The Weekly is STREAMING now. Join us at HorizonTV

How technology will change senior care

When a family member can no longer be cared for in their current home, they require specialized care that is only available in a long-term care center.

July 31, 2017 |
Stantec Blog

At some point in our lives, many of us will have to make a difficult decision regarding the long-term care of a spouse or parent. Someone may even have to make this decision for us one day. When a family member can no longer be cared for in their current home, they require specialized care that is only available in a long-term care center. These facilities are outfitted with the care providers, the skilled personnel, the equipment, and the appropriately “designed” environment suited to the frail elderly.

Developers usually build long-term care facilities in the suburbs where land is less expensive. These centers tend to be distant from the existing communities where new residents may have lived for many years. There are good reasons we have developed these facilities. Many older people need 24-hour supervised care because they are on multiple medications, and they may have some form of dementia along with comorbidities including congestive heart failure, COPD, pulmonary disease, diabetes, and a high risk of injury from falls. In short, they need specialized care. These facilities also need to achieve the economies of scale needed to make limited funding and staff numbers work. Therefore, they tend to be large facilities, often with several hundred beds.

But for many residents, these centers are alien to the way they have lived their lives. I believe many residents feel like they have been yanked out of the places they call home and stuck somewhere else miles away. Their long-term facility isolates them from the extended family and those who can support them, cutting them off from the communities where they found comfort. The scale of the facility makes the residents more dependent on the institution for services and food, limiting choice for when and what one can eat or how often one can bathe.

Today, we are locked in the let’s-get-everyone-in-one-place model, and the result is these large institutional centers.

But what if it didn’t have to be this way?

Is this the most effective way to do this? And is this best for the person who needs the care? Can we move away from large centers for the frail elderly in the suburbs? Could we find a way of providing those services on a more distributed basis within the community? For example, could we create a model where people stay in their own home or stay in their own neighborhood?

From a community development perspective, how would this model—call it Distributed Care—impact plan development and impact land use bylaws and transportation?


Technology to the rescue

What’s driving the possibility of Distributed Care? Technology. Connected care—making use of internet-connected devices and miniaturized equipment—has reached a point of sophistication and affordability that enables us to provide care remotely. Even now, we can monitor and predict (by utilizing Artificial Intelligence) someone at risk of falling at home. Predictive software can recognize behavior that will result in a fall if it continues over time and deliver a warning or give a remote caregiver a chance to intervene.

In Distributed Care, we will plan houses and smaller residences so they are connected to an internet of care—wireless smart devices that allow monitoring wellness and help in predicting when residents may be at risk. This would mean recognizing signs of dietary risk such as rapid weight loss, or recognizing a gait change that indicates a risk of falling, or changes in speech that signal other troubles. Other services can be provided by delivery or scheduled visits to the residence.

Of course, society is not going to stop building long-term care centers. There will continue to be a role for them in managing complex cases, for those in long-term care with psychiatric issues, and extremely complicated health issues.



Truthfully, there are barriers to this Distributed Care model. There are land-use bylaws that may prevent the use of a former single family home as a small commercial care facility, for example. There may be code restrictions to meet in addition to these zoning considerations. But these laws can be changed or planned around.


Distribution of services

Most promising, I believe, are the ways in which alternative distributed models will impact the delivery of healthcare services. Right now, if the family caregiver notices their elderly mother isn’t feeling well they are most likely headed to the nearest hospital emergency room. But statistically, it’s likely that her issue is simple, perhaps a case of dehydration or an adjustment in meds. So, why is that simple case tying up the emergency department, which is intended to care for the acutely ill? We are beginning to design for more integrated approaches, which better account the needs of the elderly. One example: a long-term care facility with an accessible primary care unit embedded in it to take care of day-to-day issues and access to a nearby hospital emergency room for more immediate and serious cases. Senior living co-location with acute care environments integrating long-term and primary care in a distributed model has much to offer.

Today, if someone shows up at a community care clinic with a possible heart issue, they’re sent off to an emergency room to see the cardiologist there. Technology makes it possible for health care professionals to conduct virtual visits, inter-hospital consultations, and even remote diagnoses. Wouldn’t it be better if the cardiologist could come to the clinic through remote presence technology and perform the consult? The cardiologist simply logs in from a computer and observes the patient, who is wired up and monitored as normal, but now transmitting data to the remote specialist. This type of care enables more flexibility for providing acute care within the distributed care model.

This technology may sound complex and it is, but it’s relatively inexpensive—most of the elements for remote presence examinations are available now. The challenge is changing our mindset about where the point of care is and what model of long-term care is best for those who require it. We’ll need a multi-disciplinary approach as designers, planners, and healthcare experts to adapt to this model.


Four examples of Distributed Senior Care

  1. The Greenhouse Model for senior care (as seen here) aims to reinvent the way long-term care is delivered by creating smaller home-like environments where seniors have private rooms and baths, have the ability to move freely, are given the opportunity to develop meaningful relationships with other residents and staff, and can even assist in preparing their own meals.
  2. Seniors can continue living with a degree of independency and comfort in a home-like, private room. With changes in land-use regulations, they may be able to reside in homes converted to commercial care. (The opening rendering of a resident room at the St. John Specialty Care Centre offers an example.)
  3. The “Laneway House,” or “Granny Pod,” are small independent living arrangements. These secondary suites can be built for seniors in the backyards of family homes or built and rented by unrelated property owners. Home care support teams can provide service based on individual needs. 
  4. Deliberately-planned “age-friendly” communities support the entire spectrum of life, from birth to death. Developing senior living within mixed-use developments provides seniors access to lively community spaces, amenities, and public transit, helping to reduce the isolation felt with traditional/ institutional suburban long-term care homes. 


Rendering of a outdoor courtyard between buildings with people milling aboutInternational Hotel Senior Housing and St. Mary’s Catholic School Complex in San Francisco, California. It is an example of deliberately-planned “age-friendly” communities. (Stantec Architecture with Greg Roja & Associates, Herman & Coliver Architecture, and Tai Associates).

Stantec Blog | Stantec

Published by global design firm Stantec, this eclectic blog features viewpoints, insights, and explanations from Stantec architects, engineers, and designers, on a range of issues impacting the fabric of our communities. Our contributors share their thoughts about design trends, emerging technologies, vexing challenges, and inspired solutions. For more blog posts, visit:

Related Blogs

March 16, 2020 | Coronavirus | StantecNicole McLellan, David Pernitsky, and Arthur Umble

As the global health community tracks the spread of this virus, it’s important for water and wastewater p...

ErinoakKids treatment center, Erin Sauga, courtesy Stantec

For our design for an ErinoakKids treatment center, we needed to include a staircase that incorporated a large landing, since kids with mobility issues require a space to rest. So, we came up with a treehouse concept, which can be seen at the top left of this image. Photo courtesy Stantec

July 15, 2019 | Healthcare Facilities | StantecIva Radikova and Olivera Sipka, Stantec

Standard building requirements don’t have to be boring. Here’s how you can inject whimsical touches into ev...

April 02, 2019 | Retail Centers | StantecJason Stephenson

We continually hear that “retail is dying,” but there are many foundational retail types essential to consu...

What happens downtown doesn’t stay downtown: The ripple effects of a strong center city

The mix of uses typically seen in downtowns—stores, housing, offices, arts and entertainment—typically generate far more fiscal revenue than other neighborhoods. Photo: Minneapolis Downtown Council

March 01, 2019 | Urban Planning | StantecBeth Elliott, AICP, Senior Urban Planner, Stantec

A new report from the International Downtown Association measures the true value and lasting impact of down...

February 21, 2019 | Airports | StantecMatt Colby

More airports are asking passengers to check their own baggage. What’s the ripple effect?

Student housing series: Designing a home away from home in The Golden State

A rendering of UC Davis student housing. Rendering: Stantec

January 31, 2019 | Multifamily Housing | StantecBryan Morrison, Project Architect, Stantec

California asserts building code restrictions more stringently than other states, making design challenging...

December 20, 2018 | StantecKate Ryan

When it’s time to make the move, designers can support clients in introducing a new workplace environment....

 Biophilic design in practice at Lower 48 in Denver.
November 19, 2018 | Biophilic Design | StantecKaitlyn Gillis

5 tips to infuse natural elements into the built environment—from plants to pictures.

September 24, 2018 | Architects | StantecMike Gervasi

While offering efficiency and flexibility, modular construction requires extensive planning and collaborati...

August 15, 2018 | Green | StantecNels Nelson

The WELL Community Standard equips planners to build health promotion into the very fabric of neighborhoods...

Overlay Init

Your card will be charged: 0