A New Model in Eldercare

A New Model in Eldercare

Posted on April 20, 2014 by ElderCare Resources Phoenix in Blog, Caregiver Education, Education, Geriatric Care Management, Independent Living, Long Term Care Information

Innovative responses to ageing around the world

By: Emi Kiyota

The world’s population is ageing at an unprecedented rate. In year 2000, there were more people over 60 years than children under five. By 2030, there will be more people over 60 years than children under 10. By 2050, one in five people will be over 60 years. More worryingly, 80 per cent of the world’s senior citizens will be found in developing countries — with more than 180 million older people living below the poverty line.

This is a grim picture and there is more bad news. In addition to increased poverty, there will be more seniors with dementia, due to both better diagnosis and longer lifespans.

If current trends persist, the world will face a shortage of affordable housing for seniors as well as qualified caregivers. A high proportion of elderly will inevitably become an economic burden.

Fortunately, there is good news for our senior citizens. They are getting healthier and continue to contribute to society, either through gainful employment, volunteerism or looking after their grandchildren.


Through innovative design and thinking, we can take a different approach to eldercare. The traditional institutional model had a strong medical focus, where seniors were looked after by professionals in an efficient, hygienic and safe hospital-like setting.

In recent years, the institutional model has evolved towards a person-centric approach, with individualised care in a home-like setting to encourage elders to be more independent. In this environment, creating a sense of privacy, enhancing socialisation and maximising choices and sense of control became key considerations to enhance quality of life, rather than focusing on quality of care/treatment.

As society grows older and the needs of elders have changed, we are proposing a new model in eldercare — what I call the Ibasho concept. This holistic, integrated model of care encourages people to age within their familiar community, which involves medical professionals, caregivers, neighbours and elders at large.

Residents across different generations participate in community life, respecting local cultures and traditions.

What makes the Ibasho concept different from earlier models is that the elderly are viewed as useful members of the community, who are able to contribute with their wisdom and experience — and not as patients or unwanted burdens. This requires a social mindset change in the way seniors are perceived and cared for.

This concept has been integrated into designs in different communities around the world. In Sri Lanka, a charity organisation that provides homes for elders with no families created a multi-functional elder-centric community place that acts as a social hub for the local senior population as well as people of all ages.

In Bhutan, a series of small houses around a social gathering centre were built for retired elderly monks. Here, they can pursue spiritual growth and enjoy fellowship of colleagues.

In the Ivory Coast, a community project has begun to allow retired elderly priests who did not have any place to go to integrate with the local village and engage in teaching young community members through a variety of ways. In these environments, elders have an important social role in their community and are able to “care for” others, rather than always “being cared for”.


Across the world, homes for the elderly are now being designed with ageing in mind. Generally, most senior citizens prefer to live at home, maintaining their lifestyle and friendships, while also enjoying privacy and the benefit of a familiar, comfortable setting. Common spaces or informal gathering areas encourage socialisation and relationships across the generations.

For example, in the United States, as users age, their houses are adapted to include accessible features, such as ramps for wheelchair access; grab bars in the bathroom for better mobility; and non-slip flooring for improved safety. This allows ageing in place, providing elderly residents a greater sense of dignity and better quality of life. This approach challenges our societal expectation of “housing for elders” and proposes to create adaptable environments rather than accessible environments.

In the United Kingdom, aged care homes are designed to be versatile to fit with the changing needs of users as their physical and cognitive capacities change over time, so the space can be easily adapted. The plumbing, wiring and other infrastructure are laid out to accommodate future modifications.

For instance, a large apartment can be converted into a smaller one, with the previous kitchen turned into a large bathroom, since seniors may not wish to cook any longer, but need more bathroom space for toiletry aids.

In Japan, the Gojikara Mura Village was originally completed as a nursing care centre in the 1980s.

Over the years, new structures and programmes have been added, incorporating feedback from residents to meet their physical, psychological and social needs. This includes dementia care, assisted living, child daycare and a nursing school.

The objective is to create a multi-generational community, where people of all ages from the surrounding neighbourhoods can gather together. Parts of the campus were intentionally designed to be inconvenient and difficult to access, to encourage residents to seek assistance from each other or staff, thus promoting socialisation.

In this community, elders are not segregated or over-protected, but are a part of normal life. Elders as well as younger generations can enjoy a “normal” lifestyle, rather than a rigid, controlled “institutional” lifestyle.

The key to right elderly care lies in paying attention to the views and feelings of the seniors. It is only through understanding how the elderly feel and live, that we can create a truly innovative culture of eldercare.


Dr Emi Kiyota, an environmental gerontologist and organisational culture change specialist, is the founder and President of Ibasho, a social enterprise that creates socially integrated and sustainable communities that value their elders.

Published: TodayOnline.com