Assisted Living: Long-term housing solution or short-term care at the end of life?

Poster (konferens), 2014

This research project displays the objectives for AL – residence and care – from the architectural discipline. These dichotomous objectives bring about conflicts in the use of the physical environments. It is suggested that the long-term perspective of residence and home is in conflict with the short-term care perspective. Assisted Living (AL) in Sweden displays great similarities with AL in other countries, although eldercare may be differently organized. The similarities entail a physical structure with subdivision in residential groups of apartments with shared common spaces for communal activities. They also entail an organizational structure with common activities, medical care and front-line staff (FLS) available around the clock. Residents in Swedish AL facilities are increasingly old and more multi-diseased, mainly due to increased efforts in home-based care and services. In order to meet with the changing user requirements the typology of AL has to be discussed both in a national and international context. The research is based on empirical material from observations, interviews and questionnaires in Swedish eldercare and relates to the ongoing discussion on special housing for older people in Sweden and other countries. The results suggest that efforts to create a long-term home-like residential environment are discernible on several levels: in legislation and guidelines, in the organizations and in the local routines. In contrast to these efforts, short-term care aspects tend to dominate as more AL residents become in need of end-of-life (EOL) care. This entails changing user requirements with increased focus on medical measures and more use of supportive technology. Swedish legislation equals AL and ordinary housing, with the exception that AL contains common spaces in addition to the individual apartments. The typological discussion contains issues concerning physical structure; size, number of residents, the design of common spaces and differences between specialized units or groups for people with dementia (SDUs) and ordinary AL.