Getting old needs a new look

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The pandemic has exacerbated issues like social isolation in U.S. nursing homes and assisted-living facilities. But problems with the living situations of older Americans long predate the coronavirus.

Covid-19 has exposed the lethal vulnerabilities of nursing homes and assisted-living facilities. Can better design make aging safer?

In at least one way, the United States’s tragic response to the coronavirus hasn’t been an outlier: Just like in the rest of the world, the consequences of the pandemic were amplified inside living facilities for older adults.

As of August 13, at least 68,000 residents and workers in long-term care facilities in the U.S. have died from the coronavirus, according to New York Times research, a number that comprises more than 40% of the nation’s total. That percentage that’s been matched or exceeded by other countries across the globe. In Europe, half of all Covid-19 deaths happened in nursing homes and long-term care facilities, according to the World Health Organization. In Canada, which has been far more effective at containing the disease, 82 percent of the country’s deaths have been concentrated among these facilities.

The vulnerability of nursing homes was clear from the earliest stage of outbreak in the U.S., when the disease swept through the Life Care Center of Kirkland, Washington in February, claiming dozens of deaths. At Holyoke Soldiers’ Home in Massachusetts, at least 74 residents — a third of the facility’s population — died of Covid-19 in April. The summer resurgence of infections has found its way into care facilities in Texas, Florida, and Arizona, bringing the number of cases in nursing homes nationwide above its previous peak in May.

For the entire multibillion-dollar ecosystem of senior living in the U.S. — including the more than 15,000 nursing homes, nearly 29,000 residential care communities, and about the same number of assisted-living facilities — the pandemic is exposing a deadly dilemma at a challenging time. “We weren’t prepared for Covid,” says Dr. Robyn Stone, co-director of LeadingAge LTSS Center at University of Massachusetts Boston. “Nobody was, including the nursing homes.”

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