Rating great design

from LASA Fusion Autumn 2022

The Aged Care Crisis will decide the federal election

Embedding innovative design with great outcomes for aged care residents, families and staff requires a methodology that objectively assesses design and built form by essentials well beyond dementia-friendliness and accessibility.

The Department of Health has called for input into the development of national aged care design standards aimed at promoting safer, more innovative, dementia-friendly accommodation that enhances accessibility and enablement, as part of the new residential aged care accommodation framework to be introduced in July 2024.

As collaborators on aged care and seniors’ facilities that are not only safe, accessible and dementia-friendly, but enhance resident choice, agency, diversity, inclusivity and community connection, we’ve recommended a broad definition of good design through the development of an audit methodology centred on creating age-friendly places. This will enshrine good design and celebrate outstanding design, both during development and in the finished built form.

We believe this approach embeds good design as the norm in our sector, providing residents and families the rigorous analysis and transparency they need to make informed decisions about the best options for them—based on the criteria they value most in aged friendly places.

It will also recognise residential aged care homes that go above and beyond.

Defining good design

Good design actively engages the residents, visitors and staff of residential aged care services with their physical environment, and creates homelike, domestic spaces and places that can improve quality of life. Good aged care home design should be:

• grounded in dementia-friendly design principles; • identifiably local in its approach to place, architecture, culture and user needs; • community-orientated, achieved through local community engagement; and • developing places that are welcoming and accessible to the broader community; • connected visually and physically with outdoor spaces; • human-scaled and non-institutional, allowing residents choice and diversity within a home-like environment; • environmentally sustainable, through passive design measures including appropriate built form, siting and orientation; • shaped by lessons from the pandemic, including clear separation of back-of-house; and • attention to resident and visitor access paths.

Delivering on resident choice

Residents value choice—from food services to room sizes, views and finishes, and connection to amenities. Connecting with community allows them to maintain the life they led prior to joining an aged care home. Simple connection to communal activities and areas including cafes, hairdressing, community rooms and outdoor areas helps many to maintain purpose and continue their daily routines. Most residents prefer single rooms with ensuite, but we should also cater for couples and family members who would like to live together.

Creating age-friendly places

Our proposed auditing methodology extends beyond dementia-friendly design to include the following key criteria.

Connection to community. A good residential aged care home is a place where we care for the most vulnerable older people within their neighbourhood, rather than in a secluded environment. It feels like part of its broader community’s functions and day-to-day activities and fosters active connection to residents’ families.

Intuitive wayfinding. Good design layout is focused on wayforming and journey-creation. Navigation through the built environment generates meaningful experiences and clear, purposeful destinations.

Small scale, home-like feel. Good design creates a residential feel by providing a human scale to the built environment. Clear separation of residents’ and services’ movements creates a calm, homely habitat where residents can access domestic environments like kitchens, lounge spaces and sitting areas.

Spatial familiarity and ownership. Good aged-care design promotes residents’ self-awareness and avoids confusion about orientation and location. It provides internal and external areas for residents to pursue their interests, as well as welcoming spaces to host visitors.

Universal accessibility. Universal design principles address visual, auditory and mobility accessibility and cognitionenhancing design ideas for all residents, including those with dementia.

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Dignity of risk. Caring for a resident should respect their need for autonomy and the freedom to make their own choices dayto-day. This will impact their quality of life and opportunities to learn and grow. The line between duty of care and dignity of risk is delicate. It depends on the nature of the choice.

Understanding the intricacies of care provision that safeguards residents’ dignity, choice and independence is critical. Sensitive care provision is rooted in residents’ physical and mental wellbeing.

We believe this strategy ensures well-rounded minimum requirements while rewarding innovation by acknowledging operators who develop higher-quality or more locallyresponsive designs.

Ultimately, this creates better standards and outcomes not only for residents, families and staff, but for the wider communities themselves.