A good friend wrote the following:

Which of the nursing homes would you like to be in?

If moving into a nursing home was a free service for everyone who turned 80 and was not based on a decision of assistance, the layout would look completely different. Imagine that people come to your home to see if the apartment is nice and if the staff seem good. There are municipalities that remove the requirements for assistance decisions for moving in over a certain age and where there is a surplus of apartments in nursing homes. Do they choose your nursing home?

Safety requirements at a nursing home
When a new care home is to be built, there are lots of requirements. It should be fireproof, have evacuation routes and extinguishing equipment. There are requirements for care hygiene standards and the size of the apartments, that it should be accessible for people with functional variations, disabled toilet, door width and much more.

However, when it comes to balconies and windows, the safety thinking seems to end. There have been several accidents where elderly people have fallen from, for example, a balcony with low railings. Similarly, architects and clients probably rarely think about the experience of coming to live in a home. It happens that newly built houses have a quiet, grey and empty entrance and that there are technical solutions that are not at all adapted for the nursing assistants who will work with them.

Every summer comes a period of heatwave. This means suffering and in some years even excess mortality among the elderly and frail. Air conditioning should be a natural feature in a home where elderly and frail people are to live and be cared for.
The dream nursing home

In Vellinge, Förenade Care has been commissioned to develop an existing residence into a dementia village. The idea is that those living in the nursing home should be able to move freely indoors and outdoors. Their concept includes a fitness and wellness facility, café and shop within the nursing home. Everything is adapted for people with dementia. Here, the municipality has adapted an existing nursing home.

Imagine what can be done if these thoughts are included from the start. You can have small clusters of homes located around a carpentry workshop, a music studio or a sewing studio. To have nice walking paths with oases in the garden where those who wish can sit and hear the babbling of running water or drink a cup of coffee in the company of friends. Surely the use of medication would decrease, as would falls and other medical injuries. Role models exist in the Netherlands and Denmark.

Conscious architecture with color setting and common areas can reduce the feeling of confinement and give the residents freedom of movement. At the same time, nursing homes are still being built based on older ideas about what a nursing home should look like. Night lights in the bathroom can help to maintain the ability to independently take care of one's needs. Pictures in the corridor can facilitate orientation and finding one's own apartment. Perhaps it is possible to create community without long corridors.

Roof terraces, spa departments, gyms, a common dining hall and library are other things that can contribute to comfort and create a sense of belonging among those who live in the unit. With a stimulating environment, the residents can more easily maintain functions and staff can spend more time on social interaction, when the need for other care services decreases. Most of us never get the opportunity to build new even if we can dream. But there is certainly a lot that can be done within the framework of your nursing home.

The dream would be to come to a nursing home where the feeling is "Wow, here I can die happy".

Reflection questions about choosing a nursing home
Care staff:
• Are there things you could easily do at your home to increase comfort and activity?
• How do you want elder care to work when you one day in the future may need care and nursing?

Manager, nurse, occupational therapist and physiotherapist:
• What can you do to increase comfort, activity and other things that contribute to joy of life at the residence?
• Are there measures you can take to increase the stimulation for the residents to maintain functional ability, reduce fall risk or in other ways improve the environment?

Residents and relatives:
• Is your nursing home stimulating?
• Are there activities or services you miss?
• Do you see improvements that could easily be implemented in the nursing home?

Erland Olsson
Specialist nurse
Sofrosyne - Better care every day