Environments for Aging - Fall 2020 - 24

W

hen the COVID-19 pandemic
began spreading across the
U.S. in spring, new protocols
and building solutions for senior living were
immediately put in place to support social
distancing and infection control measures. More specifically, providers closed
their dining venues, cocktail bars, gyms,
swimming pools, art studios, libraries, and
activity rooms. Visits from family members
and friends were prohibited for residents in
skilled nursing and assisted living communities, with exceptions made for end-of-life
situations. Staff looked for new ways to
deliver meals to resident rooms or utilize
space in new ways-for
example, hallways used for
game nights, with residents

to resume in properly prepared assisted
living facilities but not at skilled nursing
communities. "It's such a moving target
every day, with regulations changing in
each of the 50 states," says Rob Simonetti, architect and senior associate at
SWBR (Rochester, N.Y.) and president of
SAGE (Society for the Advancement of
Gerontological Environments).
Now, more than six months into this
pandemic, most senior living communities are still dealing with the day-to-day
impacts of COVID-19 and implementing
operational or programming changes
that balance safety measures with socialization. Simonetti
says many providers
are in "survival mode,"

different options depending on what works
best for that community and what restrictions there may be within that municipality,"
she says.
As similar discussions about a return
to socialization in dining, activities, and
visiting are held in communities and firms,
specific strategies for each are beginning
to emerge.

sitting in their doorways to
play bingo or trivia.
These drastic measures
were a necessary response
to contain the spread of
the virus and help protect
vulnerable senior populations, but they came with a
heavy side effect: increased
isolation and lack of socialization. "It's had a negative
impact on everyone," says
CC Andrews, president and
chief strategist at Quantum
Age Collaborative (Cleveland). "The psychosocial and emotional well-being, that's what
they're struggling with more every single
day."
But as eager as communities may
be to return to a sense of normalcy with
once-again bustling activity rooms and
dining spaces, they're facing a minefield
of regulations and guidelines that not only
vary by state or county but are constantly
being updated as more is learned about
how COVID-19 spreads or as new hot
spots emerge. For example, over the summer, South Carolina Gov. Henry McMaster
asked the South Carolina Department of
Health and Environmental Control to develop guidelines to allow limited in-person visitation in nursing and assisted living communities, only to then ask the department
a few weeks later to delay those guidelines
after the state had a spike in infection rates
and hospitalizations. In June, Ohio Gov.
Mike DeWine permitted outdoor visitations

making some shortterm modifications to
the built environment
but not looking long
term just yet. "The
idea of planning a
physical change in
reaction to something
that could go away in
six months or a year
may be too much for
providers, as they
contend with today's
pandemic," he says.
Andrews agrees: "So far, there hasn't
been a lot happening [to senior living design], but there's been a lot of discussion
on what could be done."
As Brookdale Senior Living begins
to discuss "reopening" plans for its
more than 700 senior living communities in states including Vermont, New
Jersey, Connecticut, New Hampshire,
and Massachusetts, Laura Busalacchi,
senior director of interior services at
Brookdale Senior Living (Milwaukee),
says her department is developing plans
that offer communities different options
to accommodate social distancing and
other regulations within various spaces.
Ideas range from setting up two empty
tables between seated residents in a
dining room to establish proper distancing and help resume limited food service
to using plexiglass structures to allow a
resident and family members to visit in
a designated outdoor space. "There are

"We were scrambling to find additional associates to help get food to residents in hot
boxes or on carts," Busalacchi says.
This solution temporarily solved the issue
of providing a safer food service experience
but exacerbated resident isolation and contributed to menu fatigue, which was already
an issue in senior living prior to COVID-19,
says Matt Schuler, director of culinary
development at Scopos Hospitality Group
(Ephrata, Pa.). This past spring, the firm
developed a guidebook with design strategies in response to COVID-19, with some
short-term solutions including reconfiguring layouts and removing furniture in main
dining rooms to provide more distance
between seating areas, installing temporary
structures between diners, implementing traffic flows in and out of the space to
prevent clustering among residents and
staff, and replacing menus with movable
boards or technology options to reduce the
number of shared surfaces.
One common question he's being asked
is if salad bars, or anything self-serve,
need to go away as part of increased
infection control measures. While he says
he doesn't see the salad bar "making a
comeback" in senior living, there are ways
to offer self-service via set-ups similar to
what's used in the restaurant industry, like
at Chipotle or Subway. "So residents still
have a choice of what they want on their
salad or sandwich but someone else with
clean hands and gloves is safely producing
the food," he says.
Looking at other long-term changes,

Providers
face a
minefield
of changing
regulations
as they try
to bring back
a sense of
normalcy.

24

EFAmagazine.com * Fall 2020

1

Dining

When the pandemic began,
most seniors in independent
living, assisted living, and memory care
communities were quarantined to their
rooms or units and dining rooms were shut
down, meaning meals had to be organized
and delivered to residents in their rooms.
http://www.EFAmagazine.com
Environments for Aging - Fall 2020

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