Are safer, welcoming care homes possible? Considering physical environments

As the pandemic rolled through care homes, did overcrowding, close quarters, large facilities, and shared spaces create the conditions for high rates of resident infection and death? Taking up the perspectives of residents and workers, this chapter draws on a physical design analysis of photo diaries and interviews at eight care homes in Canada to describe how residents, staff, and families experienced care home environments since the onset of the pandemic, including during lockdowns, restrictions, and physical distancing measures. Then, drawing on over a decade of international research, we outline six principles for planning and organizing the future of care home physical environments. We argue that there is no single “best” way to organize care home physical environments for all those who need 24/7 medical and social care, but there are principles that can guide care homes to achieve safer, welcoming physical environments for current and prospective residents and staff, including in disease-outbreak conditions.