Working with dementia

Virtual visits to Rome, fun with robotic dogs and making facilities feel more like a home are some of the innovative ways aged care homes are improving the quality of life of their residents. 

Aged care organisations are investing in new builds and technology as more people with dementia make up their client base. 

In June 2019, the Australian Institute of Health and Welfare found 53 per cent of the 183,000 people in permanent aged care facilities were living with dementia. 

Demand for dementia-friendly services is only predicted to increase. 

Assuming no significant breakthrough in treatment, the Australian Institute of Health and Welfare predicts the number of people with dementia to double between 2020 and 2050. 

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Rosewood Care occupational therapist Elizabeth Biagioni has been working with people living with dementia for the past five years and said she had seen the number of people with the condition increase. 

“I think with the really extensive home care packages that are available, we are tending now to see in residential aged care, people being admitted further down the track in terms of disease progression, so having more advanced dementia,” Ms Biagioni told Business News. 

She said a majority of residents had some form of cognitive impairment, so Rosewood had adapted its activity program and environment to meet the needs of the new residents. 

The organisation has implemented sensory elements like fish tanks, courtyards, spaces where residents can undertake productive activities like gardening and cooking, and murals on the floor so residents can locate their room. 

Bethanie chief executive Chris How said technology was helping to enrich the lives of its residents and research was informing simple changes that could make life less overwhelming. 

Mr How said Bethanie homes used VR technology to enable residents to ‘travel’ abroad, robotic dogs for companionship, and Google Bike, which lets people ride down any street in the world.

People with dementia are prone to wander, and Mr How said sometimes people could not sit still and eat a meal. 

To counter this, staff placed food at regular intervals ready for people to take as finger food so they still received nutrition and hydration while wandering around. 

Mr How said another common symptom of dementia was the loss of depth perception and the ability to see different colours. 

For example, Mr How said if there was food on a white plate placed on a white table, a person living with dementia might not be able to see the food. So red plates were used.

Building design

The counsel assisting the Royal Commission into Aged Care Quality and Safety’s final report recommended the federal government develop and publish a set of design principles on accessible and dementia-friendly design for residential aged care. 

It also recommended financial incentives be awarded to aged care organisations with buildings that complied with the guidelines. 

With funding from the Western Australian government, Dementia Australia has developed 10 principles for building dementia-friendly environments.

These include providing opportunities for people to be alone and with others, optimising helpful stimulation and creating less overwhelming environments.  

Brightwater Care Group houses people with high dementia needs, and has been implementing the ‘small home model’ for the past 20 years. 

The model involves breaking up larger shared developments into smaller, clustered communities that have their own team of carers, living and eating spaces. 

“Often you will go into an aged care facility and it will feel a bit like a hotel and it will feel quite big, whereas we live in homes that are domestic and small and it’s easy to find our way around,” Brightwater chief executive Jennifer Lawrence told Business News. 

“We believe by replicating a domestic scale in residential aged care, our residents will feel more at home, they will be able to use the space that they live in like they were at home.”

Brightwater’s $40 million, 128-bed Inglewood development will use the small house model of care and be dementia-friendly throughout, to limit exclusion.  

“Our approach is that if you build the design features into the actual building, you may only have 60 per cent of residents that have a diagnosis of dementia but the whole facility will enable people who may have issues around finding their way or mobility or cognition,” Ms Lawrence said.  

Brightwater Care Group received funding to run the first specialist dementia service in Australia for eight residents, a program which is being rolled out across the country.