Editor’s note: Barry H. Beith, Ph.D., is president and CEO of HumanCentric Technologies, Inc.
CARY, N.C – In May, a conference was held in Washington, DC, focusing on designing the home as a healthcare venue. Co-sponsored by the Human Factors and Ergonomics Society (HFES) and the Industrial Design Society of America (IDSA), the conference brought together approximately 75 professionals in the fields of human factors, ergonomics, industrial design, graphic design, architecture, occupational therapy, physical therapy, and home healthcare services and equipment. What became readily apparently from this conference is the desperate need for attention to address what is clearly a growing need.
By 2025, approximately 22-25% of the U.S. population will be over the age of 65. This rapid growth in the elderly cohort is not just a U.S. phenomenon but is rampant in first world nations. Japan just recorded it’s first year in which their population decreased because of a lack of newborns. In contrast, Latin America, Africa, and the Middle East are primarily youth-driven cultures.
The Reality – Life Stage Changes
It should be noted, however, that elderly and their ailments, their support needs, and their desire to experience continued independence as they age, are not the only cohort driving the need for home healthcare. We also have a dearth of hospital beds for injury recovery, surgery recovery, difficult pregnancies and premature births, congenital illnesses, and lifelong conditions. All of these groups need a place to receive “round-the-clock” healthcare either for brief periods or their entire lives.
Designing the home to provide this care involves a lot of forethought. Homes are not designed currently for “life-stage changes” so as people grow older their homes become less adequate to service their needs. As children begin to care for their parents in their homes, both their home-life and essential “quality of life” suffer. Sometimes the burden of providing home healthcare can not only reduce our quality-of-life but undermine the very love that inspired the care-taking in the first place. What a tragedy!
Designing the home to function properly as a healthcare venue requires many disciplines interacting together to accomplish the end goal. However, the functionality as a healthcare venue is only half the challenge. The other half is designing the home and the functional aspects in such a way that the home does not look, feel, smell, “act”, like a healthcare venue. Healthcare venues feel cold and sterile, smell antiseptic and medicine-like or worse yet, like bodily fluids. They look metallic and stainless and cold. None of these characteristics would be used to define a “home.”
Transgenerational Design
There are functional issues to be addressed. For example, the worst-case design issue is the “bedpan.” Can one imagine a more important issue relative to better design that can impact and improve the dignity of the care receiver and the “quality of life” for the care provider? A myriad of other design “targets” can be identified such as hair-washing products, eating utensils and products, toiletry add-ons, clothing hampers, kitchen utensils and tools, and so forth. In fact, the amount of “low-hanging” opportunities in this venue is enormous and the team of human factors professionals and industrial designers represents a perfect combination of skills to address the requirements, functional needs, usability, and user acceptance issues that permeate the domain.
Even beyond the individual products are more complex issues such as home design, both original and aftermarket, in which the design of lighting, non-slip surfaces, accessibility for walkers and wheelchairs, balance and reach issues, are all to be reckoned with and the architects, engineers, landscape architects, and interior designers all become important additions to the team. And the issues are more than just ADA based or elderly related. They involve crossing population boundaries and cohort issues. They are more complex that “universal design” would ever suggest and can be unique and cutting edge in nature. They address livability as well as maintainability, safety and security, and what has been referred to as transgenerational design by James Pirkl.
Then we get to the difficult issues of medical informatics and medical devices in the home. The things that allow home healthcare to grow in sophistication, support medical home healthcare personnel in doing their job efficiently and effectively, support the reemergence of “house calls” as a typical medical model, and allow lay care-givers and even patients themselves to provide clinical “treatment” under the watchful if remote “eye” of the medical professional.
The Bottom Line
The home is the one place where we are most comfortable and, most agree, the best place to get well, or rest in peace. Home healthcare should be a natural extension of the home without dire or destructive repercussions for the patient or the caregivers. Designers can and must give forethought to how we approach home healthcare and overcome the tendency for “un-intended consequences” to destroy care, lives, and very homes in which we seek to provide loving care.
Dr. Barry Beith earned his doctorate in Psychology/Ergonomics from North Carolina State University, where he continues to serve as an Associate Adjunct Professor. He is president and CEO of HumanCentric Technologies, Inc), a human factors, design research, industrial design and graphic design company. Barry can be reached at 919-481-0565 or bbeith@humancentrictech.com.
