‘Design-thinking’ needed in humane approach to aged care

The Royal Commission into Aged Care Quality and Safety called for an urgent overhaul of Australia’s aged care system. The Head of QUT’s School of Design says the focus needs to be on healthy ageing and incorporate the fields of health, humanities, economics and the arts and design.

Professor Lisa Scharoun is editor and co-author of ‘Cross-Cultural Design for Healthy Ageing’ (Intellect Books) which reports on a series of multidisciplinary, cross-cultural workshops involving university students and academics from Australia, China, Hong Kong, Singapore and Taiwan.

Case studies highlight how ‘design thinking’ can be part of long-term solutions for better aged care and taught in preregistration nursing. The Singapore workshops were followed by a public exhibition and some of the concepts are now being trialled at Nanyang Polytechnic there.

“The United Nations population projections show that many countries, especially those classified as middle and high income, are entering a period where people aged over 65 may be in the majority,” said Professor Scharoun.

“The impact of this in Australia and elsewhere will pose big social, cultural, economic and environmental challenges for contemporary society. Among other things, a longer life span equals an increased burden on the health system and housing.

“A ‘one size fits all’ point of view around ageing is completely inadequate. Such a major global challenge cannot be tackled from the perspective of a single discipline.

“At its core, ageing is a social issue and should be considered within the framework of sustainable development under which falls social, economic and environmental issues.”

Professor Scharoun said the study of human ageing was not exclusive to gerontology but should integrate information across a broad range of fields including sociology, psychology, public policy, biology, health services, humanities, economics, and the arts and design disciplines.

“A common perception in the countries we studied is that ageing is a process of progressive deterioration,” she said.

“We have instead focussed on ‘healthy ageing’; the importance of working towards supporting and maintaining the functional and mental abilities of individuals to enable well-being into older age.

“This involves reflecting on and influencing the design of environments, experiences, products and services that can best allow people to live an independent and fulfilling life well into advanced age.

“We don’t assume healthy ageing is about eradicating chronic disease and mobility issues. Instead, it focuses on how we might support and create conditions to better support people with a variety of complex needs.

“By engaging in cross-cultural collaboration among students in Australia, China, Hong Kong, Singapore, and Taiwan between 2015 and 2018, we discovered such an approach offers innovative new ways of looking at and addressing the needs of the growing ageing market. It also fostered empathy and cultural intelligence.”

Professor Scharoun said the 2017 and 2018 ‘Inspired by Singapore: Design for Healthy Ageing’ workshops, for example, brought together students from graphic design, industrial design, web design, film, media and nursing.

Dr Ragavendra Gudur (University of Canberra), Professor Lisa Scharoun (QUT), Associate Professor Danny Hills (Federation University) and Professor Daphne Flynn (Monash University) at the Inspired by Singapore Co-design for Healthy Ageing exhibition

“We had 175 students participate in these workshops from major urban centres of Singapore, Taipei, Hong Kong, Melbourne, Canberra, Sydney and Brisbane,” she said.

“They worked in partnership with residents in care homes, community housing, and hospitals across Singapore to co-design projects, services and campaigns that would assist healthy ageing.

“Each team member represented a different discipline and/or culture which encouraged the sharing of knowledge and a think ‘outside the square’ approach to problem solving.

A design for healthy ageing underway in Singapore

“Students were also presented with artificial handicaps like glasses with blurred lenses or tight gloves and mobility aids like wheelchairs, crutches, and walking frames to simulate the experience of an aged person.”

Professor Scharoun said that while designers frequently collaborated across design disciplines and other areas such as business, communication, engineering, and the arts, it was less common and more challenging for clinicians to feel they have a role in contributing to the design of products, services and systems that promote dignity and enhance quality of life for consumers in care.

“As our workshop process shows though, it is highly relevant and appropriate that preregistration nurses nearing the end of their undergraduate programs should have some foundational experiences in working collaboratively with design students,” Professor Scharoun said.

“Design thinking is not commonly taught to student nurses, yet its approaches are increasingly being employed to drive innovation in care quality, safety and effectiveness.

“Nursing students are generally much more attuned to a method of problem-solving that is more linear and convergent while design students approach problems differently but have a limited understanding and experience of healthcare systems. By bringing the two together we enabled students to learn from each other’s practices.”

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