Healthcare Insights from the 2021 Environments for Aging Expo | Henderson Engineers

Healthcare Insights from the 2021 Environments for Aging Expo

Healthcare representatives from Henderson Engineers recently attended the 2021 Environments for Aging Expo & Conference (EFA Expo), an annual event focused on senior living design. The three-day conference provided a wealth of information on how senior living is progressing across the country. While only 13% of the U.S. population was above 65 in 2013, the proportion is expected to be 20% or higher by 2050. Given this projected increase, senior living facilities should be evaluated for lighting design, increased IAQ, acoustics, and overall energy efficiency to accommodate the expected growth and to stand out within the market.

We’ve reviewed the recommendations and insights that were shared at the EFA Expo and have narrowed it down to the most important trends and topics for you here:

2022 FGI Guidelines – Updated FGI Guidelines will be released in early 2022. Multiple changes will be included with the goal and vision of providing person-centered care. The Residential Guidelines as a whole will be overhauled to align more with the Hospital and Outpatient books and will include multiple types of buildings such as residential, household, and apartment-based facilities. The guidelines will realign the sections under revised headings similar to the updated safety risk assessment and cooking sections and will include items from the upcoming Emergency Conditions White Paper that is currently available for comment. Additionally, associated references will be updated to accommodate IES lighting requirements for older adults and the visually impaired, acoustics, and ASHRAE 170 2021 to replace ASHRAE 62.1 and 62.2.

Overall, the 2022 FGI Guidelines will provide needed updates utilizing evidence and research-based elements that are centered around Environment of Care for both residents and staff. This will better define the minimum Standard of Care for the industry.

Humidity – The ASHE and ASHRAE study on maintaining the space relative humidity between 40% and 60% was discussed in multiple sessions. During many of the sessions, moderators indicated that maintaining those humidity levels showed decreases in virus infection rates. Additional research in the ASHRAE Position Document on Infectious Aerosols indicates that keeping humidity levels below 40% decreases the mucus membrane barriers and other steps in immune system protection.

We understand that adding humidity to a senior living facility is more difficult than in a hospital as senior living facilities typically do not have central HVAC systems. However, corridor and common area humidification can be – and should be – analyzed to help overall building pressure.

ASHRAE 170-2021 – Many changes have occurred lately to the Residential and Outpatient guidelines outlined in this section of ASHRAE. There are also filtration requirements across the board and operating room requirements for Ortho and other specialty procedures. An allowable alternate to all room exhaust with dedicated exhaust fans and HEPA filters to be connected to the general exhaust system was also added.

Indoor Air Quality – Indoor Air Quality is a continual focus for building design, construction, and operation. ‘Sick Buildings’ can result from multiple sources including low ventilation, increased particulate in the air, or overall smells. Multiple avenues are present to help with the ASHRAE recommendations for decreasing virus transmission factors via the technologies of Trap it, Kill it, or Dilute It. Increasing filter efficiency through MERV 13 filters appears to be the favored recommendation by ASHRAE. However, the potential increase in efficiency needs to be evaluated before implementation on existing systems to ensure existing fans can handle increased filter pressure drop. Increasing filter efficiency can not do it alone as the size of a virus is typically smaller than the average particle size capture efficiency of MERV 13. Consequently, additional technologies and practices should be evaluated to enhance the ability to reduce transmission and exposure.

Increasing outdoor air ventilation is another viable option for reducing virus transmission. However, extreme conditions during summer and winter can make it a very costly option and be detrimental to existing HVAC systems that may not have adequate capacity for such an increase in load. Moreover, you cannot ascertain that the proper ventilation is being introduced to the space when utilizing PTAC units, as is common in residential senior living facilities. The associated increases in ambient humidity usually have further adverse effects to the space due to increases in biological exposure as the PTAC units do not operate continually, but ambient air can be introduced to the building through infiltration as the PTAC unit is an opening in the building envelope. Good ventilation and filtration are keys to improved indoor air quality and should be a priority in our current climate as much as any other convenience.

In addition to filtration and ventilation, other technologies exist to help decrease virus transmission. New types of carpets and paints are being provided with embedded antimicrobials that can aid in trapping and killing allergens, VOCs, microbials, and odors. Furthermore, UVGI and ionization technologies are being utilized to decrease transmission. UVGI systems are widely recognized as a means of breaking cell bonds to help kill virus structures. UVC can be harmful to older adults with impaired vision, so extra care must be given when introduced.

Please don’t hesitate to reach out if you’d like to discuss any of these topics or senior living design in general. Our experts are always happy to help.

Written By

Health Sector Inpatient Practice Director


Recent Insights

Climate Responsive Design: A Giga-Scale Responsibility

Matt Higgins, lead energy analyst, shares expert insights into how to adapt to climate change by rethinking how we design buildings.

Read More

Exploring the Key Elements of Computational Thinking (Part 1)

The latest installment in a series of articles focused on computational thinking’s role in problem-solving, specifically as it pertains to the architecture, engineering, and construction industry.

Read More


Join our email list to get the latest design innovations, technical content, new projects, and research from Henderson’s experts delivered straight to your inbox.