Better memory support communities come from combining three decisions: learn the principles behind successful international models instead of copying their appearance, use structured environmental evaluation to target specific design changes, and reposition existing buildings when a new care model can be both more supportive and financially viable. Examples from Hogeweyk in the Netherlands, Avandell in New Jersey, Seaglass in Virginia, and Josephine Caring Community in Washington show how those decisions can operate at different scales.
The projects described in Building Design + Construction (September 21, 2026) are project descriptions and stated intentions, not controlled comparisons. Neither that article nor Perkins Eastman’s Missing Main Street page reports measured resident outcomes, post-occupancy scores, or financial results for the named communities. That distinction matters when turning examples into a real project brief.
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Start with the outcome you are trying to create
“Better” is not a single floor-plan feature. For a memory support community, the brief may need to balance familiar daily routines, legible circulation, safe access to outdoors, social connection, staff visibility, clinical support, and a sustainable operating model. Those priorities can conflict: more security can feel institutional, a larger building can improve service efficiency but weaken household identity, and a renovation can preserve capital while constraining daylight or circulation.
A useful first step is to write the intended experience in observable terms. For example, residents should be able to choose among several ordinary activities, reach a shared room without a confusing route, see an outdoor destination from inside, and encounter staff without making every space feel clinical. These are design objectives to test, not promises that a particular arrangement will improve safety, agitation, wayfinding, or quality of life.
The three approaches below are complementary rather than mutually exclusive. A provider can use international principles to set a vision, an environmental audit to identify priorities, and a feasibility study to decide whether to renovate or build. The appropriate mix depends on the site, care model, resident profile, staffing, capital, and local regulations.
Approach 1: Learn the principles behind international models
Hogeweyk is a philosophy, not a decorative package
Hogeweyk in Weesp, Netherlands, is described as a non-institutional, person-centered dementia community. Its central idea is normalcy for people living with dementia: everyday life, recognizable choices, and a sense of belonging should be supported within a secure setting. Reproducing a nostalgic storefront, street sign, or themed facade without that philosophy can produce scenery rather than a meaningful community.
Perkins Eastman’s Missing Main Street: Reconnecting Older Adults with Dementia to the Fabric of Authentic Living, published January 13, 2021, frames the lesson as 11 patterns for dementia communities. The patterns connect residents’ sense of self with physical place, authentic living, and the surrounding community. The page presents them as considerations that designers and operators can adapt to a provider’s vision, not as a universal template or a tested formula.
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1Fix the driver behind crashes, sound loss and screen glitches2Repair Windows errors before they cause bigger problems3Scan for outdated or missing drivers - takes under a minuteAvandell translates the idea into a community scale
Avandell Memory Care Center for Excellence in Holmdel, New Jersey, is the U.S. example described in the 2026 trade-publication article. The plan contains 15 houses, each for seven residents, grouped into mini-neighborhoods inside a secure boundary around a central green. A town center, activity pavilion, and barn act as shared destinations.
The stated intention is to let residents engage in ordinary activities freely and safely rather than remain confined to a single corridor or lounge. The town center and community garden are also described as open to the surrounding community. They include a clinic, education areas, support spaces, and places for caregiver respite. Those are reported program features and design intentions; the source does not provide attendance, safety, or resident-outcome measurements.
How to apply an international model without copying it
- Extract the operating principle. Write down what the reference project is trying to achieve—such as normalcy, choice, or connection—before discussing architectural forms.
- Map local expressions of ordinary life. Interview residents, families, staff, and community partners about familiar destinations, routines, foods, work, worship, and seasonal activities. Use those findings to shape authentic spaces rather than applying a generic historic theme.
- Set a security strategy that is visually quiet. Define the secure boundary, controlled entries, staff observation points, and emergency procedures early. Then integrate them with landscape, household thresholds, and daily routes so security does not dominate the visual experience.
- Organize at more than one scale. Consider a private room, a small household, a neighborhood destination, and a connection to the wider community. Each scale should have a clear purpose and a manageable route.
- Test the plan with real routines. Walk through breakfast, a family visit, a rainy-day activity, medication support, an unscheduled exit attempt, and a staff handoff. Revise the layout when a “normal” activity depends on an unrealistic staffing assumption.
Approach 2: Evaluate the environment and let findings direct design
Use an audit to replace general impressions with specific questions
Westminster-Canturbury on Chesapeake Bay used an Environmental Audit Screening Evaluation (EASE) to review its Seaglass memory-care environment in Virginia Beach, Virginia. The 2026 account characterizes EASE as a research-based checklist that rates physical-environment features in relation to resident support. Examples include the distance between a resident’s room and a living space and whether a route provides access to natural light.
The image caption identifies Robert Wrublowsky as the developer and says EASE was implemented through the IDEAS Institute and Kansas State University. It also says the tool analyzes space using five categories of metrics, but the accessible source does not name those categories. A project team should therefore obtain the current EASE instrument and its administration guidance rather than inventing categories or scoring rules.
What Seaglass changed after its review
The evaluation led the owner to prioritize the memory-care floor in a planned renovation. The design team then organized a small-house setting for 14 residents. Kitchen, dining, and living areas were centralized, and natural light was brought into the household’s center. Coastal-themed materials were selected to support wayfinding, while activity portals connected corridors to living, dining, and kitchen areas.
A follow-up EASE evaluation was planned after the renovation. No follow-up scores or resident outcome data are reported, so the project should be read as an example of how findings can guide decisions—not as evidence that the changes produced a measured improvement.
A practical evaluation-to-design workflow
- Define the unit of analysis. Decide whether you are reviewing a resident room, a household, a floor, the outdoor route, or the full campus. Record where the boundary begins and ends.
- Document representative routes. Measure and photograph routes from bedrooms to living, dining, bathing, activity, outdoor, and staff-support areas. Note distance, turns, sightlines, doors, changes in light, and points where a resident could become uncertain.
- Score or classify the environment using the selected tool. Follow the tool’s instructions consistently and preserve the original observations so the team can repeat the review later.
- Rank changes by resident effect, feasibility, and risk. A shorter route may be inexpensive; bringing daylight to a central room may require structural work. Make the trade-off visible instead of allowing the loudest preference to set the sequence.
- Translate priorities into a testable plan. Show which audit finding each intervention addresses, who owns it, what it costs, and what condition would count as acceptable during commissioning.
- Re-evaluate after occupancy. Repeat the same routes and observations after the renovation. If a follow-up is planned, publish the method and results separately from the original design rationale.
Design details that deserve close checking
- Distance and choice: A short, legible route can support independent movement, while multiple destinations can prevent a single-room routine from becoming the only option.
- Central daylight: Bringing natural light into the center of a household can make shared rooms easier to find and more attractive to use, but glare, heat, and nighttime lighting still require technical review.
- Activity portals: Openings from corridors to living, dining, and kitchen areas can reveal what is happening before a resident enters. They should not create blind corners or conflict with infection-control and fire-safety requirements.
- Wayfinding materials: A coherent coastal vocabulary was selected at Seaglass. Materials should remain legible under different light levels and should support, not replace, clear sightlines and staff practice.
Approach 3: Reposition an existing facility for future viability
Josephine Caring Community shows what adaptive reuse can include
Josephine Caring Community in Stanwood, Washington, is presented as part of a broader repositioning strategy. The community de-licensed nursing beds and converted two wings of an existing skilled-nursing building into a 21-resident, private-pay assisted-living memory-care neighborhood. The account links the decision to pressure created by Medicaid reimbursement in Washington and the cost of covering unreimbursed care; it does not provide a reimbursement figure or a verified state ranking.
The renovation repurposed a picnic shelter as an entry pavilion, added daylight-filled shared spaces, and created secure indoor-outdoor connections. Staff-only fire-alarm alerts were intended to reduce resident agitation, according to the project rationale; no measurement or study is supplied to establish that effect. Two courtyards support movement and social connection, offer choices of activity and sun exposure, and provide views into an on-site childcare center.
Rather than demolishing the building, the project retained and upgraded the existing structure. Energy-efficient systems, low-VOC materials, and improved ventilation were included in the work. These decisions illustrate how care-model repositioning, resident experience, and building performance can be planned together.
A feasibility sequence for conversion projects
- Confirm the care and payer model. Establish whether the proposed neighborhood will be nursing, assisted living, private pay, publicly funded, or a combination. Model staffing, licensing, rates, and care intensity before fixing the architectural program.
- Survey the existing building. Verify structure, envelope, fire protection, egress, ventilation, plumbing capacity, electrical service, accessibility, hazardous materials, and the location of unavoidable resident-room or service shafts.
- Choose the smallest viable conversion zone. Josephine converted two wings rather than treating the entire campus as one project. A defined neighborhood can limit construction disruption and make the operating concept easier to test.
- Create a recognizable arrival and household threshold. An entry pavilion or similar transition can distinguish the memory-care neighborhood from an institutional corridor while maintaining controlled access.
- Build indoor-outdoor options into the plan. Secure courtyards, weather protection, shade, seating, staff sightlines, and durable planting should be coordinated with resident movement and maintenance capacity.
- Upgrade environmental systems during the work. Ventilation, low-emitting materials, lighting, acoustics, and energy systems are difficult to retrofit after finishes and ceilings are complete. Sequence commissioning so the care team can verify performance before opening.
- Set an evidence plan for operational claims. If staff believe a notification system, courtyard, or room arrangement changes agitation or workload, define how observations will be recorded and reviewed rather than presenting the belief as a proven outcome.
How the three approaches differ
| Approach | Typical scale | Primary design lever | What the cited examples establish | What remains unproven |
|---|---|---|---|---|
| International principles | Community planning and residential pattern | Person-centered normalcy, choice, and social connection | Hogeweyk principles and Avandell’s houses, destinations, secure boundary, and community-facing services are described | No controlled evidence that the layouts improve outcomes |
| Environmental evaluation | Building, floor, household, and resident routes | Specific features such as route distance, sightlines, and natural light | Seaglass used EASE findings to prioritize renovation and designed a 14-resident household | No reported post-renovation EASE scores or resident outcome data |
| Adaptive repositioning | Existing building, wings, systems, and operating model | Reuse decisions tied to care delivery and financial viability | Josephine converted two wings to a 21-resident private-pay neighborhood and upgraded systems | No comparative financial or resident-performance results |
Choosing the right starting point
Use the international-principles approach when the organization is defining a new vision, planning a campus, or trying to move beyond an institutional model. Use an environmental audit when the building exists and the team needs a defensible list of physical priorities. Use adaptive repositioning when the operator has underused or financially stressed space that can support a different licensed and staffed care model.
Many projects should combine them in that order: establish the desired resident experience, audit the current environment against it, then test whether renovation or new construction is the better delivery method. A small project may reverse the sequence if a code or structural constraint makes certain options impossible.
Pitfalls that can undermine a well-intentioned project
- Theme without meaning: Nostalgic graphics cannot substitute for authentic routines, choice, and community relationships.
- A score without action: An audit is useful only when findings are ranked, funded, assigned, and checked after construction.
- Security treated as an afterthought: Retrofitting access control, staff observation, or emergency egress late can damage both the budget and the resident experience.
- Unmeasured promises: Describe reduced agitation, better wayfinding, or improved financial performance as intentions unless a documented evaluation establishes them.
- Ignoring operations: A beautiful destination that requires staffing the operator cannot sustain will not deliver the intended choice or independence.
- Overlooking existing-building limits: Structural grids, shafts, fire compartments, ventilation, and accessibility can determine whether a household concept is feasible.
A concise project checklist
- State the resident experience and care-model goals in observable language.
- Identify which international principles fit the local culture and provider mission.
- Map daily routes, destinations, daylight, thresholds, and staff-support needs.
- Select and document an environmental evaluation method; do not invent missing scoring categories.
- Compare renovation, phased conversion, and new construction using the same operating assumptions.
- Coordinate security, fire safety, accessibility, ventilation, acoustics, and landscape from the beginning.
- Record which claims are design intentions and which are supported by measured follow-up.
The strongest memory support communities are not copies of a famous project. They are deliberate responses to residents, staff, place, and the operating model: principles set the direction, evaluation identifies the physical levers, and adaptive reuse can make the result achievable when an existing building is worth saving.
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