Look at the daily news headlines and it is obvious: COVID-19 represents the single most urgent issue of our day, and perhaps our lifetime, and it will certainly cast a long shadow for years to come.
For senior living community operators, there is no greater challenge than preventing the infiltration and spread of the virus, and no greater mission than protecting the health and safety of our residents and employees. Across facilities, the focus of the past several months has been, by necessity, responsive in nature, with the threat of transmission prompting the rapid development of new operational protocols. Now it’s time to look more purposefully to the future and to consider not just how our communities should function in light of the coronavirus pandemic, but how they should be designed, configured and, ultimately, re-imagined.
In recent years, many senior living communities have been built or renovated with some basic guiding principles in mind: more amenities for residents, an enhanced focus on wellness, and more inviting spaces for group activities and family visits. Simply put, senior communities have been re-engineering themselves, in part preparing for the interests of an aging baby boomer generation.
Of course, preventing the spread of infectious disease always has been an essential priority in long-term care, but one achieved primarily through specific practices, including sanitation and close coordination with hospitals and urgent care providers. The scale and severity of COVID-19 has challenged accepted standards, spurred the creation of new regulations, and led to a re-examination of how the physical spaces in senior living communities can and should be used.
At least on an ad-hoc basis, building space already is being repurposed. Many communities have created tented outdoor locations for socially distanced visits. Rooms have been set aside within facilities for donning and doffing of personal protective equipment. Entrances have been reconfigured, and touchless doors have been added. New sanitation stations have been installed, and the movement of residents and guests has been altered, with new “traffic patterns” put in place.
Although some design changes may be temporary, many of these now-makeshift elements will be embedded permanently in designs for the future. The fact is, today there is no clear end in sight for the pandemic, and in an eventual post-COVID-19 world, residents and their families will have lasting expectations about infectious disease prevention. To feel confident, they will need to see clearly defined safety features in senior living communities.
At Miami Jewish Health, we have gone well beyond repurposing small areas of our campus and have taken steps to use significant spaces in critical new ways. As the pandemic began, we identified the need to continue caring for our residents testing positive for COVID-19 on our campus and keep them out of overwhelmed hospitals. To do this, we created multiple isolation units and converted our non-surgical acute care hospital, along with two floors of our skilled nursing building, to house COVID-19-positive residents and those suspected of having the virus.
To ensure complete separation, we designed and constructed anterooms within the hallways, working with Bloc 3 Design and TLC Engineering. Donning and doffing stations also were constructed, and an air filtration system was installed to prevent the spread of particles. Along with this negative pressure system, HEPPA-filtered air scrubbers were placed strategically outside of the isolation units to transfer conditioned air to compensate for any negative pressure.
Ultimately, Miami Jewish Health was able to create four isolation wings housing 52 COVID-19 patients and 14 patients under investigation for the virus. Clearly, well into the future, isolation units will be an important part of the equation for senior living communities. They ultimately may be designed as permanent, dedicated parts of a facility, or as units that can be converted quickly for isolation when needed. Regardless of the approach, senior living communities will need to focus on improving air filtration and HVAC design to maximize safety.
How else will designs change to reflect our new reality? From furniture selection, which will favor easily cleaned surfaces, to the way that guests transfer between entry and visitation areas, future facility plans will prioritize making residents and their families safe – and making them feel safe. More robust technology infrastructures will be critical, even when group activity spaces once again open. Finally, multi-function outdoor spaces will play a central role in senior living community planning.
Although the pandemic eventually will recede, its lessons should not. For the senior living leaders, that means planning and building for a future where the health of residents and employees lies at the center of our plans – and our facility designs.