See the guidelines here.

In November 2020, TrinityHaus, a research centre in the School of Engineering in Trinity College Dublin was awarded funding by the Centre for Excellence in Universal Design at the National Disability Authority to undertake research and develop a set of Universal Design Guidelines for improving quality of life and enhancing COVID-19 infection control in existing residential care settings for older people.

COVID-19 has highlighted that Residential Long-Term Care (RLTC) is vulnerable to infectious diseases. Recent research shows that RLTC settings have been disproportionately affected by COVID-19 (Kennelly et al., 2021), with serious impacts on residents, staff, and family members.

COVID-19, like many other airborne infectious diseases, has serious implications for spatial practices and the design of the built environment. In this regard and considering the toll that COVID-19 has taken on RLTC settings, it is important that the layout, design, and physical environment of these settings is carefully examined to determine the role and impact of the built environment on COVID-19 infections. 

Key findings and recommendations

Key findings from this project address overall quality of life issues and infection control measures. The key findings incorporate relevant Universal Design considerations in addition to findings from the stakeholder engagement process.

The design of RLTC is impacted by many aspects of the physical environment across all parts of a setting and therefore, it is important to take a holistic and integrated approach across all spatial scales, from the location, access, and overall site layout, down to building layout, building components or specific applications of technology. In this regard, the following themes and spatial scales are used to set out a holistic and integrated approach:

  1. Over-arching design characteristics, features, or approaches
  2. Site Location, inclusion, access, interaction with community, and healthy spaces
  3. Site design providing a connected, welcoming, accessible, and pleasant setting with good contact with nature
  4. Overall building layout, circulation, and key spaces (entering and moving about)
  5. Key internal and external spaces
  6. Building elements and components (finishes, furniture, fittings etc.)
  7. Internal environment
  8. Assistive technology, therapeutic technology, and ICT

Throughout this research a set of quality of life domains have been used to underpin the research and provide indicators for an environment where residents have the support and freedom to live full and meaningful lives.

In terms of COVID-19 and infection control, this research highlights how respiratory viruses are transmitted through contact, droplets, and airborne routes and that infection control strategies should take account of all transmission routes. However, there is now good evidence that COVID-19 related contact transmission is generally lower risk and that the principal modes of transmission involve respiratory droplets and airborne transmission. Furthermore, research shows that risk of transmission is reduced outdoors due to air movement removing and diluting COVID-19 virus particles, and environmental conditions such as sunlight damaging the virus particles and decreasing transmission.

The project focuses on existing public, private and voluntary residential long-term care settings for older people in Ireland and examines how the built environment in these settings can be adapted and retrofitted to:

  • enhance the quality of life for residents;
  • improve the visitor experience for friends and family members (without compromising the quality of life for residents); and,
  • improve COVID-19 infection control, pandemic preparedness and resilience while still protecting the psychosocial health and well-being of residents.

Adopting a Universal Design approach ensured that the research and resulting guidelines are created in collaboration with key stakeholders, are people-centred, and address the diverse needs of residents, staff, and visitors regardless of their age, size, ability, or disability.

This research examined the key spatial scales, from site layout to individual internal spaces, space management (i.e., function, use, and circulation), and the elements and systems (i.e., materials and finishes); fit-out; internal environment; and technology, of existing settings. Furthermore, the research and guidelines prioritise design for quality of life in RLTC and emphasises the importance of Universal Design, including dementia-friendly design. COVID-19 and infection control issues were carefully examined, but at all times through a quality of life lens.

Building on previous research and guidelines:

This research report builds on a range of age, dementia, and Universal Design projects and publications completed by TrinityHaus, TCD and members of the research team; including the Universal Design Guidelines for Dementia Friendly Dwellings and Dementia Friendly Hospitals from a Universal Design Approach.

Research Team:

The core research team includes TrinityHaus, TCD (Tom Grey and Dimitra Xidous) and Tallaght University Hospital (Desmond O’Neill and Sean Kennelly).

Project partners and collaborators:

The project involved diverse and representative partners including: HSE – Capital & Estates, Age Action, SAGE Advocacy, Age-Friendly Ireland, Nursing Homes Ireland, and TLC Nursing Homes (providing diverse perspectives across the public, private and voluntary sectors, in addition to key ageing advocates).