By Dr Pat Godbolt
As a long-time resident of Taringa, I am aware of the need for aged-care facilities within our community and I welcome the use of the Seven Oaks Street site for this purpose.
I worked for many years as a health practitioner in general medicine, and one thing I learnt was that most people want to stay in their own homes for as long as they possibly can. If they must move into an aged-care facility, they want to live in a home-like environment and to remain close to their family and friends.
Moving people into aged-care on the periphery of the city, distant from their long-term community, or into overly institutionalised settings, is not best practice and not an approach I would endorse.
Now that the council has asked TriCare to submit a new design for their aged-care facility at Taringa, I think it’s worth considering what kind of facility would offer elderly people an optimal experience. Let’s look at what the research tells us.
Feeling right at home
Firstly, research shows that aged-care facility design should mimic a residential environment.
According to Adjunct Professor at the University of Queensland and director of Wilson Architects, Hamilton Wilson, when designing a seniors’ living project: “…we need to understand we’re designing someone’s home – places we’d like to live in, want our families to live in, or we’d like to visit.” In this article published on 10 June 2017, he points out that, “baby boomers will no longer tolerate residential care environments that mirror hospitals rather than homes.”
I think it’s fair to say that TriCare’s original design of a 255-bed, nine-storey residential care facility was certainly ‘hospital-like’. Let’s hope their new design adopts a more home-like approach.
Caring for people with dementia
The Federal Government’s ‘Aged Care Roadmap’ states that dementia is one of the major reasons why old people enter residential care. In fact, more than 50 per cent of aged-care residents have a diagnosis of dementia.
According to Alzheimer’s Australia, some of the principles of good care include creating an environment that is as home-like as possible and recognising that the presence of pets may have a calming effect.
Other best-practice approaches include providing residents with access to usable outdoor space, access to communal areas, access to gardens, the ability to garden themselves, and the provision of safe wandering areas.
We are very pleased to see that the council has instructed TriCare to preserve the existing vegetation at the Seven Oaks site, including two magnificent trees which have been deemed ‘culturally significant’ by the council and are therefore protected. What a wonderful asset they will be for an aged-care facility, offering prospective residents some beautiful greenery to enjoy, which the research tells us can be a valuable therapeutic experience.
An environment that helps, not hinders
The Agency for Clinical Innovation, part of Aged Care Network NSW, sets out principles for improving healthcare environments for people with dementia. They state that a poorly designed physical environment increases confusion and that the scale of a building should assist and not intimidate.
Best-practice, modern design has addressed this issue in numerous places:
- In Holland, the Hogewey complex was opened in 2009. It sits on four acres of land. It consists of 23 two-storey houses, each of which accommodate six or seven residents. There are shops including a cafe, supermarket, pub. There are 152 residents. It has been reported by CNN that residents of Hogewey required fewer medications, ate better, lived longer and appeared more joyful than those in standard elderly-care facilities.
- Similar complexes are being set up in the UK, Switzerland Canada and US.
- At Glenorchy, North Hobart, Tasmania a village has been designed and is due to open in around 18 months. It will comprise 15 low-rise houses for 90 residents and include shops and a cinema.
- The Toowoomba Residential Care Service will open a 134-bed facility in 2018. Set on two acres in the centre of Toowoomba, it will comprise three levels with eight wings which will overcome a hospital-like appearance.
“The Eden Alternative”, pioneered by a US geriatrician in the 1990s, is another example of an approach that focuses on the de-institutionalisation of aged-care facilities. In this approach, aged-care facilities are de-institutionalised by using children, animals and plants to create an atmosphere reminiscent of home.
In fact, as reported in this ABC news story, researchers in Australia are now looking at the benefits of intergenerational playgroups which combine child care and aged care as a dual community service model operating on one campus.
Challenging TriCare to do better
Sadly, too few of these excellent facilities are available but it seems to me that new aged-care developments should endeavour to satisfy some, if not all, these criteria.
The Brisbane City Council’s Seniors’ Strategy 2012-2017 states that the Council will encourage “small, niche, well-integrated, well-designed residential aged-care facilities”, so we hope that TriCare’s revised design will align with council’s stated goals.
We hope that TriCare will incorporate these principles in their re-design of the facility and give people the kind of residential-care facility they deserve.
Dr Pat Godbolt has more than four decades’ experience as a medical practitioner, working in general practice and later at the Wesley Hospital.