Planning, designing and constructing residential settings for older persons would benefit from a focus on wellbeing, happiness and social inclusion, rather than compliance, a recently completed report has found.
Created by the director of GLAD Studio, architect Guy Luscombe, the report is based on a 2013 study tour of retirement residential, multi-age residential and aged care projects in Europe and America undertaken with a Byera Hadley Travelling Scholarship.
One of the key findings was that traditional retirement villages and nursing homes create separation and foster “otherness”, isolating people from their surrounds and from loved ones.
“They don’t tend to be environments we want to be in,” he wrote.
“The whole world needs to get a grip on designing for ageing,” Mr Luscombe told The Fifth Estate during a phone interview.
He said that because it was a relatively recent phenomenon for there to be large numbers of active, relatively fit older people, “it is not an issue humanity has had to face before.”
The focus to date in terms of designing retirement and aged care environments has generally been on the health aspects, but Luscombe argues for a broader approach that considers the breadth of human needs and the “qualitative aspects of getting older in space” beyond the purely physical aspects such as fall prevention and infection control.
His key recommendations for a new approach to design for the aged include a needs-based approach rather than a compliance-driven approach; encouraging multigenerational housing and location of projects in urban centres close to activities and public transport; and the incorporation of Liveable Housing Guidelines to ensure ageing is an accepted part of any design brief.
He also said that ageing needed to be regarded as “normal”, because current approaches too often treat it largely as a medical condition, and this leads to residential environments that are overtly “medicalised” and “sanitised”.
“We’ve got these buildings and outcomes [currently] – what does it say about ageing?”
He said the current design typologies, particularly in care settings, generally reflected broader perceptions that ageing meant there was something wrong with people, leading to developments that also make ageing look like a negative thing.
“The language is reflected in the building.”
While the buildings do need to offer a high level of safety, Mr Luscombe said there needed to be “more rigour in understanding what an ageing facility should be like” as currently there are two basic typologies, “the hospital model and the lifestyle hotel model”.
Things that should be informing design, he said, included questions around what people wanted to do with their time.
“You don’t want to be sequestered away from the world, you are still part of the world,” he said.
“Things [in design for ageing] are often done from an occupational therapy point of view. I wanted to look at it from an architectural point of view.”
His research looked at what kinds of communal-type aged-care options existed that was also close to other people, safe and engaging. This meant looking at what types of design aspects people related most to, and also looking at sustainable ways affordable residential options can be delivered.
Some of the ownership models he said could work well in Australia include owner-equity arrangements like co-operative housing where a level of resources such as common rooms and facilities, maintenance services and energy bills are shared, reducing individual costs compared to a single-owner dwelling.
He found an example of this approach in Switzerland, Wohnfabrik Solinsieme in St Gallen, developed by four women who repurposed an old factory into retirement accommodation under a shared equity model.
The current urban planning focus on questions of density, he said, also had a relationship with residential projects for older people, as the multi-storey setting in urban settings “suits older people perfectly” as it enables a mix of ages in the immediate vicinity and therefore builds community, and ensures ease of access to activities and social engagement.
One project he looked at during the study tour was a multi-storey retirement project located above the grandstands of a major football stadium in Basel, Switzerland. This gave residents immediate “belonging” to the activities in the community and a high level of connectedness to it.
Environmental sustainability, he said, was “crucial”, and that environmental performance was becoming more normalised in design generally.
“Hopefully it will become endemic in these [retirement and aged care] buildings.”
Some developments already have green qualities, such as reduced dwelling footprints per person and public transport links – both things that suit older people.
Putting the theory into practice in Parkes
He is currently collaborating with Architects Johannsen and Associates on the design for a residential aged care project in Parkes in western NSW for Southern Cross Care. He said the design was incorporating as much as possible of the results of his research, including a focus on community engagement and social connectivity and a materiality that is “as natural as possible”.
The building operates on a natural ventilation system, with the airconditioning only necessary when temperature and/or humidity conditions are extreme. The ventilation system also includes a CO2 sensor that can automatically open the windows and purge the building if required.
The bedroom walls are reverse brick veneer, timber is being used extensively including for ceilings, the floors are insulated concrete (for thermal mass) and there are 250 solar collectors on the roofs. PVC was minimised, with linoleum used instead for most areas – a project of this type would commonly have vinyl.
One of the benefits of the natural ventilation system is it reduces the level of medicalised smell that is often a feature of aged care facilities. The materials specifications themselves further reduces the odour load, as fewer chemicals are required for cleaning, and low or no-VOC products are being used for paints, sealants and adhesives.
The bedrooms are grouped around a series of courtyards, each with a distinctive and individual garden to assist with a sense of ownership and also to benefit residents with dementia. There is also a specific garden for those with dementia for exercising, a planting area so residents can grow some of their own vegetables, a walkway around the entire project with a variety of exercise stations for fitness, and a men’s shed and cafe are being included within the grounds to bring the community into the setting.
“The client embraced [sustainability], and from a qualitative point of view it offers [residents] benefits like natural light, ventilation and views outside,” Mr Luscombe said.
He said integrated solar photovoltaics like this project has will become more normal across the aged care sector, as they are residential settings where energy use is quite high and so are the corresponding bills.
Ultimately, his research showed that better residential outcomes occurred when the compliance aspects cease to define the end-product, and instead the architectural focus was on wellbeing, happiness and social inclusion.