Doctor of Healthcare Administration (D.H.A.), Franklin University, 2025, Health Programs

The rapidly aging population in the United States, combined with increased healthcare costs, has led to an increased use of integrated models of care. Despite the patient lying at the theoretical center of integrated care, existing research has focused on clinical outcomes and cost efficacy rather than whether or not the model is meeting the participant's unique needs. This quantitative, exploratory study intended to identify the relationship between perceived quality of life outcome measures and integrated care participation among a cluster of senior living communities in Michigan. This study was guided by Donabedian's model, which described patient-centeredness as a core construct in pursuing innovative models of care (Berwick & Fox, 2016). Participants were split into integrated and non-integrated care subgroups, each with 88 participants. The study found a significant relationship between perceived quality of life outcome measures and integrated care participation (p< 0.001). However, the Mann-Whitney U test found no significant relationship between the two groups with a p-value of 0.058. Additionally, findings indicated that socioeconomic status does have a significant moderating effect on the relationship between integrated care participation and perceived quality of life, with a p-value of < 0.001. These findings will encourage future integrated care researchers to focus on patient centered outcome measures to improve comprehension, allowing patients to participate in the informed consent process when enrolling in an integrated model of care.

Committee: Gail Frankle (Committee Chair); Jesse Florang (Committee Member); Usha Palaniswamy (Committee Member) Subjects: Health Care; Health Care Management

MARCH, University of Cincinnati, 2020, Design, Architecture, Art and Planning: Architecture

People of all ages inhabit architectural designs; sometimes these designs are geared toward their specific needs, but more often spaces are built for some predetermined average person. Although this has its benefits, it tends to encourage the already natural problem of age segregation within spaces because each space is designated and designed for a specific age group, such as children in a preschool or elderly in a nursing home. While such spatial segregation is easily navigated by most adults who freely move between these spaces, it can have more perverse effects on the young and old who are less able to move between spaces and who have more distinct spatial requirements and barriers to entry than the average adult. These effects include isolation which can lead to decline in health as well as slower development of social skills for children. At the same time, the groups that are affected the most are also the ones that are currently growing the most, with the elderly and youth populations expanding at a high rate. For the effects of spatial segregation to be addressed, spaces of overlap should be explored both on a programmatic and spatial level. By analyzing the research in how spaces are designed for specific groups and then refolding this information back into the fabric of overlapping spatial design, a more true form of intergenerational space can begin to arise. Alongside this exploration, programs that support overlap can be developed and explored, such as combined care facilities for the elderly and preschool age children, a type that has arisen in recent years due to much social research, but which still lacks architectural research. This model provides a useful testing ground for intergenerational concepts due to the specificity of interaction, and the design explored here will seek to map these interactive concepts. By redeveloping spaces of overlap through the lens of differing generational user groups, barriers to intergenerational exchange can be mi (open full item for complete abstract)

Committee: Michael McInturf M.Arch. (Committee Chair); Elizabeth Riorden M.Arch. (Committee Member) Subjects: Architecture

MARCH, University of Cincinnati, 2019, Design, Architecture, Art and Planning: Architecture

Independence and inclusion should not be sacrificed as one ages. However, many seniors have to make sacrifices towards their lifestyle once physical and/or mental conditions begin to decline. There is a stigma towards aging that is rooted in historical beliefs that the elderly are `undesirable' and should therefore be pushed aside from the rest of society. While acts and regulations created over time have lessened these negative connotations, there are still many obstacles faced by seniors in their day-to-day lives. Addressing these challenges and forming design solutions can decrease the burden of getting older and, in turn, make this phase of life exciting. This topic is especially important in today's world due to the demographic changes experienced in the United States as the baby boomer generation enters their senior years. With such a high increase in the older generation, planning and infrastructure is not supportive of their needs. It is up to architects to design a world that is universally accepting of people at all stages of life. This thesis examines the senior living options available today and new trends that have occurred within the last few years. Specifically, I will be focusing on University Based Retirement Communities (UBRCs). These retirement communities are affiliated with a nearby college or university and share amenities and resources. Aside from giving seniors the opportunity of lifelong education, UBRCs facilitate inter-generational connections. Students and seniors form a mutually beneficial relationship, getting to learn and grow from each other. In addition to integrating seniors into the community, I will be exploring ways to bring the community to seniors. By introducing program that is appealing to all ages, I hope to make a hub that attracts people outside of the retirement community. The design will support these ideas through a holistic approach centered on how one experiences a building and the benefit of designin (open full item for complete abstract)

Committee: Michael McInturf M.Arch. (Committee Chair); Aarati Kanekar Ph.D. (Committee Member) Subjects: Architecture

Master of Fine Arts, The Ohio State University, 2018, Design

Aging is an inevitable process and people are living longer than ever before. Currently, there are about 50 million people over 65 years old in the United States, which is expected to grow to over 72 million by 2030 (Ortman & Velkoff, 2014). This rapidly increasing population has elevated the significance of designing environments that not only meet needs of the larger aged population, but also establish healthier and more desirable living conditions. Functional declines are a normal part of aging, therefore, environments designed for older adults must establish features that support the specific needs of the aging population. As an element of design that is all around us, light, whether natural or artificial, provides both functional and emotional supports. In senior living facilities, since resident rooms are often around the exterior, many community spaces are pushed to the core and have limited or no daylight access. Therefore, it is not only important to ensure that artificial light is of sufficient brightness, but it is also important to understand what effects qualities of light may have on older adults as past research indicates that light has both functional and emotional effects on people (Martyniuk et al., 1973). The rise of LED lighting has provided an opportunity to explore qualities and application of artificial light in interior environments. LED lamps can range from 2700K (warm) to over 6000K (cool) color temperature, providing an opportunity to better understand the impact color temperature may have on older adults. This exploratory research evaluates older adults' impressions of their interior environment when illuminated by different correlated color temperatures of light. Through four sessions, older adults evaluated the facility's existing light (2700K CFL) and three replacement LEDs (3000K, 4000K, 5000K) that had similar CRI and brightness, providing their subjective impressions of the session's lighting. As senior living and long-term car (open full item for complete abstract)

Committee: Rebekah Matheny (Advisor); Jeffery Haase (Committee Member); Monica Robinson OTD, OT/L, FAOTA (Committee Member); Mary Anne Beecher Ph.D. (Committee Member) Subjects: Design

MARCH, University of Cincinnati, 2018, Design, Architecture, Art and Planning: Architecture

This project will look at senior living and healthcare in the city of New Philadelphia, OH. As the community continues to grow and age, the availability of amenities and living options will need to transition along with it. In order to make this transition successful, the city needs to take into consideration the merging of multiple generations. Through multigenerational planning we can provide aging in place that will result in a diverse social and intellectual life. Currently with the healthcare and senior living, all located on the perimeter of the city, residents must rely on a car to get anywhere. This study will look at ways in which we can bring senior housing, in coordination with student housing, and access to healthcare to a more central location in the downtown area. Centrally locating these amenities will further enhance the accessibility to existing resources in the downtown area and bring back the idea of walkability. We no longer need to isolate the aging population, instead we should embrace the collaboration and celebrate the interaction between other generations. Senior living in the downtown area may be considered a non-traditional idea, but through the multigenerational planning we can provide an aging in place option that still allows the older generations to keep the neighborhood like setting while continuing to enhance their quality of life.

Committee: Michael McInturf M.Arch. (Committee Chair); Aarati Kanekar Ph.D. (Committee Member) Subjects: Architecture

MARCH, University of Cincinnati, 2016, Design, Architecture, Art and Planning: Architecture

The senior population in contemporary China continues to drastically increase at a steady pace, especially recently. Experts estimate that China will become one of the super-aged countries in the world in 2050. In the meantime, China suffers from a serious smog problem in prevailing major cities as well where economic activity has risen as a result of this phenomenon. Gauging from the statistics of other major countries, China needs at least thirty years to thoroughly solve this predicament. This thesis aims to create a safe and healthy living environment for vulnerable seniors during the period of environmental management by weaving architectural design and garden elements together. Various types of Gardens can offer the seniors with beautiful vistas, memory care, fresh air, engagement, and happiness. Moreover, to better address the issues surrounding the anxiety of aging, a continuing-care multi-generational community can be promoted among the urban citizens. It can encourage both a closer sense of community among the residents, and mutual assistance between family members. This new type is a good choice for young couples who are willing to take care of their parents, but still wish they could keep their own privacy to a certain degree. The seniors who choose this community want to maintain greater independence and age in place. They are re-conceptualizing “Retirement” responsive to the lures of convenience, cultural life, shopping, good public transportation, and an exciting lifestyle. It is a revolutionary ideal for senior living in China.

Committee: Udo Greinacher M.Arch. (Committee Chair); Vincent Sansalone M.Arch. (Committee Member) Subjects: Architecture

MARCH, University of Cincinnati, 2015, Design, Architecture, Art and Planning: Architecture

The Baby Boomer generation presents a care-giving challenge for America, both financially and ideologically. Not only are they a much larger generation than their parents, but a more diverse population with an entirely different set of aspirations and fears about the aging process. Due to these demographic and cultural shifts, many community based models for senior living have emerged in the past decade, which allow seniors to age in place and maintain independence. These models challenge traditional ideas about senior living design and planning, as they abandon communities generated by proximity in favor of ones generated by social processes.

Committee: Michael McInturf M.Arch. (Committee Chair); Aarati Kanekar Ph.D. (Committee Member) Subjects: Architecture; Icelandic and Scandinavian Literature

MARCH, University of Cincinnati, 2015, Design, Architecture, Art and Planning: Architecture

The current practice of sustainable design often emphasizes metrics-based, quantitative means of reducing negative impacts of built form on the natural environment. For building typologies that serve potentially vulnerable populations, such as the aging, however, this practice has an added responsibility to evolve beyond the current mindset toward a human-centric design philosophy. Biophilia, defined as a love or empathy with the natural world, emerges as the overarching strategy to achieve the parallel goals of improving both human and environmental health. Using a hierarchy of theoretical and spatial patterns organized under the umbrella of biophilia, this thesis explores how an urban, university-linked retirement community can better address the environmentally-related issues surrounding the anxiety of aging.

Committee: John Eliot Hancock M.Arch. (Committee Chair); Michael Zaretsky M.Arch. (Committee Member) Subjects: Architecture