Post-Occupancy Evaluation of a Transformed Nursing Home: The First Four Green House® Settings

To study how well the physical environments of four Green Houses® served the residents, staff, and visitors and to develop recommendations for similar small-house nursing home projects. Longitudinal post-occupancy evaluation of four houses using mixed-methods, including behavioral mapping, checklist ratings of individual bedrooms and bathrooms, place-centered time scans, environmental tracers, and questionnaires and interviews. The small residential environments achieved the desired functional results for residents and staff. Some components of the environment proved problematic, especially bathroom designs, lighting and fixtures, and storage spaces. Certain areas of the buildings were under utilized, particularly a den. Space was used differently in the two houses dedicated to residents with dementia compared to the other two houses. In the latter, residents tended to use their own rooms for a variety of activities, including visits, and often kept their doors closed, whereas in the former the central hearth area was used more frequently. The physical design of the Green Houses was associated with desired behavior and outcomes in residents and staff. Post-occupancy evaluation methods were useful to elicit detailed information about environmental performance and suggest modifications for the next iteration of Green Houses.