Dignified accessibility

 Earlier this year, I published a blog on care homes, reflecting on my experiences while visiting my mom and engaging with some of the activities that she is fortunate to have available to her. More recently, I have spent much more time with her at her care home, helping her to rehabilitate from a spell in hospital. An important part of this was helping to restore her mobility - even at the age of 94, she has almost full mobility, giving her a level of independence that is core to her wellbeing and self esteem.

In the first weeks back from hospital, my mom was accommodated in a high-care ward so that she could have round-the-clock nursing support, but the plan was to see if she could rehabilitate to move back to her own room in the mid-care section. I was very involved with the nursing staff of the home and the physiotherapists in encouraging her to walk, initially to the communal lounge, and as time went on, all the way to her old room. In this process, I became aware of some very subtle, but important features of the public spaces in her home.

Entrance to lounge

Along all the passageways throughout the main building, there are stop-off points, with a variety of seating, most of it donated over the years and lovingly refurbished and reupholstered. This includes armchairs, couches, benches and upright chars and tables, all in different styles, textures and colours, which help to create a homely atmosphere, in dramatic contrast to the institutionalised environment that my mom had left behind in hospital.

Armchairs along the route to the high-care section

Each of the pieces of furniture speaks of a history, and they are grouped as one would find in a sitting room, rather than in the corridor of an institution. They are also very carefully positioned at regular intervals, so that residents with limited mobility have convenient places to stop and rest, with maximum dignity.

Armchairs and occasional table at the entrance to the communal dining room

The design of the complex lends itself to this de-institutionalised impression, with the passages being articulated along their lengths creating visual interest and spaces for convenient stopping spaces. 

A bench along the passage to my mom's room, well lit with views of the outdoors

The diversity of these pausing places is also noteworthy - in one there is a table with an inlaid chess board and two upright chairs, in another there are two arm chairs and a coffee machine for residents and guests to help themselves. 

A comfortable couch in a sunny spot, with the chess table nearby

The physical environment is consciously curated to provide spaces for residents to socialise, with each other and with guests, an important consideration for the mental and emotional well-being of the residents. 

The coffee station overlooks a sunny courtyard

Enhancing the visual interest is the use of artwork throughout the main building. I suspect that some of the works were done by talented residents, while others may have been donated. The variety of styles is enhanced by a diversity of frames and placement - some grouped together to form a theme, others given "pride of place" with a careful placement of furniture.

A large original painting gives character and emphasis to this section of the passageway to the frail-care wing

The other noteworthy attribute of the original design, enhanced over the years by careful maintenance, is the relationship of the spaces with the outdoors. This is very diverse, from the sweeping vista of the river and parkland from the dining room, to intimate courtyards visible from the passages, yet preserving the privacy of the rooms that look out onto them. 

View of one of the courtyard gardens from a passage

In discussion with the manager of the home, she said that they are very conscious of creating a visually stimulating and physically enabling environment, encouraging mobility and social engagement. They are planning a number of adaptations as part of an ongoing commitment to enhancing these objectives, including some safe outdoor sensory routes, especially for the use of residents with dementia. Her philosophy is grounded in an awareness that as our population lives to be older and older, people will be spending ever longer parts of their lives in care, so on the one hand, we need to be catering for a wider and wider age range, with a spectrum of mobility and mental capacity, and that homes need to be evolving and adapting to be constantly stimulating.