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Senior Living Communities Then, Now, and What Next?

by: Ira Chilton

The statistics are available, and they show senior living communities have been overwhelmingly impacted by the current pandemic. “In the US, nursing home residents and other seniors in residential settings make up about one percent of the population. Yet they account for 8% of total Covid-19 cases and a staggering 41% of fatalities to date …” 1 And we know in other countries, like Canada and Spain the numbers are even steeper.

It is commonly understood that most seniors see senior housing as a last resort. Seniors resist giving up the car or moving to a senior living option because they fear what they value, and for most it is a sense of independence. COVID-19 has not helped this particular situation. At the same time, COVID-19 seems to be challenging the financial situation of many seniors. This would support the fact that senior living will increase as an avenue for later life experience henceforth.

The Centers for Disease Control and Prevention (CDC) issued recommendations to help minimize the vulnerability and spread of COVID-19 in long-term care facilities. 2 However, the CDC’s recommendations have some significant operational impacts for staff, family, and the residents of such facilities.

Prior to the pandemic, senior living care providers were clearly moving the resident experience to a hospitality-based design with features and amenities that were heavily socially interactive. The COVID-19 implications and uncertainty of duration are impacting the structural and operational configuration and the nature of social engagement and activities. This will be a consideration for years to come.

There has been great difficulty mitigating the negative effects social distancing is having on residents, family, and staff. Providers have had to address the operational and physical realities that seclusion and separation impart on the senior living community. Quality of life as was once known is certainly impacted. Exacerbating this issue is the fact that some sort of physical quarantining is likely to be the new normal. There are few good answers for the adaption of current facilities to the new realities, and cost is certainly a concern. Some of the ideas and issues we can consider for the future:

- PPE donning chambers are probably in the cards. Public entry points are likely to see this added to the space program, and do not forget the hand sanitizers.

- Widen corridors into usable space during normal operation but to adapt easily to allow 6-foot passage in each direction during impacted conditions. Five and 6-foot wide corridors are likely to disappear in newer facilities. Even 8-foot wide corridors present social distancing issues.

- The dining experience will likely change. A number of interesting options are surfacing for future consideration. Bubble dining arrangements (8 to 10 maximum seating bubbles) and the physical reality of such arrangements could be a consideration. Dining in options will probably be accommodated and are happening now in the COVID-19 retrofits, but do not be surprised if you see grab-and-go options marketed too.

- Visitation will get a complete makeover. You are likely to see all sorts of recommendations some even bordering on institutional prison-type configurations. I personally think some laminar flow visitation arrangement could be much more dignified.

- Places to meet outdoors in the open air will definitely be in the future building program. Even the resident rooms will be featured with safe outdoor space in the forms of patio, porch, or balcony.

- Kitchen configurations will be carefully considered for staff and food flow.

- All building material selection will feel the impact. The anti-microbial and clean-ability of each material will be evaluated and upgraded in existing facilities.

- Elevators will need to be reconsidered carefully. They may need some change in design and operation.

- Hands-free will become a well-known term and touchless technology will continue to advance in the newer facilities.

- Finally, and quite important is the impact of telecommunications. Telemedicine will certainly remain and expand. Entertainment will mutate to allow elderly interaction. Visitation will hopefully improve.

In closing we need to thank our healthcare and senior living workers that have remained on the front lines during this incredible disruption and historic undertaking during COVID-19.

1 - More Than 40% of U.S. Coronavirus Deaths Are Linked to Nursing Homes -

By The New York Times – a regular periodical - Updated August 13, 2020

2 - The Centers for Disease Control and Prevention (CDC)

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