Biophilic design can have a profound impact on the kinds of care environments that I have worked with for almost two decades. In particular, I have seen nursing homes and similar facilities transform when even simple biophilic principles are introduced. These are care spaces—the most care-intensive kinds of spaces where the emotional and physical well-being of the residents and the staff truly matters. And I will say it again: Biophilic design has the potential to radically change for the better those kinds of spaces. For the most part during my work, I have focused on nursing homes where biophilic-principled interiors have profoundly changed the way those spaces feel and function. Today, I’d like to share my thoughts on how that particular application of biophilic design can impact elderly care and revolutionize the sensation of living within those kinds of facilities.
Nature Heals—Why Nursing Homes Should Be Designed with Biophilia in Mind
Biophilic design means more than just filling a room with plants; it’s about establishing a deep relationship with nature that fosters health and happiness. This is especially important for nursing homes, given that many of their residents are not just living with age-related issues but are also confronting major physical, emotional, and mental health problems. After completing a series of projects involving our healthcare environments, I am convinced that nature can—and should—be a significant part of the nursing home setting.
One of my initial biophilic nursing home undertakings concerned a facility located in a rather sterile, institutional structure. The hallways were devoid of adornment, the rooms were functional but without a vestige of inspiration, and outdoor space might as well have been located on another planet, given the near impossibility for the residents to get there. It was hard to imagine a less dynamic environment for the people who lived and worked there—an interior atmosphere that seemed almost legally bound to be uninteresting and uninviting, in stark contrast to any aspiration for a more patient-centered approach.
We worked hand in hand with the staff and residents to put biophilic design into female senior nursing home. We started with plants because, let’s be honest, there’s almost no better or simpler way to introduce biophilic design into a space. And the results were almost instant—and wonderful. In several of the communal areas, we put in living walls that are almost floor-to-ceiling, and we’ve had these great little congregations of residents who hang out and chat and coo over the plants.
However, plants were merely a starting point. We redesigned the building’s layout for better access to outdoor experiences. We put in a courtyard that was so much an “outdoor room” that its residents could visit it in a wheelchair; they could go to its center, and then circle around the tune of its various textures, odours, and plants. It was a world unto itself— and, more invitingly, a world that we could easily segue into from any direction, attending to the kinds of considerations that would allow us to enjoy the wide variety of species (native to every climate zone) that could flourish here.
This initiative confirmed what I have long held to be true: biophilic design is not mere window dressing; it is not even, strictly speaking, “design.” To me, biophilic design is a term that is linguistically convenient but semantically tenuous. Environment is a more appropriate term. Biophilic environments—especially in nursing homes—actively and positively promote health and well-being. Quality of life is inherently linked to what happens within, and to what happens in the immediate vicinity of, those walls.
Anticipating Connection—Unifying Nature and Community
Another focal point of biophilic design occurring in the nursing home is the formation of connections—not just between residents and the natural world but also between residents and staff. When nursing homes are designed to engage with nature, they promote social interaction among the inhabitants. This is a doubly beneficial feature of these spaces, so often the very opposite of interactive, since social occupation is a positive factor in the closing life chapters.
In one nursing home where I worked, individuals had a habit of shutting themselves in their rooms. What little time residents spent out of their rooms was often when staff were delivering care. The staff who worked with the residents noted that there was supposed to be a common area where residents could hang out, but that space remained almost always empty. After some space analysis—more on that in a minute—we figured out why.
We tackled this situation head-on, conceptualizing the areas in question with biophilic principles. The spaces were not only turned semi-outdoors, but they were also filled with plants and the kinds of textures, colors, and shapes that create an interior environment reminiscent of the outdoors. We took it a step further, filling the areas with the same kinds of natural sounds found in the outdoors, from waterfalls to birdsong.
A highly successful element we introduced was a biophilic meeting space—a room where the residents could easily come together around a central living feature—a large indoor tree in a planted bed with an abundance of comfortable seating—close to the floor, inviting everyone to come inside and enjoy social interaction. I visited several months after the renovation was complete, and I found residents sitting in this area, with the adjacent path serving as a transition space, chatting and enjoying the environment in which they found themselves.
The personnel also observed that residents were more inclined to leave their personal spaces when the common area was redesigned to feel more natural and enjoyable. It wasn’t merely an aesthetic upgrade that made the area more appealing for residents seeking communal space; it was a design choice that made the whole building feel more cohesive and livable—a communal area that invites communal living.
Designing a nursing home using biophilic principles can benefit its staff as well as its residents. Caregivers often work long, stressful hours, and yet they also can feel the positive impact that a nature-driven environment can have on mood and mental well-being. I have observed how biophilic design can reduce burnout and improve morale among nursing home staff members. One nursing home project in particular comes to mind. As part of that design, we created a serene garden for both staff and residents to enjoy. It is at the core of biophilic design that whatever benefits the residents may also redound to the staff’s advantage.
Why Natural Light Matters
Natural light is one of biophilic design’s simplest but most powerful tools. In all my work, and especially in nursing homes, where residents spend most of their time indoors, I’ve made it a nearly universal design priority to let the sunshine in—rain or shine. Natural light not only lifts the spirits but also sharpens the human mind; it regulates circadian rhythms in ways that are extraordinarily beneficial to all of us, and especially to our elders.
In an initiative focused on a nursing home, we took out the old fluorescent light and put in large skylights in main community areas, letting natural light flow in and fill the space at all times of the day. We heard back from residents that they were feeling more awake and alert, and staff joined in saying they thought residents were more consistently on an upswing sleep-wake cycle. To go with our natural lighting, we incorporated new automatic blinds that could be set to any number of configurations, from letting in all the sun one might want in the early morning to shading the room from evening sun that can be dazzling.
For people who reside in our facility and who might be more inclined to stay in their rooms, we made it a point to ensure that each individual space featured large windows that brought in copious amounts of light and offered beautiful views of the gardens or, at the very least, other greenery. I’ve learned that, in even a small way, having these nature sights to “gaze” at can help in a big way to maintain some feeling of actual living when the health of the person makes going outdoors too much of a chore for the moment.
I believe strongly in biophilic design. It’s not about making nice-looking spaces. It’s about allowing people to establish meaningful connections with the natural world, which I think enriches their lives.
Part 3: Biophilic Nursing Homes—Everyday Nature-Infused Nursing Homes is a Hospital Discharge Summary Assistant.
A highly effective method for incorporating biophilic design into assisted living facilities is to make certain that the natural world is an integral, day-to-day part of the lives of the residents and not just something that is present in the background. I have worked with a number of nursing homes to identify and implement practical ways to make nature a part of the lived experience of their residents.
Making outdoor environments accessible
Nursing home design poses some tough problems, but outdoor accessibility is one of the toughest. It’s not enough for a space to be simply accessible; it must also be inviting and easy to navigate for residents of all abilities. This is particularly true for residents with limited mobility, who may have more difficulty using certain pathways or outdoor furniture. My work has given me insight into how to design around these challenges. The solutions I have found can— and I believe they must— enhance the quality of life for all residents who call these places home.
I recall a project in which a lovely garden existed at a nursing home but was infrequently visited by its residents. It wasn’t that the residents didn’t want to visit, but access to the garden was challenging for those who relied on mobility devices. The paths within the garden were not only narrow but also uneven—and sometimes blocked by wayward plants. To remedy the situation, we redesigned the garden and made access both safe and easy. The first step was to lay out sturdy paths wide enough for any mobility device to traverse and also level enough so that any person with an unsteady gait could confidently walk on the path.
After we had restructured the garden, one of the residents, who had had trouble with the space because of mobility issues, was finally able to enjoy the outdoors again. She expressed to me what a treat it was just to sit outside and to be in the company of plant life and sunshine. Her words reminded me that biophilic design is a kind of magic when it is truly accessible to all.
Using Gardening as a Therapeutic Process
Biophilic nursing homes are a good fit for the long-recognized therapeutic activity of gardening. My work includes projects that integrate raised plant beds into the small spaces of such homes, so that even residents in wheelchairs and with limited mobility can tend to and care for the greenery. These beds and the plants within them often help residents gather, work together, and share stories in what has become a communal space.
We established a “sensory garden” in one facility for residents with dementia. The garden provided plants that had different colors, textures, and scents; the lavender, rosemary, and lamb’s ear among them were designed to bump up the biophilia a notch and better engage the senses. The staff reported back that residents who spent time in the garden seemed more at ease and involved, and for some, it opened up a space for memories of times they spent gardening or simply being outdoors in the fresh air. One resident I recall hadn’t strung together any words for months, and then, when she touched some of the plants in the sensory garden, she lit up and started sharing vivid tales of the garden she had growing up. Moments like these are why I am so passionate about bringing natural and naturalistic elements into nursing homes.
Ultimately, the homes that care for our elderly truly can become “nursing” homes; they can congregate spaces in which our loved ones can heal, or at least be comfortable for the time they have remaining. Biophilic design offers an aesthetic path toward that goal, and it carries promises of joy and connection. We should embrace those opportunities, as my daughter and I did when we filled the card for MoMA with wishes for those who would inherit its spaces.