Senior Living Industry Rethinks Building Designs, Improvises Solutions During Covid-19

It’s been a little more than two months since Covid-19 turned the world on its head — but the senior living industry is already contemplating creative ways to change how buildings are designed, to cope with current and future challenges.

In the short-term, providers have come up with ways to keep residents and staff safe and socially connected amid the pandemic. But industry stakeholders are also reimagining how communities are designed in the post-pandemic future.

From a construction and design standpoint, the Covid-19 pandemic will likely lead to changes in senior living as great as the hospital reforms of the 1950s and ‘60s, according to Joe Hassel, principal and co-leader of senior living at global architecture firm Perkins Eastman.

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Specifically, Hassel is thinking about potential architecture and design changes in three categories that address key needs: moving beyond “warehousing” older adults, human resiliency and wellness.

“We’re going to need to address the emotional and psychological toll [Covid-19] has taken on residents and staff,” Hassel said during a recent Senior Housing News webinar. “Some changes will certainly be short-term, but others will change the way we do business and impact the built environment moving forward.”

Improvised innovations

Though many of Covid-19’s pressures will result in changes for future communities that are not yet designed or constructed, providers are not sitting idly by in the meantime. Already, they have found creative ways to become more flexible amid social distancing, and to embrace technology as a way to keep residents connected.

In one example, Thrive Senior Living Founder Jeramy Ragsdale helped design “clear connection panels” that let residents and their loved ones talk on a wireless phone while separated by a see-through plexiglass barrier. The panels have helped residents keep up their social visits and avoid boredom even while maintaining social distancing.

Atlanta-based Thrive Senior Living has developed and opened a little over 30 communities in the past nine years, and is implementing the panels across its portfolio.

“We created these and custom-fit them to the front doors of each of our communities,” Ragsdale said during the webinar. “We’ve seen some very special moments happen across the glass.”

The plexiglass panels, which are emblazoned with Thrive branding, have helped the company flip the script and better control the message while communicating with members of the press. That’s especially important given the number of stories focusing on infection counts or death rates as a result of the pandemic.

“These types of things help to shift the story,” Ragsdale said. “The video and the audio from this immediately tugs at the heartstrings and makes it far more human.”

The panels can be moved as needed, and Ragsdale believes they are compliant with local health and fire regulations. Thrive has also made public a blueprint for assembling them. This is just one temporary solution, but Ragsdale said it’s part of a tapestry of senior living creativity that has emerged in response to the pandemic.

“The level of creativity that we’ve seen across the space, we certainly don’t have a monopoly on that,” Ragsdale said. “It’s really refreshing to see.”

Rethinking design

When the Covid-19 pandemic hit earlier this year, it disrupted plans already in the works. Development adviser Plante Moran Living Forward has about two-dozen clients in some phase of design, development or construction. When the pandemic hit, some of them pressed the pause button, according to Dana Wollschlager, partner at the Southfield, Michigan-based firm.

“We have a number of clients that are focusing on design adjustments and programming changes,” Wollschlager said during the webinar.

Though some senior living providers have historically resisted adopting new technology too quickly, Covid-19 isolation measures changed all that. Now, technology is already playing a larger part in projects in the works.

“Some senior living providers have been behind the curve when it comes to technology, and this pandemic has really forced them to quickly get into the 21st century,” Wollschlager said.

In the future, providers will likely utilize touchless and voice-activated controls, more devices that are always connected to the internet, tech-forward health monitoring and robotics, Hassel said. And hospitals, hotels and airports are already using ultraviolet light to sterilize spaces, a trend that the senior living industry is increasingly taking note of.

In many cases, implementing some or all of those features in future communities will require changes to infrastructure. Some companies learned that the hard way when the pandemic hit and residents turned to their electronic devices to stay connected — all while operators were implementing telehealth, virtual programming and tours and security management over their networks at the same time.

“It stressed their systems incredibly,” Wollschlager said. “Imagine operating a 100-unit building, and within less than a week, everything goes from business as usual to having all of your residents and your staff wanting and needing to use multiple devices 24/7.”

Communities are also likely to reconfigure their layouts to take social distancing measures into account. – Thrive is actively discussing how it can adapt some of its common areas into spaces that are more amenable to infection control measures, according to Ragsdale.

In its current communities, Thrive has implemented small areas to be used for solving puzzles or as a small library. But those spaces have gone underutilized, and Thrive is now looking at nixing those spaces completely or repurposing them to fit many different needs.

“In communities that are not in total isolation, we’re able to use that for smaller dining venues or for small groups of people,” Ragsdale said. “We want to look at how to do that in the future, but in a way that doesn’t permanently dedicate that space to dining or another use.”

In a way, such designs would organically help create a “small house within a much larger community environment,” he added.

Other senior living providers are also thinking small instead of big. Some Perkins Eastman clients are looking to small homes or cottage-style residences with renewed interest, while others are seeking to use existing spaces differently, similar to what Thrive is doing. Both can be achieved in communities that aren’t traditional small-home campuses, Hassel said.

“You can close down the access to the main core but still have the ability for residents to, if they’re all free of the virus, experience life and get out of their rooms and socialize,” he said.

Consumers and prospective residents will likely continue to embrace private rooms with some outdoor access. And state or local governments may enact more regulations regarding air quality and the circulation of air within a building, Hassel explained. Tomorrow’s senior living units could also come with an area where food or supplies can be dropped off in the event of future infection control lockdowns.

“There’s an opportunity for neutral-turf zones, where someone can come in and drop off products in a safe environment,” Hassel said. “It’s like in some of the older homes that might have a vestibule space.”

Capital considerations

Of course, none of these ideas will work without the backing of developers, lenders and investors. In the weeks and months since the pandemic, some banks have become more hesitant to start brand-new relationships, especially ones that involve ground-up or greenfield construction, according to Wollschlager. Providers are also seeing shorter deal terms, tighter covenants and higher presale financing triggers for entrance-fee communities.

“Everything is moving at a little slower pace and people are looking at things a lot harder,” Wollschlager said. “Hopefully this is the short term, but I would anticipate that being the case at least for the next six months.”

Looking ahead, Wollschlager worries that implementing some of these new design features could make senior living an even more expensive option for prospective residents and their loved ones. That is especially pertinent given that the Covid-19 pandemic may increase demand for middle market products.

“I really am concerned that we’ll put an affordable option for senior living even further out of reach for older adults,” Wollschlager said. “I think that is going to continue to be a significant challenge for the industry, and we still need to come up with some solutions.”

The pandemic may spur some providers to consider repositioning projects, particularly for buildings that suffer occupancy loss. It’s a strategy that should have been on the minds of providers even before Covid-19 struck, Wollschlager believes.

“Many providers already should have been looking at repositioning some of their assets, especially if they have older assets that have experienced softened occupancies,” she said.

Adapting existing buildings for a middle-market consumer could be one play to consider as Covid-19 wanes. And, in addition to repositioning existing assets, providers may find new opportunities for adaptive reuse as other types of real estate — including hospitality and retail — struggle due to the pandemic.

“I think we’re going to see … opportunities in looking at hotels, office buildings, we even had a request to study a parking garage,” Hassel said.

But while Covid-19 is no doubt creating significant challenges overall, exactly how the pandemic will change the industry, and who will feel its effects most in the end, is not clear.

“I go back to this idea of not taking a knee jerk approach,” Wollschlager said. “We’re eight weeks into this. I think that we need to take the time to see where the dust settles.”

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