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Research of Accessible Facilities Design in Domiciliary Care Institutions

Abstract


1.Origin of the study
Decade plan of long-term care was promoted by Department of Social Affairs and Ministry of Health and Welfare since 2008. Considering the rapidly aging populations in our country and the promotion of urgency, this research is imperative.
According to the Establishment Standards of Senior Citizen’s Welfare Institutions Chapter 1 Article 2, Domiciliary care institutions service to senior citizens in need of care services from others, or senior citizens who can take care of themselves for daily life but without any relative with legal support obligation, or relative with legal support obligation but unable to fulfill this obligation. Although in Article 26 some principles of dormitory, nursing station and locations for daily activities are provided, the using situation of existing buildings and the accessible facilities setting still need for further discussion. This research is aimed at users’ behavior and accessible facilities design in domiciliary care institutions. Probing into the design content and conducting inductive analysis on real situation, we propose proper recommendations for improvement.

2.Methods and procedure of the study
This research selected “Domiciliary care institutions” of Senior Citizens’ Welfare Institutions. From the view of accessible facility design, it was conducted by studying the living environment and facilities. This research mainly included the following three:
a).Investigate the present status of the domiciliary care institutions, and understand the priority projects for improving the accessible facilities.
b).By the focus group interview of managers in the institution, care providers and the elderly, establish the database of environment and analysis users’ behavior and demand.
c).By the focus group interview of teams specialized in social, architecture, institute and the government, develop the future content of accessible facilities design.
This study was design by using interviews and observation of qualitative research. This study selected four domiciliary care institutions of four districts in Taiwan which were willingness. Understanding Taiwan’s overall domiciliary care institutions, this study showed the common points of improvement and the future content of accessible facilities design.


3.Major Findings
This study sorted the spaces by private spaces, semi-private spaces, semi-public spaces, public spaces and community interaction spaces, and checked by security, accessibility, usability and identifiability of the accessible facilities design. The results were as follows:

a).Private spaces—bedrooms, bathrooms in bedrooms
1.Institutions should strengthen the environment management and make sure there are enough spaces to store items to avoid the residents tripping over by their own hoard goods.
2.Entrance to the bedrooms and bathrooms should remove barriers, eliminate the height difference and ensure adequate clear width. If not, it should be remade by consulting the accessible facilities design standard. While constructing, the sizes and the flatness of the floor should be paid high attention. Sliding door is suggested to be the entrance door.
3.The location of the bathroom is better set near by the bedroom’s entrance. Responding to the needs of wet and dry separation, we can plan bathroom separated wet and dry or public baths. Moreover, the interior setting in the bathroom should fit the accessible design standard.
4.To ensure the response of residents’ emergency situation, except the bedside calling bell, there should be another calling bell set by the floor. For weak resident, there should be more calling bells set.

b).Semi-private spaces—multifunctional rooms, clothesline fields
1.Domiciliary care institutions in the unit planning is lack of concept of unit partition. We suggest considering while repairing or new built.
2.It is suggested that while repairing or new built domiciliary care institutions there should be elevators set in order to increase convenience of vertical movement.
3.The handrail of the multifunctional rooms and outdoor aisle should fit the standard. Entrance to the multifunctional rooms should remove barriers, eliminate the height difference and ensure adequate clear width. If not, it should be remade by consulting the accessible facilities design standard. While constructing, the sizes and the flatness of the floor should be paid high attention. Sliding door is suggested to be the entrance door.
4.Clothesline fields in domiciliary care institutions should be near by the unit. The height of the facilities should fit the residents’ body type. Chairs for rest and calling bells should also be set.
c).Semi-public spaces—activity centers, public restaurants, religious spaces, public toilets, accessible elevators
1.The activity center in domiciliary care institutions should set stair lifts and service bells in order to make up for the people with disability. Old built activity center should improve setting accessible restroom in priority.
2.The design of the elevator in domiciliary care institutions, we suggest actively seek for funds to set.
3.The design of public restaurants, we suggest setting accessible restaurants nearby. Level access should be fully barrier-free in order to increase accessibility to restaurants. The washbasin should fit the users’ directions and height.
4.The religious spaces in domiciliary care institutions should be set near the neighborhood; relevant paths should be kept fully barrier-free. The entrance to the religious spaces should fit the accessible design standard.
5.The set of accessible restrooms in domiciliary care institutions, we suggest that the location should be set with clusters of space and truly promote and clarify the use of position.

d).Public spaces—guardrooms, anterooms
1.The service window of the guardroom should be adjusted to the height which users on wheelchair are accessible.
2.The entrance of the guardroom should fit the accessible facilities design in order to be visitors’ temporary waiting room.
3.There should be set anteroom next to the guardroom in domiciliary care institutions.
4.The entrance of the anteroom in domiciliary care institutions should fit the accessible facilities design.
5.The height and shape of furniture in anteroom should be set by considering the elderly and the people with disabilities.

e).Community interaction spaces—shelters, shopping spaces, hospitals, parks, community centers
1.The shelters of the domiciliary care institutions should be close to the domiciliary care institutions, and set rest and help facilities. The bus line should be negotiated, and the bus should be change into low-floor buses.
2.The shopping space of the domiciliary care institutions should be combined with the supermarket, or provide shuttles for resident being convenience to go shopping.

3.We suggest shuttle cars in order to link up the hospital. Strengthen the link of community health car so that health care resource can be promoted inside the domiciliary care institutions.
4.It’s necessary to link the domiciliary care institutions with neighboring park. We suggest strengthening the security facilities in the park.
5.Domiciliary care institutions and community centers should be combined with their activities in order to integrate the resource, link up the elderly, community activities and the local life.

4.Suggestions
a).Suggestion 1: check and repair the accessible facilities in bedroom and bathroom
Immediate action suggestion: hold review of accessible design in the elderly bedrooms and bathrooms in country-wide public expense domiciliary care institutions and instructed the government to plan the annual budget on repair to ensure the safety of the elderly.
Competent authority: Social and Family Affairs Administration, Ministry of Health and Welfare, elderly welfare institutions competent authority local government
Cosponsor: Construction and Planning Agency, Ministry of Interior

b).Suggestion 2: review of the accessible elevators setting
Immediate action suggestion: hold review of accessible elevators in country-wide public expense domiciliary care institutions and instructed the government to plan the annual budget for setting. If necessary, the central government will provide subsides to improve the living quality for the elderly.
Competent authority: Social and Family Affairs Administration, Ministry of Health and Welfare, elderly welfare institutions competent authority local government
Cosponsor: Construction and Planning Agency, Ministry of Interior

c).Suggestion 3: planning guide of accessible facilities design in new domiciliary care institutions
Mid-term suggestion: develop “planning guide of accessible facilities design in new domiciliary care institutions ", make relevant design requirements clearly to provide consultation of new built domiciliary care institutions.
Competent authority: Social and Family Affairs Administration, Ministry of Health and Welfare Cosponsor: Architecture and Building Research Institute, Ministry of Interior
d).Suggestion 4: architectural planning and design courses of senior citizens’ welfare institutions
Mid-term suggestion: hold architectural planning and design courses of senior citizens’ welfare institutions to guide architects and care providers to put accessible spaces and universal design into architecture design.
Competent authority: Architecture and Building Research Institute, Ministry of Interior
Cosponsor: Social and Family Affairs Administration, Ministry of Health and Welfare


e).Suggestion 5: assessment index of old buildings and outdoor spaces in domiciliary care institutions
Mid-term suggestion: develop assessment index and mechanisms for old buildings of domiciliary care institutions in order to have close mechanisms for the buildings which can’t be improved or without benefit.
Competent authority: Social and Family Affairs Administration, Ministry of Health and Welfare
Cosponsor: Architecture and Building Research Institute, Ministry of Interior

f).Suggestion 6: possible plan of the future planning and operation in senior housing communities
Long-term suggestion: hold informal discussion of experts in senior citizens’ welfare institutions and architecture to discuss possible plan of the future planning and operation in senior housing communities.
Competent authority: Social and Family Affairs Administration, Ministry of Health and Welfare
Cosponsor: Architecture and Building Research Institute, Ministry of Interior