Infection control


behavioural, cognitive, and emotional components) include having a sense of being acknowledged, that your habits and values are preserved, and that you have control and autonomy.


n Environmental aspects (including layout, interior design, and the surroundings) include having your own private space, access to outdoors and (quasi) public spaces, access to technology, and a homelike ‘look and feel’.9


Arguably, a home that could address each of the above would provide protective factors for resilience.


In HammondCare’s cottages and The


Green House projects, striving for ‘home’ is already at the top of the agenda – primarily for the sake of well-evidenced good dementia care. But this meant that when disaster struck, the ability to isolate in small groups was built-in, staff were already cohorted, meaningful engagement such as cooking, cleaning, laundry, and gardening were embedded, and the impact to daily life was minimised.


Through this household approach, small groups of people foster connectedness – places to go and things to do promote a sense of mastery and control. Being collaborative participants in the running of a household continually creates meaning for residents.


There is little doubt that a household model has wide-ranging benefits for elderly people living in care, from reducing hospitalisations to improving quality of life.10 We can now also see the clear advantage from the point of view of infection control. But it is also just possible that these smaller, more integrated communities were more resilient, more able to adapt to changing circumstances, and better able fight back in a way that those in more institutional environments were unable to do. What have we learnt about the design


of aged care facilities in the face of a global pandemic? Firstly, design is a matter of life and death. And secondly, the subtle craft of homemaking is more powerful than you might think.


For further information visit www.dementiacentre.com or email design@dementia.com.au.


1 The Guardian https://t.co/zVvbLguWYS


2 Maeda K. Outbreaks of COVID 19 infection in aged care facilities in Japan. Geriatrics & gerontology international 2020


June 2022 www.thecarehomeenvironment.com


Figure 2. Access outside and being able to carry on normal domestic activities is critical to a home-like environment (HammondCare Sinclair Cottage, Miranda NSW)


3 Brown KA, Jones A, Daneman N, Chan AK, Schwartz KL, Garber GE, et al. Association between nursing home crowding and COVID-19 infection and mortality in Ontario, Canada. JAMA internal medicine 2021;181(2):229-36


4 Inzitari M, Risco E, Cesari M, Buurman B, Kuluski K, Davey V, et al. Nursing homes and long-term care after COVID-19: a new era? Springer 2020


5 Chee, S. Y. (2020) COVID-19 pandemic: the lived experiences of older adults in aged care homes. Millennial Asia 11(3) pp 299–317 doi: 10.1177/0976399620958326


6 Mohana Kunasekaran, Ashley Quigley, Bayzidur Rahman, Abrar A Chughtai, David J Heslop, Christopher J Poulos, C Raina MacIntyre. Factors associated with SARS- COV-2 attack rates in aged care – a meta- analysis. Open forum infectious diseases 2022 ofac033, https://doi.org/10.1093/ofid/ ofac033


7 Mohana Kunasekaran, Ashley Quigley, Bayzidur Rahman, Abrar A Chughtai, David J Heslop, Christopher J Poulos, C Raina MacIntyre. Factors associated with SARS- COV-2 attack rates in aged care – a meta- analysis. Open forum infectious diseases 2022 ofac033, https://doi.org/10.1093/ofid/ ofac033


n


8 Christie (2020) Promoting resilience in dementia care: a person-centred framework for assessment and support planning


9 Rijnaard, M D et al. The factors influencing the sense of home in nursing homes: a systematic review from the perspective of residents. Journal of aging research vol 2016 (2016) 6143645 doi:10.1155/2016/6143645


10 Dyer, S. M., Liu, E., Gnanamanickam, E. S., Milte, R., Easton, T., Harrison, S. L., Bradley, C. E., Ratcliffe, J., & Crotty, M. (2018) Clustered domestic residential aged care in Australia:


fewer hospitalisations and better quality of life. The medical journal of Australia 208(10) 433–438 https://doi.org/10.5694/ mja17.00861


Liz Fuggle


Liz Fuggle MA MArch RIBA RIAS is a UK- registered architect providing design training and consultancy services on dementia design with HammondCare’s dementia centre. She heads up their Dementia Choices product and environment review programme, and previously worked as a design manager in HammondCare’s capital works team. Prior to her move to HammondCare,


she practiced as a senior architect and associate with dementia specialists BPA Architecture. Her 90-bed care home for CareUK was a finalist in the 2014 Pinder’s awards for ‘Best large dementia home’. She is a former associate of the


University of Stirling’s dementia services development centre and the author of Designing interiors for people with dementia (The Publishing Bureau 2013).


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