Homemaking for older Australians: Rethinking residential aged care today

by Ingrid Marshall, Churchill Fellow and Principal, Deicke Richards

This article originally appeared in Aged Care Today’s Summer 2025 issue.

If I came to need 24-hour care, where might I feel at home? It’s a question I’ve been trying to answer for the 15 years I’ve been designing seniors’ housing, a calling sparked by visiting my grandmothers in care and working as an audiologist in homes – as they were called back then – early in my career. Considering how people will use the buildings I design is integral to my role as an architect and, while I’m proud of the spaces I’ve helped create for aged care, that question has remained at the top of my mind.

Residential aged care in Australia has improved considerably since my grandmothers’ time, but we’re not done yet. With an ageing population, demand far outstrips supply and much of what’s on offer still feels institutional – clinical, efficient and disconnected from the sense of home that defines dignity belonging in later life.

In 2024, I set out to uncover alternatives through the James Love Churchill Fellowship, supported by the Winston Churchill Memorial Trust. Exploring home-like models providing high levels of support to seniors in Europe, the UK and USA, I visited examples of the Green House Project and dementia villages, intergenerational village approaches and hybrid facilities where traditional staffing and servicing were delivered into smaller ‘households’ within a large development.

Creating homeliness

Homes offer a sense of belonging and control. To make a household more homely, residents should be encouraged to personalise not only their private room but also the common spaces within the household. Residents should have input into recipes, music and television programs. Visitors entering the household should knock and be formally welcomed, as in a family home. In terms of design elements, I found the key features impacting homeliness were:

■ separating residents into small households – the closer to family size, the better

■ a front door and entry lobby in each household

■ varying degrees of privacy, from a very public entry to private resident spaces

■ domestic-looking kitchens and laundries

■ concealment of clinical and staff areas and equipment

■ ready access to natural light

■ outdoor spaces for each household

■ steering clear of long corridors.

Small households

We share our homes with people we know and who know us. Creating these relationships within a care home is more challenging as it is more a ‘share house’ type arrangement, but some providers are successful in carefully selecting residents with similar life experiences to reside together. I found the smaller Homemaking for older Australians Rethinking residential aged care households – those with six or seven residents – were more successful than the larger ones with 12, probably because it’s easier to get to know each other when living with fewer people.

Consistent staffing

The most successful homes adopted a ‘universal worker’ staffing approach. Staff are routinely assigned to work within the same household so they can build stronger relationships with the residents.

As universal workers undertake all cooking, cleaning, mobility assistance and personal care, the number of different staff working with residents is reduced. Staff become part of the household team along with residents. This social model, rather than the traditional medical model, facilitates true person-centred care. By knowing residents’ preferences and abilities, they can focus support where it is of most benefit – encouraging the residents to be as independent as possible, restoring their sense of purpose and self-esteem.

Sparking joy

My visits to successful, truly homelike residential aged care homes both in Australia and overseas highlighted the fact that many elements need to come together to maximise the homeliness of a care setting.

When we achieve this combination, we also seem to cultivate the happiest residents and staff. This impacts the overall health and wellbeing of residents and has implications for staff retention. It’s clear steps towards developing a sense of homeliness in residential aged care should be encouraged.

It is heartening these approaches are being adopted by more providers in Australia. It is a welcome shift from the traditional nursing facility approach and will take time to be fully implemented, but we are heading in the right direction.