to test the sound levels of products, such as washing machines, refrigerators and Harley Davidson motorcycles. NASA uses a similar chamber to perform stress tests on astronauts,” the BBC reported.

Thanks to research-based design firms like “Orfield Laboratories” and care models such as “The Eden Alternative” nursing home care is improving from the inside out, albeit slowly. Assessing aspects such as lighting, flooring, acoustics, temperature, and air quality impact life throughout living spaces — from an outside courtyard to private rooms and into the hallways.

Creating environmental improvements is doable even in existing structures, Steve said. His firm stands alone in the development of building performance standards for senior housing architecture and design. Furthermore, “the result is generally a far better performing building constructed for the same total cost.” You can listen to the podcast anytime and get in touch with Steve Orfield by visiting his website at Orfield Laboratoriesvia email at, or by phone at 612-721-2455.

While it’s true, there’s no place like home, in Part II – Nursing Homes from the Inside Out – I’ll share ways you can infuse a powerful sense of home.


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