An innovative approach to eldercare

English book reading event at the Ibasho cafe in Japan.

When you get older, you may need eldercare assistance. With this in mind, where would you prefer to live – in a hospital-like setting, in a hotel-like setting or within your own home amongst a familiar community? These three choices reveal the transition in eldercare models, and how we are now moving towards a new model, what I call the ‘Ibasho’ concept.

With the traditional institutional model, seniors are cared by medical professionals in an efficient, hygienic and safe hospital-like setting. However, seniors often do not want to be viewed as ‘patients’, so this led to the hospitality model, where seniors live in hotel-like environments, benefiting from personalised care. This ‘too-perfect’ scenario was also not ideal, as seniors had no familiarity or control over their environment.

This has led to the Ibasho model, a holistic, integrated concept, where people age within their familiar community, involving a range of people, such as family, medical professionals, caregivers, neighbours and other elders. Elders are now viewed as useful members of the community – people who can contribute their wisdom and experience, rather than as a patient or unwanted burden. This requires a social mindset change in the way elders are perceived and cared for.

A good example can be seen after the 2011 tsunami in Japan that had a devastating impact on lives and homes. The survivors were left picking through the rubble looking for ways to keep warm and food to eat. The elders amongst them took everyone to the mountains and showed which mushrooms could be harvested and eaten, as well as how to start a fire from wood. They had a crucial role in ensuring the survival of the community, and were able to care for others, instead of being cared for.


Better living environments

Entrance to the nursing home in Japan (Gojikara Mura Village).

As the world’s population is rapidly ageing, homes for seniors are now designed taking into account their needs. For example, in the US, houses can be adapted to include features, such as ramps for wheelchair access, grab-bars in bathrooms and non-slip flooring. This allows seniors to live at home for longer, which is their preference, since they can maintain a similar lifestyle. It also provides benefits of privacy, while giving senior residents a greater sense of dignity and better quality of life.

In the UK, aged care homes are versatile to meet the changing needs of the user. Infrastructure such as plumbing, wiring and walls are designed to be flexible as the seniors’ physical and cognitive capacities change over time. A large apartment that previously could fit a family with children can be easily modified into a smaller apartment for one or two seniors. Since seniors may not cook often, the kitchen can be converted into a large bathroom, with more space for toiletry aids.

Another way to create better living environments is to have common spaces for informal gatherings that encourage socialisation and relationships across the generations. For example, in Japan, there is a nursing care centre at the Gojikara Mura Village, where people of all ages from the surrounding neighbourhoods gather together. Programmes and facilities have been incorporated including dementia care, assisted living, child daycare and a nursing school. Parts of the campus were intentionally designed to be inconvenient and difficult to access, so residents will seek assistance from each other or staff, thus promoting socialisation.

Dr Emi Kiyota speaking at the recent InnovFest 2014.

When it comes to being innovative in eldercare, I always believe it is best to go back to the basics. Pay attention to the views and feelings of the seniors. Only after you know what they want and need can you design the right environment. Through understanding how seniors want to live, we can create a truly innovative culture of eldercare.

– Dr Emi Kiyota, founder and president of Ibasho, an organisation that designs and creates socially integrated and sustainable communities that value their elders. Dr Kiyota, who is an environmental gerontologist and organisational culture change specialist, spoke on this topic during InnovFest 2014, an event is organised by NUS Enterprise.


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