CONSUMER PERSPECTIVE

1
CONSUMER PERSPECTIVE

• Health Aged Care Facilities for the Future

2
Who will I Be in 2025?1

• An individual
• Live independently well into 80s
• Live alone or with family
• Healthier due to dietary and medical advances
• Maintain sexual relationships longer
• Live longer if I am married or in a long-term
  relationship
• Demand autonomy self-determination.

1. Department of Health and Human Services,
Population Characteristic Projections, 2004
3
Lifestyle

• Independent Baby Boomer
• Insist on making own decisions
• Computer/internet literate
• Particular about diet want diversity
• Want to participate in whole of life
  communities
• More physically active than previous generations.

4
Most Highly Used Health Services1

• Community Based
• General Practitioner
• Acute Surgical
• Mental Health Services.
• Numbers in Residential Care

1. Department of Health and Human Services, 2004,
Report on Utilisation of Health services by Over
65s
5
Expectations of Health Service Providers

• Non judgemental acceptance
• Trustworthiness
• Informed decisions collaboration with health
  professionals
• Staff competence well trained, compassionate
  willing to give information
• Protection of Rights
• Respect warmth and empathy
• Autonomy
• Safety/Privacy.

Pennebaker D, Vogels R, Browton R, Andersons R.
Consumer Satisfaction in Mental Health Services,
A Framework and Measurement for Service
Satisfaction, Centre for Mental Health Service
Research Inc, Perth, WA, May 2000
6
Expectations of Residential Services

• Part of the community
• Home-like environment
• Single rooms with en suites
• Small sized communities (8-12)
• Flexible diverse routine
• Stimulating diversions interests
• Family/friends part of the environment
• Privacy
• Protection from harm
• Dignified environment.

7
Maslows Hierarchy of Needs
The realisation of ones potential
Self-esteem the esteem of others
Love for others belongings
Feeling safe imparts stability consistency
Air, water, food, shelter, sleep, sex etc
8
Current Environment-Residential Services

• 50 of residents - depression
• 10-15 - dementia
• Most agencies do not achieve a caring, attractive
  environment
• Custodial culture
• High staff turnover and absenteeism
• Reflect loneliness, helplessness boredom
• Does not meet hierarchy of needs.

Meeks S, Treatment of Depression in Nursing
Homes, National Institute of Mental Health,
University of Louisville, Kentucky, 2004
9
Implications for Providers - Organisational

• Culture of empathy, respect empowerment
• Focus on home rather than organisation
• Serving the family not just the person
• Continual quality improvement- Look back to move
  forward
• Meaningful interaction with people
• Staff flexibility and interest.

10
Implications Providers - Operational

• Enriched daily living diversions/activities
• Resident management meetings
• Meal choices and food quality
• Informed choices - decision-making partnerships
• Regular community interactions
• Variable routine I decide when I shower.

11
Implications for Residential Services Design
Spaces

• Communities, not wards groupings of 8 - 12
• No staff station
• Small dining and sitting areas
• Comfortable community spaces
• Single rooms with en suites
• Interactive gardens no circling tracks
• Narrow corridors
• Internet access each room and central
• No paging via EWIS mobile phones
• Soft furnishings
• Domestic furniture
• ADL amenities kitchen, laundry, dining
  garden.

12
Implications for Residential Services Design
Features

• My own furniture
• Natural light and views
• Plants, pets and parties (not feathers fur
  approach)
• Sensitive sight-lines
• Thoughtful lighting
• Colour sensitivity as a means of identification
• No uniforms.

13
Whats in it for Me? Provider1

• Reduced staff absenteeism (40)
• Reduced staff turnover (87 down to 9)
• Reduced need for expensive food supplements
  (60)
• Reduced depression (28)
• Reduced medication requirements (20)
• Reduced use of restraints
• Reduction in behavioural problems, bed sores and
  bed-bound residents
• Increased occupancy (viability).

1. No Place Like Home Nursing homes find
cultural change necessary to make patients
happier, healthier - Presbyterian Medical Center,
Oakmont.
14
Whats in it for Me? - Person

• Less depression
• Higher self-esteem
• Reduced behavioural/mental health deterioration
• Maintain quality of life
• Continued relevance to family
• Reduced fostered dependency.