11
Sustainable Life-Span Design: A New Model

Amber Joplin

Background

The US Census Bureau projects the number of people aged 65 and over will increase from 39 million in 2010 to 69 million in 2030, with the 85+ population, doubling by 2025 (Day 1996). Declining birth rates and increasing life-spans result in a shift in population age structure, with nearly one in five US residents expected to be 65 or older by 2030 (Vincent and Velkoff 2010). Individuals are aging in homes, neighborhoods, and communities designed for active, mobile, sighted adults. As their health and mobility begin to deteriorate, elders will no longer be able to operate successfully in the shared community environment. The magnitude of population aging challenges our current system of progressively relocating aging individuals from their homes and communities to senior-targeted environments, whether to amenity-rich retirement communities, near an amenable adult child's home, or an assisted living facility (Heumann 2001). The costs of our current system to individuals, families, society, and the natural environment are enormous (Landorf, Brewer, and Sheppard 2008).

Dramatic demographic changes require correspondingly dramatic changes in the built environment; however, implementing research into the design of environments for elders is challenging because aging, the effect of environments on individuals, and existing social and infrastructure systems are complex. Processes of aging differ in onset, duration, termination, direction, and order (Baltes 1987). Variables impacting elders range from place, space, and relocation (Litwak and Longino 1987); meaning and significant activities (Rubinstein and de Medeiros 2004), family and community connections, programs and policies, access to goods and services, stigma, poverty, safety hazards, crime and pollution (Dahlgren and Whitehead 1991; WHO 2001); access to nature (Ulrich 2002); and to spiritual connection (Sadler and Biggs 2006).

Introduction

This essay utilizes multidisciplinary theoretical models to integrate theories on “aging within the environment” as an initial step in developing a comprehensive model that can be flexibly applied to the design of living and community environments. Models are symbolic artifacts of knowledge used by all disciplines to create, hold, or transfer complex and/or developing information about relationships, processes, change, etc. (Ewenstein and Whyte 2007). In order to distill the primary concepts identified in behavioral and social sciences, education, health, sustainability, systems, and design literatures, I have focused my literature search on models of person and/or environment relationships and then deconstructed the model elements into tables. The resulting comparative tables identify relationships and significant issues that must be considered in person-centered, sustainable life-span design.

Three areas of literature are presented in this essay to identify indicators of sustainable environments for aging. The areas are models of: (1) contexts, (2) values, and (3) person–environment interaction. Organizing the review by models rather than by discipline highlights multidisciplinary factors of environments for elders. These selected models originate from the fields of design, sociology, gerontology, environmental psychology, geography, environmental science, and education. Most address multi-disciplinary relationships and several models are adopted across disciplines, particularly Lawton and Nahemow's (1973) Ecological Model of Aging.

Several key terms in the literatures were defined by combining the perspectives of various recognized scholars. Each model discussed relates to these terms.

Aging

Aging is a natural, developmental, life-course process (Baltes 1987) that involves bi-directional gains and losses over time in emotional, intellectual (Samanez-Larkin, Robertson, Mikels, et al. 2009), social, spiritual (Sadler and Biggs 2006) and physical arenas (Koncelik 2003).¹ US Census data show the continuation of good health “free of problems with personal and instrumental activities of daily living” ranges for women from the ages of 37 to 76, and for men from ages 45 to 80 with many individuals experiencing good health into their 80s and 90s (Kinsella and Velkoff 2001). However, there is a correlation of age with increasing levels of frailty and with chronic illnesses leading to functional limitations. Age-related physiological changes may include losses in mobility, intellectual functioning, and sensory acuity (affecting hearing, vision, touch, taste, and smell) as lung capacity, blood flow, muscle mass, and physiological efficiency decline (Ebersole, Hess, and Luggen 2004). Functional deficits occur at different rates for each individual and may be episodic, chronic, progressive, or cascading, as from a major illness or accident.

The literatures included in this review variously classify aging individuals using chronological age, health, work status, living situation, or other capacity. Most studies identify age ranges that are statistically, socially, or legally associated with their classification. For purposes of comparison between studies this review will demarcate “near old” (55–64), “young old” (65–74), “old old” (75–84), and “oldest old” (85 and above) (Brault 2008). Age classifications in built environment applications are lacking in the literature, essentially limited to the terms “active seniors” or “frail elderly,” which latter is applied to people aged 65 and older with significant physical and/or mental problems (Kinsella and Velkoff 2001).

Disability

Contrasting with the typical usage synonymous with sensory, physical, and cognitive limitations (US Department of Justice 2005;² US Census Bureau 2005³); “disability” is defined as the consequence of the gap between individual capabilities and social or physical demands (WHO 2001). Significant disablement processes occur in and can be ameliorated by changes to the built environment (Verbrugge and Jette 1994).

Systems and Sustainability

The literatures express the need for a systems approach to built environments for aging because of the dynamic, multi-directional interrelationships between elements of the environment and its inhabitants. Human systems are in the continuous process of being deliberately designed and redesigned through law or policy, as well as personal and cultural expression, need, and limits (Forrester 1991). A change in one system has an effect on others, and is in turn affected by subsequent changes in those individuals and systems. The concept of sustainability implies an enduring and balanced use of resources that values the needs of all persons (Chiras and Herman 1997).

Models of Contexts

Meaningful research on the interior environment as it relates to aging requires consideration of the multiple personal, social, and physical contexts in which aging occurs (Clarke and Nieuwenhuijsen 2009). These three context models emerge from seminal ecosystem thought in the 1970s categorizing domains and proposing dynamic relationships between them. Meadows' implementation of Daly's Hierarchy of Purpose Model uses economic language to illustrate linkages between environmental sustainability and human well-being (Meadows 1998). Bubolz, Eicher, and Sontag's (1979) Human Ecology Model integrates the subject matter of the evolving human ecology field.⁴ Guerin (1992) focuses her Interior Ecosystem Model to frame integrative research in interior design. Together these models identify a framework capable of including a full range of factors relevant to aging.

The Hierarchy of Purpose Model

The Hierarchy of Purpose Model (HOP), adapted by Meadows from the 1977 Daly Triangle, is used as a framework for organizing indicators of sustainability. The triangle is based on (1) the natural world as the “ultimate means” or source for the economy, (2) science and technology as the “intermediate means” for transforming the natural resources to “intermediate ends” (the goods and services which are distributed by the political economy), to achieve (3) the “ultimate ends” (well-being and transcendence, the summum bonum subject of theology and ethics (see Figure 11.1).

Figure 11.1    The Daly Triangle: Hierarchy of Purpose (Daly 1973 in Meadows 1998: 41). http://www.iisd.org/pdf/s_ind_2.pdf. Accessed October 17, 2008.

This model is used to organize the multiple contexts related to aging and the built environment because it provides easily visualized organization and multiple entry points to link additional content. Its major limitations are the hierarchical structure and flows between elements. A weakness of the model for designers is the lack of reference to the built environment. Economic terms such as “built capital” and “human capital” must be translated into the concepts of the design disciplines. The strength of this model is its explicit values orientation linking human well-being to sustainability.

The Human Ecology Model

The Human Ecology Model (HEM) (see Figure 11.2) reframes the content of Meadows' hierarchy of purpose in non-linear, multi-directional constructs visualized in two separate images, a triangle showing major environmental categories with their inner workings, and a series of nested circles that illustrate how the environments are “embedded within each other” in the near environment (Bubolz 1979). Aspects of biological, physical, and social activity are included in each of the categories identified as the Natural Environment, the Human Behavioral Environment, and the Human Constructed Environment.

Figure 11.2    The Human Ecology Model (Bubloz, Eicher, and Sontag 1979: 28). Reproduced by permission of the American Association of Family and Consumer Sciences.

At the center of both versions is the Human Environed Unit (HEU), a place-holder element that represents any individual or body of humans that share an identity, needs, or goals, such as a family, work group, community, or state. Actual human corporeality and psychology – presence, actions, beliefs, and values – are classified within the behavioral and built environments.⁵ Corresponding to Simon's artificial world, the Human Constructed Environment (HCE) category includes all of the “consequences of our collective artifice” (Simon 2001). By definition, this complex and rapidly expanding category is the domain of the designer. The second version of the Human Ecology Model (Figure 11.3) illustrates (in general agreement with the Hierarchy of Purpose Model) that behavioral and constructed environmental constructs occur within, and are dependent on, the natural environment (NE).

Figure 11.3    Comparison of Human Ecology Model with Hierarchy of Purpose (adapted from Bubloz, Eicher, and Sontag 1979: 29). Adapted with permission of the American Association of Family and Consumer Sciences.

Comparing the two models (see Table 11.1) clarifies both sets of contexts. In addition to sharing the foundation of the natural environment, both models are concerned with human well-being, although it is an implicit goal within the HEU. The major difference in organization is apparent between the HOP inter­mediate “ends” and “means” constructs organized by type of capital and which are reorganized in HEM into “behavioral” and “constructed” (human-created) environments, more familiar categories for environmental design.

Table 11.1    Hierarchy of Purpose/Human Ecology: comparison of ranges

Hierarchy of Purpose	Comments	Human Ecology
Ultimate Ends	Well-being is the goal of the designed environment	Human Environed Unit (HEU)
Well-being		(Implicit)
Happiness, Enlightenment	Internalized values are a significant component of personal well-being	Human Behavioral Environment (HBE)
Self-realization, Identity		Psychological: Sentiments, Aesthetics
Fulfillment, Self-respect
Transcendence
Intermediate Ends	Individuals and groups are valuable even if not productive	Social: Family, Friends, Colleagues, Schoolmates
Human capital, Leisure
Health		Biophysical
Social capital	HBE and HCE include the non-desirable consequences of the HCE, on the individual, society, the built environment and the natural environment.	Human Created Environment (HCE)
Harmony, Communication		Socio-cultural: Social Norms, Values
Community		Community, Neighborhood
Mobility, Knowledge		Socio-biological
Wealth
Consumer Goods		Socio-physical: Food, Clothing, Shelter
Intermediate Means
Built capital:Tools,
Production Facilities
Processed Raw Materials
Human capital: Labor		(socio-biological & socio-cultural)
Ultimate Means	NE does not include pollution, bioengineered crops, domesticated animals, etc. as these are in the HCE	Natural Environment (NE)
Natural Capital		Other Natural Resources
Earth Materials, Biosphere		Land, Energy
Biochemical Cycles
Solar Energy		Climactic Zone
Unclear placement of space and time, although they are part of the natural environment, they are also cultural constructs		Space – Time

The Interior Ecosystem Model

Guerin streamlines the human ecology model as a guide for research, renaming and slightly modifying the constructs (see Figure 11.4). This model provides open categories, requiring the researcher to determine content; however, it has the capacity to adapt its structure and elements to accommodate the interacting issues under examination.

Figure 11.4    Interior Ecosystem Model (Guerin 1992: 257). Reproduced with permission of John Wiley & Sons, Inc.

Discussion of Context Models

Meadows' Hierarchy of Purpose Model, Bubolz, Eicher, and Sontag's Human Ecology Model, and Guerin's Interior Ecosystem Model conceptualize relationships between humans and their multiple physical, social, and personal contexts. While all models provide a platform in which environmental issues of aging, such as frailty or disability, can be visualized, they are not specifically addressed. Values of human well-being and environmental sustainability are explicit in the HOP model, but implicit in the others. Values underlying intermediate constructs are not articulated, nor are values such as empowerment of individuals, or the impact of environments on disabled or fragile individuals, which are significant to aging.⁶

Values Model: Modal Patterns for the Treatment of the Aged

The literatures of aging and the built environment are concerned with values of access, empowerment, participation, well-being, aesthetics, efficiency, and sustainability; however, these values are rarely made explicit in models. Moody's Modal Patterns for the Treatment of the Aged (MPTA) relates social values and perceptions to educational programming outcomes for seniors and has been applied to service design (Heumann 2001) and residential environments for seniors (Hofland 1990). Moody posits four distinct philosophical bases for treatment of older adults: (1) rejection, (2) social services, (3) participation, and (4) self-actualization. Each reflects “modal patterns,” “ways society tends to regard old people” (Moody 1976), and exhibits specific characteristics (see Table 11.2).

Table 11.2    Modal patterns for the treatment of the aged (adapted)

Citing Spengler, Becker, and Mumford, Moody suggests “rejection” arises from a modern consciousness of functionality which prizes growth, development, and progress, but shuns decline and death (Moody 1976). Rejection excludes aging seniors from their places (both roles and locations) in society as their usefulness comes to an end. Moody posits rejection is based on economic values (Moody 1976). Limiting resource expenditures on over-priced and outdated workers, mandatory retirement requires that seniors withdraw from the workplace and accept the lower standard of living represented by a fixed income. In the built environment, successful retirees may enjoy the “gold coast” retirement communities, while the less successful are segregated in low-income apartments and facilities.

The second pattern, social services, is a welfare state response to the needs of aging individuals who have been marginalized (retired) and are identified to be in need of care. This pattern redistributes resources to ameliorate the worst excesses of rejection, but does not fundamentally challenge the prevailing institutions. Corresponding to the medical model, case managers and service providers assume that professionals are most qualified to assess needs and provide services (Putnam 2002). “Transfer payments such as social security, food stamps, or welfare, managed by providers are provided as a “safety net” and are monitored to maintain resource-limited individuals at the poverty level (Moody 1976). The structures of the stage 1 built environment (low-income housing, nursing homes) are supported by these transfer payments, as are senior centers and leisure activity programs.

“Characterized primarily by political values, the pattern of participation challenges age-graded distribution of power and status by demanding the rights of old people that have been denied them, sometimes through the policies alleged to be in their welfare” (Moody 1976). Similar to successful aging, this stage corresponds to the political civil rights and disability equality movements, requiring consciousness-raising within the aging community, retraining of providers, reducing ageism, and implementing built environment changes such as those enforced by the Americans with Disabilities Act 1990 (Putnam 2002). Built environments expressing the value of participation include cooperatives, mixed-age housing, participatory group homes, and programs facilitating aging in place.

The fourth pattern, self-actualization, differs from participation and the earlier patterns because it is not based on or reacting to the economic values of modern society, but is based on humanistic values. Old age constitutes a distinct phase of human development rooted in the particular experience of being aged and presents opportunities “uniquely possible in old age” (Moody 1976). The biological reality of aging is that over time many adults are no longer able to be involved in active and powerful ways, and thus are no longer capable of maintaining their middle-adult roles. Self-actualization “accepts aging on its own terms and discerns in the experience of growing old not a problem to struggle against but an opportunity to reach deeper levels of meaning.”

“The prevailing values of Stage 4 are inner-directed and are psychological and spiritual in their orientation” (Moody 1976). Built environments expressing values of self-actualization evidence qualities of choice, meaning, and aesthetics, and provide for meaningful activities and roles. In a self-actualizing society the public built environment, as well as conventional housing, is designed to adapt and support human needs through the entire life cycle (Heumann 2001).

Comparing Moody's MPTA with the contextual models illustrates relationships between values and environmental categories (see Table 11.3). The most obvious link between Meadows' HOP and Moody's MPTA occurs at the self-actualization level. Both models use virtually identical language to describe characteristics of this category. The relationship between MPTA participation and HOP's intermediate ends is also clear as the social and political constructs that promote engagement in society match positive social intermediate ends. MPTA social services and HOP intermediate means are linked by the production-related components (labor, facilities, and funding streams) of the bureaucratic systems created to provide services. Provision of services, whether in a nursing home or in the community, requires cost-benefit analysis similar to that used in manufacturing (Hofland 1990). Investment in facilities and costs for labor are managed to create maximum efficiencies for providers. In the built environment this translates into minimal spaces for consumers that are arranged for staff convenience. Phillipson and Powell (2004) describe this society as offering seniors two choices: living independently in a “no care zone” or receiving care in a “no identity zone.”

Table 11.3    Modal Patterns for the treatment of the aged (adapted)

Moody's rejection stage transpires when resource preservation is based on negative economic valuations of aging individuals. Since elders, particularly those representing failures of earning, savings, personal habits, and/or health, are no longer productive members of society, community resources are not invested to ensure full inclusion (Moody 1976). The resulting shared built environment, including housing and transportation, is inadequate, and necessary modifications become the responsibility of individuals, their families, or charities.

Discussion of Values Model

The MPTA links specific philosophical attitudes to patterns of treatment of aging adults. In the built environment these patterns are etched in wood, glass, and concrete. The pattern of rejection is expressed in a built environment that ignores the needs of elders. The pattern of social services creates facilities primarily designed to be efficient for providers (Heumann 2001). Participative built environment patterns include individualized, cooperatively planned, supportive living and activity spaces and aging-in-place modifications. The only examples I have found of self-actualizing built environments are in smaller closed communities such as religious orders (Snowdon 2001).

Moody's MPTA model is particularly relevant for frail and disabled seniors, as care and support options are identified under several modal patterns. In identifying social values underlying the built environment, this model integrates a significant element not articulated in other models. The MPTA also demonstrates how constructive values can be misapplied to create negative outcomes. All of the values identified in the four environmental constructs – resource preservation, efficiency, equality, and well-being – are in fact properly applied within the environments that they correspond to. Thus, for example, resource preservation is a sustainable approach to the natural environment, while efficiency operationalizes sustainability in the built environment.⁷ Similarly, self-actualization is the sustainable value relating to human well-being; however, it is unsustainable when applied across all environments. Citizenship in society requires balancing individual desires (choice) with the common good, and preserving opportunities and benefits to all members, rather than only privileged individuals (Heumann 2001). Societies that prize all individuals invest resources to ensure social justice for all current and future members of society.

Person–Environment Interaction Models

Environmental gerontology is based on the concept that there is a relationship between persons and their environment and that this relationship can be described, explained, and modified in order to improve quality of life for aging individuals (Wahl 2004). Lawton and Nahemow's Ecological Model of Aging is the foundational person–environment (P–E) interaction, illustrating effects of congruence and incongruence between persons and their socio-physical environment. Wahl and Oswald's “person-environment processes with developmental outcomes” suggests means by which elements of the environment support the preservation of identity (self-actualization) and autonomy (social). Wahl and Lang's SPOT Analysis distinguishes changes in elders' value structures as their functionality diminishes. Values typically articulated in the person–environment literatures include the self-actualization values of well-being, autonomy, and identity, and political values of equality, often balanced with economic values of cost and efficiency.

The Ecological Model of Aging (Competence-Press Model)

Lawton and Nahemow's Ecological Model of Aging (see Figure 11.5), commonly referred to as the Competence-Press Model (CPM), represents individual competence within environmental demands. Competence (x-axis) is defined as “relatively stable capacities of biological health, sensory and motor skills, and cognitive function” that can change because of illness or injury (Lawton [1999] in Scheidt and Norris-Baker 2003). Environmental press (y-axis) includes both objective environmental conditions and subjective assessment of their impacts, consisting of external “forces appraised by the individual as possessing a demand or supporting quality” (Lawton [1999] in Scheidt and Norris-Baker 2003). Both competence and press are dynamic.

Figure 11.5    The general ecological model or Competence-Press Model as originally suggested by Lawton and Nahemow (1973); reproduced after Lawton 2000: 191. Reprinted with permission of the American Psychological Association.

The mapping surface of the model shows alternative outcomes identified as behaviors and affect (mood) resulting from the level of match between the capacities of the person and the environment. An optimal match between personal competence and environmental press results in positive mood and behavior, while a poor match results in negative mood and behavior. Sub-zones such as the “zone of maximum performance potential” illustrate benefits of moderate challenge, and the “zone of maximum comfort” the relaxing experience of reduced press. To either side of the optimal area lie narrow marginal zones buffering the great negative expanse where press is overwhelming (to the right), or conversely, demands are so low (on the left) that they result in helplessness. This model proposes that individuals with low competence require less demanding environments and have narrower optimal zones than individuals with high levels of competence; thus the former are more quickly overwhelmed or under-challenged.

Rubinstein and de Medeiros critique the CPM, contending it describes an organism's response to the environment rather than a person's response (Rubinstein and de Medeiros 2004). They posit that it is not the outside environment that directly presses on the individual, but that person's culturally influenced internal standard. An extension of the anthropological concept of cultural competence, the elder abstracts meanings from the originating culture and interprets it to establish standards for personal competence. Over the lifetime, these meanings become a sort of personal morality of the self; thus if the elder can no longer perform a personally distinguishing activity– which can be as simple as making tea – their identity is diminished.⁸ Person–environment processes are linked to developmental outcomes.

Behavior, identified as an outcome in the CPM, has been repeatedly demonstrated to be affected by the ability to function, whether because of control, permission, or well-matched facilities (Clarke and Nieuwenhuijsen 2009). On the other hand, the equally significant personal experience of the environment at the level of meaning, satisfaction, and attachment over time is more difficult to access and measure, thus may be overlooked (Wahl, Fänge, Oswald, Gitlin, and Iwarsson 2009). Wahl and Oswald's person–environment processes with developmental outcomes (PEDO) addresses both personal identity (the self) as well as functionality (agency). Their flow diagram proposes that well-being emerging from autonomy is supported by P–E fit. However identity-based well-being is supported by experiencing meaning and belonging (see Figure 11.6). Poulet proposes that the self requires place and becomes one with place, just as the organism requires space for.⁹

Figure 11.6    Overarching conceptual framework on person–environment relationships in later life. (Wahl and Oswald 2010: figure 8.1). Reproduced by permission of SAGE Publications Ltd.

The Social-Physical Places Over Time Model

The significance of agency and belonging changes over the life-span. Relocation research on the moves of older adults identifies that first moves are expected in the early years after retirement and are often selected to enhance agency (e.g., fewer stairs, close to places of activity, etc.). Second moves appear later in life and are motivated by desire for both support and continuity, for example relocation to be closer to one's children (Wahl and Lang 2004). Third moves, such as to a nursing home, are problematic as this move is required to provide care (agency) at a later time in life when the personal priority has shifted to belonging. Wahl and Lang's Social-Physical Places Over Time Model (SPOT) (see Figure 11.7 and Table 11.4) illustrates the trajectory of human motivation from prioritizing agency in middle adulthood, to valuing social-physical belonging for the oldest old.

Figure 11.7    Social-Physical Places Over Time Model (SPOT): Implications for Future QoL in Old Age. Wahl and Lang (2006: 889). Reproduced by permission of Elsevier Academic Press.

Table 11.4    Person–environment fit dynamics in SPOT

The SPOT model is intended to integrate the developmental worldview with the environmental fit model. It is based on three concepts: place, its social construction, and its dynamic nature. Place is central, because “every aging person's day-to-day behavior is embedded within given physical and spatial surroundings” that have meaning rooted in characteristics and experiences (Wahl and Lang 2004).¹⁰ These places are “socially constructed, socially filled out, and socially shaped physical environments” and consequently places are dynamic, showing stability and change over time as people age and environments are modified (Wahl and Lang 2004).

A reference table of well-being precursors over time, such as person-environment fit dynamics (Table 11.4), an earlier presentation of SPOT, enriches the conversation for designers because it sheds light on the specific needs that should be accommodated in the environment for phases of adulthood. In middle age, when the relevance of agency is high, the need is for stimulation and action. For the young old, the relevance of agency and belonging is balanced, as are needs for stimulation, activity, safety, familiarity, continuity, and meaning. In old age, as the relevance of belonging increases and agency declines, the need increases for safety, familiarity, continuity, and meaning. A sustainable and humanistic approach to design would infuse essential elements required for safety, familiarity, continuity, and meaning into environments built for middle adulthood and early age to maintain well-being throughout the entire life-span. The reference table could expand to integrate the needs of disabled adults who lose agency earlier in the life course, and suggest strategies for populations with differing types of functional deficits.

Comparing terms from the person–environment models (Table 11.5) with those previously identified in the context and values models reveals their orientation to observable (external) behavior. The interface between the individual and the social and built environment neglects aspects of well-being related to self-actualization that are internal to the individual. The person–environment models essentially disregard the natural environment despite research showing the importance of access to nature in maintaining physical and mental health (Ulrich 2002). On the other hand, they clearly articulate multiple interacting levels of the social environment and demonstrate sensitivity to residential issues, including mention of neighborhoods and distances.¹¹

Table 11.5    Comparison of terms from person–environment models with the context and values models

Discussion of Person–Environment Interaction Models

Person–environment models from environmental gerontology provide a basis for understanding the centrality of the environment for individual agency and behavior. As such, they provide a theoretical underpinning for addressing social pro­cesses implicated in enabling and disabling behavioral environments, as well as providing justification for intervention in the built environment. Lawton and Nahemow's CPM is classic precisely because it continues to provide a clear presentation of foundational concepts, facilitating multi-disciplinary interaction regarding P–E fit.

Wahl and Oswald's PEDO integrates concepts from the psychology of aging and environmental psychology, proposing that interactive P–E processes can be pathways to well-being, thus extending the connection between person and environment into the self-actualization level. Person–environment fit dynamics in SPOT develop the connections identified in PEDO and add the dynamic elements of time and place significant to understanding P–E processes as part of a system. Without self-identity components, research centered on CPM, particularly for housing, actually supports existing materialistic systems (Moody 1993), modulating service provision toward the participation level, by demonstrating positive behavioral and affective outcomes.¹² The models illustrate that over-support is equally disabling as lack of care, suggesting that facilities and services must be calibrated to the needs of individual persons.¹³ The strength of the P–E fit models is illustrated in their application to residential structure and organization, particularly significant for identifying characteristics that create or reduce disability.¹⁴

Findings/Discussion

The findings of this literature review of models are multiple. Elders, aging, and contexts for aging are complex and are dynamically interrelated in interacting systems that affect individuals, society, institutions, the built environment, and the natural environment. The concept of the built environment as an expression of values is immediately usable for researchers and practitioners to consider in person-centered, sustainable design.

The comprehensive tabular model presented in this essay retains the intent and wording of the source models and can be used for interdisciplinary collaboration or to populate existing comprehensive design models such as those of Buboltz, Eicher, and Sontag, or Guerin. Additional work is needed to simplify the tabular model and create a visual structure that is effective in communicating essential concepts. Although the genesis of this study is the needs of aging populations and the elderly within the built environment, similar concerns, beyond the scope of this essay, are likely true for other populations, such as children or individuals with disabilities, not served by our current built environment.

This essay also illustrates how many forms of visualization can be labeled a “model.” Models can be words, illustrations, tables, line drawings, three-dimensional objects, or computer simulations. While these models were discussed in terms of content and terminology, they could also have been reviewed for effectiveness in presentation. Some designs, such as the Lawton/Nahemow P–E fit model, were exceptionally comprehensible, while others, with equally significant content, such as the SPOT model, were very difficult to decipher, necessitating an explanatory table. It is likely that successful models that inspire years of debate are models that communicate well visually.

Conclusion

This essay presents aging as a natural aspect of human experience, integrating issues of aging populations and the elderly within the social and built community in order to improve individual well-being and environmental sustainability. The models of context suggest that the entire society and economic system is involved in our system for dealing with issues of aging populations and elders. Moody's model of values exposes the lack of capital investment that results in a built environment that effectively rejects aging and disabled individuals. The person–environment fit models illustrate the importance of matching environments to needs over time.

Aging seniors in Western society face a built environment that challenges well-being by progressively limiting their life activity space by excluding, and in some cases expelling, increasingly frail individuals from their environments of choice. Further, health effects, their economic consequences, and resource use are clearly interconnected; thus, the disabling impact of most existing built environments on aging individuals must be included in any meaningful discussion of urban sustainability.

While there is much research on aging and specific interior elements, there is a gap in the integration of knowledge from across the disciplines, and in its availability to designers. Planners and designers operationalize society's values as expressed in building codes, market preferences, and implicit expectations (Allen 2000); however, they are simultaneously positioned to be agents of systemic change (Buchanan 1992). In order to identify, design, and advocate for successful approaches to built environments for aging, researchers and practitioners need to integrate the complex range of elements making up current planning and design practice. Comprehensive environmental design research and planning, as well as design practice, must include life-span needs in order to serve individuals and the planet with holistic sustainability.

Acknowledgments

I gratefully acknowledge Nancy H. Blossom for practical and theoretical assistance in developing and articulating integrative approaches to complex systems.

Notes

  1    “As a dynamic human factor, aging is a complex blending of physiological, psychophysical psychological and sociological change. Aging is a process of change personality through intensification of individual characteristics. People who have reached advanced years (75–95) will be a very diverse population with increased differences between individuals than younger populations” (Koncelik 2003: 121).

  2    “An individual with a disability is defined by the ADA as a person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment.”

  3    “The Census Bureau defines disability as a long-lasting sensory, physical, mental, or emotional condition. This condition can make it difficult for a person to do activities such as walking, climbing stairs, dressing, bathing, learning, or remembering. It can impede a person from being able to go outside the home alone or to work at a job or business, and it includes persons with severe vision or hearing impairments.”

  4    The authors suggest the Human Ecology Model as a comprehensive framework not only for the study of human behavior, but also as a basis for delineating and integrating the subject matter of their field. P. 28.

  5    Any environment created by humans or adapted to human goals, including all modifications of physical, biological, social, and cultural constructs is included: the positive constructions of language, art, housing, and domesticated foods, as well as the less desirable outcomes of human action such as pollution or repressive cultural patterns.

  6    Bubolz and Sontag write about the ethical underpinnings of the Human Ecology Theory in Boss et al. 1993: ch. 17.

  7    Creating and managing the built environment efficiently typically requires greater initial resource inputs; however, the results are more sustainable (resource-preserving and waste-minimizing) over the long term, than designs based strictly on minimal resource use (Chiras and Herman 1997).

  8    “Moreover, these activities and routines are at the core of the self and are symbolically significant to the person; they are what the person does and who she is. Routines and activities are embodied within the person through their unconscious nature and the habitus” (Bourdieu [1977, 1990] in Rubinstein and de Medeiros 2004: 72).

  9    “Beings surround themselves with the places they find themselves, the way one wraps oneself up in a garment that is at one and the same time a disguise and a characterization. Without places, beings would be abstractions. It is places that make their image precise and that give them the necessary support thanks to which we can assign them a place in out mental place, dream of them and remember them” (Poulet [1977] in Chaudhury 2003).

10    “Having lived in a specific place implies an enormous amount of implicit knowledge related to everyday routines, geographical distances inside and outside the home, distinguishing neighbors from strangers, seasonal changes of the sunlight and community services” (Wahl and Lang 2004: 20).

11    Not discussed in this text, but included in the chart for robustness, are Lawton's five strata of an environment: physical, personal, small-group, supra-personal, and mega-social, four of which are social constructs (Wahl and Lang 2004: 7–8).

12    For examples applied to place experience see Calkins and Weisman 1999: 130–140.

13    For examples of expending resources on direct care rather than supporting self-care see Heumann 2001: 119–136.

14    For a comparison of therapeutic goals for environments for the elderly see Calkins and Weisman 1999: 134.

References

1. Allen, S. 2000. “Introduction: practice vs. project,” in Introduction to Practice, Architecture, Technique and Representation. Australia: G+B Arts International.
2. Baltes, P. B. 1987. “Theoretical propositions of life-span developmental psychology: on the dynamics between growth and decline,” Developmental Psychology 23(5): 611–626.
3. Boss, P. G. et al., eds. 1993. Sourcebook of Family Theories and Methods: A Contextual Approach. New York: Plenum Press.
4. Brault, M. 2008. Review of the Changes to the Measurement of Disability in the 2008 American Community Survey. Washington DC: US Census Bureau.
5. Bubolz, M. M., Eicher, J. B., and Sontag, M. S. 1979. “The human ecosystem: a model,” Journal of Home Economics (Spring): 28–31.
6. Buchanan, R. 1995. “Wicked problems in design thinking,” in V. Margolis and R. Buchanan (eds.), The Idea of Design. Cambridge, MA: MIT Press, pp. 3–20.
7. Calkins, M. P. and Weisman, G. D. 1999. “Models for environmental assessment,” in B. Schwarz and R. Brent (eds.), Aging, Autonomy, and Architecture: Advances in Assisted Living. Baltimore: Johns Hopkins University Press, pp. 130–140.
8. Chaudhury, H. 2003. “Quality of life and place therapy,” in R. J. Scheidt and P. G. Windley (eds.), Physical Environments and Aging: Critical Contributions of M. Powell Lawton to Theory and Practice. New York: Haworth Press, pp. 85–103.
9. Chiras, D. A. and Herman, J. 1997. “Sustainable community development: a systems approach,” in I. Audirac (ed.), Rural Sustainable Development in America. New York: John Wiley & Sons, pp. 107–127.
10. Clarke, P. and Nieuwenhuijsen, E. R. 2009. “Environments for healthy aging: a critical review,” Maturitas 64(1): 14–19.
11. Dahlgren, G. and Whitehead, M. 1991. Policies and Strategies to Promote Social Equity in Health. Stockholm: Institute for Future Studies.
12. Day, J. C. 1996. Population projections of the United States by Age, Sex, Race, and Hispanic Origin: 1995 to 2050. US Bureau of the Census, Current Population Reports, P25–1130. Washington DC: US Government Printing Office. http://www.census.gov/prod/1/pop/p25-1130.pdf. Accessed February 3, 2011.
13. Ebersole, P., Hess, P. A., and Luggen, A. S. 2004. Toward Healthy Aging: Human Needs and Nursing Response. St. Louis, MO: Mosby.
14. Ewenstein, B. and Whyte, J. K. 2007. “Visual representations as ‘artefacts of knowing’,” Building Research & Information 35(1): 81–89.
15. Forrester, J. W. 1991. “System dynamics and the lessons of 35 years,” repr. 1993 in K. B. De Greene (ed.), A Systems Based Approach to Policy Making Boston: Kluwer Academic.
16. Guerin, D. A. 1992. “Interior design research: a human ecosystem model,” Home Economics Research Journal 20: 4.
17. Heumann, L. F. 2001. “The role of the built environment in holistic delivery of home- and community-based care services to frail elderly persons,” in L. F. Heumann, M. E. McCall, and D. P. Boldy (eds.), Empowering Frail Elderly People: Opportunities and Impediments in Housing, Health, and Support Service Delivery. Westport, CT: Praeger, pp. 119–136.
18. Hofland, B. F. 1990. “Value and ethical issues in residential environments for the elderly, “ in D. Tilson (ed.), Aging in Place: Supporting the Frail Elderly in Residential Environments. Glenview, IL, pp. 287–309.
19. Kinsella, K. and Velkoff, V. A. 2001. An Aging World: 2001. US Census Bureau, p. 41. http://www.census.gov/prod/2001pubs/p95-01-1.pdf. Accessed September 29, 2009.
20. Koncelik, J. A. 2003. “Human factors of aging and the micro-environment: personal surroundings, technology and product development,” Journal of Housing for the Elderly 46: 117–134.
21. Landorf, C., Brewer, G., and Sheppard, L. 2008. “The urban environment and sustainable aging: critical issues and assessment indicators,” Local Environment 13(6): 497–514.
22. Lawton, M. P. 2000. “Quality of life, depression, and end-of-life attitudes and behaviors,” in G. M. Williamson, P. A. Parmelee, and D. R. Shaffer (eds.), Physical Illness and Depression in Older Adults. New York: Plenum, pp. 147–171.
23. Lawton, M. P. and Nahemow, L. 1973. “Ecology and the aging process,” in C. Eisdorfer and L. M. Powell (eds.), The Psychology of Adult Development and Aging. Washington DC: American Psychological Association, pp. 619–674.
24. Litwak, E. and Longino, C. F. 1987. “Migration patterns among the elderly: a developmental perspective,” The Gerontologist 27: 266–272.
25. Meadows, D. H. 1998. Indicators and Information Systems for Sustainable Development. A report to the Balaton Group. Hartland, VT: The Sustainability Institute.
26. Moody, H. R. 1976. “Philosophical presuppositions of education for old age,” Educational Gerontology: An International Quarterly 1: 1–16.
27. Moody, H. R. 1993. “Overview: what is critical gerontology and why is it important?”, in T. Cole, W. Achenbaum, P. Jakobi, and R. Kastenbaum (eds.), Voices and Visions of Aging: Toward a Critical Gerontology. New York: Springer.
28. Phillipson, C. and Powell, J. L. 2004. “Risk, social welfare and old age,” in E. Tulle (ed.), Old Age and Agency. New York: Nova Science, pp. 17–26.
29. Putnam, M. 2002. “Linking aging theory and disability models: increasing the potential to explore aging with physical impairment,” The Gerontologist 42(6): 799–806.
30. Rubinstein, R. L. and de Medeiros, K. 2004. “Ecology and the aging self,” Annual Review of Gerontology and Geriatrics 23: 59–84.
31. Sadler, E. and Biggs, S. 2006. “Exploring the links between spirituality and successful aging,” Journal of Social Work Practice 20(3): 267–280.
32. Samanez-Larkin, G. R., Robertson, E. R., Mikels, J. A., et al. 2009. “Selective attention to emotion in the aging brain,” Psychology and Aging 24(3): 519–529.
33. Scheidt, R. and Norris-Baker, C., eds. 2003. “The general ecological model revisited: evolution, current status, and continuing challenges,” in Annual Review of Gerontology and Geriatrics, vol. 23. New York: Springer.
34. Simon, H. A. 2001. “ ‘Seek and ye shall find’: how curiosity engenders discovery,” in K. D. Crowley, C. D. Schunn, and T. Okada (eds.), Designing for Science: Implications from Everyday Classroom and Professional Settings. Mahwah, NJ: Lawrence Erlbaum Associates, pp. 3–18.
35. Snowdon D. 2001. Aging with Grace: What the Nun Study Teaches Us about Leading Longer, Healthier, and More Meaningful Lives. New York: Bantam Books.
36. Ulrich, R. S. 2002. “Effects of gardens on health outcomes: theory and research,” in C. Cooper Marcus and M. Barnes (eds.), Healing Gardens: Therapeutic Benefits and Design Recommendations, New York: John Wiley & Sons, pp. 27–86.
37. US Census Bureau. 2005. American Community Survey: Subject Definitions. Washington DC: United States Census Bureau, pp. 31–32.
38. US Census Bureau. 2009. Disability Status and the Characteristics of People in Group Quarters: A Brief Analysis of Disability Prevalence among the Civilian Noninstitutionalized and Total Populations in the American Community Survey. Washington DC: United States Census Bureau.
39. US Department of Justice. 2005. A Guide to Disability Rights Laws. US Department of Justice, Civil Rights Division, Disability Rights Section. http://www.ada.gov/cguide.htm. Accessed October 7, 2009.
40. Verbrugge L. M., and Jette, A. M. 1994. “The disablement process,” Social Science & Medicine 38(1): 1–14.
41. Vincent, G. K., and Velkoff, V. A. 2010. The Next Four Decades for the Older Population in the United States: 2010 to 2050. Washington DC: US Department of Commerce, Economics and Statistics Administration, US Census Bureau. http://purl.access.gpo.gov/GPO/LPS126596. Accessed February 3, 2011.
42. Wahl, H.-W. 2008. Environmental Gerontology and the Psychology of Aging. Workshop at CASE in Lund, Sweden. April 10–11, Slide 26. Published in P. M. Conn (ed.), Handbook of Models for Human Aging. Amsterdam: Elsevier Academic Press (2006).
43. Wahl, H.-W., Fänge, A., Oswald, F., Gitlin, L. N., and Iwarsson, S. 2009. “The home environment and disability-related outcomes in aging individuals: what is the empirical evidence?” The Gerontologist 49(3): 355–367.
44. Wahl, H.-W. and Lang, F. R. 2004. “Aging in context across the adult life course: integrating physical and social environmental research perspectives,” Annual Review of Gerontology and Geriatrics 23: 1–33.
45. Wahl, H.-W. and Lang, F. R. 2006. “Psychological aging: a contextual view,” in P. M. Conn, (ed.), Handbook of Models for Human Aging. Amsterdam: Elsevier Academic Press, pp. 881–895.
46. Wahl, H.-W. and Oswald, L. N. 2010. “Environmental Perspectives on Ageing,” in C. Phillipson and D. Dannefer (eds.), The SAGE Handbook of Social Gerontology. London: Sage Publications, pp. 111–124.
47. Weisman, G. D. and Diaz-Moore, K. 2003. Vision and Values: M. Powell Lawton and the Philosophical Foundations of Environment-Aging Studies. Binghampton, NY: Haworth Press.
48. WHO (World Health Organization). 2001. International Classification of Functioning, Disability and Health. ICF, Geneva: World Health Organization. http://www.who.int/classifications/icf/en/. Accessed October 24, 2008.