Aged Care Insite Issue 94 | April-May 2016 | Page 26

practical living Affordable dementia plans I The number of residents in cognitive decline in aged care is only going to go up; however, some cost-effective steps can provide a safer, healthier environment for all involved. • What are the legal risks? How do I appropriately discharge my duty of care? This article aims to provide a framework to commence planning. By Erica Lambert and Kerrie Storey The most vital step for operators of existing villages is to develop an environmental risk identification and management strategy. This facilitates a systematic, process for prioritising and planning modifications to the village. It also enables operators to budget accordingly. Operators who undertake this process testify that it empowers them, giving them a feeling of being in control of the situation and, most importantly, facilitates meeting their duty of care. The first component of this process is an incident audit. This means undertaking an analysis of incidents over the past 12 months involving people diagnosed with dementia and those with known cognitive challenges. Use a site plan of the village to mark up where those incidents occurred and consider how the physical environment may have directly or indirectly contributed to those incidents. Next, develop a ‘gap analysis’ of the site and relevant buildings (both communal and residents’ houses) in conjunction with a trusted specialist who has experience designing for people with dementia. This involves walking around the site identifying risk points, while being practical regarding the level of risk exposure for residents and n many locations across Australia, there are insufficient places available for people with dementia in memory support units within residential aged-care facilities. This means retirement village operators are increasingly grappling with how to provide safe, supportive and enjoyable environments for residents with diminishing cognition. Firstly, let’s explore the depth of the issue. In 2015, there were about 190,000 seniors living in retirement villages; this number is projected to increase to close to 400,000 by 2050. The average age of those residents is 81 and the incidence of people with dementia aged 80–85 is 11 per cent for men and 14 per cent for women – and it increases with age (see table on opposite page). The depth of the challenge for RV operators is obvious. Over the next 30 years, the number of people with dementia will treble (2016: 353,800 people with dementia in Australia). A useful guide for estimating the number of residents in your village with dementia is the RV Dementia Prevalence Calculator found 24 agedcareinsite.com.au in The Dementia Guide for the Australian Retirement Village Industry, Alzheimer’s Australia 2015. Be aware that there are probably many more residents without a diagnosis of dementia who are in various stages of cognitive decline. It is generally accepted that it is, on average, three years from first onset of dementia to diagnosis. WHAT keeps operATors Up AT nigHT Many operators’ minds are occupied with questions such as: • How do we find the right balance between providing a suitable environment for people with dementia and retaining appeal for other residents and their families? • What physical modifications are required in our village to meet our duty of care to residents to keep them safe, and what are the costs vs returns? • What care and services do I need to consider to support these residents, especially when they live alone? • How do I ensure an inclusive and supportive organisational culture within my team? WHere To sTArT