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Lessons from overseas: the benefits of ‘going up’


The use of vertical developments to create affordable serviced apartments for seniors needing support and a sense of community are among key learnings for aged care executive Tonia Zeeman from a recent European study tour.

In this online series, aged care executives tell Australian Ageing Agenda about their overseas study tour experience and the learnings they have brought back to their organisation.

Ms Zeeman, who is chief operating officer of WA aged care and retirement living provider Royal Australian Air Force Association, joined a SAGE study tour to Denmark, Sweden and Switzerland last September. Here she answers our questions about her experience.

AAA: What was your motivation for undertaking the study tour and what did you hope to achieve?

Tonia Zeeman: With so much change happening in aged care in Australia, the need to think differently about the way we plan for the future is critical. We are experiencing a shift away from traditional models and with the introduction of increasing co-contributions by individuals, we are starting to see the introduction of blended models more aligned to what customers want.

With this in mind, I was looking for innovative ideas predominantly from the Danish model. I have previously supported several managers to attend SAGE tours and have seen the impact that visits overseas can have on thinking and planning new services development.

From your experience, how does aged care in Australia compare to what you saw overseas?

Older people and their families tell me that the Australian aged care system is fragmented and confusing with people uncertain of their options and how best to plan for their ageing. Frequently key life decisions are made in response to unplanned events.

Imagine living in Sweden in the Malmo area with the city council’s coordinated age-friendly approach across its 33 municipalities. They have identified that 74 per cent of their 50,000 citizens aged 65 and older prefer to remain living at home.

The home and community supports offered integrate all aspects from home modifications, handyman services and social engagement to health education with a strong emphasis on use of technology, smart homes and safe houses.

They encourage and facilitate increased involvement of consumers, co-labs for innovation and change, and maintain a focus on individual needs and assisting people to prepare for end of life. Fees are not used to fund services but rather to make staying at home more attractive.

The council has also negotiated a four-year agreement with the region of Skona to establish the ‘Elderly in Malmo Emergency Team’ with a strong emphasis on medical care for people who need it. It is working well.

This is a great example of a local model that includes nursing homes, home care, which is the largest section, social care and respite and works in a coordinated way.

What was one aspect of aged care you saw on the tour that inspired you?

Taken at Dagmarsminde Care Home, a small dementia care home in Denmark.

The standout highlight for me was a visit to a very small dementia care home in Denmark called Dagmarsminde Care Home. The home is owned and operated by May Bjerre, a registered nurse whose father had lived with dementia.

She was inspired to create a very individualised, totally person-centred home for people living with dementia.

Dagmarsminde is a home to 10 people in a converted mill in a rural area surrounded by fields and nature. None of the residents take any psychotropic medication and the focus is on creating as normal a home life as possible with meaningful engagement at the core.

Animal inhabitants of Dagmarsminde Care Home.

A small, skilled dedicated team of staff engage in the most respectful way with the residents 24 hours a day as they all go about their daily routines of meals, social activity, visits with the home’s animals and so on.

It is difficult to describe the feeling of calm and wellbeing that pervades the home. May is busy researching and has written a book about the model, hoping to replicate what has been created there.

I hope these pictures convey some of the magic.

What did you see that you intend to implement or adapt in your aged care service?

An increasing focus on creating more of an affordable serviced apartment type option for people who desire and would benefit from increased support and services but do not require high care supports in a residential aged care setting.

Affordability will likely be achieved with more vertical developments and we saw many excellent examples of this in Denmark and Switzerland.

What key learnings from the tour can you share with your counterparts in the sector?

An example of functional space saving design to create homelike mini apartments

One of the things that I have reflected on since the tour is the richness of learning as part of a group of like-minded people all with a common goal. It was a wonderful opportunity to spend 10 days together to see the same things and discuss and debate how they might translate into the Australian context.

My three key areas of learnings were:

  • the use of vertical space to create a sense of community, inviting the outside in, such as with restaurants and cafes, and the choice of location to create intergenerational precincts
  • the innovative use of assistive technology and equipment
  • the emphasis on functional space saving design to create very homelike enabling mini apartments for people (see picture above).

Do you have a study tour experience to share? Get in touch at [email protected]



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