In the 1960s, with the rising momentum of the Civil Rights movement and heightened awareness of the marginalization of the elderly and disabled, a new movement arose in the design community: Universal Design. This movement attempted to create designs that were accessible and inclusive to marginalized communities, by raising design standards to meet “universal” human standards of simplicity, ease, comfort, safety, and flexibility. But despite the idealistic intentions of Universal Design, specialized design services for differing populations are a growing need in today’s world. Case in point: a group-home for developmentally-disabled seniors with Alzheimer’s disease in Boston needed some very specific considerations to deal with the unique challenges facing the individuals living in the home. Dr. Dak Kopec, Architectural Psychologist and Director of the Boston Architectural College’s (BAC) Master of Design Studies (MDS) has been pioneering the concept of Habilitative Design – design that meets specific individual needs that allow users to function to their highest capacity. Read on to learn how a team of students from the Design for Human Health course at BAC used the principals of Habilitative Design to meet patients’ specific needs.



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Image courtesy of Bay Cove Human Services Inc. Reaching People Changing Lives

Group homes tend to be single-family residences dispersed throughout residential neighborhoods. They are a great way to help differing populations remain integrated into the community while ensuring residents receive needed support. Many who are developmentally disabled rely upon group homes to ensure personal safety while retaining independence and basic freedoms.

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The combined challenge of having a Developmental Disability with Alzheimer’s

Improvements in medicine and support systems for the disabled mean that many people with developmental disabilities are living much longer than before. They are thus increasingly affected by age-related conditions such as Alzheimer’s disease. For instance, there is a correlation between Alzheimer’s and Down Syndrome and most people with Down syndrome who live into their 50s and 60s develop the brain changes associated with Alzheimer’s disease by their 5th or 6th decade. The difference between Alzheimer’s in the general population and in the developmentally disabled population, is that Alzheimer’s disease occurs much earlier in people with Down syndrome; patients with Down syndrome begin to have symptoms in their late 40s or early 50s.

Designing for people with a developmental disability is an already complicated process, and when Alzheimer’s disease is added to the equation, designs for health and wellness becomes more complex. Habilitative Design is a design process that attempts to accommodate each individual’s unique abilities.

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When Universal Design isn’t specific enough

Developmental disabilities consist of a broad range of unique behaviors that preclude the use of repeatable Universal Design and Aging in Place strategies. The best design method to base an environment upon when designing for special or differing populations is called Habilitative Design. This is a form of design that is based upon unique behaviors and specific physical needs of the intended occupants. Habilitative design tends to have great outcomes, but is not easily replicable.

As is typical of those who specialize in Design for Health and Wellness, the scope of work includes the entire property boundaries. This includes the neighborhood, exterior landscaping and recreational spaces, and interior spaces. Likewise, with Design for Health and Wellness there are many unique challenges that might present in one environment, but not in others.

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Designing around Poison Ivy

One unique challenge of the group home redesigned by BAC students was the infestation of Poison Ivy. Urushiol, an active ingredient in Poison Ivy, can remain active on any surface, including dead plants for up to five years or longer. As such, residents of the group home needed to be protected from direct and possible airborne contact with the urushiol, which meant that remediation and barriers had to be included in the renovation process.

Another challenge the students faced was the inclusion of a built-in hoist system that would allow the residents to easily move throughout the home. Because this was a modular home, collaboration with a structural engineer was required to retrofit the ceilings for a mounted hoist system that could support weights of 350 pounds (159 Kilos).

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Making “medical” feel “homey”

A third challenge of the project was to ensure that this home retained a residential atmosphere despite the need for medical equipment, procedural workspaces and storage of supplies. Custom cabinetry was required to accommodate medical equipment and supplies, and surface materials were needed to support free and easy movement by means of walkers and wheelchairs, and fixtures (such as lighting) that could withstand or minimize negative outcomes that might derive from periodic behavioral outbursts.

• Flooring materials must be durable, and easily maneuvered upon without the creation of ruts.
• Upholstery must be easily cleanable to prevent the spread of Ecoli and other biological pathogens.
• Accessories need to be carefully selected so that damage could be minimized should they be thrown, slammed or punched.

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Image via Versehead

Sound dampening and noise abatement – how to keep residents and the neighbors happy

While these challenges were priorities, the most important challenge for this group home was noise abatement and sound dampening. People with developmental disabilities who begin to experience symptoms of Alzheimer’s disease often scream or yell in response to their confusion or disorientation. Studies have shown that environmental stressors such as sudden loud noises, loud voices, and disruptive housemates can serve to exacerbate a problem and can in turn trigger a loud, negative behavioral response. In this particular case, these group home residents’ outbursts were alarming neighbors as well, triggering calls to the police and accusations (unfounded) of elder abuse. Hence, design strategies to reduce sound transmission and noise dampening within the home were extremely important.

Noise abatement and sound dampening methods we explored were:

• Sound attenuating blanks built into the wall
• Thicker dry wall
• Double and triple paned windows
• Insulated drapery
• Rounded walls and ceilings
• Acoustical panels measured to reduce sound transmission and dampening

An important case study in Habilitative Design

Through practice based learning with real situations, students in the BAC’s MDS-DHH program were able to integrate what they have learned from human sciences with their design skills to develop a meaningful Habilitative Design. They subsequently produced a design that guarantees residents of the home with the best quality of life possible, while ensuring that the neighborhood continues to embrace the home as a community asset.

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Design For Human Health Masters Program at the BAC

With a joint emphasis on human health and design of the built environment, Boston Architectural College’s Master of Design Studies in Design for Human Health degree program provides students with the knowledge to assess and design environments based on the human dimensions of physical activity, cognitive performance, and psychological wellbeing. The program merges biological and social sciences with design skills to better serve those who have suffered a traumatic injury, have been compromised as a result of disease or chronic illness, or have diminished capabilities as a result of natural human development or aging processes. A low-residency, online format allows students to maintain full-time employment while providing the practicing designer or health professional to specialize in the growing field of human health and wellness in relation to the built environment.

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Dak Kopec

Dak Kopec holds a doctorate degree in environmental psychology with a concentration in perception and design and two master’s degrees, one in architecture and another in community psychology. He has served twice as a visiting lecturer at Virginia Commonwealth University in Doha Qatar and as a visiting professor at the University of Hawaii in the schools of Architecture and Medicine. He currently serves as a reviewer for Fulbright applications.

Dak’s most notable accomplishments include several journal articles, the completion of three books: Environmental Psychology for Design; Health, Sustainability and The Built Environment; and Evidence Based Design: A Process for Research and Writing. He has also authored two monographs, Americans with Disabilities Act and The Elderly Population and Designs that Protect: Incorporating Culturally Diverse Perspectives in Long-Term Care Facilities. Dak was invited by the Costa Rican National Congress’ of Medicine and Engineering to discuss the role of design and health, and he has also testified before the California State Senate on issues of environmental health, and has been appointed by the governor of Hawaii to sit on the Hawaii Regional Planning Council. Previously, he was also invited to present on the future of design at the IDA (International Design Alliance) Congress in Taiwan, and invited to present at a TEDx conference. He was also a member of ASID’s Distinguished Speakers

Images via Bay Cove Human Services Inc. Reaching People Changing Lives , Versehead and Shutterstock.