Many facilities have adjusted design and operations during the unprecedented pandemic of COVID-19 to keep their occupants safe and healthy. This concern is most relevant in environments for our aging population, as they are often the most vulnerable and statistically at greater risk for a variety of reasons.
Last month we participated in the Environments for Aging (EFA) virtual conference and I am eager to share some of the discussion points we learned from this conference. We've also included links to referenced articles on some of these considerations for a deeper dive.
Immediate improvements that can be accomplished in Senior living environments to increase facilities' safety and prevent sickness include some "back-of-house" improvements. These can be accomplished with minimal disruption to residents and staff and won't change the homelike setting that the industry has worked to achieve in the last few years.
Minor improvements to increase health and safety while maintaining a less clinical atmosphere of senior living facilities include:
HVAC upgrades and maintenance to increase healthy airflow and fresh air in common spaces and resident rooms. This can be as simple as using higher quality air filters in the systems (MERV-13) but an evaluation of your current system is recommended. It may require upgrading to dedicated outdoor air systems if the building was built prior to 2015.
Lighting upgrades could include the addition of upper air GUV lighting to the upper air of common areas that help to clean air indoors.
Changing out surfaces to items that can be easily cleaned and sanitized often without wear and tear.
Increasing air changes in bedroom and bathroom areas where residents and caregivers spend most of their time or creating "nearly-negative" pressure bedrooms will decrease contaminants
Adding no-contact visitor areas both indoors or outdoors by creating larger amenity rooms and outdoor living rooms.
Changing existing spaces to usable areas that allow for social distancing
Considerations for the operations, skilled-nursing, and caregivers should be a primary concern to help reduce exposure. Some ideas on long term design strategies in Senior living environments include the following:
Space - reconfigure to provide caregiver easier access to move within areas that require more time and limit the caregiver and resident's contact with germs, considerations to make it easier to contain and clean
Access - Make efforts to increase access points for staff and vendors in order to separate service access and create screening areas as well as add circulation routes to minimize exposure of residents
Air exchanges - increase the number of air exchanges in common areas and design resident room HVAC to be able to switch to negative air pressure easily
Bathroom configuration and access - allow for more room to move and easier cleaning
Technology - The addition of more touchless fixtures and devices can assist with decreasing the spread of illness and germs.
Sanitization stations - provide sinks for washing hand or hand sanitizers throughout corridors
Flexibility of amenities - provide more outdoor common spaces that can be converted to safe visitation areas with separation and shelter from elements
Another discussion from the EFA 2020 conference included consideration for different models of senior living in order to better manage the care of our elders and exposure disease. Some observations made included the following reasons for considering different models of senior living:
Small House model with a limited number of residents that have private bedrooms (approx. 10) and restrooms but shared common areas and limit exposure
Household model or living with family members to isolate exposure to seniors
Apartment style - In addition to the ability to self- isolate, this model will allow for HVAC to be separated or zoned to help limit air-borne disease and infection.
Cottage style - semi-independent living with private residences in a "village" that offers reduced contact amenities reducing contact with public and exposure
Group Home - limits contact and exposure but provide assisted living or care that is monitored and recorded (Zoning considerations may need to be addressed with local jurisdictions)
Overall the EFA conference, although virtual, offered several ideas for continued conversation and changes to the facilities that our elders live in for the safety and health of both the residents and staff. At Tec Inc. we look forward to the opportunity to consult on future senior living facilities and assist with the consideration of design for building systems that adapt for the post-pandemic world. Having been on the design team for six facilities in the last year alone, we believe the MEP design can positively contribute to healthier, safer senior living and care facilities now and in the future.
For more resources from Environments For Aging visit their COVID-19 Resources page here.