A New Approach To Design of Aged Care Facilities

Aged Care Facility

An Aged Care Facility

A group of design professionals, innovators, planners and seniors came together in a charrette (a workshop devoted to planning a design or solving a problem) to look at a new way of creating aged care facilities. Rather than design just for comfort, or looks, the group aim was to design to aid longevity. Hosted by The University of Queensland and DMA Engineers, the 120 assembled experts considered this a rare opportunity for teams of people from different fields to collaborate in some blue sky thinking.

DMA Engineers managing director Russell Lamb discussed the current dischotomy.

“It’s quite restrictive. In fact, it’s probably one of the most restrictive. I think that’s one of the struggles that the industry’s dealing with at the moment, where we hear terms about ageing in place, but if you go from a retirement living facility, where it’s in most regards an apartment that younger people in their twenties, thirties, forties may be happy to live in, to when you’re actually going to an aged care Class 9C patient room. The amount of services and facilities within that room are fundamentally different.

“One of the challenges the industry is really faced with is how we can have a space which transforms over a matter of years and transforms in a way that maintains the character of the place and doesn’t become too clinical, too quickly.”

The group was challenged to create visionary, innovative and highly connected designs to meet the needs of an intergenerational community in 2050. It was noted that too often aged care facilities are cut off from the wider community by virtue of cheaper land forcing providers to the outskirts of town.

The University of Queensland’s Director of the Healthy Ageing Initiative, Professor Laurie Buys, said

“Older people are thinking and acting very differently than ever before, and we know that future generations of older people will have very high expectations about maintaining their engaged lifestyles.”

The experts gathered into groups and took part in a design competition. The chance to throw the rule book out of the window was appealing for many of the designers who were able to think more generally about how the needs of older people can be met in a hypothetical way, rather than designing to a client’s brief. A common thread emerged of physical and social connectedness, key to promoting increased choice, economic development and job creation. Designs visualized spaces that enabled older people to be creative and productive rather than just existing in places with activities to pass the time away.

 

Thanks to Aged Care Insite for information used in this blog.

 

 

Visitors to Aged Care Homes

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The Prime Minister went on national television last Tuesday to tell aged care facilities in Australia to go easy on their lockdown measures. He said the recommendation from the national cabinet was for a maximum of two visits per resident per day in the resident’s room. He was concerned for the welfare and health of residents in aged care if they were not receiving regular visits from their families.

Several things have come to my notice as an Aged Care Placement Consultant about the situation. Aged Care Facilities seem to vary from one to another with how they are dealing with COVID-19, as mentioned in my last blog. When it comes to visitors some are in strict lockdown, others are following the government recommendations. Staff are busier than ever, as they don’t have the help of volunteers and other support services; for example, they are having to conduct all the activities to keep residents occupied.

General Secretary of the NSW Nurses and Midwives Associations, Brett Holmes, said the government needed to provide additional staff to aged care facilities so they could screen visitors before allowing them in. I agree with this and can understand the difficulties aged care homes will face in monitoring visitors, I’m aware that even at the moment where families are allowed to visit their loved ones in palliative care, in some facilities it is only for 15 minutes, yet when asked to leave they ask for another 5 minutes, then another 5 – this all takes up staff time, adding an extra burden. There will be further calls on staff time when the directive starting in May that visitors must have the up to date flu immunisation comes into effect, as this will need policing.

Brett Holmes went on to say “There are qualified nurses out there looking for work and if the Commonwealth Government wants to open up the aged care facilities, then that should be done in the safest possible way.That should also mean of course the additional resources of PPE to allow that screening to be undertaken in the same way that our public health system is responding to this risk of people from outside the facility bringing in the COVID-19.”

I have noticed when that some aged care facilities are contacting families and asking them if they are content with the precautions the facility is taking and, to my knowledge, most families are generally understanding why the facilities have taken those precautions and that it is for the protection of residents.

Last week I placed a gentleman in an aged care facility and his wife was upset that she couldn’t visit him over the weekend. As I have said before, each facility is dealing with the situation differently. The same goes for retirement villages. I am helping a client to find a suitable retirement village and one place we were interested in would not allow a site visit but also won’t allow a resident to move in unless they have seen the facility in person. Another retirement village will allow a site visit, but only one person at a time.

I am finding that only people in an emergency are now seeking aged care accommodation as they don’t want to self isolate within the facility for 14 days once they move in, they don’t like the idea of no visitors and don’t want to spend the money and make a monumental move to a home site-unseen. Trying times indeed!

 

 

How Aged Care Facilities Respond to COVID-19

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With the corona virus pandemic now in Australia there are changes to how aged care facilities are able to operate.

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In my role as Placement Consultant I help clients find suitable accommodation in aged care facilities in Melbourne. I’m currently getting frequent updates from aged care facilities on changes to their protocols. Fortunately most aged care facilities still currently taking new residents and, in some cases, respite residents. There seems to be a general requirement for new residents to self isolate for 14 days when they move into their new home. However, the need for this varies from facility to facility, with some making it mandatory for all new intakes, whilst others have made it only for those who answer positively to questions about their symptoms and/or exposure to COVID-19 or carefully check on resident’s health upon intake.

I had a client recently who I had trouble placing into a facility as she was unable to do the 14 day isolation due to memory loss. Fortunately I was able to find another suitable facility whose policy is if a new resident comes from home they will have their temperature taken and be monitored. As my client was coming from home she was accepted. However, this facility requires new residents to self isolate for 14 days If coming directly from hospital. Some facilities can no longer accept people living with dementia or people that wander as they are unable to provide care for them with the social distancing restrictions now in place.

Restrictions around visitors also vary between aged care facilities with some putting in place a total ban for visitors, with some allowance when residents are in palliative care, and others allowing minimal visitors as per the government guidelines of no more than two at a time, once a day.

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Most visits to inspect facilities are now virtual with a range of sophistication there; some have film crews do a professional video tour whilst others film the facility themselves. Some facilities will meet with you and show photos and some will even allow a personal tour but with strict cleanliness and health protocols in place.

Greenview Donvale bed

It is challenging keeping up with all the different protocols in the various facilities and another reason my clients find my services so helpful  as I sift through these frequent updates to keep them informed.

 

 

 

 

Behind The Scenes of The Old People’s Home for 4 Year Olds

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A recent interview by Aged Care Insite with Professor Susan Kurrle, director of the Cognitive Decline Partnership Centre at the University of Sydney, who worked on the recent ABC documentary The Old People’s Home for 4 Year Olds, provides some interesting insights to the program. (Photo from Aged Care Insite)

This experiment is the first of its kind conducted in Australia and Professor Kurrle believes the implications of this successful trial could be huge. The ABC show follows the progress of a group of aged care residents taking part in structured activities with a group of pre-schoolers who visit their aged care home on a regular basis.

The resident-to-resident relationship building that has arisen as a result of the experiment has obvious benefits to health, Professor Kurrle said. It was a surprise side effect of the experiment and those relationships have continued in a healthy way. Some residents felt quite lonely and isolated prior to the trial.

Allowing young children day-to-day contact with their elders can also combat ageism she said. The children who took part also benefited growing in their confidence and interactions and developing of empathy. One particularly touching moment was when one young child, whose parents described him as a “soft soul”, showed empathy for a depressed resident who was not participating or speaking and had his eyes closed, by going up to him and being with him, drawing the resident out until he broke into a beaming smile.

This experiment was the first time that structured activities were used to encourage interactions between the children and adults as they worked together to achieve particular goals. Other intergenerational programs with pre schoolers have not been structured in this way, with the children simply playing side by side with the residents. Professor Kurrle pointed out that humans are pack animals and crave the companionship of family. For residents whose families are far away or unable to visit life can become lonely. This program allowed them the opportunity to interact with young children, as they would with their grand children. The health benefits were proven by standardised health tests before and after the program.

Professor Kurrle assured the interviewer that the children weren’t encouraged by producers on the show to behave in certain ways to develop the story. All behaviour on the show was spontaneous. The only people in the room were the participants, the instructor and some of her assistants to help with the children. The cameras and microphones were hidden.

Suggestions coming out of the success of the program about how to do more intergenerational programs in aged care facilities include encouraging playgroups to set up their activities within aged care facilities. Another was for aged care providers to consider building childcare facilities within their buildings when building a new facility or upgrading an existing one.

Trailer for the ABC program

 

A New Test To Tackle Falls in The Elderly

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Older people fear having a fall, more than a bag snatch or a home invasion, according to Professor Stephen Lord, a senior principal fellow at Neuroscience Research Australia at the launch of a new screening test for falls, a collaboration between NeuRA and the aged care company, the Mark Moran Group. He stated that the reason they fear this so much is it is often the precursor to losing their independence. Once an elderly person goes to the Emergency Department of a hospital as a result of a fall and into the hospital system, they are often assessed as being unable to continue caring for themselves, resulting in them moving to an aged care facility.

Research shows one in three people over 65 will have one or more falls every year. At that rate the number of new hospitals will have to increase at a rapid rate to cope with falls related injuries.

Professor Lord stated that the cost of falls to the economy is greater than any other injury, including car crashes.

If a fall is serious, 43 per cent of people aged 70 or older who have one will be admitted to hospital. Currently, falls account for 250,000 hospital bed days every year, and will rise to 450,000 by 2050. Of those who are hospitalised, about 10 per cent will move to an aged care facility for the first time.

The new screening test, launched this week, can predict with 75 per cent accuracy the risk of someone over 60 having a fall – and recommend ways to prevent one. The kit, FallScreen +, has nine assessments. These relate to general wellbeing, including pain and mental health; regular exercise; executive function (which includes ability to assess and negotiate hazards in an unfamiliar place), and eyesight, including ability to see light and shade (which helps to avoid trip hazards).

The kit will be trialled at aged care facilities owned by the Mark Moran Group, and will also be released as an app pitched at those who work in aged care, including physiotherapists, psychologists and others. A simplified test is being developed for general practitioners.

As an Aged Care Placement Consultant I highly recommend that elderly people have a future plan in place so that if they do have a fall or several falls and find themselves in a situation where they can no longer stay safely in their home, they have a plan B ready to go. If they have developed a plan, they are in a position of having more choice and being able to move to a facility that suits their needs, tastes and location. This can make a big difference to the outcome; it can be a positive move.

Some facts taken from Julie Power’s Sydney Morning Herald article published Aug 27 2019.