Historically, a behavioral health patient with medical issues would be transferred to a medical unit, and if necessary, provided a full-time “sitter” to help keep him or her safe, explains James M. Hunt, AIA, NCARB, President of Behavioral Health Facility Consulting, LLC (Topeka, Kan.). Although this practice still exists, he states that it is “marginally effective and very expensive.”
And, although the designers of older medical units could once have assumed that patient mobility and agility were limited, Hunt says that today, some hospitals admit 40- and 50-year-old patients to geriatric units because of early-onset dementia. The relatively high physical health, strength, and mobility of these patients makes them capable of doing things (lifting, climbing, moving, etc.) and behaving in ways that unit designers never anticipated.
This only magnifies the hazard of typical medical room tools such as medical gas outlets, medical gas tubing, wires, and bed pan washers, which are not safe around psychiatric patients of any age. The challenge becomes finding ways to provide these tools so they are readily available for staff to provide patients with necessary treatment, while also minimizing risk of hazard to the patients and staff.
Thus, there’s a growing need for thoughtful renovations, explains Laurie Placinski, Interior Project Designer and Client Leader at Progressive AE. “Hospitals are saying, ‘We may not have the funding to do a completely new build or replacement but this is important to us and there’s a need in the community that we need to answer to.’ They may not have the complete demographic to do a dedicated unit, but they want those components infused within the space of all the types and populations that they may have,” she explains.
Her firm has witnessed an increased need for geriatric spaces in acute care in general. Whether it’s a psych unit, a critical care unit, a step-down unit, a med-surg unit, the aging of the baby boomers means more older, often sicker patients. Hunt notes that the geriatric population will remain the biggest growth area for behavioral health units in coming years.