EMPATHY IN SENIOR LIVING IN THE AGE OF COVID-19

In this time of uncertainty, Hord Coplan Macht’s experts have been exploring options and potential solutions for how senior living facilities can adapt to the new normal. In this series, HCM principals share their personal perspectives. We stand ready to work with our clients to create tailored and thoughtful solutions for what’s next.

Gary Prager, AIA

COVID–19 has shifted the way the world interacts, forcing us to change our routines and adapt to something completely different. The effects of COVID-19 are increasing my own awareness of how isolation and the inability to promote my independence has made me feel lonely. As a designer, it has exacerbated my concern for designing senior living environments, while keeping empathy at the forefront of the process.

As I think about designing with empathy, I wonder how our designs help fight loneliness. As I feel my own sense of loneliness, I consider the residents of these communities. During the good (pre-COVID-19) times, how did they maintain their own independence? Were they capable of getting around their communities to dine, socialize, and stay healthy? We need to consider some of the emotions that they experience daily. What is our part in slowing the spread of another flu or virus?

We know we will eventually come out of this. But we must realize that most of our seniors within our communities will never feel this independence.

Everything we see online, hear in webinars, and read in articles, as well as in conversation with clients, are all leading to the operations of the communities and now how the building design relates to a resolution to help mitigate the spread of the disease. I’ve had discussions with our healthcare studio designers, our senior living community designers, and also with developers, operators, and caregivers. In these conversations, we can only listen and advise, to determine some design concepts that could help. Following are some of the ideas that may be beneficial to consider:

Technology Decreases Isolation

There are many studies about how loneliness can lead to dementia. During a pandemic, one of the ways to mitigate isolation is through technology. We need to be sure our buildings have ample infrastructure to support the growing technology needs. What would we be doing without Zoom, Facetime, Facebook, or other online platforms during this time? It is also important that we upgrade telemedicine and monitoring capabilities that help determine when a caregiver is needed by a resident. This has become more widely used in the past two months and residents have been more at ease knowing that they can still have access to their medical providers when needed.

Spread Out and Use Disposables

Limit the number of residents in the dining room by 50%. Separate the tables to enforce physical separation and allow residents to engage in conversations. Though not environmentally-conscious, some experts in the food service industry are recommending the use of disposable containers and prepackaged disposable utensils to avoid the spread of infection. More effort will be needed to present food properly, look appetizing, personalized to the resident, and arriving as intended, either hot or cold.

Finding New Ways to Socialize and Have Fun

Virtual meetings, board game/virtual gaming apps (such as Jackbox, or House Party), and other online platforms are helping to keep people connected. Our granddaughters found a game on Zoom where we were playing against each other in real time, and it was a great way to have fun even while staying quarantined.

Re-Allocating Storage

We realize that storage areas are a non-revenue generating use and that most communities have limited space. One approach that I’ve heard from a client is to eliminate all the items in storage that are not used, such as broken or outdated equipment and old furniture to make more room for additional PPE. Another potential idea for communities with multiple sites in a single market is to rent storage space in a central location to store these materials. Families feel more confident knowing that there are sufficient supplies of PPE for their loved one as well as for staff and visitors.

Antimicrobial Finishes and Surfaces

Carpet, wall covering, and countertops, to name a few, can be finished with antimicrobial materials. There is a variety of products on the market in multiple colors and patterns. We should be looking at ways to enhance our specifications to include these materials.

Touchless Technology

Faucets, toilet flush valves, hand dryers, light sensors, automatic doors and other technology should be considered to prevent users from having to touch these surfaces in communal areas of the buildings. Automatic door openers should be installed at all exterior doors of the building with override capabilities to lock down as necessary for security. Not only will this put people a little more at ease knowing that they are not having to touch these items, but it will also make the building more user-friendly for the residents.

Cleaner Air with Mechanical Ventilation

For a relatively low cost in existing buildings, duct sanitizers can be added to the ductwork. These “no maintenance” air purifiers are easily installed but do require an outlet for operation. We are also specifying antimicrobial filters in all mechanical equipment.

Voice Activated Technology

Amazon Echo (AKA “Alexa”) and Google Home are capable of many tasks including light and temperature controls within the resident units. Most systems require very little to retrofit these devises for operation.

Smaller Community Spaces

Consider creating some smaller spaces where socialization can still occur but add additional negative pressure with the mechanical system. Residents who are infected can be isolated in those spaces (maintaining physical separation of course) allowing for some socialization.

Keep Your Hands Clean

Consider adding automatic hand sanitizers at all entrances and throughout the public areas of the community. Also explore designing paper dispensers/waste receptacles at the pull side of public restrooms and in resident rooms for visitors and caregivers. We are also considering adding automatic sanitizer dispensers in resident units for use by families and caregivers.

Screening Capabilities

A concept we are exploring is rearranging the entry sequence into buildings, locating an office adjacent to the entry vestibule. This office will be used for security, discovery, concierge, or other functions as necessary for operations. A “pass through” window will be placed in the wall between them. This opening can be located behind a piece of artwork, a decorative panel, or concealed with a flush panel that can be removed to render the window operable. All other doors can be locked down for entry making sure not to impede the egress requirements and ensuring anyone entering the building through this main entry can be screened as necessary. Another concept is to provide a room with movable glass partitions where a resident can enter the room through one door and their family through another. The room will be equipped with microphones and speakers so families can talk to each other without having to use their phones and be a more natural “visiting” setting.

We are in the middle of the worst pandemic since the early 1900’s. We still have a lot to learn and will continue to have discussions with stakeholders on what their needs are as they discover how their operations are working and how the building design might assist in the mitigation of the spread of another virus.

I am fortunate to have my work to keep me busy and help fight the loneliness factor. During the week, I am involved in many virtual meetings and phone calls with my team. I live in a ranch– style house with a finished basement where I have an office area. I spend 9-11 hours a day in my office while my wife is upstairs working on her own things. We try to keep our daily routine to maintain a sense of normalcy during this crisis.

I miss socializing with my co-workers, collaborators and clients. I miss the comradery and the project collaboration and can only imagine what the seniors of the communities we design are experiencing. How are they coping? How are their caregivers coping? How are we going to change our design to help slow the spread of another virus? As a designer of these communities, I am dedicated to finding solutions that safely allow them to enjoy and engage in their communities.

 

Gary Prager is a principal in HCM’s Senior Living Studio. He manages the senior living projects based in our Denver office. With 43 years of experience in all phases of the architectural practice, he has a thorough knowledge of senior healthcare, memory care, assisted and independent living, multifamily apartment planning; contract reviews for compliance with owner’s requirements and progress; design/build programs; site observations, cost control, change order preparation and review, project closeout procedures and post construction services; construction materials and methods of construction; city requirements, process and procedures.