Both public and private investment is set to grow significantly as rich countries adapt large-scale long-term care facilities into smaller, more human-scale, household units. This result is typically called the household model.
This is a positive step toward improving the living and working conditions at these buildings, which are often badly lit mazes where you numb your senses as a coping mechanism to filter out the physical environment.
There's something important that seems to be getting little attention in the run-up to splashing out for these multi-year programs. That something is that the process used to make the adaptations will impact how effective they are in improving the quality of care and, whether the results are households in anything more than name.
To properly exploit the full range of potential benefits, in addition to improving the physical environment, the transformations will need to be done in a way that also cultivates the culture within care organisations. This is done by using human-centred design.
An alternate approach is currently the norm. This involves expert proxies, usually architects or interior designers, who may have taken dementia design courses, making choices instead of users. In fact, you can already see architects positioning themselves as experts ahead of "the big spend" with, for example, articles in trade press where they explain what the household model is - say in the form of a listicle.
For this Best Eldercare conversation, we are drew on the expertise of Florence Mathieu, founder of Aina, a French design agency that creates new products for older adults and supports the redesign and reimagining of the nursing home experience using human-centred design.
Florence and her team work with architects on renovation and new build nursing home projects in France. Their involvement begins before the architect drafts anything. When we met to prepare for the session, Florence had this remarkably down-to-earth way of explaining the situation:
“When you work at a start-up you know you have to solve a problem by taking the user perspective. In large organisations, like in long-term care, work has been divided up, there is distance between the leaders and users. When this happens, we forget why we are doing what we are doing.”
In our conversation, we discussed why human centred design is needed, how it's done, and the ways in which the results are better than alternate approaches. We touch on improvements to organisational culture and working environment. We discuss the relationship to staffing issues and closing the gap between aspirations and reality.
What strikes me is how obvious her point is. These renovations are perfect moments to train people and build the social and human capital needed to cultivate more person-centred care. By involving people in a meaningful way, everyone also owns what happens. Not only is the resulting environment better than it would be without this input, but the change to a household model also begins long before the new space is actually delivered. A household where everyone can feel at home.
Since the 1980's researchers have called for co-creation. We've previously published a report that summarised thirty-five years of research on the benefits of personalising interiors for people with dementia. When comparing Aina's work to what already exists people who've gone through Plantetree International certification, or implemented the green house model will recognise and see similarities with the programs, processes, and outcomes they have experienced.
Three things combine to make Aina's perspective different and fascinating. First, Florence's take has the freshness that comes when an outsider comes with new tools in the kit. She also doesn't have a prescribed model that she's trying to achieve - rather the result is site-specific - the unifying principle is that users are in the driving seat. And thirdly, using renovation of large sites as a moment to cultivate culture.
If your organisation is considering the transition to smaller-scale units or if you are an architect who wants to deliver outstanding results, this v. Along the way, we touch on similarities in what's happening in long-term care in different countries,
Watch the recording
About Florence Mathieu, Founder, Aina, France
Florence graduated from the prestigious Ecole Nationale des Ponts et Chaussées with a master’s in industrial engineering. After working on innovation projects at a number of global companies, she found her passion for the eldercare space when she joined a program that sought to reinvent the bathroom experience for seniors.
In 2014, Florence began working at the renowned Paris d.school to specialise in innovation and design thinking for the elders and eldercare. There she led the development of user-centred methodologies for projects involving elders.
In 2017 she founded Aina, where she and her team create new products for seniors and enable the redesign and reimagining of the nursing home experience using human-centred design.