Addie Abushousheh If You Value it, You Evaluate it

In this thought-provoking episode, host Chase Miller welcomes Dr. Addie Abushousheh, a designer, researcher, and environmental gerontologist whose research sits at the intersection of neuroscience, organizational development, and healthcare design. Together, they unpack how environments act not merely as backdrops for care—but as active participants in the healing process.

From her unconventional career path and early work in traumatic brain injury units to her leadership within the Facilities Guidelines Institute (FGI), Addie shares how evidence-based, human-centered environments can empower both patients and caregivers. Her insights challenge conventional thinking about architecture, healthcare operations, and what it truly means to design for “our future selves.”



Key Themes & Takeaways

1. The Environment as a Therapeutic Tool

Spaces aren’t neutral, they can either enable or disable human potential.
Addie’s work in traumatic brain injury rehabilitation revealed that intuitive design cues like contrast, lighting, and layout can reduce dependency on staff and improve independence.
“When the environment functions like a prosthetic, it restores ability rather than reminding people of their limitations.”

2. The “Competence-Press Model” and the Zone of Adaptation

Derived from Powell Lawton’s environmental gerontology research, this model describes the relationship between a person’s capability and the complexity of their environment.
The sweet spot, the zone of adaptation is where people perform and heal best.
Too much simplicity can disable capable individuals; too much complexity can overwhelm the vulnerable.

3. Rethinking Age-Friendly Health Systems

CMS’s “Four Ms” framework; mentation, medication, mobility, and what matters most guides age-friendly healthcare.
Addie argues for a fifth “M”: multi-complexity, acknowledging the layered needs of aging populations.
Despite strong evidence from environmental research, the built environment is still missing from these national quality frameworks.

4. Building the Business Case for Design

The ROI of evidence-based design can and should be measured.
Addie encourages leaders to evaluate the cost of inaction: falls, turnover, never-events, and inefficiencies.
Embedding “evidence-based design sheets” into construction documents helps preserve crucial interventions through the value-engineering process.

5. Dementia-Friendly Design Is Just Good Design

Addie and Chase’s collaborative project - the Dementia-Friendly Waiting Room, proved that low-cost, high-impact design moves can dramatically reduce anxiety and confusion.
Adjusting color contrast, lighting, and furniture placement enhances safety and comfort for everyone, not just those with cognitive decline.
“Designing for dementia is really just designing well for humans.”

6. Shaping Policy Through the FGI

As co-chair for the Residential Healthcare and Support Facilities guidelines, Addie helps define national design standards.
The upcoming 2026 FGI update will include expanded sections on mental and behavioral health and clearer language for sensory processing environments, a huge step toward more inclusive care settings.

7. The Future of Healthcare Is Everywhere

Healthcare doesn’t exist in isolation; it’s embedded in cities, homes, workplaces, and justice systems.
Addie’s example of a memory-care ward within a correctional facility, where inmate caregivers received CNA training, showed a 60% drop in recidivism, demonstrating how design can transform both health and society.



Memorable Quotes

“If you value something, you evaluate it.”

“We aren’t actively enabling our future selves—we’re discriminating against ourselves in advance.”

“Designing for dementia isn’t niche—it’s simply designing for humans.”

“The future of healthcare is everywhere.”



Lightning Round Highlights

Favorite healing space: A New York camp called anthroposophy, designed to cradle patients in light and acoustics.
Book that changed her life: How to Win Friends and Influence People by Dale Carnegie.
Inspiration outside of work: Observing how people interact with spaces in everyday life.
The future of healthcare: “Everywhere.”



Episode Resources

Learn more about the Age-Friendly Health Systems initiative: IHI.org/AgeFriendly
Explore the Facilities Guidelines Institute (FGI): fgiguidelines.org
Book mentioned: How to Win Friends and Influence People by Dale Carnegie
Connect with Dr. Addie on LinkedIn


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