How Covid-19 Is Shaping the Future of Senior Living Architecture and Design

Original article by Tim Regan in Senior Housing News

While it’s uncertain how or when the Covid-19 pandemic will end, the disease’s unique pressures will likely shape how senior living communities are designed for years to come.

Senior living providers across the U.S. are radically altering their normal operations to prevent or limit the spread of Covid-19, such as by canceling group activities and communal dining in favor of in-room entertainment and meals on delivery. At the same time, providers are relying on technology as a tool to overcome social isolation, and looking for new ways to remotely connect residents with family members and medical workers. The senior living community of the future will be designed with these scenarios in mind, and create ways for providers to support these technologies and minimize future disruptions.

And while sheltering a community’s resident population in their rooms protects them and gives them peace of mind during a pandemic, it also comes with a cost to operators who rely on socialization as a way to keep their communities vibrant and full. Future designs will seek solutions to safely maximize interaction with the outside world even during a quarantine situation.

The challenge for senior living architects and designers will be making such adjustments without shifting to unnecessarily institutional layouts, which would represent a “downgrade” for the industry, David Dillard, principal with D2 Architecture, told Senior Housing News. But there are already existing models of smaller, more intimate styles of senior housing which accomplish this well.

And although Covid-19 may be a once-in-a-century pandemic, design lessons learned now may aid the industry with infection control protocols for more routine challenges, according to Jeff Anderzhon, a senior planner and design architect at Milwaukee-based Eppstein Uhen Architects.

“If we look at designs for the worst case, then we’ll be a lot better off for those more minor epidemics, like the flu every fall,” Anderzhon told SHN.

Separate together

To avoid community-wide disruptions in the future, more providers may choose to adopt designs that emphasize the use of separated neighborhoods, where residents can live, socialize and dine together in smaller groups. For example, communities with pocket neighborhoods or other smaller, village-like campuses could work well. That way, areas could be cordoned off in the event of a future epidemic or pandemic without bringing the entire community to a full stop, according to Dillard.

“Having talked to some of our clients and friends who are actively trying to mitigate tragedies in their campuses around the country … I think we’re going to see more compartmentalization,” Dillard said. “We’re going to see a rising of the walls between levels of care on the same campus, just like you’d partition off a submarine.”

Architects with New York City-based firm Perkins Eastman also believe that more strategic separation of residents will be a key design priority going forward.

When Perkins Eastman released its future-looking “Clean Slate Project” in 2019, the goal was to explore the disruptive forces that might shape the senior living industry of the future. While technology, the evolving preferences of baby boomers and climate-fueled natural disasters made the list, the possibility of a global pandemic was not on the radar at the time, according to Dan Cinelli, principal at Perkins Eastman. But the disruptive nature of the pandemic is currently teaching some in the industry that scale or efficiency in senior housing is not always a good thing.

“We still see old-model nursing homes out there that are 60-bed, two-people-in-a-room [models],”  Cinelli said. “During a COVID-19 crisis, how can you self-isolate such a large population?”

There is still a place for communities that house dozens or even hundreds of residents on the same campus, Cinelli said. But hard lessons learned during Covid-19 might push providers to consider campus and community designs that house residents in smaller, self-contained neighborhoods.

“I think you’re going to start seeing [assisted living communities] get broken down into 16- to 20- bed households,” Cinelli said. “It would be easier to be able to self-isolate that population.”

Urban senior housing highrises would also work under this model, Cinelli said. In those cases, there might be 16 units to a single floor, with a smaller dining venue connected to a larger, main dining venue via an elevator shaft. That way, providers wouldn’t have to close down an entire community to enact strict infection control protocols.

Some of Perkins Eastman’s projects carry these sorts of designs. One recent example is a Green House expansion at Jewish Senior Life in Rochester, New York. The project goes big on the small-neighborhood concept by grouping residents in 12-unit homes with private rooms and bathrooms, decentralized dining and other features that could help with infection control protocols.

D2’s Dillard already was a fan of pocket neighborhoods and agrees that they will seem more appealing following Covid-19.

“If you have a small neighborhood, and somebody’s got Covid-19, then you don’t have a wing of 60 people who are all sharing the same stuff,” Dillard told SHN. “So, I think the neighborhood concept, in fact, grows stronger legs as a result.”

But Dillard warns against taking too strong an approach when it comes to designing for potential future quarantines. He worries that, in preparing for another potentially once-in-a-century pandemic, the industry may undo years of “healthy evolution” away from more institutional senior housing communities.

“We shouldn’t overreact and design for quarantinable buildings,” Dillard said. “Do you want to live in a hospital for the last 15 years of your life?”

As for the size of the living spaces themselves, that will vary from market to market. And while it’s not clear future residents will demand larger units as a result of the pandemic, they may be interested in ones that seem well-suited for sheltering in place, with ample access to the outdoors, according to Joe Hassel, principal and co-leader of senior living at Perkins Eastman.

“The ability to have outdoor connectivity to a small terrace or Juliet balcony becomes really important to the sanity and the health and wellness of an individual [during a pandemic],” Hassel told SHN. “So, I think we’re going to see that perhaps happening more and more in a variety of levels of care within senior living.”

Communities may also come with more spaces that can be used as interim housing for staff.

“You might convert a storage room to allow you to have sleeping cubicles for staff to stay overnight,” Cinelli said. 

Architects and designers may also choose to work with new materials that are either antimicrobial or are easily cleaned. In the future, providers will look to make flooring, furniture, accessories, countertops, cabinets, handrails and doors more resistant to pathogens like the novel coronavirus that causes Covid-19, Hassel said.

Already, there are products to keep countertops and floors easy to clean and, in some cases, more resistant to germs, according to Ann Yearwood, an associate and interior designer at Austin, Texas-based STG Design.

“There are things like copper, which you can put in your fabrics and your solid surfaces,” Yearwood said. “Copper is already antimicrobial, so copper meshes and fibers will allow for those surfaces not to promote growth of [microbes].”

And, air filtration and purification may also become more important in senior living design, possibly driven by future changes in air quality codes, Dillard said.

Designing for tech

Another force shaping the way architects think about senior living communities is technology. Senior living providers’ embrace of technology is not a new trend, but it is changing and accelerating as a result of Covid-19.

For instance, many residents are embracing remote communication tools such as Zoom or Skype to stay in touch with friends, family members and even medical professionals. The use of such services will likely only increase in the future and will necessitate a strong technological infrastructure in communities.

“What a senior living community has to offer is… virtual socialization, tech support if the TV or the Wi-Fi goes down and a clear communication system in place so that residents can ask questions and get answers back quickly,” Hassel said.

Senior living providers may also take a closer look at technology that allows residents to navigate communities without pressing buttons or grabbing handles. This could be accomplished through motion controls, which are already in use in the senior living industry, or voice controls, like the ones seen in Amazon’s Alexa product.

Future senior living communities may also facilitate in-person visits with the help of a dedicated “clean room,” Anderzhon said. Under that concept, residents would meet with their loved ones or friends in two adjacent rooms separated by a glass partition and equipped with an intercom system or even mobile phones. Staff would then sanitize the room after each use.

Already, some providers are experimenting with this type of solution. Thrive Senior Living founder Jeramy Ragsdale and his father conceptualized and built “clear connection panels,” involving glass barriers with a wireless phone on each side.

Thrive Senior Living

Meanwhile, communities will likely invest more heavily in telemedicine and other ways for residents to remotely visit with their health care practitioners as a result of Covid-19, Anderzhon said. Providers might have a specialized room for telemedicine sessions, or even just a cart with video conferencing technology that can be rolled throughout the community.

“We’re going to get through this,” Anderzhon said. “And in the end, the designs that we derive from this and how we care for seniors is going to be even better.”