Does the design of hospitals meet the needs of older people? An evaluation of three acute care settings

Increasing emergency admissions for older people create an imperative for hospitals to develop appropriate facilities. This pilot research identifies design criteria that can improve the quality and outcomes of acute services for older patients. Three acute care settings in the UK were recruited: an NHS Foundation Trust hospital; an inpatient rehabilitation hospital and a nursing home providing intermediate care. A pilot design evaluation tool was developed. The building evaluation assessed the design quality of the building and evaluated its performance in supporting the specific needs of older people. Findings showed that hospital designs do not meet the needs of older people. Key issues lie in the basic design layout which impacts on domains important to older people including wayfinding, dignity, support for dementia and mobility. Small design changes can impact on the success of the built environment in responding to the needs of older inpatients. However, overcoming original poor layout and subsequent poor retrofitting can be extremely difficult.