by David Lane

Eldercare in the Community

Representatives of the Australian aged care industry have been developing a dialogue with their counterparts in China, for the exchange of expertise and ideas between the two countries.

In 2006, a SAGE Study Tour (Studying and Advancing Global Eldercare) visited Beijing. SAGE Tours were organised in collaboration between Thomson Adsett Architects and Aged Care Association Australia, to provide a forum for aged care providers to gain experience in markets outside Australia.

Chinese officials told us that the one-child policy, while successful in controlling population growth, has had consequences in caring for the aging population. The natural order of children looking after their grandparents has been weakened, because for 4 elderly people, there are now often less than 2 people to look after them. This is a sobering reality, and we were challenged by their willingness to discuss the problems and seek solutions.

"The Australian delegates were impressed by the approach to lifelong health in Chinese culture," said Thomson Adsett Principal David Lane. "From childhood, Chinese people learn that you get up in the morning and you go and do something physical. We saw thousands of people in the parks in Beijing doing exercise, from water calligraphy to tai chi, sword dancing, line dancing and people singing opera."

Mr Lane said the Australian visitors were humbled by the enormity of the challenge facing China.

Mr Lane said there were opportunities for the embryonic Chinese aged care industry to learn from the errors discovered in Australia in past generations. "In the 1960s and 1970s we were forced to pursue institutionalisation of the aged, but the government is now giving greater priority to community care. Chinese culture provides an ideal support to a community care approach."

"Australia has a lot to offer in professional expertise, education and resourcing at a macro level. We can add value in strategic planning, policy development, master planning, concept design work, and through engagement with Chinese universities. We can share the philosophical underpinning of our architectural decisions."
David Lane

Some young Chinese architects were training in Australia. "We have a number of young professionals who desire in the long term to return to their country and work there," said Mr Lane. "Our long term plan would be to have people benefit from our experience and what we have learned from 35 years of aged care architecture, and become able to apply it in their home country."

Australia can also assist in an advisory capacity as China is establishing the policies that will carry it into the future.

"The key issue for elderly staying in their homes is that the building must support them," said Mr Lane. "For example, if the only option for bathing is to use a bath, someone with a disability may have difficulties with ongoing hygiene because they can't easily get into the bath. They could end up being institutionalised for that one problem, whereas they can still care for themselves in every other way. We are looking at developing building guidelines and other strategies to enable newer buildings to take account of those sort of impediments."

Integrating eldercare into the community is an area where government regulations can help. "For example, rather than build a 300 bed nursing home in a community," said Mr Lane, "you could mandate in the building code that for each 5000 units built, there must be 500 units designed for the elderly, integrated within the residential clusters or towers. In the base of the towers there can be smaller medical services, so that instead of people coming to a separate medical facility, the medical facility goes to the people."

"World experience tells us that this may initially be more expensive, but it's more caring and you don't need to build health infrastructure that becomes redundant over time," he said. "Because the Chinese economy is growing so quickly, and people's life expectations are growing with it, non-integrated eldercare facilities can become outdated. Integrated eldercare will be more relevant and less expensive in the long term, because it's actually a house, not a hospital."