Design of many aged-care facilities may promote isolation and mobility loss

• Study of residents’ feelings about personal possessions and identity
• Study found many residents avoid communal areas
• Residents spend many hours alone in their rooms
• Industry partner translated findings into an improved chair for aged care

QUT industrial design researchers from QUT School of Design and Dr Claire Craig from Sheffield Hallam University, UK, studied aged-care environments and interviewed residents and staff on their experience of living and working in nursing homes in Australia and the United Kingdom.

The team worked with industry partner Brisbane-based LifeCare Furniture, who funded the study, to use design to improve the environments of residents in aged-care facilities and enhance their quality of life.

QUT Professor Thea Blackler, said both studies explored the role of personal possessions and environmental design in relation to residents trying to feel ‘at home’ in aged care and how it affected their quality of life.

“Residents' identities are influenced by their ability to keep treasured objects and personalise their rooms, and the design and accessibility of communal areas influences residents' willingness to spend time in them,” Professor Blackler said.

“In the first study we focussed on attachment to chairs and other possessions and the process of what to keep when transitioning into a nursing home.

“Staff recognised the role of personal possessions in the transition into care and encouraged residents to bring their own furniture where possible, especially chairs and bedding to help create a home-like atmosphere.

“Residents rated ‘my chair’ highly, whether they were appropriately designed or not.  

'However, physiotherapists and other staff assess personal chairs to ensure resident and staff safety before they can be kept.'

“While deep vein thrombosis (DVT) risks associated with sedentary behaviour can be alleviated with footrests and recliner chairs, in aged-care homes footrests are deemed a falls risk, especially in common areas.

“Many residents had brought their recliner chair; however, we observed these chairs were often too close to the wall to allow reclining in the small space.

“We saw many rooms had a personal chair stacked full of books, activities and laundry, leaving the resident with only their bed to rest on.”

Professor Blackler said residents often said they went to communal areas only for scheduled activities or events such as weekly concerts.

“When they wanted to relax, residents returned to their rooms where they might spend several hours a day sitting in their chair or lying on their bed.”

"Residents had their own reasons for not using communal areas, and often preferred the isolation of their own room.

“For some residents cleanliness was a major deterrent to spending time in communal areas because they didn’t want to sit in seats they perceived as dirty and smelly due to the incontinence of other residents.”

Professor Blackler said the industry partner had translated this finding into a new furniture system to address the issue of easily changeable, hygienic chair coverings.

“Another factor in reluctance to spend time with others is the layout of shared spaces which, in Australia, tend to resemble hotel lobbies or clubs with chairs in rows, to allow room for wheelie walkers.

“This type of layout makes it difficult to hold a conversation with someone across the room, particularly for those hard of hearing, as well as providing an ‘unhomely’ setting.

“These findings suggest that design issues in common areas resulted in relatively well residents preferring the isolation of sitting or lying in their rooms far more than necessary, which does not support their mobility nor cognitive or emotional health.”

Professor Blackler said the studies found that creating a home within a “home” with personal and treasured possession was enabled only in the “small and cluttered space of residents’ private rooms”.

“Better consideration of residents' needs can be built into the design and enable more personalisation in common spaces.

“Aged care homes could do this by encouraging placement and use of residents' personal possessions in common areas, whether pictures or photos, craft supplies, finished craftwork or chairs and other furniture.

“Currently, many schools do a far better job of this than most so-called “homes”. Work must be done to allow residents to personalise both private and communal spaces so that they can retain their sense of identity and feel ‘at home’ in the home.”

LifeCare Furniture CEO Ian Reinhardt said the company designed and manufactured a chair in its Systm range based on the findings made during the collaboration with QUT for the study on aged care seating.

“Because cleanliness featured strongly in residents’ reports in our study, we have designed a chair that allows its covers to be easily removed for cleaning and reassembled with a new cover in less than 20 minutes,” Mr Reinhardt said.

“This is just one of the projects we are working on with QUT School of Design to make comfortable, safe and home-like furniture for people in aged-care homes.”

Making a “home” into a home: How design of aged-care homes impacts residents was published in the Journal of Aging Studies.

The QUT research team comprised Professor Blackler, Dr Claire Brophy from the School of Design and Dr Fatima Kamali from the School of Information Systems.

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