Article summary: Nursing Home Design and COVID-19: Balancing Infection Control, Quality of Life, and Resilience (JAMDA)

Diana C. Anderson, Thomas Grey, Sean Kennelly, Desmond O’Neill,
Nursing Home Design and COVID-19: Balancing Infection Control, Quality of Life, and Resilience,
Journal of the American Medical Directors Association, Volume 21, Issue 11, 2020, Pages 1519-1524, ISSN 1525-8610,

Article published in the Journal of the American Medical Directors Association (JAMDA) discussing the urgent need to examine the architectural design models of nursing homes to address both long-standing concerns about the adequacy of these facilities to support quality of life, and the inadequacies highlighted by the COVID-19 pandemic.

The article tackles the need for balance, and convergence, between infection control, quality of life and overall resilience and provides an overview of the relevant literature on design for quality of life and resilience, and on design issues across key spatial scales. The spatial issues covered include:

  • macro-scale: proximity to a person’s home community, integration with health and social care and emergency services,
  • meso-scale: neighbourhood integration and connections, local air quality
  • micro-scale: these are particularly relevant to infection prevention control and include issues linked to the size and density of facilities, building configuration, access and internal circulation, key resident spaces (such as private rooms with bathrooms), transitional spaces, outdoor areas and spaces to exercise, key staff spaces and ventilation and air quality.

The article ends by proposing that “the future of residential design for older adults should promote quality of life, social interaction, and engagement, but more importantly foster collaboration with older adults“. The authors acknowledge the costs of retrofitting existing facilities or constructing new ones and call for research on the cost-effectiveness of nursing home design.

Finally, the authors call for collaboration between health and design professions “to yield design solutions that promote quality of life alongside pandemic preparedness and resilience“.

The full article can be found here:

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