Taking the citizenship of people with dementia seriously

Scalabrini’s newest facility marks the emergence of a new paradigm in Australia, writes Richard Fleming.

The Village by Scalabrini

Scalabrini’s newest facility marks the emergence of a new paradigm in Australia, writes Richard Fleming.

A few times in my career I’ve had the privilege of watching a building grow from an idea into a beautiful reality.

The Village by Scalabrini, opened by Minister for Aged Care Ken Wyatt in Sydney last month began with an idea, a tiny spark that was translated into a magnificent building through hard work and a clear vision.

It was the vision of former Scalabrini CEO Chris Rigby and carried forward by the current CEO Elaine Griffin and Scalabrini’s board of directors.

The Scalabrini vision for people living with dementia is full of life. It is about seeing the person living with dementia as a full person with rights and autonomy. A person who is worth getting to know and is worth serving.

The Village stands apart from the great majority of aged care facilities built for people living with dementia because it was built with this unwavering vision in the minds of everyone involved.

The Village by Scalabrini opening (from left): John Sidoti, Chris Rigby, Professor Richard Fleming, Professor Leroy Certoma, Ken Wyatt, Concetta Fierravanti-Wells and Elaine Griffin

I believe it marks the emergence of a new paradigm in Australia. When people look back in 30 years’ time, the Village will take its place along with the emergence of dementia-friendly communities as a clear indication of the time when Australia began to take the citizenship of people with dementia seriously.

Amid examples and media reports of the worst in aged care, there are more examples of the best in aged care. We need these examples to give us hope and to guide us through turbulent times. We know that things need to change for the better and there are clear signs things have already started to do that.

The team that worked on the Village have provided an environment that is understood by the people who live there.

It is familiar and easy to find what you are looking for, and simple to make choices about what you want to do – whether that be to sit in the busyness of the café or at the quiet end beside the grotto or go and feed the chickens.

They have also provided an environment that is manageable. It is designed to make it easy for people to get around, to be and feel safe and to do the things of normal life.

The elevator door at the Village by Scalabrini

In addition to that they have provided an environment that supports a meaningful life. A meaningful life is one that has more to it than survival or just getting by.

People experience a meaningful life when they feel valued, when they look forward to getting up in the morning and getting on with things, and when they can put their lives into a broader context or see it as part of a bigger picture.

The building tells the people living in it that they are valued; it offers them activities to engage with and reminds them of the bigger picture.

The ingredients I outline here – understandability, manageability and meaningfulness – are the three ingredients of ‘salutogenesis’, which means ‘sources of health’ from the Latin word ‘salus’ (health) and the Greek word ‘genesis’ (source).

In the context of dementia care, a salutogenic approach is about finding opportunities for a person with dementia to live as full a life as possible.

It’s about finding the things that support health and wellbeing and shifting the focus to these things away from a ‘pathogenic’ focus on disease and illness.

The salutogenic approach is the guiding principle for our work at Dementia Training Australia (DTA) and it aligns with the directions set out in the Aged Care Workforce Taskforce Strategy and the emerging Aged Care Quality Standards.

The Village, which is based on DTA design principles, is a salutogenic building because it promotes health, while having the necessary support required for people living with various stages of dementia.

It is different to many other aged care facilities, which promote a concern with the source of illness or problems and make it difficult for people to engage in life-affirming activities. These places may be well described by the word facility but that is not a word that comes to mind when you walk through the Village.

This is a turbulent time for aged care in Australia but there is a new paradigm in sight. I hope that the Village and other examples like it will help us all keep a clear vision of where we want to go – towards health and life and away from pathology and regulation.

Professor Richard Fleming is the executive director of Dementia Training Australia, which is funded by the Federal Government to provide nationwide education and training on the care of people living with dementia.

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Tags: chris-rigby, dementia, dementia training australia, dementia-friendly, dta, Elaine Griffin, Ken Wyatt, richard-fleming, Scalabrini Village, slider, the village by scalabrini, wellbeing,

10 thoughts on “Taking the citizenship of people with dementia seriously

  1. Totally agree Richard and bravo Scalabrini! One can be as impressed with this ‘Village’ and the conceptual care as the De Hoegwey community in the Netherlands. Older people in Australia deserve more opportunities like this.

  2. Wonderful, this is what we are doing at the Chipping Norton Scalabrini Village, Irene Potts, Art Therapist MVA, Sydney

  3. sooo – still a locked facility ?? — we can do better surely — a REAL dementia expert seeking

  4. It’s great to open these kind of facilities focused on specialised care for dementia patients but how much do they cost? In my experience these facilities are unattainable for everyday Australians to afford.

  5. “a new paradigm in Australia” Yet another “paradigm”. Richard no one will remember this one either in 30yrs. I totally agree with Elizabeth above. More rhetoric from the rhetoric machine. Nice promo pic

  6. A great step forward in aligning enabling design principles and care philosophy to create physical spaces that support and promote the models of care and social wellbeing of people living with dementia. Well done to everyone involved. You’ve set the bar, now up to others to meet it!

  7. It makes sense that if people recognise their surroundings and know where they are in time and space they will be more competent in directing their lives. It is true that many facilities look nothing like what people have experienced in their past, enabling further deterioration. ACH Group (SA) have used this approach for decades, utilising Social Role Valorization (SRV) as a basis for their work and The Better Practice Project that showed staff how to do this. Its not just ‘valuing” people that makes the differences; its that they are able to occupy and maintain valued social roles and the transformation that brings to how others see them and how they see themselves. Certainly an environment sets the stage for such things, but other factors are also needed: how people spend their time (the meaningfulness), who they are with, how they appear, what possessions are enabled, even what the staff look like and what their roles are etc. Relying on the setting alone would naturally limit the potential of this approach.

  8. It doesn’t matter how good a job you do there will always be naysayers…as seen by some of the earlier comments above. Great Job Scalabrini. The concept of combining Group housing, and Dementia care in a CALD environment (presumably since the accommodation is “Casas” and the eatery is a “Tratatoria”) is an interesting move. I was excited by the Elevator door image in the article with its hint of the Greek islands. Postmodernism, although out of favour with Architects for a couple of decades certainly has a place in Dementia design. Wayfinding, Symbolism, the importance of entrances…. great stuff…. kudos to the Architects involved to not be swayed by current trends and to design something that will actually help the residents.

  9. Well, my two bobs worth is that if Richard Fleming is giving it his blessing then I think it will be a positive step forward.

  10. Have been impressed with what I’ve seen and if Richard Fleming has put his seal of approval on it, sounds good. I wonder though if it’s only available for the wealthy.

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