The importance of indoor air quality (IAQ) in senior living and care has received a lot of attention over the past few years. Even before the pandemic, owners and operators were beginning to take notice of the effect that air quality can have on senior living residents.

Although IAQ affects everyone, research shows that older adults are particularly susceptible to the health risks associated with poor air quality due to the aging body’s decreasing ability to compensate for the effects of environmental hazards. Air pollution, which can be two to five times worse inside than outside, can aggravate existing chronic health conditions common among seniors, including asthma, lung disease, chronic obstructive pulmonary disease, diabetes and heart disease, in addition to negatively affecting cognition. Ventilation, on the other hand, can positively affect sleep quality.

Before the pandemic, senior living owners and operators already were beginning to take action, given the aforementioned effects on senior health and quality of life, even if indoor air quality was not top of mind for prospective residents. The pandemic, however, dramatically increased public awareness around the importance of indoor air quality to the health of at-risk groups, such as older adults.

Senior living and care communities, where residents are vulnerable due to age-related changes in immune function, were particularly hard hit by COVID-19, for which transmission primarily is airborne. Results from a survey conducted by the Delos Consumer Insights Team in September support this increased awareness within the general public. The team surveyed 983 seniors and their families and found that 57% of respondents felt negatively about the health and safety of senior living residences as a result of the pandemic and the breakouts in nursing homes. Given that the number of Americans going into nursing homes — part of the long-term care continuum of which senior living is a part — is expected to increase from 15 million in 2000 to 27 million in 2050, 57% is a sizable amount of potential residents and their families who feel negatively toward senior living and care as a result of COVID-19.

With respect to indoor air quality, 62% of respondents said that COVID-19 made them more aware of the importance of good indoor ventilation and air filtration, compared with 29% of respondents who said they always felt that air filtration was important. The survey also showed that prospective residents and their families were likely to factor a community’s indoor air quality mitigation measures in their decision on where to live, with 46% of respondents indicating that air purification measures were important factors or even a necessity in deciding where to live and 63% of respondents indicating they would likely or very likely choose one facility over another based on prioritization of air purification.

As one respondent stated, “Air quality is an important part of living, especially for the elderly and immunocompromised. Any company willing to go the extra mile and make air filtration/quality a priority will always get my respect and consideration before companies that choose not to make it a priority.”

From the results of Delos’ survey, we can conclude that indoor air quality is a much stronger consideration for prospective residents and their families than it has been in the past. Indeed, seniors rated it as the third highest concern they had, behind quality of care and safety.

So what actions should senior living communities take to help future residents feel more confident about their health and safety of the facility? From the perspective of future residents, senior living communities need to go beyond HVAC upgrades. Prospective residents and their families responded that, with respect to air purification units, what would contribute most to their feelings of safety were indicators that air purifier units were working, such as flashing lights or the device activating in the presence of pollutants. Respondents also highly ranked other measures, such as receiving alerts when air quality becomes a concern, as well as having air purifier devices in their private residences/rooms and also in common areas where residents are likely to congregate.  

The survey also showed that prospective residents and their families would overwhelmingly choose a senior living community that receives a third-party health and safety certification over one that does not. Such certifications provide outside review and validation of a senior living community’s operational policies, maintenance protocols and emergency plans. Among survey respondents, 93% stated that third-party certification was at least a consideration, and 49% of respondents viewed it as an important factor in deciding where to live. Sixty-four percent of respondents responded that they would likely or very likely choose one community over another if they received a health safety certification.

Additionally, certain respondents stressed the concern for the third party’s credibility. As an example, one respondent noted, “Certification from a *respectable* third party tells me that the facility is serious about providing decent care.”

As the Delos survey suggests, there is considerable consumer concern over indoor air quality that is unlikely to go away any time soon. The pandemic highlighted an important aspect of indoor environments that was previously not as well understood by the general public as it was by the scientific community. Now is the time to listen to the concerns of prospective residents and their families and take actions to provide a safer, healthier living environment and raise consumer confidence.

Carolina Campanella, Ph.D., is a vice president at Delos Labs who specializes in behavioral science. She works with research and development, product and marketing teams to collect and analyze behavioral, marketing and UX insights. Campanella is an expert in well-being and productivity.

The opinions expressed in each McKnight’s Senior Living marketplace column are those of the author and are not necessarily those of McKnight’s Senior Living.

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