Aged Care: The city and the bush

Ian Fitzgerald rides his horse in the sunshine.A Roy Morgan report gives us a good idea of what younger people think of aged care and what they expect for themselves. In a survey covering people aged 18-70+ years, they found that younger people think that going to aged care is acceptable. However, the closer the survey participants are to older age, the more likely they will want to stay home. This was emphasised in a program on ABC TV about a small rural community in Queensland.

The ABC program featured a 91 year-old farmer whose wife went to their nearest aged care facility 50 km away. He said, “I’ll feel guilty ’til the day I die that she had to go off.” The story featured the grief of the farmer and others who were separated from their friends and relatives. The farmer said he was “grafted onto the place”, but that it was inevitable he would need to go to a facility.

The ABC story was about a campaign to build a care facility in the small town. There was no mention of aged care at home. There was also no mention of home modifications or other options. Another solution is to have 6-10 universally designed villa-style units as a cluster where home help could be provided. A better solution is to have all new homes universally designed and start building housing stock suited to our futures.

There will always be a place for aged care facilities, but they are expensive to build and to run and are highly regulated. The Roy Morgan survey found that those who had visited an aged care facility felt residents had no control over their lives, were lonely and not happy. Nevertheless they believed residents were safe and comfortable. 

Hardly anyone had an idea how much the government contributes to aged care costs. Most thought it about half, but it is 78 per cent. This is something to consider. If people stay home longer, even with home care, the costs of running a facility are avoided. 

Bottom line? As people get closer to 70 and 80 years they want to stay home and be cared for at home with a mix of family and paid care. Younger people prioritised medical services whereas older people emphasised the need for help with everyday household tasks. This supports their wish to stay put. The different perspectives indicate that what younger people perceive about aged care and ageing is different from reality. 

The Roy Morgan report was commissioned by the Royal Commission into Aged Care Quality and Safety and is titled, What Australians Think of Ageing and Aged Care.  

The ABC program is titled, Queensland country town pushes for regional aged care homes so the elderly aren’t forces to move to cities. It was broadcast on 19 July 2020 in the Landline program. It is available on iView.

Image courtesy ABC.

Biophilic Design is for everyone

A workbench with computers overlooks a waterfall and stream. People are looking out of the window.Biophilic design is about the health and wellbeing of building occupants. So is universal design. Biophilic design is receiving interest in design disciplines, but buildings also need to be inclusive. Otherwise the biophilic aspects are lost.

An article by Andrew Heaton in Sourceable discusses some of the studies of offices, hotels, schools and other public buildings. Natural light, natural materials such as timber, and living plants make people feel better. Students study better and hotel guests appreciate the extra sense of comfort. And it goes beyond views from a window. Sounds of nature, textured material, direct sunlight, and natural patterns all have an effect. 

There’s more in this article, including a link to a study on biophilic design in the workplace

It is no surprise that being able to look out at nature and water views effects wellbeing. If it didn’t, homes, hotels and offices would charge a premium for them. They are in demand because people prefer them, even if they don’t know why. 

The title of the article is, Why You Need Biophilic Design on Your Next Project.  


Fully accessible. What does it mean?

A blue banner with the words in white, Fully Accessible.People with disability are often stereotyped and considered “the others” in plans, policies and products. This means we haven’t found the right terminology to cover this diverse group. So we have gradually invented words and phrases as we go. Some terms are OK such as universal access. Others are demeaning or patronising, for example, “differently abled”. Making something accessible also has many variations. It could be a building complying to government regulations. Or it could be something designed with the broadest range of potential users in mind. But saying universal access or something is fully accessible is vague.

Carrie-Ann Lightley discusses this issue in a blog post. When a website or brochure says “fully accessible” – fully accessible to whom? “Wheelchair Friendly” doesn’t help either. As Carrie-Ann says, “you just really like wheelchairs?” In the context of travel and tourism she repeats the message about information. That is, information that helps everyone decide if they can visit and get around in a place. Sweeping statements and wheelchair icons don’t cut it. Similarly, websites that ask people to call to confirm their needs. Information is power. 

Carrie-Ann also has a useful short video on her Twitter page.

From the editor – other terms to avoid are “all abilities” or any word where “ability” has been captured in a way to make it sound inclusive. It doesn’t. Special words are still special and segregating and label the group you are thinking of as separate. 


Creative bathroom designs

A long black sink shaped like a shelf hangs longways from the wall. The backwall is full length window and it is difficult to see the tap. It looks very modern.Todd Brickhouse’s latest Newsletter has some interesting pictures of bathroom designs. All are wheelchair accessible and look really good. 

While these designs are great for wheelchair users, there are others who might find these designs tricky to use. A case in point is a cantilevered sink against a glass wall. Maybe in real life it doesn’t trick the eye as much. However, I wouldn’t classify these designs as universal design. Anyone with perception problems would be confused with the sink. Have a look and see what you think. 

What the pictures clearly show is that accessible and universally designed bathrooms can look good. There is no limit to creative design.  Pale marble tiles line the walls of this bathroom. There is one long shelf with a mirror behind. A bath with a hand held shower is fitted just above the bath rim.Of course, a custom design for your own home should work for you if not others. 

This newsletter also has a picture of a man who got a tattoo of a cochlear implant on his head to make his daughter feel more comfortable with hers. 

Todd also has a magazine. He is based in New York. 


Universal Design for Kitchens

An open kitchen drawer showing stored crockery and a coffee pot.Better Homes and Gardens magazine from the US has a feature on universal design and kitchens.  Some of the key points are:

    • Choose smart surfaces 
    • Install adequate lighting
    • Consider flooring options
    • Opt for a single-lever tap 
    • Embrace contrast
    • Install open shelving or glass front cabinets (find things easier)
    • Include pull out storage (drawers)
    • Install a wall oven

There’s more links on this section of the Better Homes and Gardens website and links to advertised products. Good to see universal design included even if it is presented as different type of design. The information is interrupted by advertisements, so keep scrolling to access the information.


Compliance isn’t an aim – it’s a duty

Entrance to the LightHouse building showing a man using a cane and a woman with an assistance dog.Do you know of good examples of universal design in buildings? One or two maybe?  Bess Williamson asks in Metropolis magazine, Why Are There So Few Great Accessible Buildings? Of course, accessibility in its fullest sense is much more than compliance to the building code.

Professor Williamson discusses the LightHouse project, and the Berkeley’s Center for Independent Living. Including people with disability in the design process means these buildings are not a regular type of commission. In some respects they are specialised buildings because people with disability were central to design thinking. It’s puzzling to think that architects can’t apply the same thinking to all their projects. After all, everyone benefits from inclusive design. What’s worrying is that the Americans with Disabilities Act (ADA), isn’t being heeded.

Williamson also discusses the recent architectural “triumph” of the new Queens Public Library which revealed major access problems. The architects claimed compliance on the basis that patrons could ask a librarian for help. However, this is not equitable access. It shows scant regard for the ADA and not only people with disability. Families with prams also use libraries, and staff cannot take trolleys to the shelves. Thinking about all users makes a case for universal design. The Queens Library is a case of form over function – the views from the windows, if you can reach them, are fabulous. 

Williamson concludes that access remains an afterthought for designers who look to the minimum. But disability-specific places show that access can be creative beyond the legal minimum. The article is easy to read and has a gallery of illustrations.


Nursing home design: It could be deadly

An older woman in a red jacket uses a cane to walk with a younger woman along a pathway.Nursing homes, not to be confused with retirement villages, are under the spotlight, and rightly so. Their design is showing how infection is almost impossible to control. With two or four people in a room and dated systems it’s time to re-think design. A FastCo article has some advice from experts.

An obvious start is for residents to have their own room within a cluster that has its own living and dining room. This is so any infection outbreak can be contained in the cluster. Private rooms also allow more flexibility for family visits. 

In Oslo, a cluster of cottages allows care and socialisation in the form of an outdoor retreat. Also suited to enabling family visits. The article also discusses removing unhealthy building materials such as glues and paints that generate gases. 

Progressive thinking about nursing homes and aged care is leaning towards housing that mixes all ages including children. While this doesn’t address infection control, it does build in socialisation opportunities. Perhaps this pandemic is a chance to stop and think outside the box.

The title of the article is, Nursing home design is deadly. Here’s how to change it. 


Returning to work with universal design

A modern office with lots of space and workstations by windows.Returning to work post-pandemic might be a bit scary. A useful article addressing the psycho-social issues discusses universal design as a wellbeing solution. That is, to place equal weight on the wellbeing of all employees.

Against the backdrop of COVID-19, Bonnie Sanborn argues that universal design principles increase employees’ perception of being valued at work. For example, adjustable workstations and social spaces with easy access for all employees. Being able to freely express concerns and ideas without fear of reprisals gives a sense of psychological safety.

Suggestions include creating layouts where all employees have equal access to the best views. This might mean allocating this space as a common area. A blanket standard for ergonomic features on furnishing might sound equal but doesn’t cater for differing needs. Giving people the right tools and equipment for the job shows the boss understands the nature of their job. 

The article, The Psychology of Returning to the Office: How Design Helps, discusses these factors and more. There is a reference list at the end.


Retirement villages: Boomers are over them

The Longevity by Design banner in pink and purple.Age-friendly communities where people of all ages live, work and play could be the way of the future. That means the desirability of age-segregated living could be on the way out. Many people will live 30 years after the age of 65 years. So time to re-think the notion of retirement and what that means for urban design and retirement villages.

An ABC article reports on the Longevity by Design Challenge. The idea of the challenge was to identify ways to prepare and adapt Australian cities to capitalise on our longevity bonus. It seems walled and gated age-segregated enclaves might have had their day. Instead, the future might hold more age-inclusive neighbourhoods where older people continue to contribute into late age. So, no more need for doom and gloom about population ageing.

A scene from the charrette where people are sitting round a table discussing their project.Key points emerging from the challenge were inclusive infrastructure, people of all ages together, and a mobility “ecosystem” made up of different types of transport options. The underpinning principles turned out to be age-friendly communities, something the World Health Organization has promoted for more than ten years.

As an urban design challenge the design of homes suited for all ages was not included.

The ABC article is titled, Retirement villages have had their day: Baby boomers are rethinking retirement

Design mobilised by a pandemic?

a row of public toilet handbasins sit in front of a large mirror. There are sensor taps and soap dispensers. Seems a pandemic is causing designers to consider designs from another perspective. An article on the ABC website discusses a re-think of both public toilet design and workplace design. FastCo website has a similar article on public bathroom design. They are both about infection control. But what might any new designs mean for people with disability, older people and people from diverse backgrounds?

Some suggestions have links to a universal design approach. Automatic doors to the bathroom or no door at all, sensor taps and sensor soap dispensers for a start. Women queuing inside and outside toilets has to be re-thought as well. But some immediate makeshift ideas might not work for everyone. The ABC article includes a picture of a large hook so people to use their forearm to open the door. However, the problem needs to be considered as whole, not just a door and a tap.

The article from FastCo looks deeper into the issues and the potential designs of the future. It goes beyond the details of sensor taps and looks at the design of the bathroom space itself. There are more issues than just touching surfaces and washing hands. A door hook is clearly not sufficient to prevent the spread of infection, and doesn’t solve the problem of social distancing.  

The title of the article on the ABC website is, Experts suggest public toilets and offices should be re-engineered to reduce the spread of infection

The title of the article on the FastCo website is, We may have to rethink the toilet seat altogether: How the coronavirus could change bathrooms for the better. 

The pandemic shows that designers can take a front seat for solving public health issues. But it shouldn’t take an emergency to make design changes for inclusion. However, it does show the importance of design and designers in our everyday life. 

Editor’s note: the noise of electric hand dryers make public toilets unusable for some people with autism. They also stir up any bugs lurking in the bathroom. People shaking off excess water before using the dryer isn’t a good idea either.