Wave of change turns the tide on health care

15 Aug 2018 | Aged Residential Care
Tagged aged care older people aged residential care

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The Aged Residential Care programme is keen to profile the good work being done in the sector. We’re inviting organisations to share examples of best practice by blogging on our website. Here, Hilda Johnson-Bogaerts, Director of the Selwyn Institute, talks about her organisation’s unique care partnership and how it allows residents to take charge of their own lives.

There was a time (and not that long ago) when a medical professional’s will and word were not to be challenged. Any sharing of information was largely to encourage a patient to agree with a particular course of action, rather than putting forward an alternative viewpoint.

Hierarchical models were the norm; roles, responsibilities and even care facilities evolved accordingly.

Enter the digital age and, with the simple click of a mouse, patients discovered they could legitimately have a role to play in what is important to them. Namely, their health.

Initially, the pendulum of power, in some cases, might have gone too far, with people enjoying their new-found ‘rights’ without a sense of perspective or understanding of consequences. This made them prey to the quirky and the quacks rather than those with an educated perspective.

True participation is what the Society for Participatory Medicine describes as ‘a movement in which patients and health care professionals actively collaborate and encourage one another as full partners’.

In recent times, the Selwyn Foundation has been developing its own participatory care model and application, based on international best practice.

The challenge was to develop an integrated approach and process that could be replicated throughout Selwyn’s care homes across our retirement villages and which demonstrated innovation in the provision of aged care.

This new approach is designed to create a true home for older people by having small communities or ‘households’ of twelve residents within the larger care home community. Each household functions as a home would do: residents have their own room with ensuite and share a spacious lounge with open-plan dining and kitchen area, leading to a large outdoor deck and seating. Additional amenities elsewhere within the care home include a community hub with multi-functional areas, a shop, clinic and hairdresser.

The environment supports our unique care partnership and allows residents to take charge of their own lives. They tell us what’s important to them and we formulate a tailored care plan based on their needs and wishes. They’re in the driving seat, making decisions about their own wellbeing and lifestyle supported by our care team and modern assistive technology.

Offering inviting environments without an institutional feel gives people a real sense of belonging. Close relationships can blossom, and life is as normal as possible.

We also encourage family members to be part of the community at any time, but particularly at critical points, including end of life, when residents can have their loved ones nearby.

To date, the Foundation has created two such care homes at our Selwyn Oaks village in South Auckland and Selwyn St Andrew’s village in Cambridge. A third care home is nearing completion at our flagship Selwyn Village in Auckland.

Within each, we reinforce the fact that each resident is a valued member of the household. For example:

  • Personal possessions and unique routines are respected.
  • We use new terminology and language (there’s no place for ageism or patronising terms).
  • Staff and residents together make informed decisions about the working of the household.
  • Residents have opportunities to contribute voluntarily to this household and the wider community.
  • Respect for privacy and dignity is paramount (eg, knocking on doors before entering, asking what the resident would like and listening to what they have to say).
  • Opportunities are provided for an individual’s hobbies and recreation.

We are strong believers in evidence-based measurement and testing original assumptions. Our expectations, and hopes, are that what we have created will deliver:

  • No institutions – it’s like being at home.
  • State-of-the-art and paradigm-changing environments.
  • Enabling technology.
  • An aspiration that residents experience wellbeing, including at the end of life.
  • More fulfilled staff and reduced staff turnover.
  • Happier families.
  • Preparedness for and ability to deliver future person-directed living along the continuum of care.

The Selwyn Foundation may be ahead of the game in committing significant resources to genuine participation. My guess is that, as the baby boomers enter the picture, having a say in one’s life direction will become the norm.


The Selwyn Foundation is an independent, Christian faith-based New Zealand charitable trust providing services to older people and their families.

If you’d like to blog for our website, please email arc@hqsc.govt.nz.

Last updated 01/10/2018