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Next-Decade Design Makes Good Health a High Priority


Senior living was, is, and ever will be concerned with health, safety, and infection control—but quality of life is just as important.

Throughout the coronavirus threat and into the foreseeable future, providers and designers will be seeking ways to simultaneously make any residence as much a place that people want to live as a place that’s safe to live.

Despite the trendy popularity of stainless-steel finishes and industrial-style fixtures, no one wants to live in a biosecurity laboratory. The best design solutions integrate health-promoting factors, style, and comfort.

Fortunately, “clean” design is trending—more natural light and air circulation, more durable and cleanable (yet beautiful) materials, and traffic flow patterns and hallways that naturally support distances—to give space for people and assistive devices. Design is already heading toward a healthier future.

The village approach

The first step—and one that may inform more communities into the future—is the overall community design. Kim McCann, AIA, LEED AP, CEO and partner at Eleven18 Architecture, describes a “village” approach. It’s based in residents’ wants and needs, but also has built-in safety factors.

“Integration of the local community and environment is an important part of design for the future,” McCann writes in an email interview.

“We can accomplish this by responding to the natural or built environment, integrating multiple lifestyles, and breaking the overall community into smaller villages, which will respond to the changing needs of the residents.

“The small villages can operate in isolation if the need arises, protecting the community as a whole. When isolation is not needed, the villages are integrated back into the overall community, sharing multilayered activities and events.”

It’s the best of both worlds, with each part of the community functioning as an island or as the mainland, depending on need. Some communities already do this on a smaller scale, with neighbors holding parties for their floor or block, and different types of architecture reflecting different lifestyles within.

Antimicrobial materials?

One of the actions characterizing senior living now (and also in every flu season) is the near-constant cleaning and disinfectant wipe-downs—rails, elevator buttons, doorknobs, and virtually every other surface. What if the materials that these high-touch areas are made of could have built-in disinfectant properties?

“Development work on materials with inherent antimicrobial properties has been around for many years,” writes Amanda Bakken, lead chemist at Ecolab, in an email interview.

“These materials often have long-acting performance claims that may even encompass the full life-span of the material itself.

“However, these materials are often very limited in their actual antimicrobial performance and are often not effective on public health organisms, including the very pathogens that make people sick.”

The bad news is there’s not likely, even in the next decade, to be self-disinfecting materials. But materials do matter in a healthier environment.

“The most cost-effective approach is not focused on a particular technology, but rather on what that material allows you to do,” Bakken says.

“Excellent environmental hygiene and handwashing procedures are the best practice for reducing infection risk in residents, so focus on designing residences with easy-to-disinfect surfaces.
“For example, furniture with hard or non-permeable surfaces allows for frequent and thorough disinfection. Installing luxury vinyl tile flooring in place of carpets creates floors that are easier to clean, while still maintaining that comforting home-like feeling.”

Miles of tile

From STG Design: Materials that stand up to disinfectants include tile floors that have the warm look of wood, continuous countertops, and wipeable vinyl chairs.

Making it easy to clean yet home-like is the approach STG Design is using in its senior living designs.

“People gravitate toward a cleaner, brighter, more open environment,” says Larry Meeks, principal and architect at STG Design.

“There’s definitely a lot of balance that needs to happen between acoustics, sanitation, and clean design—and also maintaining the health of all of those residents,” Meeks says.

STG has been working with new surfaces and technologies to achieve this, including lighting systems that reinforce circadian rhythms.

“There are a lot of things we can do with the material selections,” Ann Yearwood, associate and interior designer at STG Design says.

“First of all, we have to engage the client and understand their cleaning protocol, and make sure the protocols are compatible with current standards—and also making sure that we’re providing a flexibility for those cleaning protocols to change, as they are right now.”

One such material is extra-large-format tile, such as three-by-ten-feet tiles—which also happen to be an emerging design trend. “You essentially have no grout line, says Yearwood. Together with materials that clean easily, this means almost zero places germs can hide.

Retrofitting for touchless fixtures and appliances is another feature that was important before the pandemic. But in the coming decade, touchless will be more the rule than the exception, showing up for faucets, doors, lights, curtains, thermostats, and more.

With all the cleanliness, there’s a caveat: High ceilings, big windows, and tile surfaces can combine to make spaces echo and sounds sharper. It’s this “museum effect” as much as the look of a residence that can prevent people from feeling at home. Designers can soften the acoustics with features such as perforated boards (cleanable) and by mixing materials.

Windows and barriers

“There’s going to be an inclination to permanently design for social distancing, and we have to resist that reaction while still finding new ways to make senior living communities safer,” writes Myles R. Brown, AIA, LEED AP, principal at Amenta Emma Architects.

“It’s already happening—within a week of the pandemic beginning, we had a request from a senior living project we are in the middle of designing to add negative pressure rooms, which hospitals use to prevent the spread of airborne pathogens.”

While understandable, this might not be the most future-facing approach. One solution is design that ensures flexibility. Many communities are right now using areas in different ways than they were intended—for instance, an outdoor dining patio becomes a visiting area, with social-distancing spaces chalked in. Other communities are using thick, clear plastic to make barriers and booths for visiting.

In the future, clear, germ-stopping retractable walls or curtains could divide rooms when needed. A great room with conversation groupings can welcome visitors when that’s possible, but also serve as an ad hoc gathering or staging area in trouble or emergency situations, or space to prepare items to go to residents’ rooms during isolation.

Larger and more comfortable break rooms (also easy-to-clean and disinfect), as well as places staff can dine, clean themselves up, change, and occasionally sleep over may become essential components of future senior living communities.

he move toward more choice in dining could coincide with healthier design as well. Future communities may want to plan or renovate a space for a popup grocery store, or a staging area to pick up delivered groceries or restaurant meals safely. That means less need to leave the community.

Open the drawbridge

Outdoor-rated upholstery and furnishings have made huge strides in looks and comfort— and they stand up to cleaning protocols.

Just before the pandemic disrupted life, the Pratt’s Manhattan Gallery opened the exhibit “New Old: Designing for Our Future Selves.” An apartment concept commissioned for the exhibition included a sort of cabinet door in the back wall of the apartment. Behind that back wall was a hallway lined with shelves. The idea was that when a resident needed something, they would order, and a robot would deliver through the door. Robots also did cleaning.

It was a no-touch system designed for independence, but it was criticized for being “a gilded cage.”

Anyone in senior living could see the flaws immediately—it’s a model for social isolation. A resident might not get a virus, but their health would suffer greatly, nonetheless.

That tendency is one path that Amenta Emma architect Myles Brown could see future senior living design going down—and now is the time to guard against it.

“This crisis will accelerate the process of senior living communities becoming one of the more tech-driven spaces in our society,” he writes.

“How well senior living designers are able to execute this sped-up technological transition is the question. Social connection is such a key component of senior living for mental health and overall health.

“In my view, the balance is struck by implementing technology as invisibly as possible. Senior living communities still need to look and feel like home.”