Those in the know by Darragh O'Keefe

A leading provider has discovered it pays to involve staff and residents in the design of new aged care facilities. Darragh O Keeffe reports.

Wesley Mission’s new Parkview facility is an interesting case study in more ways than one.

For a start, it is, quite literally, built on the Eden principles. Underpinning the design was a consideration of the needs of both residents and staff, not to mention the facility cats and dog.

Secondly, the new building illustrates the importance of resident and staff input and involvement during the design stage.

Countering a widely-held view, the residents of Parkview said they actually wanted long corridors; they wanted to come out of their room and see who was about. Furthermore, they told management to forget about making the new building ‘home-like’. It was an aged care facility; it was never going to feel like ‘home’, they said. Rather, the new building should mirror an apartment complex, where residents would have their own privacy and space, and yet feel part of a vibrant community.

Annie Gibney, the director of nursing at Parkview, is passionate that management and the architects, Fulton Trotter, succeeded in creating a ‘community within a community’.

“Eden is very strong on the need to prevent people feeling isolated. We have big picture windows and wide doorways, so you don’t feel excluded from any room or area; you feel involved. In the gardens and courtyards we included seating areas, to encourage people to sit and socialize,” she tells INsite.

As well as including a permanent home for the resident cats and dog, the building was designed with children in mind – another Eden principle. Each courtyard contains play equipment, while children’s safety was considered throughout.

In terms of interiors, Gibney says the emphasis was on neutral; achieved through the use of marble, glass, wood and neutral colours.

“It was about creating a blank canvass, so that a resident could come and hang a large pink picture, if they wanted, and it wouldn’t clash with anything else in the room.”

All ‘nursing signals’ were removed during the move to the new facility. For example, there are no laminated signs on the walls. The corridors were designed with plenty of storage space, ensuring there is no nursing equipment left in view.

The new building has also facilitated a positive shift in the facility’s dementia care model.

“Initially we were planning to have a specific dementia area. We did some research on this and it became apparent that some relatives didn’t like the idea of mum or dad ‘being locked up’. We wanted to change the philosophy. The primary goal was to create a safe environment for all. We mixed the residents up – in terms of those with dementia and those without.”

Gibney says that a review following three months of operation found staff, residents and family were positive about the change.

“After a while, the staff no longer saw the residents as people with dementia. We also started to see residents looking after each other, and a lot of caring going on,” she says.

Of course, there were challenges along the way.

Primarily, for Gibney, moving to a multi-storey complex required a new way of thinking.

Her overriding concern was safety.

“We had to ensure that residents and children couldn’t fall off the verandas or out of windows, for example. We overcame this by choosing large picture windows, and then having coloured louvres to the side to let in fresh air.”

For Mark Trotter, director at Fulton Trotter and architect behind Parkview, the multi-storey aspect was also a challenge.

“In a previous project for Wesley Mission Brisbane, which was built in the outer suburbs, we took the view we didn’t want to build one big, high care facility,” he says.

“Rather, we would think of it in terms of a small town, and divide the project into different buildings. We incorporated a town centre and a corresponding street system. That way, the building wasn’t daunting for the residents; it was broken up.”

Parkview, however, was being built in a high density area, so the process had to change, he says.

“We broke the development into three, with a central three-storey building with a commercial element, and then two two-storey buildings, which are the apartments, off that. Also, we weren’t designing horizontally. Instead, we used a modular approach so the building has texture; the modules push and pull out the façade. It has a more town-house flavour, rather than a hospital, which usually exaggerates the horizontal,” he explains.

Trotter has been involved in designing aged care facilities around the Eden principles previously. His knowledge and experience in this area was bolstered by Gibney’s independent research.

“I have been overseas and visited facilities in the US and Europe. I think people had been taking bits of philosophies and trying to make them work in their own projects. It was interesting and it certainly gave me some ideas. There aren’t a lot of buildings I know of that were built from the ground up embodying the Eden principles, so quite a bit of research and thought was required,” she says.

Further, engaging the staff and residents during the design phase meant all perspectives were heard, which benefitted the finished project.

“We took samples of carpets and curtains back to residents for their feedback, for example. We changed the designs more than once because of resident input,” says Gibney.

“We worked very closely with the staff too. I remember one issue was we just couldn’t figure out how to fit everything – the toilet, shower, sink – into the bathroom, with room for equipment. Mark and myself brought it to a staff meeting and within three minutes they had figured out how to arrange it and fit everything in. I mean, these are the people who will be showering the residents, so it made sense for them to have input to where things should go.”

Involving the staff and getting their feedback means there is a sense of ownership, not to mention a sense of excitement, says Gibney.

“They asked for good sized offices, well equipped staff rooms where they could relax and enjoy their breaks. And we tried, through the layout, to minimize their walking time; I mean that’s a huge daily issue for staff,” she says.

Trotter says his firm’s philosophy s that the design team is a joint effort involving the architects, the client and the multiple interest groups.

“Buildings are complex arraignments of spaces. And if as architects we’re sitting in an office doing the designing, we lose opportunities for clients to tweak the plans as we go. You have so many different needs at play – those of the residents, the nursing staff, hospitality staff. You need a collaborative and methodical approach to incorporate all those views.”

Meanwhile, further recognition of the Parkview development came recently when it was awarded a Queensland state commendation in the multiple housing category by the Australian Institute of Architects.

Read this article on Aged Care INsite