While working in residential aged care, you will encounter older people from all walks of life.

Irrespective of their background, culture, identity or life experiences, every older person receiving aged care should be supported to feel welcome and experience a sense of belonging during the provision of services (ACQSC 2023).

Everyone experiences care differently, so by ensuring the service environment is inclusive, each resident will feel welcome and comfortable to ‘be themselves’ (ACQSC 2023).

So, how can this be achieved?

What is a Welcoming Environment?

A welcoming environment takes into account the physical, emotional and social aspects of a space. It should support independence, interaction, function and belonging (ACQSC 2023).

The organisation should consider:

• The physical design of the service environment
• Whether residents feel like they are being supported
• The quality of relationships that residents are able to maintain with staff, visitors and other residents
• How easy the service environment is for residents to understand and navigate.

(ACQSC 2023)

Providing a Welcoming Service Environment Under the Strengthened Aged Care Quality Standards

Standard 4: The Environment - Outcome 4.1b: Environment and equipment in a service environment under the strengthened Aged Care Quality Standards (Action 4.1.1a) requires aged care service environments to:

• Be clean
• Be well-maintained
• Be safe, welcoming and comfortable
• Be fit-for-purpose
• Be accessible, including for older people living with disability
• Facilitate movement, engagement and inclusion through its design
• Facilitate free movement both inside and outside
• Reduce safety risks without being obtrusive
• Promote useful stimulation
• Be easy to navigate.

(ACQSC 2024)

Physical Design of the Service Environment

Age-related changes and disability may cause residents to have difficulty moving around, orientating themselves or navigating spaces. Contributing factors might include:

• Sensory impairment (e.g. vision or hearing loss)
• Reduced mobility
• Cognitive impairment (e.g. dementia)
• Using mobility aids (e.g. wheelchairs or walking frames).

(ACQSC 2023)

Residents should be able to easily find their way around the service environment to important locations such as the dining room and bathrooms (ACQSC 2023).

An environment that is easy to understand and pleasant to occupy is more likely to be one that is welcoming. Consider:

• Reducing unnecessary noise and clutter
• Increasing levels of light and illumination
• Using contrasting colours
• Using signs and aids to assist orientation and wayfinding
• Keeping room temperatures comfortable
• Avoiding overstimulating noises and visuals
• Allowing access to outdoor ‘therapeutic garden’ areas
• Providing areas for residents to be alone and with others
• Providing residents with single rooms
• Adapting the service environment to fit residents’ changing needs (e.g. physical or cognitive decline).

(ACQSC 2023; Fleming & Bennett 2021)

Choosing Colours

Colour choice is an important aspect of physical design. Colours evoke different emotional responses and can assist visibility, navigation and orientation if used appropriately. On the other hand, poor colour choices can be distracting or hard to see (Health.vic 2021).

Keep in mind that older people require three times more contrast than younger people in order to find objects (Health.vic 2021).

Tips for colour selection include:

• Avoiding using too many colours together, as this can be distracting
• Using strong, warm colours, which older adults are able to discern more easily
• Using colours with high brightness (e.g. yellow)
• Using colours that add a sense of warmth, including peach, coral and soft apricot
• Avoiding pastel blues and lavenders, which are difficult for older adults to see and may look grey
• Taking residents’ colour preferences into account in their private spaces
• Avoiding poor-contrast colour combinations such as dark green and bright red, yellow and white, blue and green, and lavender and pink.

(Health.vic 2021)

Creating Familiarity

Aged care environments that are familiar feel more welcoming (ACQSC 2023).

You can help to create a sense of familiarity by:

• Supporting residents’ family members to participate in their care
• Implementing home-like furniture, furnishings, living areas etc.
• Arranging furniture in a home-like way
• Where possible, allowing residents to use their own furniture and fittings, as well as decide the layout and decoration of their private spaces
• Personalising residents’ living spaces
• Decorating with personally familiar objects
• Using posters, photographs, artwork, magazines etc. that portray the service environment as being inclusive of all people
• Allowing freedom of movement
• Employing staff who speak residents’ preferred languages or come from the same cultural groups as residents
• Supporting residents to participate in their own cultures (this may require engaging with staff or volunteers from the resident’s cultural group)
• Promoting autonomy and independence
• Providing spaces for residents to engage in religious or cultural practices
• Allowing pets, if possible.

(Health.vic 2016; Carrie 2019; Fleming & Bennett 2021; ACQSC 2023)

Communication and Relationships

While the physical design of the environment is important, you also need to ensure the environment is socially and emotionally welcoming for all.

The relationships between residents and staff play a significant role in this. Staff can help residents to feel welcome by:

• Using the language of home rather than the language of healthcare
• Taking an experiential approach to communication
• Establishing meaningful relationships with residents
• Being sensitive to culture, religion and spirituality
• Providing individualised care
• Using flexible problem-solving techniques
• Providing unobtrusive support.

(Health.vic 2016)

It’s also important to be mindful that some residents who are in the process of transitioning to aged care will experience feelings of loss and grief and might require extra support.

Read: Transitioning to Residential Aged Care: Loss and Grief