Natasha Chadwick entered the aged care industry early in her career, and it didn’t take long for her to become determined to change the way things were done.
“It is as if people who reach a certain age… are discarded, left to spend the rest of their days in drab dormitories in institutions,” Natasha Chadwick, CEO and founder of NewDirection Care, told HelloCare.
“I was motivated by a desire to avoid making the elderly a negatively perceived minority, and to encourage more positive expectations,” Ms Chadwick said.
After years of research, Ms Chadwick developed ‘micro towns’™, in which small groups of older people and those living with dementia live together in homes on regular streets, and are able to spend their days in ways that closely resemble their former lives.
Changes weren’t being enacted quickly enough…
Ms Chadwick began her career as the National Executive Officer for the National Association of Nursing Homes and Private Hospitals.
During her time in the role, she helped reform Federal Government policy, providing advice about the provision of quality care for senior citizens, which was implemented in the Aged Care Act 1997.
“But I was becoming increasingly frustrated that big changes weren’t being enacted quickly enough to transform a staid industry,” Ms Chadwick said. “I wanted to accelerate the pace of change.”
What would I want for my own mother?
“The catalyst that really made me take action was when I asked myself what I would want for my own mother if she was in an aged care facility.
“I was also guided by the vast body of research that has revealed that people with Alzheimer’s have a much better quality of life in familiar home-like surroundings than they do in an institutional setting,” Ms Chadwick said.
“I started conceptualising ideas of how we could let elderly people with complex care needs to live a normal a life as possible for as long as possible, rather than them being stuck on a ward or on a sofa for hours in front of the TV,” she said.
“I spent a lot of time researching, which included visiting other countries such as the Netherlands and the UK to learn about their best practices and to see how they were trying to move away from large institutional aged care buildings,” Ms Chadwick said.
Radical change was needed in aged care
Looking to “disrupt” the way aged care was delivered, in 2006, Ms Chadwick founded IBIS Care Group.
IBIS consisted of six aged care centres and a retirement village, but Ms Chadwick felt even more change was needed.
“While we were certainly improving matters with person-centred care, I concluded that something even more radical was needed,” she said.
“In 2012 I embarked on an intense period of research and ideation for a new model of caring that would give the elderly and those living with dementia an inclusive community and a normal environment,” Ms Chadwick told HelloCare.
Small-scale living in a “microtown”
The end result of this research was a model of aged care that Ms Chadwick calls “small-scale living” based around a “diagnosis inclusive microtown”™.
“Instead of constructing large institutional buildings housing hundreds of residents, we built two homes in Wynyard, Tasmania, with a handful of residents in each.
“This pilot model was a first for Australia and the forerunner of NewDirection Care at Bellmere,” Ms Chadwick said.
A “diagnosis inclusive microtown”™ is a place where older people with complex care needs, including those with younger onset dementia, live a fulfilling, happy and as active life as their condition allows in an inclusive community, Ms Chadwick told HelloCare.
“The focus is on the individual and their unique needs, values and interests, a marked contrast to the institutionalised aged care setting where highly medicated individuals lead regimented lives,” she said.
“Our microtown™ is just like any small town or community with residential streets and houses, public gardens, barbeque areas and a retail precinct with a café, cinema, beauty salon, corner store and more.”
An inclusive and diverse community
One hundred and twenty residents live at NewDirection Care, Bellmere. Around 63 per cent of those are living with dementia, ranging from the mild, early stages of the condition to the more severe later stages.
The rest of the microtown™ comprises of elderly residents, some with complex care needs.
“We are an inclusive and diverse community that doesn’t separate people according to their physical or cognitive condition,” Ms Chadwick said.
“Up to eight residents with varying degrees of diagnosis live in each house and we have placed them according to their lifestyle preferences and the sorts of people they will get on best with socially,” she said.
“For example, someone with motor neurone disease who is very cognitively aware could be sharing a home with someone who has severe dementia.”
“We wanted to completely move away from traditional residential aged care where you have ‘dementia-specific units’, ‘dementia wings’, ‘high-care dementia floors’ and so on.
“Integrating residents with and without dementia provides a stimulating environment and improves the quality of life for all,” Ms Chadwick said.
Residents can pursue an independent life
“Our residents are free to pursue an independent a life as they can in a familiar environment that is close to normal,” Ms Chadwick said.
“Unlike traditional aged care nursing facilities, residents are part of a suburban community living in one of 17 houses located across six streets.
“Our residents live in homes that are designed around their lifestyles and who they are as individuals,” she said.
Each property features ensuite bedrooms, sitting rooms, a shared kitchen and front and back yards. Each house has a ‘House Companion’ – a role that doesn’t exist anywhere else in the aged care industry – who helps out with daily activities such as cleaning and cooking.
“He has dignity, he’s got independence. I know he’s happy, and I know he’s safe.”
Ms Chadwick said she sees multiple benefits arise from the freedom and autonomy of small-scale living.
“Since opening in September 2017, there has been little or no sundowning, or late-day confusion and minimal nocturnal activity,” she said.
“We attribute this to several factors such as residents not having to stick to regimented meal times and being as active as they want, whether that’s socialising with friends and family in the café, performing household chores or catching a blockbuster movie at the cinema.”
“Preliminary research has also revealed a reduction in residents receiving prescribed medications such as antidepressants and antipsychotics.
“Increased appetite and healthy weight gain are also being reported as is a wider engagement with the community,” Ms Chadwick said.
NewDirection Care has also been able to successfully “deinstitutionalise” residents who have been transferred from traditional residential aged care settings and secure dementia units with reported severe behaviours.
“One of our residents has younger onset dementia and was previously in a dementia secure unit for many months until his wife, Angie, got him moved to NewDirection Care at Bellmere,” Ms Chadwick said.
“The difference is amazing,” Angie said.
“There is no amount of words to describe the difference. He has dignity again, he’s got independence. They cater to his needs rather than him having to slot into a system.
“I know he’s happy, and I know he’s safe.”