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Residential Care Design Shifts Post COVID-19

Professional Consulting Series

Seniors housing, in all forms, has been severely impacted by the COVID-19 outbreak and has received more media attention than perhaps any other market or industry. And rightly so. Seniors are our most vulnerable members of society and have the highest risk associated with the virus. Not surprisingly, residential care homes have witnessed a substantial challenge in overcoming the spread of COVID-19. There is still much we don’t know about this virus, but one thing is certain: the seniors housing sector will see significant changes to both design and operations.

Care providers not only focus on the physical health, but also the mental wellbeing of residents. Social interaction and engagement with staff, friends and visitors comprise the core of successful care models. Resident interaction is a fundamental component of leading a healthier, longer and more vibrant life. When making the difficult choice to transition a loved one into a care home, isn’t that what we want for them? The whole idea is for residents to be engaged, happy and fulfilled. Ultimately, the challenge becomes, how do we plan for future pandemics and social isolation in an environment that depends on interaction as a primary health requirement? How do we interact without interacting?

Rethinking Planning and Design

To understand rethinking of planning and design, we must first recognize current levels of care and service delivery models. While many operators offer a continuum of care within one building or complex, the higher forms of care present the greatest challenges in preventing the spread of a virus due to the significant sharing of services and spaces.

While these concepts are unlikely to change due to their intrinsic role in mental wellbeing, consideration should be given to functional layouts that limit the number of residents that share these services. Creating smaller “houses” or groups could potentially minimize the spread of a virus, however the ability to accommodate larger gatherings should also be maintained.

The importance of visitors and social interaction cannot be overstated. Visitor limitations and protocols will also need to change significantly. Isolated visiting areas could be designed to permit visitors, while eliminating physical contact during pandemic responses. For example, a public waiting area could be converted into a quarantined visiting area with isolated entrances for residents and visitors.

The greatest challenge will be to design for adaptability and agility. Every building should be designed to efficiently transform and provide isolation wings or areas, which would require flexibility both in floorplan and building systems. The isolated areas could be entirely self-sufficient and include appropriate service spaces, along with specific ventilation systems that provide 100% fresh air in a crisis.

Recalibrating Systems and Spaces

According to the World Health Organization, there is initial evidence that the COVID-19 virus can be detected in the air and could result in airborne transmission. Further research and review of Ultraviolet germicidal irradiation (UVGI) as a potential secondary infection control measure is required to determine its possible disinfecting capabilities in HVAC systems that could potentially lead to improved indoor air quality.

HVACDesigned to function at 100% fresh air during pandemic response to eliminate circulating the air between the spaces
Bypassing heat recovery wheels to avoid cross contaminations between fresh and exhaust air
Designing air distribution from clean areas to less clean areas (i.e. supplying air at the ceiling and returning the air lower elevation side wall grilles)
Consideration for higher filtration in the air handling system
UVGIIn-duct air disinfection
Upper-air disinfection
In-duct surface disinfection
Common SpacesUpgrade to touchless technology and transition surfaces to anti-microbial finishes
Temperature and sanitizer stations for residents and staff
Resident RoomsIncreased personal space in suites
Internal windows into suites for visual connectivity and servicing
Increased Wi-Fi capabilities and bandwidth for each suite to accommodate video conferencing
Holding AreasDeliveries of food, laundry, goods to be stored in a holding room for several days before introduced into the building

Reimagining our World

We need to question current design paradigms, challenge conventional service delivery models, and develop a strategy to advance the design of seniors housing. Finding solutions to our “new normal” will be an integrated effort between owners, operators, designers, builders, and authorities and will likely include a robust pandemic plan moving forward. These plans will have a great impact on the design of the buildings.

NORR looks forward to working with these integral stakeholders to help lead the design of care homes into the future. Our seniors’ communities depend on it.


Bruce McKenzie, M.Arch., Architect, AAA, AIBC, FRAIC, LEED® AP
Vice President – Canada
T 403 538 3389