A New Approach to Residential Aged Care

Ashfield Baptist Homes

The Ashfield Baptist Homes team’s foundational philosophy acknowledges that aged care residents need more than just physical care – they require emotional, social, and spiritual support as well.

“When someone moves into residential aged care they will usually be alienated from their local community,” Mr Holding points out. “They will generally lose contact with their friends. They often lose contact with their family.” The displacement often touches all areas of a resident’s life. “For example, when they were living independently, they might be hosting family dinners, talking to people over the back fence, participating in local community activities. But when they move into a residential aged care setting, almost all of those roles come to an end and people’s value as an individual, in their own perception, drops.”

The emotional toll can be overwhelming. “It’s not surprising that most of the literature demonstrates that most of the people who move into a residential aged care setting become depressed,” Mr Holding points out. “It’s a very difficult time for people.”

Traditionally, residential aged care has not addressed this alienation. More often than not, a rigid, institutional backdrop discourages visitors and limits natural interaction, particularly with children. “[Residents] will often receive visits from friends for a while, but frequently friends will drop out of visiting. They will receive visits from family, but if the family includes grandkids it is unlikely that the grandkids will continue to visit on an ongoing basis,” Mr Holding says. “That’s a loss.”

Ashfield Baptist Homes is actively addressing this problem of social displacement and strained relationships at its two residential facilities, Bethel Nursing Home and A H Orr Lodge. “We try to provide opportunity for a vibrant and effective local community onsite and we also try to provide opportunity for those relationships between grandparents and grandkids to continue, to be effective and [even] strengthen,” Mr Holding explains. The result is an exciting range of facilities and activities designed to keep residents engaged. The team’s plan is bold, exciting, and extremely successful. In fact, it might even change the way our society approaches aged care.

Socialising, of course, is often based around dining, so the team has opened a café inside the residence. Unlike the restaurants found in many institutions, this one isn’t a dreary cafeteria with cardboard masquerading as food. “We’ve got a café here that would not be out of place in any shopping centre,” Mr Holding says. “We focus on good, quality food. We focus on good, quality service.” The quality is so good, in fact, that people are actually coming to the aged care centre just for a meal, providing an additional opportunity for members of the broader community to come onsite.

The café provides an ideal environment for interaction between residents and guests. “I look out my window, which looks out over the café area, and I often see two or three or four tables taken by families with three generations of people there,” Mr Holding reports. There is also a small playground within the eating area, so grandchildren feel comfortable to interact naturally. “The kids can run around in complete safety. They can play on the play equipment. They can make noise.” As a result, visits between family members have become more frequent and more relaxed. Relationships are being nurtured and supported.

Ashfield Baptist Homes is also making good use of a swimming pool to promote a sense of community within its aged care centre. Little Monsters Swim School teaches lessons onsite, which means around 70 families pass through the area each week. “Those families naturally gravitate toward the café so we’ve got community happening in and around the café, and in fact in and around that whole public area, which is tremendous,” Mr Holding reports. The team has also opened a small boutique onsite, so grandparents have the ability to shop independently for birthday cards and gifts for their grandchildren.

Ashfield Baptist Homes also hosts art exhibitions onsite to help residents stay active and involved. The events are advertised through the council and in local papers to encourage the public to drop by. The most recent exhibition featured artwork that the residents had created themselves, both before and after moving in. “That brought a lot of interest from residents, family, and friends,” Mr Holding recalls.

The wide range of amenities at Ashfield Baptist Homes sets the residential aged care facility apart. Other facilities may have a pool, Mr Holding says, but not in addition to a fully commercialised and family-friendly café. A lot of facilities offer a restaurant of some type, but not one open every day 8:00am to 5:00pm that is capable of competing with offsite eateries. Add to this the art exhibitions and overall commitment to community. “There might be other places that have [some of these things],” Mr Holding says. “But I certainly haven’t seen a place with the combination of elements that we’ve been able to put into place.”

Ashfield Baptist Homes’ commitment to community didn’t happen by chance. When Mr Holding came on board as CEO five years ago, he had a vision to foster community onsite and support residents’ relationships and social roles. He immediately recognised that the foundation was already in place to implement his plan, but that it would take some serious effort and creative thinking to make it happen. For example, the Home already had a swimming pool, but the team wasn’t using it as a tool to foster multi-generational interaction. “I felt like [doing] this for some time, but I hadn’t really had the opportunity prior to being in this place to actually implement this philosophy,” he explains. “So having the pool in place, having the space where we could establish the café – they were the key components because they are both ways in which you can reach a lot of people quickly.”

Equally imperative is the organisation’s not-for-profit status and “very supportive board,” Mr Holding reports. “They have said to me, ‘even though we are in a difficult financial set of circumstances in residential aged care at the moment, our focus is quality first, it is not financial outcomes.’ So, having that kind of a decision on the books reflecting actively the attitude of the board was important. And it means that… I can focus on quality of service for our residents.”

Mr Holding believes that other residential aged care homes have the ability to move in the same direction, despite their differing circumstances or financial bottom lines. First and foremost is “having an approach that says, ‘let’s look at the whole person.’” This begins by uncovering the root causes of discontent among residents, Mr Holding explains. “You recognise that most people become depressed once they move into residential aged care… And then try to understand why that’s happened, and you go back to the alienation, the loss of roles and the loss of contact with family.”

Once these losses are recognised, a plan must be developed that fits each facility’s particular circumstances. Mr Holding recognises that not every residential aged care home has the space or facilities to offer a pool or a restaurant, for example. “But that doesn’t mean that the attitude can’t be brought to bear in other circumstances where you don’t have these opportunities,” he explains. “You might have other opportunities that can address this issue of loss of role and alienation and loss of self-worth. You don’t have to have all that we have available here to do it. You can do it in the context of where you’re at, providing you are heading in that direction of responding to the whole person.”

Ashfield Baptist’s strategy has been extremely effective, and the organisation now operates at full capacity and boasts a long waiting list for admittance. But it hasn’t been easy getting there. “When we started this process I found that it was difficult to get people to understand the concept,” Mr Holding admits. Once his philosophy was brought to life, however, the positive response was overwhelming. Ashfield Baptist Homes’ activities and amenities have been so popular, in fact, that the team plans to increase the capacity of its high care centre and develop a 55 unit retirement village nearby. That project, like the ones before it, will take dedication to complete. But the team knows they are on to something, and are committed to helping as many seniors as they can lead to fulfilling lives within the aged care system.

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July 20, 2018, 1:06 PM AEST

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