Small household model of care gains popularity for healthy ageing

Backed by the Royal Commission into Aged Care Quality and Safety’s support, the small household model of care is becoming more common across Australia’s aged care landscape. 

Small scale living is seen as a way to deinstitutionalise aged care, breaking apart the expectations of residents living alongside dozens of strangers in large communal spaces.

Instead, our elders can enjoy living in households with anywhere between 8-14 people, where privacy and socialisation are prioritised equally. 

There are shared living spaces, including a kitchen and dining area, but residents can always retreat to their bedrooms which are not located off busy hallways. Throw in a core group of staff and far less foot traffic, and you have a far more personalised aged care lifestyle.

Small household accommodation, as the Royal Commission called it, is something they wanted to prioritise, too. 

When the Royal Commission handed down its final report recommendations in 2021, Commissioner Lynelle Briggs personally called for dedicated capital grants and incentives from the Government to help providers develop small household models of accommodation.

“Every floor has its own living area, dining room living room, kitchenette and nurses station. Day to day, they really are living with only ten to 11 other neighbours,” Aimee Gullotto, Chief Wellbeing Officer at aged care provider, Oryx, said.

“We try and maintain the same staff in each area so residents can develop relationships and there is continuity of care.”

New residents are also walking into a far less confronting space where they feel like an outsider. Whether they have recently lost a partner or have lived alone for a long time, it’s often easier to make new friends when there are 10 new faces as opposed to 40.

“It does foster community companionship and it’s very much a supportive environment for them,” Ms Gullotto said.

“They have their own living space where they have their meals but if they have friends in another household they can absolutely go and have a meal there. 

“There are lifestyle activity spaces that give all the residents an opportunity to mingle and a daily lifestyle program that help to facilitate those interactions.”

While the idea itself isn’t overly ambitious, financial restraints, old infrastructure and limited resources mean it’s hard for aged care providers to take the lead and design a care home that delivers tailored care on a personal scale. 

Oryx Communities was able to buck the trend when it opened The Richardson in 2018. Their third premise, Melvista, is set to open soon, joining The Richardson and Queenslea.

“The floorplan of The Richardson really lent itself to the small household model that they [Chief Executive Officers Nita Peploe and Toby Browne-Cooper] wanted to bring to life,” Ms Gullotto explained.

“It was cutting edge in aged care and that has formed the basis for delivering more home-like care to our older population. It deinsitutionalises aged care. 

“It’s a space where residents and families can develop genuine partnerships and friendships with the other residents, families and care staff in an environment that is unlike a typical nursing home.

“We’re bringing vitality to our residents and helping them to live their best life. Whatever that looks like to them, we’re just here to support that.”

The apartment buildings have proved handy for Oryx as the small footprint isn’t limiting the number of rooms or households built. It’s a valuable consideration for any provider looking to create a new home as you can design self-enclosed households without needing vast square metres.

But it’s not just the small footprint that helps. Clustered domestic residential aged care in Australia: fewer hospitalisations and better quality of life, research published in 2018, found that residents living in clustered models of care had a better quality of life than their counterparts in standard models of aged care. 

Meanwhile, residents also experienced fewer hospitalisations and emergency department presentations. Overall, there was a reported saving of nearly $13,000 per resident as well.

Those implications are good signs for the aged care industry, and the benefits are there for those who can achieve it.

Bringing together the generations

Innovation doesn’t have to end at small scale living, either. Intergenerational care is a proven winner, as trials for intergenerational playgroups with young children and aged care residents brought about cognitive, physical, social and emotional benefits for older people

The success of the television program Old People’s Home For 4 Year Olds also highlighted the unbridled enjoyment of time spent together between the generations.

Oryx has also adopted this method in their homes, providing ongoing programs that give residents time to play and interact with young children at on-site early learning centres. 

“We have a formalised program that runs weekly between our residents and the children in the early learning centre,” Ms Gullotto said.

“We monitor the benefits of the program on our residents, we monitor their moods and how they might be feeling about their quality of life. 

“Every time they see the kids we ask them how they’re feeling beforehand and afterwards and you see a significant uplift in their mood.”

The West Australian provider is by no means the only one to adopt the model of care, either, with The Herd Intergenerational Learning Centre in Victoria’s Mornington Peninsula located at Uniting AgeWell’s Andrew Kerr Care.

There, shared activities are held regularly, while residents can visit a public lounge space where they can watch children play, providing an opportunity for interaction and communication when they’re feeling lonely.

Much like the small household model of care, it facilitates a sense of belonging and community where relationships can be fostered between residents, staff and children alike.