The Art and Science of Healing Design

Join AIA|DC’s Design + Wellbeing Committee and the Biophilic Practice Group for a discussion exploring the nature, art, and science behind design for healing. 

Drawing on four decades of her creative design solutions and research for 300+ domestic and international healthcare projects, Barbara J. Huelat will define the core principles of her Healing Design approach integrating both the beauty of the arts and evidence-based science to create places where people can thrive. Huelat’s presentation will illustrate concepts of fractals, nature-based patterning, perspective, refuge layering, and full spectrum lighting. She will incorporate case studies from projects including Sentara Northern Virginia Medical Center, Merrifield Behavioral Health Center, and MedStar Health at Washington Hospital. Dr. Dina El-Metwally will then discuss how human-centric Healing Design is seen through the medical lens and experience of patients and medical professionals. Her collaborative transformation of UMCH’s Neonatal Intensive Care Unit open-bay facility into a family-centered space with cutting edge medical technologies and a nature-inspired sensory environment was achieved through innovative spatial design and the balancing of color, light, earth, sound, touch, movement, taste, and smell in support of the hospital’s youngest patients. 

Presentations will be followed by a panel discussion moderated by Dana Oprisan, MD, Assoc .AIA, LEED AP BD+C, EDAC, further exploring how the healthcare facilities may become healing environments, the importance of a holistic approach, and how the interface between design and healthcare professionals may be smoothened for improved communication, design work, and design outcome. 

Hosted by the AIA | DC Design + Wellbeing Committee. Organized by the Biophilic Practice Group, a new nonprofit initiative launched by Biophilic DC. Co-sponsored by Women in Healthcare, CB Flooring, and Gazelle CX. 

Presenter Name: Barbara J. Huelat, FASID, AAHID, EDAC: Interior Designer, Author and Speaker, Healing Design www.healingdesign.com 

Dina El-Metwally, MD, PhD: Associate Professor, Medical Director, Drs Rouben and Violet JiJi Neonatal Intensive Care Unit Division of Neonatology-Department of Pediatrics University of Maryland School of Medicine 

Click here to register by: March 4, 2019 5:59 PM Eastern Time

Care for the Caregiver

Care for the Caregiver

By Barbara Huelat, FASID, AAHID, EDAC

Volunteer caregiving is a difficult job that rarely finds its way to resumes. Some survive, many do not. Survivors all have battle scars. They have little or no training, no honors, badges, or metals of honor. They sacrifice out of love. How do we empower future caregivers?

Who are Caregivers? photo

A caregiver is a volunteer responsible for taking care of another person; for example, a person who has a disability, or is sick or very young. 80% of us at some point in our lives will be a caregiver. Caregivers are daughters, wives, husbands, sons, grandchildren, nieces, nephews, partners, and friends.

Responsibilities

  • Buys groceries, cooks, cleans house, or does laundry for someone who needs special help doing these things
  • Helps a family member get dressed, take a shower, and take medicine
  • Helps with transferring someone in and out of bed, helps with physical therapy, injections, feeding tubes, or other medical procedures
  • Makes medical appointments and drives to the doctor and drugstore
  • Figures out paperwork, the medical system, medical conflicts
  • Makes major decisions at all levels and states of crisis
  • Talks with the doctors, care managers, and others to understand what needs to be done
  • Spends time at work handling a crisis or making plans to help a family member who is sick
  • Is the designated “on-call” family member for problems
  • Personally, emotionally, and physically “care” for their loved one
  • Worries about outcomes, finances, family conflicts, and loss

Cost of Caregiving:

  • 44 Million Americans 37 billion hours of unpaid care each year
  • Families provide over 75% of caregiving
  • 65+ age group will double to 70 million by 2030
  • Families provide care for aging parents, siblings, and friend with chronic conditions who wish to remain at home

Initial Research

I Interviewed and documented 11 personal stories. Listening to their stories and knowing that they are a part of the 43.5 Million caregivers out there that need knowledge and help. I ask how can we help this situation?

Caregiver Burden

  • Caregiving involves complex responsibilities from activities of daily living like bathing and feeding to dealing with strange equipment, mood swings, disruptive behaviors as well as schedules for medications and doctor appointments.
  • Caregivers are also faced with conflicting demands with family, work, and social activities. They see the suffering, social isolation and are required to make difficult decisions.
  • They typically see increased financial pressure, loss of income, and often loss of their job. They often wander through complex forms of insurance, bills, and cost of meds without knowledge or guidance.
  • Caregivers face physical and emotional health problems of stress, burnout, insomnia, depression, poor diet, declining health, and even death.
  • They find little or unknown support. Where to get information, how do they find help? What are the rules? What do they do next?

What are Caregivers Asking for?

  • Information – on the disease: “What is it? “How to manage it? What are the symptoms and triggers? What happens next?”
  • Empowerment – “If you are asking me to manage this illness, pay attention to me, I know what I am talking about, I live with it.”
  • Knowledge of costs – “Why is the medical system so complex, I don’t understand the forms and especially what something cost until after they send a bill”.
  • Training – “Help me understand how to use the equipment? Not just the use, but what do I do if something goes wrong?”
  • Resources – “Are there any resources that can help with the care, people, products, places? Don’t tell me to call X after the fact… I didn’t know that X even existed.”
  • Knowledge – “I wish I knew about Hospice services much earlier. Social workers at the hospital could have discussed this with me when we had the dire diagnosis right at the beginning. The promotion of Hospice should be focused on Hospice as a more patient-centered way of managing long-term health care, not just a place where you take your loved one to die. The big point for Cay was to reduce significantly the trips to the hospital.”

Next steps:

I made the above was a presentation to the Planetree National Conference in Boston October 2018. It was based on my personal experience as a “Caregiver” leading to my question – “Do all caregivers experience the same complexities?” My mini research led me to the above conclusion. I would ultimately like to test and find solutions that empower caregivers and provides knowledge and solutions to these volunteers.

I am looking for additional stories. Do you have a Caregiver story that you would like to share? Please contact Barbara at bhuelat@healingdesign.com

Barbara Huelat is a healthcare interior designer of 42 years with a focus on Senior Living. She is a trained Hospice volunteer. Barbara has also been a caregiver for her late mom, mother in law, father in law, and husband Joe.  

 

 

Empowering the Caregiver: A Human-Centric Experience

CaptureTrending in the world of healthcare – Patient-Centered Care moves to Person-Centered Care. This was the major focus of this year’s annual conference at Planetree. Since the inception of Planetree 40 years ago, Planetree was about the patient experience, making them comfortable and providing satisfaction as it greatly improved outcomes.  This concept has not gone away but expanded the patient and has included people that include the patient’s experience including caregivers, family and the healing team.

Consistent with this new messaging, Barbara Huelat presented a seminar session on Empowering the Caregiver:  A Human-Centric Experience. The Human-Centric- model allows us to reach the center core of our humanness and journey with our care partners for successful outcomes. The session was made 9 interviews from the human-centric perspective and spouses, children, parents, and close friends of the patient who have engaged in this calling. Their heartwarming stories share the laughter, tears, successes, and failures of caregiving.  These stories told the human side of their journey.

Planetree International Conference on Person-Centered Care was held in Boston last week from October 7-10

Human Centric Approach to Understanding Dementia

By Barbara Huelat, FASID, AAHID, EDAC

What is Dementia?

My mother used to call it Oldtimers disease – or is this dementia? She wasn’t sure if it was just getting old or was there more to it? As my late husband entered the journey and realized he was forgetting a lot of things, he lamented “I’m just getting old.” But there is more to it! We know this dementia disease is lurking out there, and we are hopeful it will not visit our doorstep.

Our population is aging, and our fear about memory loss rises. We all know someone that is suffering from these diseases. Can’t remember a name or misplaced your keys? and we fear we are getting dementia. Dementia is terrifying! It is your neighbor, your bridge partner, that gentleman in church. Last week you discussed your vacation with your dear friend and this week he doesn’t know who you are. Families are often guarded about it, it is somehow an embarrassment, and not wanting the secret to get out. “ – there is something not right about my mom. She is outside at midnight picking the neighbor’s flowers but says she just wanted to surprise me, “a friend shared with me.  They don’t look any different, she still has her same giggle, or he still yells at traffic. Then one day it becomes clear – an event happens. You receive a call from the police, he went to the post office and got lost, didn’t remember where he lived, couldn’t find his way home. Then the trip to the doctor, the test, more test and then the diagnosis. It looks like dementia, most probable Alzheimer’s disease. It is the verdict that one in ten people over 65 will get.

AbrialsPartnersJP & BH1262My mom had Parkinson’s disease with dementia and hallucinated that were spiders down her shirt, my father-in-law had dementia from Alzheimer’s disease and confused the sink for the toilet. My grandmother had a stroke which left her timeframe confused and wanted to plant her tomatoes in January. And finally, I lost my dear friend and husband to Alzheimer’s disease and learned to understand the disease on a very human level.   Early on I learned that the person with the disease is still the same person you knew and love. Their personality will remain the same, they are still your mom, grandmother, father or spouse. The difference is now their brains function differently and they have lost their ability to communicate in a way that you understand.

Dementia isn’t a specific disease. It is an overall term describing all types of diseases and illnesses affecting memory and cognitive processing. It affects our ability to solve problems, remember people, places and robbing us of meaning while leaving our physical bodies relativity intact.

Alzheimer’s disease is the most common (50-77% of dementia is linked to Alzheimer’s disease). As it is the largest dementia type it is also the most studied with well-known and established symptoms linked to the disease. However, there are other common types of dementia include vascular dementia – stroke (25%), Lew body dementia (15%) and frontotemporal dementia. Less common forms are normal pressure hydrocephalus, Parkinson dementia, syphilis, and Creuzfeldt-Jakob disease and many more. There are also people that have multiple dementia diseases. Some dementias are linked to a wrong combination of meds, or even a reaction to silicic disease.  Dementia affects about 46 million people in 2015 with about 10% affecting our population indicating they will develop the disorder at some time in their lives. As our population continues to live longer lives, dementia is becoming more common in our aging. It is the most common disability among the elderly and it is believed to cost $604 billion annually.

We must remember that all dementia is not the same. It is critical to determine what type of dementia a person has as the symptoms can vary greatly, and some have treatment options which can reverse or improve outcomes while treatment options are ineffective in other types. However, as Alzheimer’s is the largest category, of dementia most people with dementia are often put in this group and all treated the same. Even within the population of Alzheimer’s disease, the individual symptoms will vary greatly with different behavioral triggers.

Disruptive behavioral events are one of the most troubling aspects of the disease. They can range from screaming event, throwing objects, kicking, other aggressive behaviors to crying and head banging. These behaviors often lead caregivers to overreact and inappropriately respond to the events. This often leads to a chain of events which make the event even worse or get totally out of control requiring physical and medical intervention. The most effective way to deal with these events is to observe, identify and respond to the “trigger” linked to the behavior. Once the trigger is identified the caregiver can often mitigate the trigger for a better outcome.

Wandering is a common disruptive behavior that leads to getting in closets, boxes, drawers, pulling out other people’s personal things, taking long walks outside and getting lost. Wandering is often associated with trying to find something or missing an old habit. My father-in-law always had ice cream before bed. Not finding his ice cream at bedtime he went searching for his bedtime comfort.  He was unable to tell us what he was doing, but once we remembered his ice cream habit we were able to intervene or distract with his favorite treat. When we call him over telling him his ice cream was ready, a big smile came over him and he left the closet he was rummaging and happily enjoyed his ice cream with us.

It is not easy living with dementia. We often hear It’s the disease, not the person – No. It’s the same person you love trying to communicate in a new unfamiliar language. It is a language that the caregiver must learn to survive the demanding challenge in front of them.

Barbara Huelat is a healthcare interior designer of 42 years with a focus on Senior Living. She is a trained hospice volunteer. Barbara has also been a caregiver for her late mom, mother in law, father in law and husband, Joe.  

 

 

Speaking Engagement at MedStar MIND Lab: Health in Buildings for Today & Tomorrow

I was honored to present last week at the MedStar Institute for Innovation on Healing Design on Health in Buildings for Today & Tomorrow, highlights from NIH’s 2018 Healthy Buildings Roundtable. Below is a short synopsis of my talk. Green buildings are among the fastest growing industries in the world, representing a $260 billion market in […]

Human – Centric Design

By Barbara Huelat, FASID, AAHID, EDAC

“We can’t solve problems by using the same kind of thinking we used when creating them.” – Albert Einstein

“Does environment impact the human condition?  Can our physical environment influence our health, wellbeing, our creative process or ability to innovate?”  Believing space and places do play a major role on health, wellbeing and creativity, I continually seek evidence to define this hypothesis.  I call this philosophy Human-Centric Design.

Human-centric thinking stems from the healthcare term – Patient centered design or patient-centered care which has been established by the Planetree organization.  Through the work of a patient wanting to change the way hospitals treat patients, Planetree has established best practices in the delivery of medical protocol to care for patients based on basic human needs including the spirit, touch, nourishment, nature and community.  Today, patient centered care reaches far beyond the Planetree model and is integrated into many visionary healthcare practices.

The DaVinci Man – Squaring the circle is impossible yet the Vitruvian Man can fit in both the circle and the square illustrating the ability to take any position. This one sketch illustrates “humanity” at the center of the universe, changing the position of geometry, mathematics, philosophy, religion and architecture.

The DaVinci Man – Squaring the circle is impossible yet the Vitruvian Man can fit in both the circle and the square illustrating the ability to take any position. This one sketch illustrates “humanity” at the center of the universe, changing the position of geometry, mathematics, philosophy, religion and architecture.

Fortunate to be at the vanguard of the patient centered movement, it became clear that healing environments based on patient-centered practices provided positive outcomes and evidence to improve the hospital environment.  Design intervention is real and does make a difference.  Patient-centered care does make patients and families more comfortable throughout the healing journey, but it falls short in areas of human complexities, social welfare, education, creativity and the well population.

My continued journey has moved beyond “patient-centered” design and has led to a greater understanding of the environment from the human perspective.  Principles of biophilia, healthy buildings, human factors, experiential design can change the human experience. Benefits have been found to reduce stress, improve health, wellbeing, increase joy, and pleasure.  These factors can support innovation and provides deeper meaning of place.

Human – Centric Philosophy

Human-Centric design describes an unfolding philosophy which has become the backbone of my research, writing, advocacy, leadership and design work.  It is a process that starts with human need and extends to innovating solutions impacting the human condition.  “Human-Centric” design is both a process and place.  The design process develops criteria to support the wholeness of the person, the biology of the physical being, the emotion of one’s spiritual nature and the cognitive process of the thinking person.  Human-centric is an interactive systems approach to design consisting of and focusing on the unique characteristics and needs which make us human. This creative “process” creates a structure that define the components of an innovative space. “Place” is the product of the process.  It is the environment where humankind can optimally flourish.

Can design also support these human complexities including innovation and creativity? To address these questions, let’s look at what it means to be human.  This seemingly simple question has many diverse and conflicting answers.  The clarity primarily resides in “human being” vs, “being human.”    Human beings are easily described by our biology and characteristics, genius and species.  However, it often takes, essays, books, psychology, theologians and opinion to define “being human.”  Being human will never have a clear definition because as a philosophy; it is an ever-developing interpretation of an evolutionary species.  Human-centric design requires we address all environments with people at the center as a biosocial being.

Design for the bio-human can be achieved by carefully addressing the needs of human biology, providing ergonomics, nourishment, sensory input and elements that support all bodily functions.
It is not an easy process but is achievable with the current understanding of physiology.

Addressing “being human” also requires we embrace the emotional spirit, mental cognition and social/cultural dynamics.  Being human is a face of humanity’s self-expression.  The challenge to design environments which can achieve such a goal is great and one worth pursuing.  Today, the human experience is crying out for change.  A new philosophy of “Human-Centric” design can make a difference and leave environments in a better place for humanity to thrive.

Well Building

By Barbara Huelat, FASID, EDAC, AAHID

Have you heard about the WELL Building Certification? No? Well, that’s not surprising because the WELL Building Certification is a newly launched accreditation program shaped by Green Business Certification Inc. (GBCI). The WELL Building Institute (WBI) is a public interest corporation whose mission is to improve human health and well-being through the built environment. The WBI administers the Well Building Certification as well as LEED professional credentialing.

well_logo

This is not just another building certification, it deals specifically with the health and wellness of the occupants. There is no other certification which addresses this. Spaces can actually help create healing environments to help improve a person’s nutrition, fitness, mood, and sleep patterns which lead to better health outcomes. We spend an average of 20 hours a day within our homes, schools, workplace, retail, places of entertainment and healthcare. Are these environments healthy for us? Do they support well-being? Can they even make us sick?

Everyone cares about their personal health and that of their family and love ones. It is scary to learn that indoor air quality in 70% of our built environments is worse than outdoor air quality. Most of us have experienced off-gassing from a new carpet that can lead to headaches, nausea and fatigue. The wavelengths of light can interrupt our natural circadian rhythm which lead to sleeplessness at night and attentiveness during the day, and we are often office “couch potatoes”, leaving our workstations only to recline at the lunchroom table full of unhealthy food options. Some never see daylight. Research is now linking our health effects to our built environment.

Traditional healthcare focuses on healing the individual after disease or sickness has occurred. However, within the growth of chronic disease, especially diabetes and heart disease, cancer research is finding there is a need for greater emphasis on lifestyle and prevention. Can design intervention produce a healthier Well Building? And a healthier population? This is the “take away” from the WELL Building Standard which moves design interventions to measureable outcome which can be directly linked to health benefits of the occupants.

User satisfaction is a prime factor of certification as is overall health. Elements such as acoustics, thermal comfort, access to nature, ergonomics, aesthetics, and comfort have been found to reduce sick days and increase productivity. However at the end of the day, it will be a business decision that will link WELL to a better ROI, Return on Investment.

This rendering illustrates our newest Well Building certification pursuits. The MeadowView facility in Marion, Iowa, is a Senior Living campus that is focused on the residents’ experience. Designed using the small house model; it provides homelike amenities that support the WELL Building components of quality water, fresh air, access to nature, good nutrition, comfort and ergonomic, beauty, quality of light, and mindful experiences. It has not been without challenges. Many of the requirements are components that have always been a part of our design strategy such as quality of lighting, ergonomics, and access to nature. However, one of biggest challenges has been specifying products that are not on the “RED LIST.” Red List items are toxic components of finishes and furnishings, such as PVC and formaldehyde. We were very surprised to find out how difficult avoiding Red List items can be. Vinyl flooring, plastic laminate and common interior materials are full of these components. We are moving to natural materials like rubber flooring and solid surfaces.

Personally, I have dedicated my professional life in pursuit to “Healing Environments” totally believing that an environment can and does support healing and wellbeing. I have researched and authored two books on the topic and have lectured nationally on the subject. I often thought I was on the fringes. However I am so thrilled to find that I am not, and there are now organizations that have recognized that WELL Buildings can and do make a difference to the health of its occupants.

VAMC

Huelat Davis and Davis Partnership Architects are proud to support this WELL Building initiative with active WELL certification projects in the Denver office with the Colorado Heath Foundation and the Huelat Davis office with the MeadowView facility in Marion, IA.

Healthcare Design Magazine focuses on Merrifield Center

Healthcare Magazine did an amazing 4-page piece on Huelat Davis’ recent project Merrifield Center which combines 13 different behavioral health services scattered throughout the county into one comprehensive building.
http://bit.ly/22D2jIp

This facility is unique in terms that it’s a behavioral health facility and police substation.

“If there’s an incident of a person behaving badly, someone who obviously has some sort of psychiatric disorder, in most counties they’d go to a hospital ED and then to the police station,” Noritake explains. “In Fairfax County, they’d be sent here. It’s almost like a police substation, with a specially trained officer on duty who takes over and writes a report, and the patient is under police control until they’re diagnosed by facility staff.” The goal, adds Huelat, “is to keep a lot of these people out of jail and get them safely into a rehab or treatment program.”

“People may be in a psychotic state, and if they come into a place that’s dreary, that’s dark, that looks like an institution—this may hinder recovery. But now, they come into a bright place. There’s good lighting, which seems to really play an important part. They can sit in emergency services, see this very welcoming design. There’s a place where kids can play, where moms and dads don’t have to worry about little kids when they’re trying to help a loved one. There are people down there to keep an eye on things, peer workers to help intercede. It’s almost night and day,” Williams says. “It has reduced the number of [violent] incidents and we’re able to do more for these folks.”

Despite some initial concerns from both staff and users about losing the independent, cozy nature of their previous workplaces, Williams is emphatic about the results and how the community has responded. “They love it!” Williams says. “People are happy, they’re proud to come into this building now. Our compliance rate went up. Incidents are way down.”

Barbara Huelat Develops New Healing Color Palette for LG HI-MACS

LG HI-MACS introduces 15 colors selected by Barbara Huelat for their new Healthcare Collection.  The 15 colors have been found to be the most suitable for healthcare environments.  In addition, the collection tells a story.

Garden Stone Collection

“The conscious stone to beauty grew” – Emerson

Zen Gardens are both peaceful and playful.  These are healing environments specifically designed to provide peace, serenity and escape from stress of daily life.  They are environment to reflect, seek inner peace and support healing.  Unlike other typical gardens that feature flowers, Zen gardens feature stones.  These stones are considered the “Soul” of the garden and represent nature’s elements.

Exploring nature’s themes for healing environments, this collection of “Soul Stones” offers 15 solid surface stones that are inspired by Zen healing garden.

The soul stones designed specifically for healthcare environments provide five palettes. The Root Stones of Harmony, Balance, Simplicity  and Natural   the essence of the healing environment principles allowing designers to create healing spaces.

Japanese Zen gardens actually have very little plant material. There is no pond and no river. It represents the Zen Buddhist philosophy and helps in meditation. It also teaches the principles of the religion. Materials usually consist of rock, gravel, sand and maybe some moss. Ryoanji is the Zen temple most famous for its rock garden. Stones are more important to the Japanese than trees. Rocks may be handed down from generation to generation.

In Zen gardens of all kinds stone is the major element. There are three types of Japanese Zen gardens. The Tsukiyama or hill garden, the Karesansui or dry garden and the Chaniwa or tea garden which is built for the tea ceremony. All of these gardens incorporate rocks.

The idea of a Zen garden is simplicity of design. This adds dignity and grace to the Japanese garden. Everything placed in  the garden symbolizes something. Rocks represent a sense of power and desire or can symbolize a feeling of tranquillity, depending on the shape of the rock.

Soul Stones 1

There are five classes of stone shapes. The taido is a tall vertical rock, the reisho is low vertical, the shigyo is arching, the shintai is flat and the kikyaku is reclining. Each shape is carefully chosen and placed to create an idealized conception of nature along with the artistic feeling of the creator.  The new “Garden Stone Healthcare Collection” invites designers and architect to create their own healing garden to support healing.

Visit www.lghimacsusa.com/pates/44/for-healthcare

 

 

Barbara National Speaking Engagements

Barbara_Headshot

Barbara Huelat presents “Healing Environments for Home Work & Play”  accross the country with Design Arts Seminairs.  It is a 8 hour class with 8 AIA & IDEC CEU’s.  The topic deals with healthy building concepts that can be integrated into all building types.  See Guest Speaking, Lectures & Seminars for full details on the next class near you.  You can also visit Design Arts Seminairs at www.designartsseminairs.net for full couse details and regristration.