How do you choose furnishings and decor for your facility when upgrading or building new facilities? The answer isn’t a simple one size fits all.
Sydney-based interior designer Trish Shields advises many aged care providers on furnishing new facilities or giving a fresh look to older ones. She says the dÃ©cor of hostels and nursing homes is moving away from the “cosy, homey, cottagey feel” of 10 years ago, more in line with what’s seen in independent living units or retirement villages. It’s a hotel-style decor – comfortable and inviting but definitely more upmarket in style than the chintz and wooden furniture look.
“The dÃ©cor is moving away from that home-like cottagey look to more of a hotel dÃ©cor in all its evolutions,” she says. ” This is in keeping with market trends – the clients or consumers of course are not the residents but their children or families, and this is the kind of look they expect.”
Ian Forbes, Director of Health at architecture and design company, Woodhead International, agrees. He says with the first Baby Boomers “coming on line” in the next few years into ACFs, “they’re going to want to see more clean lines, more ‘cool school’ finishes” – glass topped tables, more metal, more solid colour.
“The sort of furnishings that are in the hotels now, not the over-stuffed old homestead look.”
AC facilities are adopting more of a hotel look.
Function AND aesthetics
Safety and functionality are priorities in choosing furniture and soft furnishings, Shields says, “but the end result should not look like hospital furniture.” As ever, managers should do their homework and research what they need in terms of seat depth, back height, density of foam, ease of getting in and out of chairs, table heights, access for wheelchairs to dining tables, as well as the cleaning and maintenance requirements. Shield says reputable furniture suppliers to the health and aged care sectors have researched these needs thoroughly, and will generally have specifications of each piece of furniture in their brochures or on their websites.
Physiotherapist Robyn Townsend stresses the importance of the height of all furniture – bed, commode, shower chair, toilet raiser, dining chair or lounge chair — in relation to the individual resident. If the furniture is too low, it’s a too deep a knee bend and the resident has trouble getting enough muscle power to lift themselves up, she says. (See ‘getting the height right’)
Lifecare Furniture’s David Tatum says his company has been specifically creating furniture for the aged care market for 15 years. “We recognised a need to design furniture that is both functional and fashionable that suits the proportions and abilities of elderly persons.”
Design criteria to take into account, especially when choosing chairs or couches, are the amount of time a resident is likely to spend sitting in a chair and likelihood that they may nod off to sleep; and the ability of the elderly to confidently get themselves in and out of the furniture. This ease of getting up from a chair is achieved by the correct seat height and a forward high arm front.
“These are important factors that we can use to create a sense of security for the occupant. I feel one of the primary design criteria is this ability of the elderly to confidently manoeuvre themselves in and out of furniture that feels and looks robust, as this creates a psychological and physical tool helping the individual’s self confidence,” Tatum says.
The Centenary Lift Chair from Lifecare Furniture
Responding to the elderly resident’s lack of mobility or strength are a range of innovative products that can assist staff as well as residents — such as meal trays, sliding footrests, wheels and handles — which can be added to the chairs. Well designed extra features can complement the furniture rather than looking like ‘add-ons’, making it more comfortable and functional and blending in with the dÃ©cor.
Getting the height right
One of the most important aspects of falls prevention for elderly residents is the height of the furniture – bed, commode, shower chair, toilet raiser, dining chair or lounge chair. If the furniture is too low, it’s a too deep a knee bend and the resident has trouble geting enough muscle power to lift themselves up, says physiotherapist Robyn Townsend.
“If they’re in a low chair and they can’t raise themselves up to stand up and walk to the toilet, then they’ll probably soil themselves, and this can lead to incontinence and loss of dignity and ability.
“I think it’s absolutely tragic when an elderly person loses their mobility, has a fall because they’ve gone into a nursing home, and no-one has bothered to adjust the furniture properly. I think it’s criminal!”
If the bed is too low, not only is there the danger of the resident falling out, carers and nurses risk back problems trying to help the resident stand, and there is again the possibility of a fall during transfer from bed to chair or hair to bed.
Alternatively, if the bed is too high, the resident has to slide to the edge and try to jump down, with increased risk of falling and subsequent injury, or care staff have to assist with transfer.
Townsend says all furniture must be adjusted to suit the individual to allow them to maintain their mobility by being able to move from sit to stand by themselves. In many ACFs, the furniture is at the incorrect height for 90 per cent of residents, causing loss of mobility and transfer problems.
She says correctly adjusted furniture allows elderly people to regain their mobility relatively quickly, even after a hip repair or a stroke. If the correct lower leg measurement was taken, the equipment could be ordered from the equipment supplier, or existing equipment adjusted.
“Allied health professionals are trained to measure and set chair and furniture heights, but they might not always be available when a new resident is admitted. Care staff are often taught to use a tape measure to gauge the correct height. But it is often difficult, to get an accurate measurement and to set the chair or bed at the right height. Staff must measure from the person’s knee crease down the side of their leg to the floor. This measurement is then increased by 10-20 per cent to get the ergonomic and comfortable height for the resident.
“Research shows that seats and beds at 100-120 per cent of the lower leg length will facilitate sit-to-stand ability,” she says. “Once that measurement has been determined, all furniture the resident will use – bed, chairs, commode, shower chair, toilet raiser – should be set to that height.”
Initially Townsend developed a wall chart for the facilities she visits, showing how to measure and the formula applied, but then she invented the Stick-to-Stand. This simple tool is held against the person’s leg at the knee crease and measured to the floor. The stick then shows the range from 100-110 per cent of the lower leg height, with different colours for each step in the range. This makes it much easier to calculate the correct height and then set adjustable furniture accordingly.
Measuring a resident to ensure the bed or chair is set to the correct height.
Electric beds have proved a problem for nurses and care staff, and there is a real problem of them being left in too low or too high a position, Townsend says. This is where an additional gadget comes in handy – the bed height indicator tag. Once the bed is set at the correct height, the tag is clipped on. When the bed is at the correct height, this tag just touches the floor. This is particularly important with low beds and beds in dementia units, where residents are likely to be easily confused and fall from a bed at the wrong height. If cleaners raise the bed to mop under it, or nurses to attend to leg dressings, they can always see where to lower it to the optimum position.
The Stick to Stand is available through Compact Business System: 1800 777 508
As well as complementing the colour and feel of the dÃ©cor of the room, soft furnishings need to be easily cleaned, and to cope with spills from incontinent residents. Fabric companies like Materialized produce specific incontinence fabrics. These fabrics are easy to clean, available in many different colours and styles and are priced competitively. They are virtually indistinguishable from other domestic fabrics. Incontinence fabrics and clever cushion design can create a chair or sofa that is attractive to look at, comfortable to sit in, and easy for the staff to service and promote a safe level of hygiene.
The right soft furnishings can be easy to clean and promote a safe level of hygiene while looking fresh and inviting