Aged Care: Homes not Facilities- Ingrid Marshall’s Churchill Fellowship

Our Principal Ingrid Marshall has completed her Churchill Fellowship report after a lengthy study tour and extensive research.

Ingrid’s Churchill investigates international house-like residential aged care models and their Australian viability. She travelled to Europe, the UK and the US as part of her research, visiting a wide range of exemplary aged care models and meeting with numerous leaders in the field.

Ingrid cares about Australian seniors; her compassion and attention shaped by the experience of her own elderly parents and grandmothers in residential aged care. She is committed to helping all elderly Australians make the most of their final years.

Ingrid is the leader of our seniors housing team, managing in-house designers as well as external specialist consultants. Clients value her knowledge of both traditional and innovative approaches to seniors housing. The projects she works on vary from large high end traditional care facilities to minor home modifications. Her completed projects include independent living homes for retirees, residential aged care, and various hybrid forms of supported accomodation. Through this work she has developed a comprehensive understanding of various care models and their associated strengths and challenges.

Please see Ingrid’s executive summary below:

My Churchill Fellowship enabled me to visit a range of house-like residential aged care homes in several countries:

• In the USA, where residential aged care is largely privately funded, I visited a range of Green House Project centres, including one retrofitted into a building originally providing a traditional model of care.
• In the UK, where some government funding is supplemented by means tested resident contributions, I visited care homes which operate as separate functional units within a larger development. One centre offered independent living apartments and a nursery on the same site as the care homes.
• In Europe (Netherlands, Denmark and Norway) where government-funded support is more substantial, I visited a number of Dementia Villages. Including a visit to de Hogeweyk where the dementia village approach originated.

I found residents, families and staff all preferred house-like models of care over traditional models. This is not surprising given they had chosen to live and work there. In Australia there are very few house-like aged care options, so the choice is not available to most. Many of the National Aged Care Design Principles and Guidelines are inherent in house-like models. Regulation under the new Aged Care Act is to be rights-based, person-centred and risk proportionate. Delivering this model may be facilitated with the adoption of a house-like model.

I found the more closely that sites resembled a family home, the calmer the atmosphere and the happier the staff and residents seemed.

What contributes to making a setting more ‘homely’?

• smaller resident numbers in a functional unit / house
• consistency of staff working in a functional unit / house
• more domestic activities occurring in the functional unit/ house
• communal spaces within the functional unit / house being a domestic scale
• access to outdoor spaces
• minimizing views of support equipment not typically seen in a house

The aged care sector in Australia is undergoing change. Some providers already offer this model in Australia, indicating it is viable. There are challenges in providing aged care through a house-like model. However I believe the benefits outweigh the difficulties. I recommend more providers adopt this approach when building new, or retrofitting existing centres.

Click here to read Ingrid’s full report.