While the COVID-19 pandemic will have a lasting impact on communities, industries, and entire nations, the older adult population is among the most at risk when it comes to health and safety. Insights gained from the spread of the coronavirus in senior living communities will shape how these spaces are designed for years—and generations—to come.

Recently, senior living operators and designers have shifted away from the institutionalized design practices of the past to approaches that are more reminiscent of home and focused on fostering community, connection, and mental and emotional well-being. However, new design challenges have arrived, as highlighted by the recent spread of COVID-19 in senior living communities.

Thoughtful and intentional design can help mitigate the spread of germs, but operators and designers would be remiss to simply return to their healthcare-oriented design practices of yesterday. Instead, the future of design in older adult communities must limit the spread of germs and foster personal connections.

These four design strategies will be key in helping operators and designers meet both of these needs:

1. Compartmentalization
Reducing the number of interactions people have with potential germ sources is key to reducing the spread of diseases. The capability for compartmentalization, or temporarily breaking down a larger building into self-sustaining smaller communities, will be instrumental to the future of senior living design and can take many shapes, including:
• Designing in small house capabilities—Just as older adult communities often have smoke compartments to increase safety, so too could they break the community itself into smaller living compartments. This could be done, for example, by closing down some larger common areas and keeping residents in their wing or on their floor temporarily to minimize potential contamination from other residents and staff.
• Designing around a common node—Larger assisted living and memory support communities could be designed as a cluster of smaller household models that share common amenity areas among smaller groups of people. This connectability can allow for staff and resource flexibility in an emergency situation, while maintaining the benefit of having fewer individuals in contact with the separate households.
• MEP and HVAC—Zonal isolation in HVAC systems can ensure that residents and employees are not only isolated from contact spreading and physical cross-contamination but also through droplet and particulate exposure in the air. Touchless plumbing and electrical fixtures can further reduce the spread of diseases by limiting the number of surfaces for people to touch.
• Small house model—The small house model itself may see an increase in popularity post-COVID-19 because it directly mimics the look and feel of home while also limiting the number of staff and residents in a shared space. This model typically contains 10-12 suites that can be broken into smaller neighborhoods. Meals can be shared in smaller spaces and airflow can be easily broken into zones covering individual corridors.

2. Reducing entry points
Limiting the number of outside sources who enter the community can also help reduce exposure to germs. Several design considerations could eliminate or reduce otherwise regular entry into older adult communities by mail carriers; package handlers; food and supply delivery drivers; and third-party staffing sources for salons, fitness areas, and flexible exam rooms.

For example, locating all outside service-related spaces served by third-party operators in one area, accessed from a single entry, significantly reduces outside source interaction with the community. Likewise, creating a receiving room with refrigeration and storage on the perimeter of the building allows for a landing zone for food and bulk good deliveries prior to further distribution within the building. Similarly, moving the mail room to an exterior wall and incorporating rear-loading mailboxes can further reduce exposure to outside sources.

3. Unit design
Just like moving delivery access to an exterior wall of the building can help prevent the spread of germs, so can moving certain service-related access to the exterior wall of each living space. Designs options include locating trash in a cabinet adjacent to a corridor wall that staff could access from the hall. Lockable medicine storage and unit plumbing shutoff valves also could be in this area to allow emergency access while limiting the number of staff members entering the suite.

Designers should also consider surfaces and materials that help limit the spread of germs and bacteria. For example, consider impervious countertop materials like solid surface or manufactured quartz for kitchen and bathroom counters; resilient sheet flooring that creates a sealed flooring surface; or decorative window valences instead of long drapery panels that are more likely to come into contact with a person and collect bacteria.

4. Site design
Integrating outdoor spaces that allow residents to walk, sit, and visit with family members while also allowing social distancing between individuals will be key to striking the balance between emotional well-being and safety. To help achieve this, outdoor resting spaces can be spaced apart to allow for both conversation and social distancing. Outdoor paths can be designated as “one-way” to reduce interaction with others, and traffic flow can be reversed on specific days for variety. Also, creating pull-offs at regular intervals along walking paths can help create separation without requiring individuals to navigate uneven terrain like turf, gravel, or mulch.

Although many aspects of how we care for aging adults in the era of coronavirus remain unclear, one thing is certain: We must find a new way forward when it comes to keeping the most vulnerable members of our population safe, including attention to physical, mental, and emotional well-being. Design will play a vital role in how we create spaces that serve to keep seniors both safe and happy.

Jami Mohlenkamp is principal and head of the senior living practice area at OZ Architecture (Denver). He is also author of the “Designing for Emergency Preparedness Insight Report,” which outlines design considerations that can help reduce the spread of disease and infection in older adult communities. He can be reached at jmohlenkamp@ozarch.com.