Shared living

should be a piano and as a focal point, a real or good imitation fire. If the manager decides that a shared television is desirable, perhaps so that people can discuss what they are watching or choose film shows from a streaming facility, then it should be in a separate room rather than in the main lounge. Residents should be able to put their own non-valuables in the lounge and other communal areas if they wish to do so; this includes pictures, photographs, ornaments and items they would like to explain or show to others and that help their visiting friends and relatives feel welcome. All these features promote opportunities for conversation, sharing and quiet reflection.

Bedrooms should be as individual as possible. This is of course easier in an old, quirky house where each room will have different features, but it is perfectly possible to design-in a variety of room shapes, sizes and aspects to a new build. Views from windows are also important; many older people say they enjoy and benefit from being able to see life going on outside, especially if they can watch children playing or going to school, local shops, a park or even visitors arriving at the home.

The kitchen is at the heart of the home. A good architect will find ways of making the division required for safety purposes as ‘permeable’ as possible with the dining room, so that the cook can easily talk to residents and their appetites can be stimulated by the sights and smells of cooking and baking. Similarly, the dining room must be designed and decorated to make the experience of shared meals attractive and encourage pleasurable eating and conversation. One of the features a number of people have mentioned are beneficial in the dining room is large windows allowing in as much light as possible, especially during the winter. Again, residents’ paintings and other possessions should be accommodated if possible; this is not a restaurant, it is a family room.

One of the issues raised during interviews was the importance of bathroom design and maintenance to dignity and respect. It is ideal for every bedroom to have its own washing facilities and toilet, but baths (especially those that need space and hoists) are likely to be shared. Therefore they need to be carefully sited so that people do not have to walk a long way in a dressing gown; they should also be decorated as you would expect in a family home, not in a hospital facility.

36 Wellbeing

One of the most valued communal spaces is a garden room. A conservatory may get too hot or cold, but a brick built garden room with large windows, greenery and if possible a good view of the garden or landscape beyond encourages exercise in the garden, connects people to their locality and provides plenty of natural light. The importance of a garden to spiritual wellbeing cannot be overestimated. I have observed wonderful, imaginative gardens in the homes I have visited, some of which have areas decorated to look like beaches or old movie sets, some with mini orchards and one with figurines dedicated to past pets. However, if there are not enough space or willing volunteers to create an extravagant garden, then there are three things that are so much appreciated as to be essential: a summerhouse (heated for all seasons), a water feature and flowerbeds with paths that are easy to navigate for the less mobile. The more the garden and house merge together, the better for encouraging fresh air and mobility and avoiding claustrophobia; for example, semi-covered courtyards and ‘open’ corridors with French doors that can be left open in the summer and maximise light in the winter.

Views from residents’ windows over the garden and from the garden into the landscape beyond are not only uplifting, but where many residents come from a rural background, help to maintain a connectedness to community and past life. During my research a manager told me that the garden was ‘of great emotional significance’ to residents. This was sometimes the result of working in it; some people found joy in gardening, while others did not welcome any expectation that they would be involved in the job.

Other factors

Other factors to consider in relation to the environment are the size of the home and the maintenance arrangements.

Resources Reader offer

This article is based on excerpts from: Woodward J, Kartupelis J. Developing a Relational Model of Care for Older People: Creating environments for shared living. Jessica Kingsley Publishers, 2018.

TCHE readers can purchase the book with a 10 per cent discount (please enter code KAR at checkout) at: • November 2018

The dynamics of family relationships seem to adapt to various models. In smaller homes, each person will out of necessity form some sort of relationship with every other person, leading to a higher level of understanding but also a potential problem if one person is ‘difficult’; managers spoke of having to act as mediators in this event. Much larger independent living developments tend to act as mini villages, with people viewing each other as neighbours and closer bonds forming between those who identify with others as like-minded or with interests in common. Not surprisingly, cleanliness and good maintenance of all the rooms is vital, not only for health reasons but also to support the dignity and self respect of everyone. Managers should consider employing a local part-time person to carry out general maintenance rather than relying on a large contractor who may not be immediately available. A local person becomes known and is welcomed and people have more of a sense of control over their lives if they are able to ask for help, for example, hanging personal pictures or fixing a radiator quickly.

In conclusion, the care home environment can encourage and favour the creation of family bonds, but it must be a real home. If it looks lived in, is very clean but maybe a bit messy, reflects the personalities of the people living and working there and avoids being beautiful but sterile, then it is probably a place where the inhabitants are living their lives rather than waiting to die.

About the author

Jenny Kartupelis MBE MPhil, is an author and researcher involved in issues of spirituality, older people and interfaith. She is director of faith for Society Ltd and development officer for the World Congress of Faiths.


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