Beyond the Walls: Designing Elderly Care Environments for Holistic Well-being in 202517 June 2025
The conversation around healthcare is increasingly shifting towards a more encompassing vision—one that looks beyond the walls of residential care to the everyday lives, autonomy, and dignity of elderly residents. MCA’s leading healthcare design team are at the forefront of design for long-term care facilities in Ireland, where the emphasis is shifting to deliver places that feel like home—spaces that nurture physical comfort, psychological security, and a genuine sense of community. The Teaghlach model is central to this vision, enabling us to place the resident at the heart of the design process.
At MCA, our specialist team has built deep expertise in designing contemporary healthcare environments for vulnerable patients undergoing investigation and treatment, including radiation oncology centres such as those at University Hospital Galway and Cork University Hospital, Mater Private Network’s Heart Centre Day Unit, Community Diagnostic Centres, Cardiac Catherisation Laboratories, CTs, Interventional Suite and Theatres. These projects sharpened our focus on how design shapes human experience in highly sensitive medical settings. We bring that same lens to residential care for older people, designing places that reflect the realities of ageing, dependency, and—importantly—belonging. Through creativity, certainty, and innovation, we are evolving what elderly care design can achieve.
The Evolving Blueprint: From Institutional Care to Personalised Living
Effective elderly care design demands a shift away from the institutional nursing home model towards more human-centric, household-based living:
- Prioritising the Resident Experience: As seen in our oncology projects as well as in elderly care settings like Nenagh CNU, Heather House CNU, and Sacred Heart Hospital, design decisions must center on the user’s perspective. In oncology, this means softening clinical spaces for anxious patients; in elderly care, it means recognising the setting as a resident's final home. Design must therefore support daily routines, preserve dignity, and promote independence within a safe environment.
- Harnessing Light, Nature, and Familiarity: As explored in Peter’s previous blog, access to natural light and views of the outdoors play a fundamental role in enhancing well-being. In acute hospital settings, where clinical adjacencies are paramount, we introduce daylight through central lightwells—serving both functional wayfinding and psychological comfort. At Nenagh Community Nursing Unit, the design afforded a more domestic and human-scaled approach. Generous daylighting, framed vistas of gardens and distant landscapes, and intuitive circulation routes help residents maintain orientation, reduce anxiety, and foster a sense of calm. These are not simply design features—they are intentional, empathetic responses to the lived experience of ageing.
- Supporting Staff and Community Connection: The well-being of staff directly impacts the quality of care. We prioritise respite spaces, intuitive layouts, and proximity of support functions to reduce staff fatigue. Furthermore, the Teaghlach model encourages community integration—designing shared social spaces and ‘destination’ amenities like hairdressers and reflection rooms outside household clusters helps dissolve the barrier between “care” and “living”, replicating daily routines that residents would be familiar with and take comfort in.
Key Principles for Designing ‘Beyond the Walls’ in Elderly Care
1. Household-Centred Design Rooted in the Teaghlach Model
Moving away from large, impersonal wards, the Teaghlach model organises accommodation into smaller household clusters, each with shared living, dining, and activity spaces. In our Merlin Park Community Nursing Unit, this translates into carefully zoned spaces that allow for safe wandering, rest, and social engagement—prioritising autonomy while protecting vulnerable residents.
2. Creating Comfort Through Design Detail
Residents with cognitive or sensory impairments require environments that feel secure, legible, and calm. Carefully considered acoustics, colour palettes, tactile materials, and access to nature all contribute to a homely feel—an essential aspect of Teaghlach-based care. This mirrors our work in oncology centres, where detail can transform anxiety-inducing spaces into healing ones.
3. Sustainability as a Health Strategy
Good elderly care design also addresses environmental sustainability. At Nenagh, renewable technologies and natural ventilation systems contribute to a healthier indoor environment while reducing energy use. It’s about long-term resilience and health outcomes.
4. Adapting for the Future of Care
Design must be agile enough to adapt to new care standards, staffing models, and resident profiles. Flexibility in elderly care spaces—movable partitions, modular service zones, and scalable units—ensures longevity and responsiveness to future needs.
Certainty, Innovation, and Compassion
The future of residential care architecture requires a fusion of technical precision, compassionate design, and deep understanding of evolving care models. Projects like Nenagh Community Nursing Unit, Heather House, Letterkenny CNU and the Merlin Park Nursing Unit illustrate how challenges—balancing homeliness with clinical safety, for instance—can drive innovative design responses that enhance life quality, not just regulatory compliance.
At MCA, we continue to advance the design of elderly care settings by anchoring our work in models like Teaghlach. Our aim is always to go beyond the walls—to design environments where people feel known, safe, and valued.
Better is our blueprint.