Designing for aged care is an increasingly important area of architecture and design for many reasons. First, our ability to provide the requisite levels of care and safety to aging people has been brought into sharp focus by the COVID-19 pandemic. Second, concerns around parts of Australia’s aged care system were enough to warrant a royal commission, which has subsequently returned 148 recommendations for reform. Third, as our population continues to age, greater capacity - and greater compassion - needs to be built into our aged care system to ensure a high standard of care and dignity for all elderly Australians.

Sadie Burling is the Health & Ageing Business Development Manager at Australian-owned construction services company Paynter Dixon. She's also a registered nurse, a non-practising midwife and holds a Child and Family Health Certificate, Bachelor of Health Science and a Master's in Management. She has significant practical and academic expertise in the field of aged care construction, honed over a long career.

The design of aged care facilities has changed over the years,” says Sadie. “We had our roots historically in poorhouses and asylums. And over the years, thankfully, we've changed the way we house and accommodate our seniors. Now, we’re much more focused on the design of the building, and how it can work smarter to alleviate some of the workload for the staff. This can increase capital costs upfront, but the return on investment will be realised in staffing costs and utility costs.

“The pandemic has shown that even the newest of buildings doesn't always accommodate some of the infection control processes that are required during a pandemic,” she continues. “So that’s an opportunity going forward to work more closely with clients on the infection control aspect of the building.” One of the recommendations emerging from the Royal Commission is to get rid of the large vertical buildings that are common these days, and go back to the small house model. “The question is, can small house models be built into a vertical building?” asks Sadie. “And yes, they can. We’ve built a facility that has a 12 bed small house model within a seven storey building. So those people have their own social spaces and quiet spaces, kitchen and dining and lounge areas. But we’ve built a back spine into the building so areas such as the nurse's station, medication room, and the dirty utility room are behind the scenes. So it's not part of the house, but still easily accessible to the staff.”

For Sadie, the future of aged care sits at the intersection of design and technology. “We need to look at how we can make the aged care environment look homely, but also meet the care needs of the residents,” she says. “Technology plays a huge part in aged care these days. For example, dementia is on the increase, so we need technology to be able to let the resident be themselves - to walk around and be safe, but also for the staff to be able to have a mechanism by which they can keep an eye on the residents. So real time locator service technology is very beneficial, and often helps alleviate the need for securing units to contain people, which is not really very humane. So what we're trying to do is to build environments that allow people the freedom and the liberty to move around as they wish. And having some technology in place often helps the staff ensure that the safety of the resident is maintained.”

As it is across all construction, sustainability is also a concern in designing for aged care - one which Sadie, in her role at Paynter Dixon, keeps front of mind. “We review the land suitability and optimise the site to minimise the impact of construction to the local ecosystems. We look at energy optimisation wherever possible and determine the best outcome for the client in terms of energy consumption and costs, bearing in mind the impact to the environment. We look at indoor environmental quality, sustainable building, maximising daylight, appropriate ventilation and moisture control to make sure that we don't get high VOC emissions, temperature and lighting controls are also important aspects of sustainable quality environments. So there's lots of things that we look at in creating a building.”

Lots of things, indeed. There’s no doubt that designing and building for aged care presents a vast number of considerations above and beyond what might ordinarily be required for a building. But - as Sadie has said - through careful planning for the needs of residents and significant commitment to sound design principles, we can produce better buildings for our ageing population.

This podcast is bought to you in association with Caroma LiveWell, proud sponsors of the Aged Care Series of podcasts. 

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