[ The University of Melbourne Voice Vol. 3, No. 8 13 October - 10 November 2008 ]
By Janine Sim-Jones
On any given day around 160 000 Australians live in residential care – they are rarely, if ever – asked what kind of environment would best suit them.
As an aged care bureaucrat Ralph Hampson visited a lot of nursing homes and admits he saw “some pretty terrible places”.
“I often wondered why have we allowed these places to be like this. How did we let this happen?” says Mr Hampson, who has turned his passion for aged care into a University of Melbourne PhD which explores the role of the built environment on the quality of life of people who live in residential aged care facilities.
“When I visited nursing homes, I often talked to people who said the built environment did not matter because the care they provided was good – but that’s just not correct,” Mr Hampson says.
Mr Hampson recently completed his PhD – a unique cross-disciplinary study supervised jointly by the University of Melbourne’s School of Nursing and Social Work, and Faculty of Architecture, Building and Planning.
His research confirms what he had long suspected – that built environment does indeed matter to the elderly people who live in nursing homes.
And that even though on any given day around 160 000 Australians live in residential care – they are rarely, if ever – asked what kind of environment would best suit them.
Mr Hampson says it is often wrongly assumed that older people do not need to be consulted, as many nursing home residents have dementia.
“But 30 per cent of older people are in nursing homes because they are frail. They do not have dementia and are clearly able to communicate their needs,” he says.
Mr Hampson’s research included interviews with 24 elderly residents (whom he saw over four sessions) as well as their families and paid carers, at three aged care facilities around Victoria.
“It is very important that residents can maintain their independence as much as possible while in residential care,” Mr Hampson says.
“This can mean really practical things like having a toilet seat at the right height, but it can also mean being able to paint the room the color you want, or being able to have your own furniture, being able to get outside easily and having enough room to store personal belongings.
“It is really the little things that matter a great deal.”
Mr Hampson says elderly residents also enjoyed and welcomed the opportunity to voice their ideas about how their environment should be.
At one nursing home, residents wanted a gazebo built in the garden – but they were also aware that, as elderly people, time was not on their side. The bureaucratic process for getting the gazebo built could take longer than the time they had left to live.
Mr Hampson says those designing nursing homes also needed to take into account the hearing and vision needs of residents – particularly in large noisy open plan areas.
As part of his research Mr Hampson convened a forum of nursing home managers and architects who discussed how they could improve collaboration to improve design and residents’ quality of life.
It was the first time two such groups have met, illustrating what Mr Hampson says is a real lack of attention to this issue.
Mr Hampson proposes a new process for designing nursing homes which includes input from elderly people before it is built.This could be achieved, he says, by talking to local elderly people – who have not yet reached the stage of being in a nursing home – about what they envisage their needs would be.
Mr Hampson says the subject of nursing homes and design has received little attention because people simply do not like to imagine that they will one day end up in aged care homes.
But with the number of people in aged care expected to double in the next 20 to 30 years, and 50 per cent of women aged over 75 likely to spend their last days in a residential aged care facility, according to the Australian Institute of Health and Welfare – there are compelling reasons to show more interest.
“We spend $5 billion a year on residential aged care in Australia We need to make conscious decisions about the built environment of these facilities and rise above simple cookie cutter designs to ones which consider what residents needs are,” he says.
“We need to think more carefully about what residents are going to want and whether they are going to be happy where they are living.”