Transforming an aged care home into a ‘home’

A new study has highlighted the importance of personal possessions in designing communal areas to create a sense of belonging for its residents.

The QUT School of Design and Sheffield Hallam University study in the UK explored the link between personal items and a facility's design in shaping the residents' sense of home.

They found that many preferred spending time alone in their rooms and avoided communal areas when the design of the common room was viewed as 'unhomely.'

QUT professor Thea Blackler said residents' identities were influenced by their ability to keep treasured objects and personalise their rooms. 

"The place may be called an aged care home, but for many residents, it might not feel like a home at all," she said.

"Creating a homely atmosphere is crucial for residents to feel a sense of belonging and comfort.

"We need to do better in considering residents' needs in the design and enable more personalisation in common spaces."

The researchers found that residents rarely used the communal areas due to impersonal and flawed design, such as resembling a hotel lobbies, and only visited them for scheduled activities.

Instead, residents turned to their rooms to spend several hours a day sitting in their chairs or lying on their bed.

Cleanliness was reported as a major problem, where residents didn't want to sit on seats they thought were unclean due to the incontinence of other residents.

The shared spaces were also designed 'unhomely', looking similar to clubs with rows of chairs to make space for people using wheelie walkers.

This layout negatively impacted residents' ability to interact and communicate with others, particularly those with hearing impairments. 

Professor Blackler said this preference for solitude in their private rooms adversely affected their mobility, cognitive abilities, and emotional wellbeing.

"Spending so much time in small rooms can make people more isolated and less mobile," she said. 

"Especially if they are lying in or on the bed due to clutter on their chairs."

While staff and family might view personal belongings as clutter, they presented a strong bond to the residents and their identity, professor Blackler said.

One interviewee explained the significance of her 'clutter', saying, "Because we don't have much left when we come into places like this, we like to keep things."

"They say to me, get away with the clutter, and you'll have more room, and you can do things better. And I say, 'No, leave it, it's my clutter'," she said."

Professor Blackler said that, generally, downsizing is a natural process where people let go of items as they undergo changes in self-identity and keep others as symbols of their life stories.

This process carries existential significance, as personal belongings are viewed as an extension of one's identity, she said.

"But most people in aged care move into residential care immediately after hospitalisation, leaving them with little time to undergo their 'natural decluttering' process."

While the QUT team emphasised the importance of personal belongings, they also acknowledged that it presented fall risks and lowered movement in private spaces.

Falls are considered the number one preventable injury in aged care, representing 42 per cent of hospitalisations and 40 per cent of deaths.

People who move around less are at a higher risk of falls and fall-related injuries as muscle strength reduces and deconditions.

Before allowing residents to keep their personal chairs, physiotherapists and other staff assess furniture to ensure the safety of both residents and staff.

"We saw many rooms that had a personal chair stacked full of books, activities and laundry, leaving the resident with only their bed to rest on," professor Blackler said.

"But it's important to encourage older people to sit rather than lie down."

One interviewee told the team his office chair was a powerful connection to his lifelong legal career. 

He shared, "Well, this is my [office] chair from when I was at the bar. I've kept it all these years..."

In response, Brisbane-based LifeCare Furniture, who funded the study, worked with the QUT team to address design challenges in aged-care environments.

They devised a new chair where the covers could be easily removed to clean, and a new one reassembled in less than 20 minutes.

The team recommended that private rooms be redesigned to encourage residents to comfortably spend time in but not in bed.

They also suggested that aged care providers should remove physical barriers to improve communication and comfort.

"Residents should have comfortable spaces to spend time in their rooms, promoting mobility and engagement," professor Blackler said.

"Aged care homes should encourage placement and use of residents' possessions in common areas, whether pictures or photos, craft supplies, finished craftwork or chairs."

Do you have an idea for a story?
Email [email protected]