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We like to say that that when we’re designing for the aged care industry, we’re designing for our future selves.

But instead of guessing what we might want in the future, we should be listening to what older people want in aged care facilities today. We can start from the fundamental question, “What does a successful day look like for you?”

We’ve got design problems in aged care. The built environment might be working against us, the systems and available technology might also be working against us at times. But that question sets the compass to the true north of residents’ experience. That's the place to approach challenges from. Exploring and designing solutions from this perspective enables a broader conversation that’s bigger than staff ratios, skill mix, and average hours of care per day (although these are likely to be important factors).

Co-designing with families and residents has never been more important. Recently I’ve been seeing think tanks, thought leaders and industry experts explore ageing in the absence of older people. The approach is tech-centred rather than human-centred, and calls for disruption are misapplied. Ageing is not a problem to be solved, it is a normal stage of human life, to be managed by the individual, their families, neighbours, communities and the health sector. When older people don’t fit a certain tech-driven conception of ‘successful’, they risk being labelled ‘non-compliant’. ‘Success’ must be defined by aged care residents themselves.
With the impending Royal Commission, the aged care sector will delve into what they have to do to produce systems that deliver improved quality of care. Let's aspire to focus on more than simple service delivery. The findings of the Royal Commission will probably be harrowing, as the findings of the Four Corners investigation were, but they will also be an opportunity to shift to totally new approaches that centre and enrich the lives of older Australians in aged care facilities.

— Matiu Bush

Matiu is a Design Integration Lead at Bolton Clark who uses human-centred design to transform the aged care sector. 

How we design homes for older people has changed radically

Recommended by Iain Phillips

In the past 30 years or so, we've shifted from a focus on care and safety, to design solutions that help older people stay active, keep working (whether paid or volunteering) and involved in their communities.

“In the 1980s, people were quite happy to design for older people as passive, housebound, retreated from economic contribution, just consumers,” says Jeremy Myerson, curator of the New Old exhibition at London's design museum. “Ambitions for older age are much greater now.”

Myerson, like our guest writer Matiu, wants us to see ageing as part of the course of life, not a problem to be solved. Unlike Matiu, he says designers should imagine themselves as septuagenarians. The items in the exhibition are exciting, but it's unclear if they were designed with the needs of real people in mind.

Patricia Moore: an early voice in designing for older people

Recommended by Kate Goodwin

This article from 1985 describes Moore's three-year social experiment, in which she, at the age of 32, artificially simulated the effects of ageing (through latex make-up, splints to simulate stuff knees, taped and gloved fingers to simulate arthritis). It's an uncomfortable read for someone in 2018. Why do we need a young person to fake being elderly in order to learn what that experience is like?

But older voices were not being listened to, and Moore was. She used the experience for good, to shed light on practices like shopkeepers routinely shortchanging older people, and the terror of being caught halfway across a pedestrian crossing when the lights change. She went on to design products that meet older people's needs, such as easy-to-open medicine bottle caps.

Moore's approach is outdated. We like to think she would use practices like co-design to centre older people's experiences now. We would really like to think your average policy-maker would no longer listen to the voice of privilege over the voice of lived experience, but sadly that's probably not the case.

'Eating well is about so much more than nutrients on a plate': A multidisciplinary approach to malnutrition in aged care

Recommended by McKinley Valentine
Half of aged care residents suffer from malnutrition, which has all kinds of flow-on effects to their health and wellbeing. The ABC uncovered an epidemic of underfunding and untrained kitchen staff leading to low-quality meals, but that isn't the only cause. Older people often have lower appetites, for a huge variety of reasons. For example, poor dental health makes it painful to chew. Reduced sensory input makes even good food less appetising. Dementia-related dysphagia makes it hard to swallow.

Combine with circumstances in many aged care facilities, and it gets even worse. The food (which tends to be of the 'meat and three veg' style) might be very different from what you're used to eating, especially if you're from a non-Anglo background. It might be unappealing to eat alone under fluorescent lights if you're used to lively, conversation-filled meals around the kitchen table. Or maybe you like to have a late breakfast, but your facility serves it at 8am sharp.

These are exactly the sort of challenges that service design excels at identifying and addressing. In the Journal of Dementia Care, The Lantern Project shares how their multidisciplinary team goes about it.

Decline should not be seen as a sign of failure

Recommended by Leah Baxter

Clinical social worker Felicity Chapman is concerned that the current mantra of 'ageing well' might be doing harm as well as good. While we should give older people every support they need to remain active and independent, we should also accept that, at some point, everyone who lives long enough will become frail and dependent on others for their basic needs. If we place too high expectations on ourselves, we may feel shame or anger at our frailty, instead of acceptance. This is only likely to worsen our mental health.

Truly valuing older people means valuing them as people even when they are not strong, when they do need substantial amounts of care. We should strive to live the type of life we want into old age, but we should be kind to ourselves when that is no longer possible.

VizConf 2018 – Australia's first conference for visual practitioners
This 'open space' conference will allow you to bring your own topic to present, or suggest topics for other conference attendees to present on. Based on the topics submitted, attendees will co-create a schedule for the day. Enjoy interesting presentations from a a range of experienced, engaging practitioners.
October 13, Melbourne
Info and registration

Innovation in Not-for-profit: 'Pragmatic design' in the social sector
This quarterly meetup is for anyone keen to promote innovation in the social sector and share practical lessons with those in similar roles. In this first session, join speakers from Mission Australia, The Smith Family, Australian Red Cross and Paper Giant in a discussion on 'pragmatic design' - or, how much can you compromise on good design before it becomes bad design?
October 30, Melbourne
Event details

The Australian Loneliness Dialogue
Australia's first national conference on loneliness looks at breaking the stigma of a hidden suffering. Participants will work together to understand loneliness in our communities, raise the profile of this issue across sectors as well as the media and develop recommendations for actions required by government, policy makers and practitioners.
November 13, Melbourne
Registration and program

Workshop: 'Make Meaningful Work' to build great team cultures
This workshop will help teams spend more time on meaningful work, on projects where people's skills and practice strengths are working well together and individuals are able to learn, improve and thrive. Especially for those who've struggled to find time for reflection, practice and learning outside of the project deliverables and the pace of day-to-day work.
November 22, Melbourne
Workshop details and tickets

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Paper Giant acknowledges the Wurundjeri people of the Kulin nation as the traditional owners of the lands on which we live and work. We recognise that sovereignty over the land was never ceded, and pay respects to elders past, present and emerging.

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