A small-scale approach to aged and dementia care

Dementia is a growing challenge. Every day, 250 Australians are diagnosed with dementia, and this number is expected to rise to 318 people per day by 2025 — care settings are ill-equipped. If we don’t address dementia as a specific care need, the cost to our country will become unmanageable as families and care workers struggle.

At this point in time, there is a shortfall in the system. Funding does not match the needs of the community; we are not able to seamlessly navigate different care options or access funding when it is needed. There has been a focus on nursing home and clinical models, rather than the benefits of small-scale, social models. We talk about people suffering with dementia rather than focusing on supporting people to live beyond a diagnosis.

There is a fear in our community that surrounds dementia, created from a lack of understanding and fear of the future of care. For those living with dementia and their care partners, there is a challenge in finding the right kind of care so that they can be supported to live rather than suffer. This system can be a minefield to navigate and is not made easier by an extra layer of emotion.

There is a model that works. The Group Homes Australia (GHA) model is a small-scale social model that focuses on residents’ abilities rather than their disabilities. It has health and social benefits, supports dignity of choice and engages residents to live beyond their diagnosis. Our group homes have 6–10 residents with 24/7 dedicated care. Our innovative model of care is an alternative to traditional aged-care facilities. Smaller care environments have been proven to increase quality of life, reduce rates of depression and reduce hospitalisation for people living with dementia.

At GHA, we believe that the environment is a contributing therapeutic factor for someone living with dementia. If the environment is too big, it can be overstimulating and disabling, causing the person living with dementia to feel vulnerable. Whereas a small-scale environment has many benefits.

Research shows that health outcomes in smaller environments are superior to traditional nursing homes. Group Homes are not designed like care facilities — they’re homes first and foremost. Our homemakers work alongside residents to get them involved in all sorts of day-to-day activities of living. This could be cooking, gardening or shopping: anything that is purposeful and meaningful for that person. Yes, homemakers need to be able to cook a meal — but just as importantly they need to be able to work alongside residents to encourage and support those who want to be involved in cooking meals, encourage involvement in serving the meals and sit at the dining room table with the residents, engaging in conversation during the meal.

Group Homes have a dementia-specific environment, which means we’ve thought about how to make the space engaging, functional and purposeful. No matter where a resident goes in a GHA home, the environment is friendly and functional. It looks and feels like an ordinary home — it doesn’t feel like an institution.

Residents know that a living room is a living room because there is a lounge, a coffee table, family photo albums, a resident’s knitted blanket that they brought from home, and maybe even a pet, or a basket of laundry waiting to be folded, and a fireplace, creating a warm, cosy environment. The kitchen looks and smells like a kitchen where there are freshly baked muffins, the kettle ready to be boiled and a soup simmering on the stove. Before a meal, residents will be encouraged to participate in chopping and peeling vegetables and setting the table. The garden is open and inviting. A resident will walk into the garden and find a veggie patch that needs to be watered, leaves that need raking and a space that is tranquil and inviting.

All the pieces of the puzzle — the staffing model that results in continuity of care and supports active engagement, the environment that gets the residents involved, the commitment to involving families — come together to mean that we offer a different approach to dementia care. It’s not one thing on its own.

We believe that small-scale living environments such as GHA allow community members to live beyond a dementia diagnosis, to flourish and ultimately receive the quality care they need and deserve. When people are given the dignity, respect and care that they need in the best setting that suits them, then there is ultimately more value to the community.

Providing a more trustworthy and clear system for navigating the industry will help those seeking care to find the best option for them. It can create a better quality of life for residents and their families.

Tamar Krebs, Founder and Co-CEO of Group Homes Australia.

Top image credit: ©stock.adobe.com/au/Robert Kneschke