9 Aged Care Design Opportunities in a Post COVID-19 era
This article comes as we are starting to have some relief from some COVID-19 restrictions and it also coincides with the review of the Code for Visiting during COVID-19, and it got us thinking about how aged care building design and operations may change as a consequence of this unprecedented experience – the 2019/2020 Pandemic.
Here’s our top 9 ideas:
Structuring of resident communities
Cohorting residents during an outbreak has highlighted how important it is for consumers to have access to essential spaces like dining and recreation space. Any one who has spent time in a social isolation would attest to the difficulty of not having access to fresh air or any type of external space and lets face it we all want an out of being in our bedrooms 24 hours per day. A lockdown can be structured into relevant sections so I suspect architects will be looking for ways that access can be managed in a way that minimises cross movement and that communities can in effect be locked down into smaller sections so that resident or staffing movements are minimised.
Look at opportunities for more windows/see through walls and how these structures can provide a barrier whilst also enabling communication. Definitely having access to safe verandahs for fresh air and stretching / gentle exercise areas.
Isolating individuals with challenging behaviour
Consumers that pace and are used to regularly moving throughout the entire aged care home, generally, also touching surfaces like handrails can be particularly challenging to support in an isolation phase, bringing several matters to the fore; Having a part of the home with line of sight access and separation means that meaningful engagement activities can be deployed whilst at the same time as not having a consumer completely shut off and away. The double edge to that is the line of sight means the consumer is actively seeking to exit then use of frosted glass with one way view can help overcome these issues.
Small contained breakout areas for active engagement of a small group of residents (1-2) means that physical distancing can be accommodated without the issue of complete isolation in the limited area of the residents room.
Cleaning Regimes – Access and Movement throughout the Home
Consideration as to how occupants move regularly throughout the home is very important to identify high contact areas risk. Individuals – residents, staff, contractors and visitors all use lifts, for example.
Lift programming can restrict to designated floors and prevent staff / visitors or residents from accidentally accessing floors will minimise cross infection.
If you contract cleaning services then you will likely need to have a ‘high risk’ cleaning program that aligns to your services high contact points. Staff/nurse stations, medication rooms, lifts and utility rooms are great examples of a high contact point where the cleaning regime will likely need a higher frequency.
Consider where the complimentary tea and coffee making facilities are located for visitors or guests. Are they near a nodal point which is accessible and prevents movements to areas which could be avoided, like walking past a group of resident rooms. Consider where the hand washing facility is for these areas and have you automatically considered placement of alternatives such as hand sanitisers or they somewhere else not intuitively where the high contact point activity occurs.
Temperature checking and signing in
RFID, App based auto sign in will likely be a standard sign in processes. Outside of the obvious benefits of record keeping who has attended the home in the event that contact tracing is required it also provides great insights and some of the newer technology integrates temperature checking with face recognition.. Some left field benefits to these solutions include better insights into understanding high volume visitation times, the actual volume (head count) of visitors, your ability to grow contact databases for communication and also creating a real ‘point in time’ feedback loop if the solution includes survey questions options.
For providers that are being entrepreneurial about additional services this will also assist in developing commercial solutions that focus on ‘pain points’ for visitors – think access to hairdressers, access to cafes, purchase of meals or holding of events. Integrated systems that also allow simple feedback will create more responsive feedback.
Physical distancing and visitation areas – beyond the residents bedroom
Whilst we know the resident’s bedroom is an option for visitation, the downside is that visitors need to travel through the home to access that area. Consideration to planning a well appointed reception and front lounge of the home enables visitation pods to be created. Homes that have had this design featured in have been able to easily accommodate booked visitations and also comply with social distancing. Ideally you would want enough space that 3/4 visitation pod areas could be accommodated. In this situation families with 2-3 people can visit one resident in a 1.5M physical distancing arrangement without having them unnecessarily travel through the home. The benefit to the resident is that they can experience an ‘excursion’ by being assisted to leave their room and receive their visitors in a safe manner (of course assuming they are symptom free!)
Think non touch/touchless for everything you can
Every opportunity for non touch technology – voice activated commands, foot operated, sensor and RFID to enable/disable doors, Voice activated electronic care systems
Staff facilities in a lockdown
If cohorting staff in a section with residents make sure you consider some storage areas that allow for staff break areas and possible even overnight accommodation if workforce supply issues are encountered.
The staff room in an aged care home during an outbreak can be where high transmission risk occurs. Especially if lockers are shared amongst staff and the areas in size haven’t really had regard to the highest volument of staff taking a break at any given time. Ideally Staff room areas should be used only as a staff changing facility if the requirement is to come to work and put on a cleaned uniform to wear during shift and then at the end of the day change into the clothes being worn to travel home. Have you planned in a laundry shoot or dirty laundry store in staff areas? Most don’t. Where staff store personal belongings will also need to be thought about- ideally creating a plan that directs staff to leave as many personal items at home as possible- including meals, handbags and anything non essential for the shift.
Infection control – other considerations
Location of hand hygiene to be integrated more frequently throughout the home, finding the balance between hospital-like environment and home environment- ideally touchless where possible.
Auto close lids on toilets when flush activated – this will help reduce aerosols and droplet transmission. Consider flipside of reducing the risk to residents if having difficulty opening and closing lids.
Communication and wayfinding.
Throughout the pandemic we have seen homes and services need to allocate one point of entry. This can result in confusion and difficulty for visitors to the service if the service has multiple entry points. Future builds can increase the use of electronic signage and wayfinding that can be easily updated to indicate changes to access points- hard wired signage probably becoming a thing of the past