Access Insight - May 2018

APRIL / MAY 2018

Designing for Ageing Communities

by Lara Calder

Designing buildings for individuals with Autism Spectrum Disorder (ASD)

by Shelly Dival

Designing for Dementia

by Paul Huxtable

Research on use of Handrails in Aged Care facilities

by Nicole Maree Swan

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FROM THE PRESIDENT’S DESK

by Mark Relf AM President of the Association of Consultants in Access Australia

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s interest in access, inclusion, livability, universal design, performance based design and a plethora of terminology continues to increase day by day so to does the need to stay abreast of the developments and the marketing edge to stay relevant in a competitive marketplace.

Am I really talking about access consultancy .... absolutely yes.

Access Consulting and the movement generally has come a long way in the last 25 years and as part of the vision, to mainstream access into every day thinking, there is the continuing need to educate new entrants into the field to ensure the integrity of access and inclusion is realised and not watered down to a level of mediocrity that disempowers people with disabilities.

The integrity of access and inclusion must be at the forefront of an Access Consultant’s mind and not just the slick website promoting “World Certified Consultant”, “Internationally Awarded Consultant” or similar claims of self-promotion.

We must stay focussed on what is important and what is just froth and bubble. In my view it is skill development, increased knowledge and recognition that is recognisable in our market.

I know it sounds like I am making a play for ACAA and yes I am because we are the only Association representing Access Consultants in Australia.

The ACAA Accredited Member has national recognition and represents knowledge, expertise and experience in Access Consulting.

Sure there are recognition programs in other countries but are they based on Australian Standards, the NCC, DDA Premises Standards and other Australian guidelines for accessible built environments and the simple answer is NO. Recently, the question was asked, what is ACAA’s position on International Accreditation of Access Consultants. Well, in short ACAA supports organisations in other countries in their endeavours to progress the movement of creating accessible and inclusive communities.

IN THIS ISSUE From the ACAA Committee............................. 3 Designing for Ageing Communities................ 5 Designing for Dementia.................................10 Feedback on the ACAA Mentoring Program.........................................................13 Designing buildings for individuals with Autism Spectrum Disorder (ASD)..................14 Research on use of Handrails in Aged Care Facilities.................................................18 CPD Opportunities.........................................21 ACAA Corporate Sponsor.............................. 22 May Hot Apps............................................... 23 What is, or should be, the role of an Access Consultant in the design of residential care facilities?............................. 24 2

Address: 20 Maud Street, Geelong VIC 3220 Email: office@access.asn.au Phone: +61 3 5221 2820 Web: www.access.asn.au Editor: Farah Madon vicepresident@access.asn.au April / May 2018 Issue Cover photo credit - Calder Flower Architects- Dudley Foord House at The Ponds Please email the Editor if you would like to showcase your project on the Cover of the next Access Insight

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ACAA MATTERS However, ACAA does not give recognition to overseas accreditation and certification programs as a replacement for ACAA Accredited Member status.

ACAA also believes that a mix of work experience and education are essential for Accredited Member status and a qualification on its own only goes part of the way, often it is just the beginning of a journey to become an Access Consultant.

ACAA places education and skill development at the centre of everything we do and while CPD may sound dull it is essential for all of us individually to engage in ongoing professional development and to demonstrate to the

community at large that ACAA Accredited Members are the preferred consultant of choice.

The development of a new ACAA logo announced in the previous edition of Access Insight is now complete and member logos will be available upon renewal of your membership.

So renew or join today and to all Associate members who are eligible to sit the Accreditation test and not sure if you are ready just send an email or call to discuss with Lindsay Perry or Farah Madon.

Mark Relf AM

From the ACAA Committee of Management MAY 2018

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CAA COM have decided to publish the minutes of the management committee meeting from June of 2018. A copy of the minutes will be made available for members on the ACAA website.

The ACAA Committee of Management has decided to offer an incentive to ACAA Associate members to upgrade to the Accredited membership category.

From the 1 April – 30 June 2018 eligible ACAA Associate members are able to start the upgrade process by paying the special offer of $750 (which includes the Accreditation Test & the accredited membership fee till end of June 2019), a saving of $250 on the current fee pricing.

Those considering this offer will need to review the Rules on applying for Accredited membership. The steps would be as follows: • Pay the Special Offer Fee $750. The online Accreditation Test will be arranged to be taken by the 30th of June 2018 • Prepare your application submission to include, Proposer/Seconder, Curriculum Vitae, 3 Access Reports and 3 Referees • Review and update your Continuous Professional Development (CPD) • Complete the application form & include all supporting documentation.

ACAA COMMITTEE OF MANAGEMENT CONTACT DETAILS PRESIDENT: VICE PRESIDENT: SECRETARY: TREASURER:

Mr Mark Relf AM Mrs Farah Madon Mrs Lindsay Perry Mr Francis Lenny

ORDINARY MEMBERS: Ms Jennifer Barling

Mrs Anita Harrop

Ms Cathryn Grant

Mr Bruce Bromley

April / May 2018

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FEATURED ARTICLE

Dudley Foord House at The Ponds

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FEATURED ARTICLE

Designing for Ageing communities

by Lara Calder

Lara is the Managing Director of an architecture practice that challenges the conventions of Aged Care and Seniors Living design. She designs refreshingly alternative buildings for older people and is motivated to deliver and positively influence the future needs for the care and accommodation of the elderly and their social relationships in the community.

Lara is currently involved in the design and delivery of numerous residential Aged Care and Independent Living Unit developments across NSW. She actively participates in discussion forums and as a speaker on research surrounding the future of care and seniors housing design and has presented at various conferences throughout Australia.

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s architects who specialise in buildings for ageing communities, at Calder Flower we believe accessibility in aged care ideally means considerably more than only meeting regulatory compliance.

When we plan a new facility, we know and observe the regulatory code requirements for amongst other things, level thresholds, turning circles, wide doorways and latch side clearances etc. but essentially access for an aged and elderly resident is also about being able to move around with dignity. This is if a person in independently mobile or if they are assisted by others.

Dignity is; ‘the importance and value that a person has, that makes other people respect them or makes them respect themselves’.

Providing dignity is finely linked to the topic of accessibility through having the ability to find one’s way, ease of movement and comfort, safety and the lessening of fear and anxiety about moving away from the security of their own familiar space.

An elderly person will feel reassured and supported in a place where wayfinding is clear

Wayfinding Diagram - For Dudley Foord House NSW - for Anglicare April / May 2018

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FEATURED ARTICLE and easy, where places are simple to find and if the physical environment is safe and legible. In feeling these things, they will feel respected.

The following list describes why each of the five senses need to be stimulated, and gives some suggestions how we can design to make sure they can have opportunity to engage.

An aged care environment is where a person typically has yielded to the physical weakening of an ageing body, and has succumbed to a stage in life that depends on care and assistance in a nursing home.

SIGHT:

An aged care home is a large building. It is much larger than the residential house that we typically grow up and live in over most of our lives and one of the biggest challenges in aged care is navigating the substantial scale of these unfamiliar buildings.

It is essential in our role as architects to consider lengths of corridors and paths of travel to make them efficient and to provide clarity as to where they lead and how to seek out destinations. Clarity in wayfinding relies on clear spatial configurations and sightlines that easily identify, for example, where the dining room is from a resident’s room.

Confusion is an everyday issue amongst residents who have dementia or poor memory recall. Accessing and locating dining and lounge rooms, toilets and a person’s own room in a corridor of many identical other rooms can be distressing.

In this sense, in addition to achieving compliance with access regulations, good access is furthered by reducing potential anxiety and stress from confusing planning.

Aged care environments need good visibility from lighting and clear signage to describe where places are, together with uninterrupted sight lines and recognizable landmarks.

Daylight in particular is a strong visual cue as it varies over the day and night and supports the natural circadian rhythms of the body clock. Daylight quality is varied, characterful, moody and familiar. It evokes feelings and emotional responses.

Buildings that have deep floor plates and spaces that cannot have windows can have skylights and light wells to bring daylight inside.

SOUND: Acoustic treatments must diminish reverberations, echoes and distortions.

A quiet, soft environment is reassuring and calm, especially for people with Dementia who struggle to separate different sound sources.

Music is a powerful means of memory support, and has a huge ‘happiness factor’.

Access to outdoor sounds like birds, water, rain etc. will help residents maintain essential positive connections with nature.

At Calder Flower we think of accessibility and mobility being supported by wayfinding and multi-sensory cues. The basic five senses being touch, sight, taste, hearing and smell, guide us as humans in understanding the world around us. The stimulation of our senses is an important feature of daily life and assists us to recognise where we are.

For this reason we must design internal environments that provide opportunity for their inhabitants to engage their senses as much as possible.

Aged care facility for BUPA at Baulkham Hills

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FEATURED ARTICLE

Aged care facility for BUPA at Baulkham Hills April / May 2018

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FEATURED ARTICLE TOUCH: It has been said that touch is the last sense to fail as we age, and residents who cannot see or hear well rely on touch to recognise places, objects and people. Age care homes require textural richness and a variance in real materials because these environments are predominantly finished with homogenous smooth vinyl, plasterboard, laminate and plastic surfaces. Providing tactile signage, real timber handrails, textured wallpaper and fabric coverings are some examples of creating textural variety.

Access to the warmth of sunlight and even the brisk air of cooler seasons through having connection to the outdoors maintains important connections for people with the world.

SMELL: Internal environments are often unchanging, artificially ventilated spaces and residents who are confined indoors can become

disoriented without the stimulation of atmospheric variance. Aged Care environments are often plagued by the smell of human bodily functions and can be stuffy and humid so it is essential to give residents access to fresh outside air and so they can experience climatic and seasonal changes that the human body recognizes. The scent of spring flowers, the afternoon rain or just the humid air of a summer night are valuable emotional memory triggers.

If the human body is denied access to environmental sensory triggers - then the body turns inward and becomes physically depressed resulting in diminishing physical and mental health.

Accessibility is importantly about having access to those elements in the world that we take for granted in our non-confined, non-aged lives. It is easy to underestimate the significance of seemingly simple things because life in an Aged Care home is far different from the active lives we as designers and planners mostly experience.

Aged care facility for Uniting - Shellharbour

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FEATURED ARTICLE

Designing For Dementia

by Paul Huxtable

to a model where residents with dementia are not segregated from other residents.

Here are a few observations:

Paul Huxtable is a Sydney-based Architect and Access Consultant. He has 40 years’ experience in architectural practice and 15 years as an accredited Access Consultant. His commitment to people based design began in the 1980’s with group homes and seniors living projects with his close friend and mentor Leif Kristensen. For the past 6 years he has been involved in the design and delivery of new nursing homes, all with a dementia specific component.

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hen I was asked to write this article I thought - be sure to address your target audience and answer the question. So I am assuming I am writing primarily for access consultants, and that the question is ‘what is designing for dementia’?

Here goes! Most spheres of architectural design relate to building types that have been around for a very long time. Seniors living and aged care as types of project are relatively new and pose their own challenges. Within the new types, designing for dementia provides further challenges.

For access consultants reviewing buildings, dementia specific housing includes requirements - an onus to be up to speed with latest dementia research and developments; the principles that such a building will be designed around; specific do’s and don’ts. Issues will range from preferred models for this type of housing, site planning external spaces, internal spaces. For example, consultants are likely to see widely different models for dementia. A project model may range from a dementia specific entire ‘facility’ 10

1. While many people and professionals think they can speak for people with dementia, people with dementia are rarely consulted directly in the design process 2. Despite being around for some time, the field of dementia and therefore designing for it is still in a preliminary and exploratory phase.

Evidence-based design has been difficult because there has not been a reliable body of evidence to underpin design decisions. Without that evidence some doubtful design principles, guidelines and ‘rules’ have been decreed by ‘experts’ and adopted by providers.

3. When architects design for dementia, there is a number of users. These include the residents, family and friends, residents’ visitors, staff and visiting professionals.

4. Legislative requirements.

Expanding on these: 1. The primary users of the building - the residents. For designers in the field of aged care the drive to de-institutionalise is ongoing and a constant challenge.

Buildings that house numbers of people, particularly when they are people in a narrow range demographic, and/or have physical and intellectual disabilities. ’Nothing for us without us’. Many assumptions are made about a resident’s ability to provide input about what they want, and what they regard as important in their environment.

Talking to residents, even the most institutional looking space is regarded as home. And home is not just their own room. The wider ‘facility’ is their extended home.

There will be many and varied inputs like

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FEATURED ARTICLE this that emerge from talking to residents.

There will also be areas of the projects which have features of which a consultant may not be aware. Access consultants should familiarise themselves with the background to these issues and be ready to question how they present themselves, and how they feature in a particular project.

A couple of examples: A. Courtyard gardens for dementia residents. A dementia garden will typically be a ‘circuit’, with secure fencing. The pathway(s) will be continuous – ie no dead ends. With careful and sensitive landscape design, these spaces can be very beautiful, and will be free of features that label them as ‘special purpose’. It has been an issue in the past that providers deal with the observation of residents looking out through fences. A response was to provide solid colorbond fencing 1.8m high. That is, detention centre fencing. Over time, most providers have gone away from this approach.

B. “Pretend’ features: Projects over the recent years have included elements such as fake bus stops and kindergarten workshops. While many providers do not include these ideas now, consultants may still see them.

The philosophical approach will be the prerogative of particular clients, but consultants should be aware of those client briefing requirements.

C. Colour variation in flooring materials.

One of the longest held beliefs in designing for dementia has been the absolute taboo of strong contrasts between flooring materials along paths, corridors etc. While there is evidence that residents with dementia will avoid ‘stepping off’ between zones, colour and materials schemes can address this sensitively. A monochromatic interior scheme going overboard to have the same floor finishes everywhere is not necessary.

It runs contrary to the concept of a

home-like environment and should be called out.

2. Designing for dementia. In designing for dementia, ‘first principle’ factors are hugely relevant. Because we are dealing with new ground rules, designers tend to retreat to known project types. The design profession has to be dragged away from the wrong precedents. Those precedents will typically be institutional models - the ‘hospital model’. The hospital model puts staff at a high level because ‘patients’ were short stay. This is reversed for aged care buildings.

Nevertheless staff needs are often still rated above those of residents.

For access consultants reviewing drawings for new residential care projects many subtleties in design should be examined: 2.1 External massing of the building(s) that is strongly modulated. The building should reveal itself as a process rather than one big hit.

Materials should be finely scaled rather than use of large single expanses of monolithic materials.

In the absence of a town-based model that includes all residents in a mixed use community, the development should present to the outside world as open and friendly.

The building should display itself as residences with nothing to hide.

Landscaping should be finely scaled and reinforce public, public/private and private hierarchies

2.2 Internal spaces should also have a clear hierarchy of public to private movement between zones. The interior design should underpin the transitions. For example, main entry (public space), a cafe (for example) (public/private), private dining (public/private), small sitting rooms (public/private) then to dining rooms (for residents but also family and friends) and then to resident rooms (private).

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FEATURED ARTICLE 3. Users of the building form a hierarchy also.

As residents are the primary users of the building their requirements should be paramount. Obviously the needs of family and friends visiting have to be addressed but there can be an overemphasis on first impressions by resident families, and not on the residents themselves.

Each project will have had to deal with provision of the rights of residents. This includes the rights of an individual to lead as independent a life as possible.

4. NCC issues: 4.1 The NCC requires accessible bedroom suites as a proportion of total suites.

Consultants will be faced with client requests for Performance Solutions to avoid this requirement. This is usually on the basis that a provider cannot guarantee an accessible suite can be available for a resident with dementia, who is a wheelchair user.

Should facility management take precedence over residents?

4.2 Each project must deal with access for staff with a disability. Providers will often request Performance Solutions to exempt staff areas. But these areas could include reception, hairdresser, facility manager, admin staff, and upper management and so on. We should be more circumspect about rushing to please our clients.

people - luminance contrast, thresholds, cognitive impairments, but there are part of the DTS requirements of 9(c) buildings.

Consultants should be aware of these requirements in the same way that they area aware of other building classifications.

To summarise: Access Consultants are likely to be called on to review 9(c) projects. Whether dementia only facilities, or hybrid models, there are major opportunities to provide an enhanced service. The basic rules of designing for dementia can be easily accessed on the web. We should be aware of them, but we should also be advocates for spaces for people with dementia in the same way as we are advocates for the broadest range of people in the community.

4.3 Bathroom design - Consultants should be aware of design criteria such as WC’s in view of beds, circulation paths of shower trolleys and so on 4.4 Corridor handrails: Very recently there has been a move to deleted handrails in corridors (via Performance Solution). If asked to prepare and/or support a Performance Solution for the deletion, Consultants should closely review the evidence base for such a move.

4.5 Other issues: There are other issues in relation to designing for older 12

In relation to the application of AS1428, the Standard takes a broad approach to nursing home design. In the same way as , say, a consultant will be required to assess a child care centre, consultants will need to look to other relevant compliance, guideline and international benchmarking to ensure their services do not stop at mainstream nursing home design.

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Feedback on the ACAA Mentoring Program

by Michael Moutrie

Michael Moutrie is an ACAA Associate member and has been working as an access consultant for Accessible Building Solutions for the past year. Michael completed the Certificate IV course in Access Consulting in July last year and is working towards achieving ACAA Accredited membership status.

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or some time the ACAA has provided a facility for the mentoring of associate members by more experienced members.

While the eForum can provide a valuable resource for members, there is nothing like having a personal mentor. As I am working towards accreditation, I would like to share my experiences with the mentoring program.

I am somewhat fortunate that my mentoring is being undertaken as part of my employment.

This means that I have virtually continual mentoring in a wide variety of areas. It also means that I can seek immediate advice on a subject, rather than waiting for a meeting with my mentor. Even in the context of my employment I have a formal mentoring agreement with my mentor which has been lodged with the ACAA. I also lodge with the ACAA a quarterly log of the mentoring sessions. In the beginning, the mentoring was very regular and generally 2 to 3 times a week, reviewing the work being undertaken, but now, almost 12months since we started, the sessions are less frequent and often around a particular subject. The direction of the topics is also changing. Whereas initially they were all project based, reviewing technical aspects of the work they are now tending toward more management or unusual technical issues. The mentoring fills in many

of the gaps I found were left by the Certificate IV course in Access Consulting.

One of the advantages of mentoring is that you learn what is behind the Standards.

I have learnt not just the technical requirements, but why they are so, and this allows me to understand what we are trying to achieve and offer solutions and alternatives when appropriate.

I am lucky that I work with my mentor on a day to day basis but I know that is not possible for everyone. The issue with mentoring is that it can take a lot of time and effort by the mentor, who is probably busy running their own business.

To get the most from the process I recommend that you explain to your mentor exactly what you want to achieve and how you would like the process to happen. If the mentor agrees that they can work with you in that manner this should form part of your mentoring agreement. The agreement is important to ensure both parties understand what each can provide and give to the relationship. If you want one on one time each week with your mentor and the proposed mentor, due to work commitments, can only provide email responses to specific questions on an ad hoc basis, then the relationship won’t work and you should seek someone who can meet your needs. The ACAA website has a find a mentor section, but unfortunately this doesn’t seem to be well patronised. You could contact a person who contributes to the ACAA eForum or if your state has network meetings, approach someone at the meeting.

I have found the process extremely valuable as I move towards achieving accreditation.

If you would like to know more about the ACAA Mentoring program, please contact Francis Lenny

April / May 2018

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Designing buildings for individuals with Autism Spectrum Disorder (ASD)

by Shelly Dival

Shelly Dival is an accredited (BDAWA), multi award winning Building Designer and consultant and researcher of Autism Friendly Design. Based in Perth, Western Australia, she works with individuals and organisations and is currently completing her Churchill Fellowship travels in Europe. Her report on the global perspective of Autism Design will be published mid August. Updates and further information can be found at autismfriendly.com.au.

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ost people have never heard of such a concept, and nor had I until my grandson was diagnosed. When I found examples of Autism friendly design being undertaken overseas, it was my light bulb moment. Of course! It makes perfect sense!

Physical disability has long been recognised in construction codes and standards (as it should), however neurological disability is entirely ignored. The lack of support through specialised building design isolates members of our community like no other bias can. It stops people from attending sporting and social events. It stops them from travelling. It stops them from doing everyday things that those of us who consider ourselves neurotypical do without much thought.

Since my grandsons’ diagnosis I have been a keen researcher in this field of design. There is very little work being undertaken in Australia, and probably less than a handful of people that understand the connection between architecture and Autism in any detail 14

nationally. To continue my research I applied for a Churchill Fellowship. The Churchill Trust financially supports individual researchers to travel overseas to study a specific project (for more information about the Trust and Fellowships go to churchilltrust.com.au). To my absolute delight, I was advised of my success in September of last year.

My program saw me travel through the United States, Denmark, The Netherlands, Scotland, England and France and even more time zones! I have spoken to researchers, Architects, service providers, non-profit organisations and scientists to understand the intricacies of this subject, and to review what is happening globally. It has been truly amazing to visit the buildings found during my online research, see every professional and discuss (sometimes with an interpreter) a topic that everyone involved is very passionate about.

I have discovered that the issue is quite complex, and that issues other than design (such as funding models, government and public understanding, budgets), connections between design professionals and service providers, and builder/contractor understanding all need to align, or at least as a bare minimum need to intersect to make a successful project in meeting the needs of the indented users.

To be fair, while most people have heard of Autism, they have little understanding of the disorder, so the concept of designing our buildings to meet the needs of Autism is not one that immediately comes to mind. To explain the complexities of Autism would take more time that this article allows, so for the purpose of the article I shall keep it to a minimum and in the context of design. For further reading on ASD useful articles can be found through organisations such as autismspeaks.com and the Australian Medical Association (AMA.com.au)

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“Street� view of Le Scarabee, an adult residential facility, designed by Emmanuel Negroni, showing floor treatment for wayfinding, choice of seating and light treatment among the many features of this innovative structure April / May 2018

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An example of interior design which can adversely affect those with ASD, the lighting and pattern of the ceiling treatment can have adverse affect on a person’s vision affecting proprioception.

Autism affects individuals in different ways, and with different levels of intensities. One of the main issues people face with ASD is sensory overload from the environment, which can lead to meltdowns and a total inability to cope in a given situation. This ‘overload’ can also be physically painful for the individual.

All of the senses are affected: sight, smell, hearing, touch and vision. Designing buildings and other spaces and places to minimise the impact of these sensory issues is an important aspect of designing for ASD. An associated outcome of Autism friendly design, is the built environment being more user friendly for people with Dementia, those who suffer from conditions such as migraines and epilepsy, and indeed the neurotypical too.

As people on the spectrum have disrupted brain pathways, cognitive functions are also impaired. Individuals will often take longer to process information, and will process quite literally. As a result of this information about Autism, clear way finding indicators and signage in buildings is very important to help guide people around spaces and places. This also has safety implications which at times conflict with statutory requirements making, it difficult to find the best solution. Instances of exit signs on fire doors, where the individual may end up in an unsafe environment is just one example of this.

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Often, in relation to construction codes, an alternative solution rather than the prescriptive will need to be proposed.

Clearly defined areas of use, such as eating, learning, bathing, sleeping areas, are also important so the individual can clearly understand where each activity is to occur.

Each area of activity will then need a fully thought through design solution, down to the finest detail. One opinion is that the smaller details need to be worked through first (for example, fittings and fixtures) and then expand into how the large spaces will be shaped. Whereas generally, as designers, we start with larger concepts and work through to the detailed specification. The larger aspect of the building’s form and its specification is just as important as the other when creating Autism friendly spaces and places.

During my trip, I saw various design solutions to deal with the sensory and cognitive challenges faced by people with ASD. While there was an agreement on design requirements, a diverse range of design solutions were produced. Services offered by the healthcare providers, geographical location (both locally and by country), proximity to external services and, at times, the personal ideals of organisation founders were all contributing factors to the final design outcome.

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FEATURED ARTICLE Another area of discussion was designing for the mind. Proprioception (the ability of a person to feel where their body is positioned in space) and vestibular (the perception of body position and movement) can be influenced by our surroundings, particularly through vision. While talking to Ute Leonards from the School of Experimental Psychology at the University of Bristol, I learnt that some patterns and colours can cause interruption to our proprioception and vestibular abilities and, for those with ASD, these interruptions are heightened.

ten years old, and does not communicate like you and me, the medical term is non-verbal, he is nearly toilet trained, and certainly has difficulty with learning at the same pace that you and I might. But, you cannot tell just by looking at him that he loves Diff and Murphy, the family dogs. He loves sitting on the bobcat at his great Pops farm and fossicking around the shed, he loves football (sadly an Essendon supporter), he loves dancing, music, the Big Bang Theory, particularly Sheldon (go figure). He is a cheeky little monkey that loves a good joke.

Care needs to be taken by Designers when choosing patterns and contrast levels, as it can have quite an adverse effect. Patterns in items which are typically in specified or block colour, such as door mats and carpets, and strong linear lines in certain widths and contrast, for example balustrades, can be difficult for people on the spectrum to process.

Sometimes as Designers, we get caught up in all the regulations and details and sometimes we forget who we are designing for. Two people in particular that I spoke to, Steve Maslin, an Architect from Bristol, and Teresa Whitehurst, a researcher at the University of Worcester (Dementia studies) reminded me of this. We need to give people choice when we design spaces for them. Giving people choices supports everyone’s human factor and empowers individuals to live their lives in the way they want, even if they cannot communicate that to us at the time. We need to balance solutions for the physical and sensory challenges with choice in our designs.

Another important theme that emerged during the research was, the human factor.

Designing for who we are as people, as an individual, as a human. Forget the codes, forget construction details, forget councils and planning regulations. We need to design for the human inside the body. Our physical body and it’s abilities or inabilities does not define who we are. Our heart and soul does that. My grandson’s diagnosis of ASD, along with his Down Syndrome does not define him. He is

By providing these choices in the built environment, individuals have the chance to explore new hobbies and interests, it allows them to do ‘ordinary’ things like go shopping, attend a football match and have meals with their friends, while allowing them to explore their inner selves and express their personalities.

The specifically designed residential seniors housing facility, Denmark for Specialist Area Autism, designed by Wienburg Architects in conjunction with Frier Architecture, shows various design features including lighting, signage and visual choices for residents through internal planting shown left.

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Research on Use of Handrails in Aged Care Facilities

by Nicole Maree Swan

Nicole Swan completed her Bachelor of Occupational Therapy (Honours) in 2017.

During the course of her studies she developed an interest in universal design and access. Her thesis entitled ‘What are the perceptions of staff who work in, and professionals who advise on the design of, Australian Aged Care Facilities on the value and use of handrails in corridors’ explores the value and use of handrails in corridors. Her thesis aims to increase safety, occupational performance and participation of users of the environment.

require assistance with activities of daily living.

To support people who reside in Australian ACFs, the built design of ACFs should incorporate features, fittings and fixtures that support and maximise safety and mobility.

Handrails are one such fitting and are defined as a rail that can be grasped by the hand for guidance and support in circulation areas, including corridors of ACFs (Building Code Australia, 2016).

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The current Australian Building Code (BCA) requires ACFs to install handrails along both sides of every corridor used by residents. This code does not specify handrail shape or height and does not extend to other common areas, such as dining rooms or lounge areas. It is understood that despite the BCA requirement to provide handrails in corridors, there is variability in the design and position of handrails currently being installed in Australian ACFs. Additionally, there have been instances noted by one of the authors of this study where building designers and developers request the exclusion of handrails in corridors of ACFs due to them being perceived as unnecessary and ineffective supports.

As the proportion of older people in Australia’s population increases, the promotion of safety and independence through the built environment of Australian Aged Care Facilities (ACFs) is an important field of investigation.

Australian ACFs provide permanent or temporary support and accommodation for people who commonly experience health related conditions, mobility impairments and

There is limited literature on the value and use of handrails in corridors of ACFs. Using a descriptive cross-sectional research design via a self-administered online survey, this study recruited staff who work in, and professionals who advise on the design of, Australian ACFs. Information was gathered on handrail users, reasons for handrail use, actual and preferred handrail design features and other mobility supports used in ACFs.

hat are the perceptions of staff who work in, and professionals who advise on the design of, Australian Aged Care Facilities on the value and use of handrails in corridors?

Handrail 1

Handrail 2

Handrail 3

Handrail 4

Figures 1-5: Various handrail shapes 18

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Handrail 5

FEATURED ARTICLE Users of handrails in corridors of ACFs As identified by participants within this study a variety of individuals use handrails in corridors of ACFs including residents, residents’ friends and family. Unexpectedly, participants also reported that staff use handrails in corridors of ACFs.

Reasons for handrail use in ACFs amongst users Participants within this study reported that handrails in corridors of ACFs are commonly used by residents during a variety of activities for the purpose of ‘balance support’, ‘exercise’ and ‘mobility’ (including mobility in the absence of a mobility aid and using a walking stick). Residents’ friends and family were reported to use the handrails for mobility and balance support while visiting ACFs. Additionally, the findings of this study identified staff as both direct users of handrails and also indirectly using the handrails to provide services to residents. To carry out employment duties staff reported using handrails in corridors of ACFs for ‘storage’ and ‘while mobilising stairs and other common areas’. Tasks carried out by staff while residents use the handrails include ‘exercise prescription’, e.g. ‘Physiotherapists use handrails when attending to their programs with residents including sit to stand exercises’ and ‘balance support while ambulating residents’.

Handrail design and aesthetics A majority of participants reported that handrails were installed in ACFs, with corridors being the most common and preferred handrail location. Most participants in this study reported that the user’s ability to hold and use handrails is influenced by the handrail shape and material. Due to its grip and temperature control, timber was described as the most common and preferred handrail material amongst the majority of participants.

Victorian styled handrails (Handrail 4, as depicted above) was the most common handrail shape installed in corridors of ACFs. However, participants within this study perceived that circular handrails (Handrail 1 as

depicted above) were the preferred handrail shape due to its grip and suitability for a range of person differences. The BCA (2016) does not specify handrail shape for corridors of ACFs. While most participants reported that Handrail 4 was most commonly installed in corridors of ACFs, it is not perceived to be as preferable as a circular handrail (Handrail 1). Overall, this study reveals that handrail shape should be considered during the design process of ACFs and that further research with larger samples are required to determine the best handrail shape to maximise effectiveness.

Other mobility supports To facilitate mobility and independence, compensatory strategies including mobility aids are commonly recommended and used by residents’ in ACFs. As both handrails and mobility aids cannot be used simultaneously, participants within this study perceived that handrail use is limited by a person’s use of a mobility aid, e.g. ‘A suitable mobility aid should negate the need to mobilise with the use of a handrail’. While some participants preferred the use of mobility aids as they provide balance support in all areas without a break in continuity, more than half of participants have highlighted that corridor handrails provide an alternative support to users of ACFs. Although the findings of this study reveal that mobility aid use is preferred over the use of handrails in ACFs, not everyone in an ACF may have access to a mobility aid or remember to use a mobility aid. Safe and effective assistive technology use is influenced by personal capabilities such as memory and cognitive ability (DHAC, 2016) and as highlighted by participants in this study, a handrail can serve as an alternative form of support.

The current study has provided insight regarding environmental design factors, including ACF design planning, handrail design elements and assistive technology. While some participants of this study preferred the use of mobility aids over the use of handrails, corridor handrails were perceived to offer an alternative support to those without a mobility aid, those unable to safely use a mobility aid, or those

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FEATURED ARTICLE who experience an unexpected sudden loss of balance, ultimately assisting users’ mobility and safety within ACFs. Additionally, corridor handrails were noted to assist ACF staff to carry out employment duties such as exercise prescription and balance support while ambulating residents.

Conclusion The findings of this study reveals that handrails are commonly installed in Australian ACFs, with the most common location being corridors.

Participants within this study identified that a variety of users including residents, aged care staff, residents’ family and friends use handrails in corridors of ACFS. The majority of participants reported that handrails assist users with balance support, exercise and independent mobility including assisting users’ in the absence of mobility devices or using a walking stick. Additionally, handrails were perceived to assist staff to prescribe exercise to residents and provide balance support to staff while ambulating residents. The findings of this study demonstrate the varied use of handrails in corridors of ACFs.

While the staff who participated in this study may prefer residents to use their mobility aid; participants also reported that handrails should be installed in corridors of ACFs to provide an alternative form of support. Further research should be conducted to strengthen these findings. Areas of future investigation should include preferred handrail installation height and handrail diameter. With more consistent and specific evidence, health professionals and those who advise on the design of ACFs will have stronger justifications for design strategies; and best practice relating to handrail use in ACFs to help users to maximise mobilisation and engage in meaningful activities.

Australian Bureau of Statistics. (2017). Census of population and housing: Reflecting Australia - Stories from the census, 2016. (4430.0.).

Canberra: ABS. Retrieved from http://www.abs.gov.au/ausstats/abs@. nsf/Lookup/4430.0main+features302015 Code Australia (2016). National construction code volume one – Building code of Australia. Retrieved from http://www.abcb.gov.au Department of Health and Aged Care (2016). 2015-16 Report on the operation of aged care Act 1997. Canberra: Dept. of Health and Aged Care. Retrieved from https://agedcare.health.gov.au/sites/g/files/ net1426/f/documents/12_2016/2015-16_report-on-the-operation-of-theaged-care-act-1997.pdf

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CPD OPPORTUNITIES ACAA NSW Access Consultants Network Meeting

ACAA VIC Access Consultants Network Meeting

Date: Thursday, 28th June 2018 Topic: Introduction to NDIA SDA

(Specialist Disability Accommodation) Venue: MS Society Lidcombe Cost: $35 members / $50 non-members

Dates: TBC

ACAA QLD Access Consultants Network Meeting Date: Tuesday, 19th June 2018 Topic: Election of the QLD Sub-committee and NDIS Specialist Disability Accommodation.

Venue: 18/14 Ashtan Place, Banyo, QLD 4014 Cost: Free Contact Francis Lenny for details

ACAA SA Access Consultants Network Meeting Dates for 2018: June 5th – CPD July 17th – Business Meeting August 28th – CPD October 9th – Business Meeting November 20th – CPD December – Breakup drinks date Contact ACAA SA Chairperson Grant Wooller for details.

ACAA WA Access Consultants Network Meeting Dates: Tues 5th June and Tues 4th September Venue: Student Services Conference room at

North Metropolitan TAFE, Leederville.

Time: 4pm to 5:30pm Contact ACAA WA Chairperson Anita Harrop for details.

Assisitive Technology Australia provides a Home Modification Course which includes units CPPACC5016A and CPPACC4020A. CLICK HERE for details

International Urban Design Conference To be held at the SMC Conference and Function Centre, Sydney (12 - 13 November 2018) CLICK HERE for details

Australian Cladding & Building Standards Summit 25-26 June 2018, Day 2 - Inclusive Egress: Factors to consider for safer and more accessible buildings CLICK HERE for details

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our new CORPORATE MEMBER category!

Association of Consultants in Access Australia

CORPORATE SPONSORS

From 1st July 2018, our ‘Corporate Sponsor’ membership category will be available. The annual fee is $1,100 and is suitable for businesses that provide: • Products that relate to accessible built environments and support the objectives of ACAA. • Disability access-related consultancy services (provided that the business employs at least ONE financial ACAA Accredited level member).

‘Corporate Sponsor’ Package includes the following: Use of ‘ACAA Bronze Sponsor’ logo on your website and advertising material (for financial members).

Early release of ACAA Conference Trade booths and other Sponsorship packages at 10% discount for the next ACAA National Conference to be held at Luna Park Sydney in August 2019.

Free listing as a ‘Corporate Sponsor’ on ACAA website

• ¼ A4 page advertisement in six issues of Access Insight magazine (approx. value of $1,500); OR • 2 x ¼ A4 page advertisements and 1 page ‘Advertorial’ in Access Insight magazine (approx value of $1,500 based on current Access Insight advertising rates).

Free admission to attend any two ACAA State Network seminars / meetings for two people (approx. value $200)

For details, contact Farah Madon: vicepresident@access.asn.au

APPLY NOW

HOT APPS

May 2018 Hot Apps

I

n this section we feature apps that are Access Industry related. If you have an app that is useful for Access Consultants, please let the Editor know so that it can be included in the next issue of Access Insight.

Reviewed by Jen Barling SNAP, SEND, SOLVE This app enables you to take a photograph of an issue in your community and send directly to Council with a text or voice memo message.

It’s an innovative way to let councils know about accessibility issues in real time, as well as covering a range of other issues like abandoned trolleys, parking, footpaths and graffiti.

Download from iTunes Download from Google Play

ADA IN 3D An illustrated and interactive version of the 2010 Americans with Disabilities (ADA) Standards for Accessible Design. The standards are shown in 3D pictures and models which can be rotated. Useful for visually demonstrating accessibility requirements to colleagues and project teams.

Download from iTunes Download from Google Play

IAUDITOR An inspection checklist app that allows you to create customised inspection forms, streamlining the inspection process and making data collection more consistent. After an inspection is complete, an instant shareable report is generated.

Download from iTunes Download from Google Play

April / May 2018

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FEATURED ARTICLE

What is, or should be, the role of an Access Consultant in the design of residential care facilities?

by Mark Relf

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hen it comes to residential care facility projects as Access Consultants we are often tasked with writing compliance reports and performance solutions for: bathrooms not complying with AS1428, handrails removed from common corridors, doors and doorway circulation spaces, and other building elements.

The NCC is such a blunt design tool where minimums become maximums which stifles the true extent of what Accessible and Inclusive environments really mean and what they should look like.

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I’m sure we’ve all seen or heard of many gut wrenching stories of that moment when a parent, relative or partner enters into the world of living their final days in a residential care facility and they become separated from family and homelife to become just another commodity in the aged care system.

In my view, as Access Consultants, we have more to offer than just writing a report complying with sections D and F2.4 of the NCC and the paltry role of AS1428.1 in the design process.

However, the Access Consultant is rarely, if ever, involved in the schematic design phase when building shapes, styles and layouts are being developed by the architect. Even beyond then DA phase the Access Consultant is not part of selecting flooring materials, furniture, fittings, lighting and other items to enhance the access, inclusion and quality of living for residents.

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FEATURED ARTICLE Okay so how do we change this situation ?

It is overdue that design guidelines for residential care facilities are developed that deal with; • Non AS1428 bathrooms that provide appropriate access for all users regardless of their abilities and mobility aids, • How to use colour, luminance contrast and materials in a manner that accommodates people with vision impairment, people with dementia and others to provide intuitive wayfinding and comfort zones where privacy is the choice of some residents in an otherwise communal environment, • Using colour, lighting and memory boxes to assist people with dementia in navigating their environment, • Interiors that minimise reverberation to achieve high quality acoustic environments to aid people with hearing loss,

• Selecting manual door and window handles or automation to suit residents with limited or no dexterity in their hands and fingers, • Access to outdoor spaces and floor to ceiling windows and glazed doors to maximise views for people who spend more time in bed, use a wheelchair or are just sitting.

In nominating this list as a starting point I’m sure readers have many more ideas to develop the Access and Inclusion Design Guidelines for Residential Care. Send your ideas to ACAA and hopefully, together, we can move the debate on best practice access and inclusion forward.

All photos are of Retirement Facility Mark Moran at Vaucluse

• Handrails, rest points and alternative strategies to support people with reduced mobility, • 1:20 maximum gradient walkways and comfortable step geometry for people with reduce mobility with in-laid stair nosings where possible, • Selecting appropriate furniture and fittings to maximise independence and inclusive participation,

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2019 ACAA National Conference August 2019 at Luna Park in Sydney More details coming soon

The content of this newsletter is for information purposes only and opinions expressed in articles are those of its author and not ACAA. ACAA assumes no liability or responsibility for any inaccurate or incomplete information, nor for any actions taken in reliance thereon. Advertised products and services that appear in this newsletter have been provided by such organizations without verification by ACAA. ACAA does not guarantee, support nor endorses any product or service mentioned in this newsletter, nor does it warrant any assertions made by the manufacturers of such products or services. Users of are recommended to obtain independent information and to perform independent research before using the information acquired from this newsletter.

In this newsletter, you will find links to other websites. ACAA cannot be held liable for the content of these websites nor for the way in which these websites handle your (personal) data. For information in this regard, read the privacy policy, disclaimer, copyright notices, general terms & conditions, if available, of any website you visit.

No part of the newsletter may be reproduced without the prior written consent of the ACAA Committee of Management.

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