Eileen Nacht, our Senior Living Director, recently spent time with Environments for Aging to discuss crafting meaningful environments for older adults and the importance of repositioning senior living communities. Read the full article below.

What are the operational challenges driving these moves? 

Existing floor plan arrangements can be a challenge, sometimes requiring doubling up on staffing. And right now there’s a shortage of staff both from a new hiring and retention perspective. 

In reaction to staffing challenges, organizations have been taxed with thinking outside the box when it comes to meeting resident needs, and that’s where technology comes in, with things like advanced food service equipment, including robotics, etc. Reaching and maintaining communication with residents is imperative, which can be done with CATIE/iPad devices to share community information or allow residents to alert staff when they need something.

Staffing amenities and incentive plans are important, as well. This is a tough environment to work in, so attracting talent with competitive wages, nice amenities (e.g., break room), creative incentives, and more is necessary.

Then there’s the focus on safety and health and new strategies for infection control. Post-Covid, many communities are maintaining 6-foot separation in seating arrangements, dining venues, etc. They are providing residents with more private rooms for intimate events and gatherings, as well as breakout spaces for resident programmed activities.

They’re also programming more flexible spaces for programs and activities. Considerations include adjacencies to kitchen, technology infrastructure, and acoustics to maximize usage.

Many senior living communities seem to be repositioning themselves right now. What’s driving that?

Communities recovering from the impact of Covid are facing several challenges. On the marketing side, there are lower occupancies; aging infrastructure (from both a functional and aesthetic perspective); and a lack of amenity spaces. They need well-programmed and adaptable public spaces to attract prospective residents and retain current residents, as well as a variety of dining venues (casual and formal) to give residents a sense of autonomy through choice/option.

Adding or upgrading spaces and programs to encourage resident wellness is a strong initiative. Older adults are increasingly conscious of how exercise, socializing and connections to the outdoors can improve their health. Providing larger and more varied fitness spaces, changes to bring in more natural daylight, increasing opportunities to connect with paved outdoor walking paths and gardens, pickle ball courts and other features promote wellness through exercise and connection to nature.

What are some of the key goals of these repositioning projects?

In response to market research and understanding profitability of the different levels of care, we have seen a reduction in skilled nursing beds and the addition of more memory care units/households. Many communities are “right-sizing” the healthcare census and changing to more short-term rehab beds and upgrading physical therapy spaces. Other goals include:

• Updating nursing homes, with a push toward private rooms within the household model.
• Adding independent living (IL) cottages and more affordable “middle market” IL apartments.
• Wellness-focused amenities and food options that don’t tax current staffing.
• Addressing quality of life challenges faced during pandemic: social isolation, communication, and programming.

Tell us about a couple of recent RDL design projects that successfully address such goals.

United Zion in Lititz, PA is an existing community, that like many older communities, has an imbalance in the ratio between skilled and personal care beds and independent living units. We worked with them to develop a master plan to examine the existing 11-acre campus and adjacent contiguous parcels, including a mobile home park. The goal is to position UZ as the “go to” independent middle-market provider in the area. 

Laurel Lake in Hudson, OH is in the last phase of additions and renovations to transform their aging town center to a Center for Healthy Living. The program consisted of expanding the community room to accommodate larger events, reimagining the formal dining room to address staffing challenges, renovating the “old” pub into a flexible social space, and repurposing an underutilized patio area.

What steps do you take to ensure your work supports the needs of residents in a particular community?

Aligning the master plan with market studies and operations is key. The market study helps to gauge what the competition is doing in terms of the number, type, and size of units, as well as the amenities that are being offered and promoted. Operationally, we ensure that the environment supports staffing ratios and such considerations as type of food delivery, medication dispensing, trash removal, etc.

We work with our clients using an interactive design charrette process to help them uncover and define their unique goals. The conclusions are thoroughly documented to serve as a guide for specific phased upgrades of the community.

Based on your experience, how do you predict senior living communities will evolve over the next 10 years?

We see a continued focus on holistic wellness as well as design to facilitate “aging in community,” supported by technology like health trackers and monitoring devices, as well as telehealth. We’ll see more robots incorporated for tasks within housekeeping and dining, which will help address staff shortages and reduce operating costs.

We also expect more affordable options, including “assisted living light,” with a la carte services customized based on needs and budget. And overall, we’ll see better integration with the wider community by strengthening links to services and amenities outside the campus. At the same time, we’ll continue to develop attractions to bring the public onto the campus.

Post-COVID Design

Joanne Horton, Residential Director at RDL Architects, recently co-led a discussion at AHF Live in Chicago, IL regarding post-COVID design and how the pandemic has affected the design of affordable housing developments. Along with David Layman, President and CEO of Hooker DeJong (HDJ), Joanne discussed how architects are transitioning and evolving the design of spaces to align with client goals and overall professional industry standards and improve the resident experience.

At the onset of the COVID-19 pandemic, the industry was focused on creating safer spaces for residents. Now, with 2/3 of the U.S. population fully or partially vaccinated, architects are focusing on design trends that are less in response to a virus, and more in response to the cultural change brought on by living through a pandemic. These are trends that will have an impact in perpetuity.

Below are Joanne and David’s top five design tips to further enhance the resident experience in response to the pandemic.

1.   DESIGN INTENTIONALLY DISTINCT ENTRY POINTS

Being socially and physically distanced has been an important way to keep residents safe during the pandemic. Because of this, strategies for designing entry/exit points have changed throughout the affordable housing landscape.

One strategy to consider is to utilize “stacked flats” building types as a method for reducing congestion at entrances. Historically very popular with residents, this building type provides private entrances for both the first and second floor units. Stacked flats are also popular with developers and property managers as they lead to cost savings and reduced maintenance, as there are no common corridors.

Another design strategy is to implement entry stoops on ground level units that engage the streetscape. This helps promote vital/walkable/new urbanistic developments that connect the neighborhood to the community.

2.   LESS IS ACTUALLY MORE

In early 2020, the overarching theme was that residents would demand more physical space due to being quarantined and having to balance work and homelife all in one place.

Nearly two years later, this mindset is fading, and there is a greater demand for just the opposite.

Residents are forgoing larger units and are downsizing to essential space only. Having small spaces leads to lower rent payments, which is the main driving force behind this recent trend. The demand for a smaller living unit and more shared amenity spaces is increasing, as residents are looking for more options to spend time outside of their home.

3.   PLAN TO CREATE BOTH PUBLIC & PRIVATE SPACES

Private entrances and smaller garden-style walk-up buildings are becoming more and more popular. This reduces density in apartment buildings, which decreases the amount of pedestrian foot traffic through an enclosed hallway or corridor and allows for stand-alone amenity buildings. This creates distinct areas of public space, ensuring that these spaces do not overlap with the resident’s daily life.

In environments where apartment buildings are necessary or better suited, public spaces can be centralized on the ground floor with multiple entry points implemented so that residents can easily and safely access community spaces. When available, it is important to design both interior and exterior entry points for community spaces, such as fitness rooms or larger gatherings places.

4.   IMPLEMENT WELLNESS & FLEXIBLE SPACES

With the trend of remote/hybrid work environments seemingly here to stay, it is more important than ever before to create flexible, versatile spaces.

Community spaces that are multi-purpose give residents options. Having a space for study rooms, remote workspaces, and even telemedicine wellness rooms is a huge benefit for residents and can be used as a key marketing message for developers and property managers to attract residents. But no matter what the specific programmatic needs are, the key is flexibility in use.

5.   CULTIVATE SOCIAL INTERACTIONS WITH RESIDENTS

Outdoor spaces are vital in affordable housing. Not only do these spaces create a general sense of community for residents, but they also provide a safe place for gathering in open-air environments.

Creating a holistic design system (high ceilings, ceiling fans, furniture, lighting fixtures, etc.) in an outdoor environment can bring residents (and their visitors) together in a safe and effective manner. These transitional spaces promote health and wellness and further connect the spaces throughout a residence.

Utilizing these design tips in your affordable housing projects post-COVID can help to ensure that your clients and your client’s residents are happy, safe and can maintain a high quality of life despite the effects of the pandemic.

RDL’s Senior Living Studio Director Eileen Nacht, AIA, LEED AP, EDAC, recently co-led a session at LeadingAge Ohio focused on COVID-19 Aftermath: Reinforcing Appropriate Design. In the session, Nacht and co-speaker Brit Vipham discussed how COVID-19 has made a lasting impact on the Senior Living community. Over the past year, architects, developers and consultants have had to reapproach strategic planning as it relates to designing spaces that safely allow residents to maintain a level of social interaction and safety. Additionally, industry professionals have been forced to rethink quality of life challenges, such as:

• Social isolation
• Communication
• Dining experience
• Activities and programming

Here is Nacht’s advice for creating holistic senior living communities post-COVID-19:

“Appropriate Design”

Now more than ever, it is important to evaluate the design, technology and operations of a senior living facility.

As we adapt and look to the future, we need to evaluate design, technology, and operations. We recognized that what is accepted as good design for enhancing the user experience, is “Appropriate” design for reducing spread of infection.

RDL has incorporated multiple entry points in senior living communities to achieve operational efficiencies, marketing benefits of distinct entry points for different levels of care and screening back of house operations. The further advantage of multiple entry points during a pandemic is to control visitor access.

Utilizing “small house design” is traditionally a great option for memory care because the residential scale and familiar room to room circulation patterns tends to reduce agitation. Additionally, the small house model allows operators to quarantine a house to reduce spread of infection.

Designing designated outdoor spaces, is crucial for maintaining social interaction during and participation in extracurricular activities. Development of meaningful outdoor space is a priority.

Adjusting the furniture layout of dining rooms allows for residents to maintain a level of social interaction during dining while properly social distancing. An added benefit of increased distance between tables improves acoustics for more comfortable conversations. RDL is utilizing adjacent flexible, activity rooms as decentralized dining spaces to allow residents to socialize safely and comfortably.

Keeping the interior spaces clean and sanitary is critical to the safety of residents, operators and staff. Consider specifying interior finishes with non-porous, nano-septic and anti-microbial properties. Additionally, enhance indoor air quality by installing HEPA filters, bi-polar ionization and UV technology. Another key consideration for enhancement of the interior environment is “hands-free” technology that keeps users safe, such as, plumbing fixtures, light sensors, door hardware and entry systems, etc.

Technology

Keeping residents connected and engaged is a challenge, even in normal times. COVID-19 has only made this task more difficult. As a result of the pandemic, RDL has implemented a variety of technology solutions to enhance the resident experience, such as:

• Handheld devices (CATIE)
• Skype/computer rooms
• Telehealth rooms
• Virtual programming spaces
• Virtual reality (VR) gaming spaces

Other considerations Post-COVID-19

In addition to enhancing the resident experience in senior living communities, prioritizing staff spaces is an important consideration for architects and developers. Creating spaces that staff want to be in will increase employee satisfaction, which is a differentiating factor in the marketplace.

Unfortunately, COVID-19 has affected the development of senior living communities. When developing construction schedules, take into consideration material shipping delays due to the backlogged global supply chain. Consider ordering in advance and look into storing materials in local warehouses or shipping containers.

Finally, it is critical to keep your client’s budget at the forefront, especially when costs of materials and commodities are at an all-time high. Engaging team members early in the process places your team ahead of the curve in analyzing supply chain issues to see the project through to fruition.