David Hoglund admits taking an anecdotal approach when working on a care facility for patients of Alzheimer’s—a disease for which the federal research budget could soon reach $1 billion. A principal and executive director at Perkins Eastman’s Pittsburgh office, Hoglund has helped lead the firm’s senior living practice to international importance, and his intuitions have played no small part in transforming design for the world’s aging population.

His interest in the subject goes back to time spent in Sweden, Denmark, and England studying environments for seniors and the developmentally disabled on an NEA grant. “What I saw in Northern Europe was the small-scale residential model,” Hoglund said, and he applied it to a project in Pittsburgh called Woodside Place. 

Little did he know that when the small, four-building campus opened in 1991, it would become not only an architectural prototype for dementia care facilities around the world, but also a model for patient care in the medical community. The facility has since gone on to foster several studies on the environment and aging, and was awarded the AIA/AAHSA Design for Aging: 10-Year Award in 2007.

The Woodside model gained attention in part because it eschewed some of the traditional concepts about design for dementia patients. “It was very clear that ‘wandering’ was one of the big issues,” said Hoglund, referring to the common behavior of Alzheimer’s patients to wander and, often as a result, become lost and frightened. The solution was to develop a walking path so that patients could pass through a facility’s rooms, and to the outdoors, without coming across a barrier. In this way, the patients encounter a variety of stimuli—music, daylight, or temperature—that keep them engaged with their environment.

Working with an interdisciplinary research team of caregivers, family, therapists, and social workers, Hoglund also developed the idea of what he calls the country-kitchen model. “We use the analogy of most people’s households,” he said. Integrating staff into the kitchen, the space allows residents to interact over familiar activities and enjoy the sensory stimulation of food. Discovering that patients were more able to concentrate in rooms with windows and views led to another important architectural change contrary to popular thought about easily distractible dementia patients.

Even though his earliest studies and models have continued to influence the nearly 60 specialized care facilities Hoglund has designed, he remains aware that senior demographics are always changing. Perkins Eastman’s Research Collaborative, formally established in 2007, is continually conducting studies into emerging concepts of elder care. “The whole continuum has shifted,” said Hoglund. “The people we’re seeing in long-term care are older and frailer and are coming to purpose-built facilities only when there are no other alternatives.”

Recently, Perkins Eastman has completed several senior living communities in Japan, for which the firm’s clients visited Woodside and other facilities representative of its model of care. Even at more than 170,000 square feet, centers like Sun City Takatsuki follow the cluster-design concept of small-scale neighborhoods off a connective walkway. Hoglund said he is pleased to see U.S. design influencing a culture with such a large aging population—a demographic that, both stateside and abroad, will continue to grow and demand new design solutions well into the future.