Dementia and autism have received a lot of attention in the design world, but what about people with brain injury? I suspect some of the design solutions are similar. Using a human centred approach an exploratory study looked at developing a prototype home that could address common symptoms of people traumatic brain injury. The idea is to minimise negative feelings and behaviours. The title of the article is, Chronic Traumatic Encephalopathy and the Built Environment. It lists design measures for different symptoms. The article is technical in parts, but the background, findings and conclusions provide some interesting reading. Also good for those involved in Specialist Disability Accommodation.
Anyone involved in dementia and autism studies relating to the home environment should also find this interesting. Health practitioners who know about the health side of things, should find the home design ideas useful. The authors from University of Nevada conclude that “The strength of these designs is that they do not call attention to a differing ability,…” That’s also what universal design is about.
Abstract Traumatic Brain Injuries (TBIs) are often connected to the development of Chronic Traumatic Encephalopathy (CTE), a degenerative brain disease commonly found in athletes, military veterans, and others that have a history of repetitive brain trauma. This formative exploratory study looked at person-centred design techniques for a person with CTE. The person-centred design method used for this study was based on a two-tiered reductionist approach; the first tier was to identify common symptoms and concerns associated with CTE from the literature. This information provided specific symptoms that were addressed through brainstorming ideations. Each singular ideation accommodated the singular, or small cluster of symptoms, that affected a person with CTE in a residential environment. This method of understanding a health condition through its symptoms, and then designing for those symptoms can extend the practice of interior design by providing probable solutions to specific health symptoms, thereby including designers into the healthcare team. Commonly identified behavioural and physical symptoms of CTE served as the factors of analysis and thus a variable of design. The health condition symptoms became the variables of design, and each symptom was assessed through additional data obtained from the literature for environmental causality, mitigation, or accommodation. Once the outcomes were determined, each design implication was assessed for its relationship to specific design actions.
Looking at housing through a typology lens, Matthew Hutchinson discusses the issue of suitable housing for an ageing population. He claims that segregated and congregated living is unlikely to serve the upcoming older cohorts. Instead he poses the idea of “salt and peppering” suitable housing for older people in developments. There is a mention of accessible features in the research, but ideas such as having stairs to stay fit are questionable. A useful text giving an Australian context, but lacking is the concept that all new homes can be designed for ageing in place, at any age, and also provide a safe workplace for care staff and family carers. However, there is much more useful discussion in this chapter.
Hutchinson’s book chapter is titled, The Australian dream or a roof over my head. An ecological view of housing for an ageing Australian population.
Editor’s note: Ideas such as salt and peppering in communities takes us back to the proportion argument. Without a register of accessible homes that means they will disappear into the general milieu of the marketplace. Having stairs to stay fit sounds good, but we can’t put off ageing for ever. Besides, accidents and chronic illness can happen at any age to render a person immobile either temporarily or permanently. That’s not the optimum time to think about moving.
What do government representatives think is the best way to supply homes suitable for people with disability? A research study by an occupational therapist and an architect found out. Mandating accessible features in all new mainstream housing is the way to go. That means both owners and renters would benefit. Plus it would suit ageing in place and not be detrimental to the rest of the population. One participant suggested that the Livable Housing Design Guidelines should be turned into an Australian Standard. That would also help guide home renovations. The research also looked at technology and support issues.
In the Results section of the article, authors Libby Callaway and Kate Tregloan summarise the participants comments about making all homes accessible:
“Several opportunities to take advantage of, and to stimulate, both accessible and adaptable housing supply and demand were identiﬁed through the focus group. Participant 5 stated, “This is a conversation about housing for people with disability, not disability housing”. Aiming to design and build homes that may also be rented on the open market or on-sold highlighted the need for suitable housing models beyond single houses. This need for a range of housing options, suitable for on-selling, has been identiﬁed in both current research and NDIS policy documents (Wiesel et al. 2015a; National Disability Insurance Agency 2016c). Roundtable participants recommended a legislative approach to increase accessible housing supply. They felt this would ensure an increase in volume via inclusion of accessible design principles and relevant standards within regulations for all buildings (e.g. via the Building Code of Australia) and other regulatory devices. This was seen to offer beneﬁts to people with disability as well as other community groups, such as ageing Australians who want to remain living at home. It was anticipated that a relatively low-cost impost would offer great community beneﬁt, depending on the level of requirement established (e.g. silver-level Livable Design compliance; Livable Housing Australia, 2012). Participants suggested this approach may offer greater ﬂexibility for any subsequent home modiﬁcations required for people with disability. Participant 7 summarised the need for further work in this area: “Making all housing accessible isn’t already a national level of discussion . . . Liveable Housing design can be taken over [and incorporated] into the Australian Standards”
There is much more to this study which includes inclusive communities, integrated technology and transportation.
Editor’s note: While such an approach will suit most people with disability, there are some people who will need a home designed or adapted around their particular needs and that of their carers. This is the role of the Specialist Disability Housing funded under the NDIS.
An Australian perspective on living in the right place in later life is the subject of a new report from the Global Centre for Modern Ageing. Their research is aimed at the business community, but the findings support other social research. They use a “House-Home-Haven” framework to present their findings. They found that older Australians are not planning their enablement to remain at home:
“Despite wanting to stay at home, only 17% of respondents thought their home would require repairs or modifications to enable them to do so.”
“Even amongst those who are experiencing difficulties at home, only 40% acknowledge the need for home modifications.”
The report identified seven distinct needs that make the right place: Choice; Safety; Comfort; Access, Independence; Connection; and Happiness. But they weren’t planning get all this in a facility where help would be available. There’s much more in this easy to read report, Ageing in the Right Place.
Attachment to home is a complex concept. For older people it is often interpreted as a place holding memories and providing security and peace of mind. Consequently, attachment to home is usually cited as the reason older people are not keen to move. However, it could be because there aren’t any better places to move to, and that includes retirement villages. The design of the dwelling might be more important than the “resort-style” features in the glossy sales brochures. And that comes down to the details of the design.
Residents in a retirement village were the subject of a recent studyto find out what would help them become more attached to the place they might move to or live in. That is, what design features would make them feel happy. Functionality of the space turned out to be key – not the latest fashions. This excerpt from the abstract shows that:
“…having an open/semi-open layout of internal space, large windows and plenty of sunlight, accessible large closet and storage space, shared/public green space and accessible and age-friendly design of entry, bathroom and kitchen area are features most participants found to be important in raising their sense of attachment to where they live”.
While this study was not on a broad scale, it does indicate that these features, which would be attractive to any age, aren’t just needed in retirement villages. If we had mainstream homes with these features then perhaps more older people would “rightsize” to a new home.
The Design Council in the UK ran a workshop to ask participants to think about the future and their homes. They presented a series of scenarios based on experts ideas about our living arrangements. There was a call for human contact, and for the public and private outdoor spaces and gardens by the homes. The group also wanted to see whole neighbourhoods that were “self-sufficient, sustainable and communal”. Homes would be “safe, comfortable and warm, for all the family from the cradle to the grave”.
It is good to see that the concept of home does not end at the property boundary, but merges into the neighbourhood. It’s not clear who the participants were, how they were recruited, or what groups were represented. This is an ongoing project and it will be interesting to see if inclusive design gets a mention or whether getting older is outside the participants’ frame of reference. The title of the article is Our Home of 2030.
The Royal Institute of British Architects (RIBA) asked Julie Fleck to write a book about inclusive design, which was published recently. Fleck was asked by Tourism for All whether she thought we are doing a good job with inclusive design. She said the UK has made huge progress since the 1980s when access became a town planning matter. Improved building regulation, including housing, have had a significant impact on the accessibility of the built environment.
The book also provided an opportunity for Fleck to look at what still needs to be done. She discusses the need to challenge perceptions, attitudes and behaviours. These are the factors that exclude and discriminate – often unintentionally. The book also looks at the London “Square Mile” and the 2012 Olympic and Paralympic Games. It has case studies and lots of pictures. The title of the book is, Are you an inclusive designer?
Overview: Despite improvements in the last 20 years we still have a long way to go before all of our buildings, places and spaces are easy and comfortable for all of us to use. This book puts forward a powerful case for a totally new attitude towards inclusivity and accessibility. Exploring both the social and the business cases for striving for better, this book will empower architects to have more enlightened discussions with their clients about why we should be striving for better than the bare minimum, and challenging the notion that inclusive design should be thought of reductively as simply a list of “special features” to be added to a final design, or that inclusivity is only about wheelchair access. The ultimate aim of this book will be to help make inclusive design business as usual rather than something that is added on to address legislation at the end of the development process. Accessible and engaging, this book will be an invaluable resource for students as well as practicing architects, richly illustrated with case studies showing both good and bad examples of inclusive design, and celebrating inclusion. Rather than a dry manual, this book combines a powerful, thought-provoking polemic arguing for a step change in attitude, a guide for practitioners on how to have constructive conversations with clients around ID, and a learning resource for students and architects on how to adopt inclusive design and inclusive environment approaches in their work Offers an engaging challenge to widespread assumptions around what constitutes good, accessible design Provides practical advice, illustrated with case studies, for inclusive design principles The book will also act as a guide for practitioners on how to have more enlightened discussions with their clients around inclusivity
If you ask an older person if their home will suit them in their later years, they are likely to say yes. But how will they know and will they find out when it’s too late? That is the key issue when policy makers talk about ageing in place. Are we actually prepared for it? And not only are they people’s homes, they are potentially the workplaces for care service staff.
The intersection of home design and support services is one of the factors looked at by Matthew Hutchinson from QUT. His thesis looks at a myriad of housing types including collective living and mutual support, which on the face of it, looks like group home living. Building design is mentioned in passing. The thesis proposes several ways of re-thinking the types of dwelling and dwelling arrangements that might better suit older people to age in place and receive care at home.
This is a very academic text with lots of diagrams and flow charts. Suitable for architects who are interested in housing typology and policy makers interested in ageing in place strategies. The title of the thesis is, Housing for an ageing Australia: What next?
Abstract: Within the policy context of ageing-in-place aspirations, this thesis examines the potential nature of housing for Australia’s ageing population. By conceptualising housing and support together as an ecology and using grounded theory methodology to involve relevant stakeholders the thesis reveals both the desire and need for new urban and suburban based housing typologies arranged around collective living and mutual support. It further proposes a performance brief comprising desirable housing design principles. The thesis makes a contribution theoretically to the fields of architecture and critical gerontology.
Downsizing is not happening even if policy makers think it’s a good idea for older generations. This is the bottom line of the latest brief from AHURI. So, what is downsizing? First, this concept is mostly about home owners not renters. There is financial downsizing to release equity by buying a cheaper home. But only 20 per cent of owner-occupiers aged 55 to 64 years in 2001 moved to another home of lesser value by 2016 (this age cohort was the most likely to have ‘financially downsized’ during this 15 year period).
Physical downsizing is often seen as reducing the number of bedrooms, but this is a crude measure. This is because the number of bedrooms isn’t the issue. The size of all the rooms could be smaller, but it’s the size of the yard and maintenance that really matters to older people. Fewer than 15 per cent of older home-owners moved to another home with fewer bedrooms between 2001 and 2016. This latest research serves to confirm the key study by Bruce Judd and team where they found all bedrooms were in use. Also, older people spend more time at home, so it’s their space for recreation and activities
The title of the brief is, Understanding downsizing: What are the different types of downsizing and how common is it? There are references to other related AHURI research in this brief.
Editor’s comment: Government and the property industry might be keen to see older home owners move. However, the evidence is showing that the property industry might have to re-think their strategy of trying to entice people into their retirement villages by continuing to design and build homes so that people can’t age in place.
The tool has four steps: individual wants and issues; opportunities for improvement in the home and lifestyle: different options for maximising the use and value of the home; and other choices such as moving, sharing, home modifications and home support. This well researched tool is easily adapted from this New Zealand model.
Another research group has developed a prototype web application to use at home when needed, over time and at the user’s own pace. It consists of three modules Think, Learn and Act to facilitate awareness, offer information and knowledge and enable the user to decide and act on issues relating to housing. Topics are: preferences, the home, the neighbourhood, health status, social network and support, financial situation, the future, options for help and support and housing options.
A poor fit between the home and what older people need can lead to unnecessary care needs, loneliness, worse quality of life, increased caregiver time and early institutionalisation.