Simon Bryant, the ‘chef’ to Maggie Beer’s ‘cook’, was recently discussing the issues around food quality in aged care and how it could be improved.
The discussion outlined the parallels between food quality and building quality. At their best, both create experiences and impressions that can positively influence attitudes and behaviours by not only fulfilling rudimentary health requirements but by providing inspiration and pleasure in daily living. However, both are heavily armoured with regulations that if slavishly followed produce a safe but often unnecessarily mundane outcome.
What can be done? Is there a ‘recipe’ for success? Indeed, would it be possible for an aged care facility to be a delicious place, a place of choice rather than just one of need; a place where people feel good?
The first place to look is at the level of need. As we age, we must respond to changes in our lives and the space around us needs to respond as well. Older people need to be able to use and access the spaces they live in, with accessible design helping everyone function effectively in a space.
The problem is that people don’t just use and access these buildings but live in them. Universal design goes a step further and looks at ease of use as well as pure functionality. The Federal Government’s “Liveable Housing Design Guidelines” are in part a response to needs of older Australians. While not mandated, they recommend various ‘core’ easy living or universal design elements that can be incorporated into every building. A good aged facility should adopt these features.
However, a space can work ‘perfectly’ on a functional level and still not be a place that fosters positive feelings. In Maslow’s hierarchy of needs, physical needs are base level needs, essential as they are. Design can provide security, the next level of need, both physical and perceptual. But what about the higher needs? Can space actually make us feel better?
Esther Sternberg, certainly believes so. In her book ‘Healthy Spaces’ she cites the example of patients in a health care ward who recovered more quickly on the side that had the view of nature than those who were looking at a brick wall. This intrigued her and she went on to examine what other effects space has on health, she states:
“Health includes your emotion, it includes the social space around you, it includes your built space, your communities, your cities, your local space, your home, your environment. ….. We should be able to, by constructing the right kinds of environments, prevent illness and maintain health not only correct illness and heal.”
Maslow’s higher levels of need also include self esteem, dignity, respect, purpose and meaning. When it comes to design, taking these needs into account is extremely important.
The Aged Care Certification Guidelines actually hint at this. The priority put on privacy and dignity dictate single-resident rooms and private ensuites becoming the norm. While this is a step in the right direction, it raises other issues for caregivers, such as travel distances between clients and supervision. Clever design solutions are needed that balance the need for privacy with the need for care. Designs that incorporate good sightlines from a central location but maintain privacy and short travel distances would meet these criteria.
A sense of belonging to a community can also help provide for esteem and purpose needs. When designing to enhance community, urban design and placemaking are part of the recipe.
There are many other indicators of building quality, materials and construction for example, but in the end a good building must in part be a reflection of what is says about itself, those who inhabit it and the social and cultural context in which it sits. We all need to identify with something and to feel good about who we are. If we want the best care for our aged, we need to improve the facilities that house that care by not only providing a better-regulated space but a better-considered space all round – a better-designed space that can give the kind of delight that food can.