Innovation in the familiar

KAY SHANNON AUT Centre for Active Aging When an aged care provider decided to develop a village inspired by the pioneering Hogeweyk model of care for older people with dementia, they approached the AUT Centre for Active Ageing to partner with researchers and document the journey.

he CARE Village at Ngongotahā on the shores of Lake Rotorua is a purpose-built dementia-friendly village offering rest home, private hospital and specialist dementia care. The provider had operated a traditional facility in Rotorua and developed the village, inspired by de Hogeweyk in the Netherlands, in response to the expiry of the lease on their premises. They saw an opportunity to innovate to contribute to greater resident wellbeing.

The AUT study identified that management had collaborated with government officials to ensure the village would be safe and comply with regulatory requirements. The physical environment was transformed to enable residents to feel at home in small houses and live with others from similar backgrounds. Person-centred care was promoted, enabling staff to know residents well and support them to continue to with activities they value, contributing to their continued sense of identity.

The village resembles a small community, residents live in houses with five or six others and usual daily life is normalised. Each house has an open-plan living, dining and kitchen area, two bathrooms and a laundry, as well as a single bedroom for each resident.

A staff member familiar to residents manages the day-to-day running of the houses including resident care, cooking, cleaning, and laundry. Additional staff assist with caring for residents with high care needs. Registered nurses co-ordinate clinical aspects of care.

The move to an innovative model of care at The CARE Village has resulted in improvements in resident wellbeing. The entire village is enclosed, keeping those who require a secure environment safe, while technology enables others to come and go from the village as they please. There is no segregation between those who require secure care and those who don’t, with everyone free to enjoy the beautiful lakeside grounds.

The small environments, with familiar staff and peers are calm and quiet, with staff reporting fewer distressed and agitated behaviours and lower use of as required anti psychotice medication compared with in the previous facility. Recognisable domestic environments provide cues to normal living such as the smell of food cooking and familiar kitchen sounds reminding residents that meal times are approaching. Staff support residents to contribute to cleaning, laundry and gardening if they want to.

The ability to continue contributing to their household has a positive impact on resident wellbeing. Residents and their families report a feeling of renewed sense of purpose resulting from making those contributions. A dedicated team organises activities that are purely for pleasure, guided by resident preference.

Connections to culture contribute to continuation of lifelong identity for Māori residents, supported by Māori staff, including use of te reo, karakia and growing of kai in the garden beds.

Family members report greater satisfaction with their relative’s care, appreciating seeing their family members happy and settled, and enjoying visiting the pleasant home-like environment that has plenty of space for children to play and run around.

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