It took a pandemic to expose the serious shortcomings of the institutional design of residential aged care facilities in Australia.
Almost a quarter million Australians with an average age of 85 years live in residential aged care today, and the number of people in the 85+ demographic is projected to double to over one million by 2042. As more seniors transition from the comfort of their homes and retirement villages to residential aged care, not only will there be a heavier demand for aged care facilities, but also a higher expectation in the quality of accommodation, amenities, lifestyle offerings, and opportunities for physical activities and social engagement.
Based on the recommendations of the Royal Commission into Aged Care Quality and Safety, the Australian Government is creating the National Aged Care Design Principles and Guidelines, a new framework, which will guide the design of residential aged care accommodation from 1 July 2024.
However, a significant number of aged care providers and architects have already taken the next step to designing for the next generation of older people, with the design thinking underpinned by the need to place residents at the centre of design strategies, where they would be able to continue the active lifestyle they had prior to entering long-term residential aged care.
Here are 3 trends that prove aged care design has truly come of age in 2023.
Smaller homes with 8-12 residents
The de-institutionalisation of residential aged care homes is one of the major developments in reimagining aged care design. The large hospital-like impersonal environment with tiny rooms, long corridors, dining halls and common rooms is giving way to smaller homes, designed to accommodate not more than 12 residents living in independent suites.
While the rooms are designed as spacious sanctuaries where residents can spend time with family and friends in privacy, the shared kitchen, dining, living and garden spaces provide the perfect convivial environment for physical and social interaction, all backed by 24-hour care and support. Any special equipment is discreetly out of sight – and the staff do not wear uniforms! Small homes also allow for easier isolation in the event of an infection.
West Australian aged care services provider Oryx Communities has adopted the ‘Small Household’ model at some of their premium urban locations by providing specially designed homes featuring up to 12 large suites centred around a shared kitchen, dining and living area, “embracing the concept that the heart of every family home is its kitchen”.
Oryx's 'Small Household' model with the shared kitchen, dining and living area (Source: Oryx)
Similarly, the Hassell-designed Karingal Green in Perth, Western Australia features small clusters of bedrooms organised around communal kitchen and lounge areas, in addition to companion rooms offering premium accommodation to couples planning to enter residential aged care together. The choice in room typologies is a critical point of difference, according to the developer, Hall & Prior.
While the small household model does raise questions about financial viability, the way forward would be to create clusters of households on the same site, as Oryx is doing.
Personalised interiors and technology
"... creating a sense of place that enables older people to continue living a fulfilling life as they have at home should be the primary goal of aged care architecture," says Ellis Jones managing director Rhod Ellis-Jones, who also advocates co-creation and co-design in aged care.
The transition to residential aged care can be quite challenging for older people used to their way of life. Modern residential aged care design, therefore, needs to be built around the personal comfort and wellbeing of the residents. This design approach will go a long way in alleviating the fear in those moving from their homes into residential aged care about their loss of identity, independence, and connection to family and community.
Rather than the one-size-fits-all universal design template, modern aged care facilities must prioritise personal spaces with independent suites designed with a private ensuite, and sufficient space to accommodate the residents’ personal possessions including furniture. Ample seating and storage, wardrobes, natural light, generous views to the outside, room to entertain family or friends, and similar features will help create a more familiar and reassuring environment for the new resident.
Designing dementia-friendly environments has become imperative with nearly 500,000 Australians living with dementia, and more than two-thirds of aged care residents showing signs of cognitive decline. Aged care homes purpose-designed to support a safe and comfortable environment for residents combine interior strategies based on colours, spatial layouts, furnishings, decor, acoustics and wayfinding with technology-based solutions such as smart home systems, touch-responsive lighting, and floor sensors among others.
Greenway Views Seniors’ Living Village in Canberra (Source: Gray Puksand)
For the Greenway Views Seniors’ Living Village in Canberra, multidisciplinary architectural practice Gray Puksand employed “purposefully selected tones aimed at minimising dementia agitation, improve quality of life, facilitate spatial recognition, and help residents to navigate the buildings”.
Connected with community
“Findings show that older people prosper when they have connections to real activities, and to communities,” says Associate Professor Ralph Hampson from the University of Melbourne’s School of Health Sciences, who co-authored a discussion paper that called for Australia’s residential aged care system to move from a nursing home model to one that provided a home sanctuary for residents.
Older people treasure their place and connections within the community – a sentiment that must be respected and included in residential aged care design. Instead of being insulated from the surrounding neighbourhoods, residents must be provided the opportunity to engage, socialise and interact with members of the local community through shared spaces such as gardens and activity zones that are accessible to all.
Karingal Green in Perth shares various wellness amenities with the wider community, enabling residents to embrace their new lifestyle through social interactions and physical activity.
Karingal Green (Source: Hassell)
Designed by Hassell for Hall & Prior, the aged care facility features a medical centre, allied health consulting rooms, a gym, and a hydrotherapy pool as well as green spaces flourishing with vegetable gardens and trees. The facilities are open to residents as well as allied health professionals, community care clients, and local families, further encouraging residents to connect with the community.
“It’s where the residential component of aged care living is combined with a seamless continuum of care – and the facility contributes to the health and ageing objectives of the community,” says Hall & Prior CEO Graeme Prior.