2021-12-13 GC Agenda - Item 8 -Attachment 1 - Housing Needs Assessment

       Where older people live affects their sense of security and their quality of life.
       Accommodation that is well designed to meet people’s needs can improve their lives and
       their wellbeing.
       Most older people choose to remain at home as they age. But for some older people, it is
       necessary or desirable to move into residential aged care to receive the support and care
       that they need. It is essential that the built environment of residential aged care is suitable to
       meet their needs. People living with dementia are particularly sensitive to their environment
       because dementia can change the way in which they perceive their surroundings. The built
       environment can be supportive, familiar and therapeutic, or it can be a barrier to independent
       functioning and to a high quality of life.
       In broad terms, the evidence before us is that good design in residential aged care,
       particularly for people living with dementia, usually involves smaller, lower-density
       congregate living arrangements rather than larger, more institutional settings. Smaller, lower-
       density congregate living arrangements generally promote better quality of life for everyone.
       Large, noisy institutional environments can worsen the adverse consequences of dementia.
       The average size of residential aged care facilities has increased in recent years. In 2008,
       39% of facilities had over 60 places; by 2019, 60% of facilities had over 60 places. We
       consider that, in general, residential aged care services should transition progressively away
       from large institutional design settings. Accessible and dementia-friendly design should be
       the norm for new or substantially refurbished residential aged care buildings.
       To build awareness and ensure greater consistency of standards, the Australian Government
       should develop and publish a comprehensive set of national aged care design principles and
       guidelines on accessible and dementia-friendly design for residential aged care. The National
       Aged Care Design Principles and Guidelines should permit flexibility in their application in
       different circumstances. The Australian Government should actively promote and encourage
       their adoption by approved providers, builders, architects and others. Financial incentives
       should be paid to providers that demonstrate the adoption of the Design Principles and
       Guidelines for their residential aged care buildings.
       Creating ‘familiar households’ facilitates the provision of person-centred care. We have heard
       that for residential aged care, there is significant benefit to a domestic setting instead of a
       traditional institutional model. Small household models usually involve housing eight to 10
       people receiving aged care services, and sometimes up to 16 people, within a home-like
       environment. Common features include ‘a focus on domestic, homelike, familiar or
       normalised environment with medical equipment hidden’. Regular staff are employed and
       they do not wear uniforms.
       Without wishing to limit innovation, we consider that the small household model is one way
       in which residential aged care can adopt dementia-friendly and accessible design
       principles….
       People’s accommodation should, where possible, cater to their changing needs.
       Accommodation with accessible and dementia-friendly design features will allow older people
       to remain in familiar surroundings if they become frail or if they begin to develop symptoms
       of dementia. Accommodation located close to shops and other amenities is not only
       convenient but may also help to maintain social engagement with the local community.
       Older people who are at risk of not having secure and accessible accommodation are
       especially at risk of not being able to receive aged care services in their homes or to age in
       place. Special attention should be paid to the needs of these people, including through
       integration of the aged care and affordable housing programs, and through increased aged
       care support for people in insecure housing who want to remain in the community.


Until now, the Australian Government has provided accreditation and funding to approved aged care
providers through Aged Care Approval Rounds (ACAR). The allocation of new places was


Noosa Housing Needs Assessment 2021                                                            Page 109