UBC Theses and Dissertations

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UBC Theses and Dissertations

Learning from long-term care : COVID-19 and architecture for ageing Buchanan Dee, Brendan Cole


Throughout the pandemic, long-term care (LTC) facilities have repeatedly been identified as the location of some of the most infectious and deadly outbreaks of COVID-19. As specialized facilities where mostly elderly residents are housed and cared for in congregate settings, LTC communities are more vulnerable to infectious diseases as many residents are frail and live with chronic illnesses and comorbidities. This thesis examines the relationship between COVID-19 outbreaks and infections within LTC facilities in British Columbia (BC) seeking out possible building design factors that might have influenced risk of exposure or severity of COVID-19 outbreaks. The study first assesses the impact of COVID-19 on global LTC facilities, identifying suspected determinants of COVID-19 infections and mortality rates. The disparities of LTC systems are then discussed through the concept of a ‘syndemic’ which suggests that pre-existing crises in within LTC such as funding, staffing, and crowding exacerbated the impact of COVID-19. The historical design and aesthetics of LTC architecture are then scrutinized, tracing lineages from eldercare and healthcare architecture through the rise of modernism and postmodernism. Through historical analysis and photographic comparison, the study considers how the progenitors of LTC have influenced the design and reputation of contemporary facilities. Turning to the built conditions of LTC facilities in BC, satellite imagery and Streetview remote site visits are used to classify BC’s LTC facilities into typologies according to building footprints and massing to observe trends within the spatial arrangement of floorplans. Lastly, the investigation undertakes a regional cohort analysis of BC’s 355 LTC facilities by linking administrative survey data from BC Office of the Seniors Advocate and COVID-19 outbreak data from the BC Centre for Disease Control’s weekly pandemic reports. Timelines and data graphs are used to illustrate the course of the pandemic as it occurred in BC’s LTC facilities during the observation period of March 5, 2020-Feburary 9, 2022. BC’s LTC facilities are sorted according to chronology, regional health authorities, resident population size, repeat outbreaks, highest infection rate, and legislative compliance to assess the influence of building design on occurrence of outbreaks and resident attack rates.

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