HH Designers is an interior designer for Assisted Living facilities. We have designed over 20 facilities.

Operating an assisted living community is equal parts heart and systems thinking. The average day asks residents to do hundreds of tiny transitions—sit, stand, turn, reach, step—often with limited strength, vision, or balance. Good interiors make those micro-movements easier and safer. Great interiors make them almost effortless.

This deep dive translates biomechanics, vision science, accessibility standards, and long-term care evidence into specific design moves for furniture and space planning. It’s how HH Designers aligns dignity, safety, and aesthetics—so residents can move more, need less help, and feel at home.

Why mobility-first planning matters

Standing up from a chair is one of the strongest predictors of independence in older adults. Sit-to-stand (STS) performance declines with age as joint moments rise and compensations (forward trunk lean, momentum strategies, hand push-off) increase. Systematic reviews and classic biomechanics papers consistently show that seat height and the availability of armrests materially affect the forces required at the hips and knees; higher seats and stable arm supports lower the demand and improve success rates. (review, systematic review). Oxford AcademicClinBiomech

And while code compliance is table stakes, designing to the person, not just the minimums, is what turns an accessible plan into an enabling one. Below are the 20 critical, research-backed elements we bake into assisted living projects to promote mobility and independence.

1) Chair seat height set to residents’ lower-leg length (and adjustable where possible)

The lower the seat, the higher the joint torque required to rise. Studies show raising seat height reduces hip and knee moments and improves STS success, especially in older adults. Target a seat height roughly at or slightly above the popliteal height (knee-to-floor), with limited “sink” under load so height doesn’t collapse. (review of STS determinants; experimental/older adults). Oxford AcademicSpringerLink

Design move: Use dining and lounge seating with optional leg “risers” or factory shims so facilities can tune heights for different resident cohorts without buying new chairs.

2) Armrests designed for safe push-off

Allowing hands to push increases STS success and reduces lower-limb demand. Studies comparing arm-supported vs. unsupported STS show significant reductions in required moments when armrests are available and properly placed. (overview + data). Oxford Academic

Design move: Specify continuous, firm arm caps (not upholstered mush) with a flat, grippy top, ~8–10" above the seat and extending forward so hands can engage early in the stand.

3) Seat pan geometry that controls posture (without trapping people)

Shallow-to-moderate seat depth supports the thighs without pressing into the calf; a gentle waterfall front reduces popliteal pressure and eases foot placement prior to standing. Combine with medium-firm foam or webbing so users don’t “bottom out,” which effectively lowers the seat and increases STS difficulty. Evidence on STS mechanics supports avoiding excessively low/soft seats for older adults. (STS determinants). Oxford Academic

4) Table and desk clearances that actually work for mobility devices

Code minimums exist for a reason—and they’re your baseline. Knee and toe clearances at tables, desks, and vanities must let residents roll under and get close enough to work surfaces without twisting. Reference the ADA/Access Board specs for dimensions (e.g., knee clearance zone and minimum widths). (Access Board, Ch. 3). U.S. Access Board

Design move: For shared dining, we favor table tops at ~28–30" with clear underside framing and 30" minimum width knee spaces so a broader set of chairs and mobility devices can tuck in comfortably.

5) Bed and toilet heights tuned to transfers

Multiple studies show higher bed and seat heights (within reason) reduce trunk angular velocity demands and lower failure rates during stand transfers; very low beds and toilets increase difficulty and need for assistance. For toilets, anthropometric matching to lower-leg length (100–120%) improves outcomes in older adults. (bed height & STS; toilet height ergonomics). Europe PMCHealth Science Journal

Design move: In resident rooms, specify adjustable-height beds and consider toilet seat risers (or “comfort-height” bowls) where residents struggle to stand.

6) Floor transitions and thresholds that don’t trip or slip

Tiny level changes cause outsized problems when you combine depth-perception loss with walkers. Keep flooring at a single plane wherever possible. If a change is unavoidable, follow the ADA change-in-level rules (≤¼" vertical; ¼–½" beveled at 1:2; anything greater needs a ramp). (Access Board/ADA guidance). U.S. Access Board

And select finishes using ANSI A326.3 (the Dynamic Coefficient of Friction test) as your common language; it’s the U.S. standard for measuring hard-surface slip resistance in lab and field. (Tile Council on A326.3). TCNatile

Transitions between materials change gait demands; one study found older adults were more vulnerable to slips shortly after moving from carpet to vinyl. Plan material boundaries thoughtfully. (flooring transition study). ResearchGate

7) Lighting and contrast optimized for aging eyes

Normal aging reduces contrast sensitivity and slows glare recovery, both of which impair navigation and object recognition under typical ambient lighting. Research links contrast sensitivity decline to functional limitations and even cognitive outcomes. (PLOS ONE; JAMA Net Open). PLOSJAMA Network

Design move: Use matte, low-specular materials; layer ambient + task lighting; create strong luminance contrast between key objects (chair vs. floor, vanity top vs. wall). For deeper design targets, see IES RP-28-20 (lighting for seniors and low-vision populations). (IES RP-28 overview). ANSI Webstore

8) Avoid visual illusions in floors and walls—especially in memory care

Heavily patterned or high-contrast floors can be misinterpreted as steps, holes, or water. Dementia design guidance from the University of Stirling’s DSDC and other public resources recommends calm, non-glossy, non-confusing patterns to reduce stress and wayfinding errors. (Housing LIN/DSDC guide; Kirklees toolkit). housinglin.org.ukkirklees.gov.uk

9) Circulation widths that fit people, not just plans

Accessible routes require 36" continuous clear width (with brief pinch points permitted) and 60" turning spaces for 180° turns; many jurisdictions reference ICC A117.1 for the same fundamentals. In real life, wider is friendlier for two-way traffic with walkers or wheelchairs. (Access Board: Accessible Routes; Turning space). U.S. Access Board+1

Design move: We target 48–60" in busy interior paths, add passing bays every ~200 feet (also recognized in accessibility guidance), and swell to 72"+ in dining entries and nursing-station pinch points to relieve congestion. (passing space interval reference). ADA Compliance

10) “Parking” for walkers, wheelchairs, and scooters—at the places people sit

Mobility aids need a home that doesn’t block circulation or become a trip hazard. Dementia-inclusive design toolkits call out clear storage and resting points as part of an enabling environment. (Dementia-inclusive planning guidelines). housinglin.org.uk

Design move: Create 18–24" side “bays” alongside lounge seats, reinforce walls for fold-down hooks, and carve alcoves near dining entries sized for common devices.

11) Hardware and controls that don’t demand grip strength or fine motor control

The ADA requires operable parts usable with one hand, without tight grasping, pinching, or wrist twisting, and ≤5 lbf to operate. That translates to levers, loop pulls, paddle switches, and big, friendly dimmers instead of knobs and toggles. (Access Board—Operable Parts). U.S. Access Board

12) Reach ranges that keep essentials in reach (seated or standing)

Place shelves, wardrobes, microwaves, mail slots, and nurse-call buttons inside the 15–48" reach range where possible; it reduces risky tip-toe or crouch maneuvers and lets seated residents act independently. (ADA reach ranges). U.S. Access Board

13) Dining rooms that favor posture, propulsion, and participation

Dining is social and physical. Chairs should resist sliding during push-off yet move easily when staff assist (glides that are stable on your flooring choice; casters only when clinically indicated). Table legs should be out of knee-paths with generous 30" clear widths per seat and real knee space—not an apron that steals clearance (see Access Board knee and toe guidance). (Access Board—knee/toe). U.S. Access Board

14) Bathrooms designed around transfer geometry, not just fixtures

Beyond grab-bar placement per code (e.g., 33–36" AFF for horizontal bars), the clear spaces and approach paths determine whether a resident can transfer with or without assistance. Reference ADA/ICC A117.1 for grab bars and clearances; then adjust the layout so residents can approach at the angle their clinician recommends. (ADA §609 grab bars). U.S. Access Board

15) Acoustics that calm the room (behavior follows sound)

Dementia and aging ears amplify the impact of noise. Reviews and emerging trials show that reducing disruptive sound and intentionally augmenting calming soundscapes can lower agitation and improve sleep and participation. (systematic review; MDPI study; music meta-analysis). Cambridge University Press & AssessmentMDPIFrontiers

Design move: Soft finishes near hard dining surfaces, acoustical ceiling tiles with real NRC performance, automatic door closers re-tuned to reduce slam, and thoughtful sound masking in corridors.

16) Light without glare, everywhere residents transfer

Older eyes are more sensitive to disability glare and slower to recover from it, which can tank visual performance at exactly the places where footing matters (e.g., thresholds, bedside). Keep luminaires out of sightlines at seating and bed transfer zones; use diffusers and indirect light; specify matte paints and low-sheen flooring. (optometry review). Journal of Optometry

17) Material palettes that support orientation by color and contrast

Use consistent color cues (e.g., darker floor, lighter wall, distinct door color for resident rooms) to help residents understand space and route choices. Aging and dementia design literature emphasizes predictable palettes and legible contrast for wayfinding and hazard recognition. (ageing & dementia design review). SpringerLink

18) Furniture engineered for real-world loads (including bariatric)

Public and lounge seating in care environments takes concentrated loads, lateral pushes, and repeated transfers. Specifying products tested to ANSI/BIFMA X5.4 (public & lounge seating) and, where appropriate, large-occupant standards increases durability and safety under repetitive use. (BIFMA X5.4 overview). BIFMA

19) Micro-resting places along longer routes

Even robust residents benefit from a place to pause. Add short benches or single lounge chairs with arms every so often along longer corridors or between activity zones, ideally where natural light or artwork offers a cue to stop. Accessibility guidance also recognizes periodic passing/turning spaces along narrow routes to ease two-way flow. (accessible route passing spaces). ADA Compliance

20) Careful choreography of “the four transfers”

Design every room for these four high-risk moves: bed ↔ chair, toilet ↔ stand, chair ↔ walker/wheelchair, and shower ↔ seat. Arrange furniture to shorten steps, keep assistive devices within the 15–48" reach band, minimize turns, and eliminate conflicts between door swings and movement arcs. Evidence around bed and toilet heights (above) underlines how much the geometry of the setup changes the success of the transfer. (bed & toilet height evidence above, toilet height). Europe PMCHealth Science Journal

Putting it together: how HH Designers applies the science

Resident rooms: We start with a transfer map—overlaying the four transfers on the plan—then position the bed, chair, and wardrobe to shorten routes and remove sharp turns. Beds are adjustable-height with stable headboards that accept over-bed lights and integrated hand-holds. Reading chairs are medium-firm, with grippy arm caps set for push-off and a seat height matched to local anthropometrics. Vanities float or have deep knee space; mirrors are matte-edged to cut sparkle. Lighting layers include soft indirect ambient and bright task light at transfer zones, with concealed sources to limit glare (see RP-28). (RP-28 overview). ANSI Webstore

Dining and lounges: Tables are framed for clearance, aisles are wider than code, and there’s visible “parking” for walkers. We balance hard, cleanable surfaces with targeted acoustics to keep the room lively without crossing into agitation-inducing loudness (see the acoustic evidence above). (systematic review). Cambridge University Press & Assessment

Corridors and entries: Primary routes exceed minimum widths, with rest spots at natural wayfinding nodes. Flooring avoids high-contrast or glossy patterns; level transitions are eliminated where possible or detailed per ADA bevel/ramp rules. (ADA accessible routes & level changes). U.S. Access Board

Bathing/toilet rooms: Clearances suit the resident’s approach path and assistive device, not just fixture “fits.” Horizontal grab bars are mounted per ADA, and where the authority having jurisdiction references ICC A117.1, we include vertical bars to aid turn-to-sit maneuvers. (Access Board note on ICC A117.1 vertical bars). U.S. Access Board

Quick specification checklist (save this)

• Seating: Seat height ≈ resident popliteal height; firm cushions; full-length armrests with grippy tops; BIFMA X5.4 tested. (BIFMA X5.4). BIFMA
  
  
• Tables/vanities: Provide real knee and toe clearances and 30"-wide knee spaces per Access Board guidance. (Access Board Ch. 3). U.S. Access Board
  
  
• Floors: Single plane where possible; ADA change-in-level rules; select using ANSI A326.3 DCOF and test in the field. (A326.3 overview). TCNatile
  
  
• Lighting: Layered, glare-controlled light; emphasize task/transfer zones; use matte finishes; follow IES RP-28 for seniors/low-vision where project scope allows. (IES RP-28). ANSI Webstore
  
  
• Routes: 36" min clear width, frequent 60" turning/passing spaces; make busy segments 48–60"+. (Access Board). U.S. Access Board
  
  
• Reach & controls: Place essentials 15–48" AFF and choose operable parts that don’t require tight grasping/pinching. (Access Board—reach & operable parts, operable parts). U.S. Access Board+1
  
  
• Acoustics: Mix absorption, diffusion, and soft closures; use gentle soundscapes in memory care per emerging evidence. (MDPI study, meta-analysis: music & agitation). MDPIFrontiers
  

What this means for operations

• Less caregiver strain: When the seat is high enough, the floor is forgiving, and the route is clear, staff spend less time doing two-person lifts and more time engaging residents. (See STS and transfer evidence cited above.) Oxford AcademicEurope PMC
  
  
• Fewer avoidable incidents: Eliminating level changes and choosing high-traction, low-glare materials reduces slip/trip risks—a direct safety win that also decreases fear of falling, which itself suppresses activity. (A326.3 slip-resistance standard; flooring transition risk). TCNatileResearchGate
  
  

Better participation: With contrast-aware lighting and calmer acoustics, residents navigate to activities more confidently and stay longer—because environments feel legible and comfortable. (contrast sensitivity & function; acoustics & behavior). PLOSCambridge University Press & Assessment