Environmental Modification

What we know

The physical environment of an older person’s home or their space in residential care contributes to their quality of life. As a person gets older, modifications may be needed to make it easier to move around and to continue to engage with people or just to be safe. This may also be a consideration when planning and delivering palliative care and end-of-life care.

The space in which the person lives may need to be modified to accommodate equipment or to enable aspects of care to be provided. This can sometimes cause tensions between making it easier to provide care and the person feeling 'at home' or in a homelike environment.

Go to Evidence Summary

What can I do?

Putting too much importance on reducing risk can limit the older person's sense of comfort and ownership. Talk to them about what they want.

Consider creating opportunities to support a person’s spiritual wellbeing or spiritual care of patients, family members and carers. This can be through the connection to nature, and the provision of appropriate space for the person which can include creative spaces (art and music).

Check out these resources that can be shared to show how changes can help in their home or in residential aged care:

Share resources from My Aged Care on help for aids and equipment.

Think about whether a person's quality of life can be improved with modification of the home. Ask the doctor or occupational therapist about what changes to the home might be helpful for the person. Carer Gateway has useful information on this.

What can I learn?

Australian Occupational Therapy Association Position Paper: Occupational therapy in palliative care 2015 (555kb pdf)

Read:

palliAGED In Focus Aged Care Standard 5 and the need to design service environments (March 2020) including palliAGED Aged Care Standards Insight Can environmental design influence wellbeing at the end of life? (202kb pdf)
Fleming R, Kelly F, Stillfried G. ‘I want to feel at home’: establishing what aspects of environmental design are important to people with dementia nearing the end of life. BMC Palliat Care. 2015 May 12;14:26.
State Government of Victoria, Health Victoria. Dementia-friendly environments [Internet]. 2021 [cited 2022 Jan 20].
Australian Commission on Safety and Quality in HealthCare (ACSQHC). Welcoming environments [Internet]. 2019 [cited 2020 May 1].

What can my organisation do?

Have information on local suppliers and providers to assist with needed resources or modifications to the home.

When designing or redesigning aged care spaces, create a homelike environment with:

adequate general lighting
low or minimal background noise
temperature control
colour contrast
access to views of nature, and/or gardens/natural spaces
visual, auditory, tactile, and olfactory stimuli to stimulate or comfort a person
technological aids for people with cognitive impairment to orient themselves and not wander from a safe environment
the ability for a person to personalise their space.

Have information on local suppliers and providers to assist with needed resources or modifications to the home.

Page updated 20 January 2022