practical living engaged ? We need to take a good look at residential aged care and ask the question , does it actually promote people to be able to live meaningful lives and contribute to the community ?
How can we design aged care homes to become more homelike , and what factors are important ? It comes back to , what is it that we want to do or want to achieve ? And if we want to create a place and a space for people to be able to live life and engage in life , then we need to design our infrastructure to allow that to occur .
When we did an activity called Longevity by Design , we brought together a full range of professionals . We had some architects , some designers and interior designers , but we also brought together academics who were sociologists and health professionals and a whole host of other people in between .
We said , ‘ Okay , how can we design or redesign an aged care facility as a home , a place where people are able to live their lives in the way that they want and have that meaning and purpose , and have that complexity of experiences , and to make the choices that they want to do ?’
They came up with some really clever ideas that enable the design of the actual infrastructure . The physical infrastructure enables people to have those experiences and to have the opportunities to engage .
At the same time we have to look at our service provision , so they match that infrastructure . To do that we also have to make sure that our regulations and policies match it as well .
You can design it so that you have different places and different spaces to do different things , and it encourages that continuation of being active and being able to do things like we all do in our homes . We want to make sure that that continues right throughout our lives , even at the end of life .
How can services better support a more person-centred care approach ? That ’ s a real challenge , and I think it needs to be a conversation we have within society . It comes back to the dignity of risk . We need to allow people to have dignity of risk throughout their whole life so that when people are in aged care , it doesn ’ t become a place that is so confining and so restricted that we remove all of their rights of being an adult .
At the moment , when you ’ re in aged care you ’ re not even allowed to make your own cup of tea because there is a risk that you might burn yourself . Now , while I understand that , we ’ ve actually taken away the dignity of risk of being able to make your own cup of tea .
It ’ s important that when we ’ re looking at aged care , we actually have an acknowledgement that we ’ ve got adults , and many of them have capacity . Some of them don ’ t have full capacity , others have varying degrees , but everyone has certain capacities that they can affect choices in their lives .
We do have to balance care and safety with continuing to live our lives , because we all live with that dignity of risk every day , and we have to think very carefully about the consequences of taking it away .
How can someone continue to age healthily when they ’ re living with a disease such as dementia or Parkinson ’ s ? Our life has a lot of transitions . We grow , we start as children and we go through our lives , and life does transition , so we ’ re all used to changes . Older age is no different . It ’ s actually just a transition .
Yes , you might lose some things as you go along , but there ’ s also some other things that you ’ ve also brought with you through your life , like wisdom , experiences , skills and expertise .
When you do experience maybe an illness or a disease or an injury , you have to pivot . And we have to be able to enable people to pivot , but still actually build on their strengths .
Rather than only deal with just the disease or the illness , we also need to say , ‘ Okay , how can we empower you to continue to use what you do have ?’ Maybe you have to learn to do things in a different way .
People with dementia can still do quite a few things . They might do them differently than they did in the past , but they can still do things . They still have skills , they still have their expertise and they still have things that they can contribute , and we just need to empower them to pivot and to support them in that way .
What role does stigma play around older people who society might view as less capable or frail ? I would argue that ’ s come about through the way society views people . I grew up in a rural town in West Virginia in America . It was only 4,000 people , so I knew most of the people and everyone kind of knew each other . Everyone had a job , and your job changed throughout your life because of your different skills , abilities , interests and so forth .
Everyone had a job until you took your last breath . I had no idea that older people were considered frail or a burden , because even in my hometown , when you were frail you just changed your job .
When I married my husband and came to Australia , my in-laws kept saying to me that they didn ’ t want to be a burden to us . I had no idea what they were talking about .
Then I realised that that was a saying in Australia . I feel like that ’ s a society construct . It was such a surprise to me that that was the way it was .
I think we have to really reframe the way we see people . Just because someone ’ s changing or their abilities change , it doesn ’ t mean that they become of lesser value . It just means their meaning and purpose might change , but our meaning and purpose changes over time anyway .
Old is a mindset , age is a thing . Birthday candles , I love them . It ’ s a privilege to be able to age . But you don ’ t have to become old , you don ’ t have to become old-thinking .
We have to really think about where the continuation of learning and growing fit with how we build our infrastructure for people throughout their whole lives .
What else would you add that ’ s important to improve care and healthy ageing for older people ? Intergenerational activities are really where the community becomes incredibly vibrant . Really , that ’ s where societies are strong . Like in our rural town , older people connected with younger people and they built those relationships and forged those relationships . And there was some upside and downside , but they actually weather and become resilient .
What I ’ d like to see is if we can have conversations around not pitting the generations against each other , but giving everyone what they need throughout their lives so that we can work together and create really great lives for everyone throughout their life . ■
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