on one hand and towards protecting them from anything bad and to
doing no harm on the other hand. Dignified care respects the
individual personality and the right to self-determination and promotes
and esteems autonomy, because self-determination and autonomy
are important benchmarks for the quality of life of each human being.
Therefore, life in retirement and nursing homes should be as normal
as possible. Daily routine should follow the individual human rhythm
and not rules that have been determined arbitrarily by institutions.
During visits, some facilities lacked a cosy and appealing ambience.
They looked shabby and bare and were not personalised. In one
facility in Salzburg, the smell of urine and faeces was noticeable even
in the dining area.
For elderly people, in particular those who suffer from dementia, a
daily routine that resembles normality is very important. In this respect,
many retirement and nursing homes are attempting to find their own,
new approaches. For example, nursing wards are set up as house
communities. They are built around live-in kitchens, where food is
freshly prepared together with the residents and other daily activities
take place. Specially trained staff is available to create the daily routine
with the elderly – and not just for them. However, they themselves do
not carry out any nursing activities. In smaller units that are furnished
in a homely way, residents can participate in meal preparation,
cooking, folding napkins, ironing, etc. and experience personal
attention and appreciation that is perceived as important. Even if
participating in these activities is no longer possible, memories of
favourite dishes or family celebrations are triggered by smells, which
has a positive effect on persons with cognitive impairment. The goal is
to create a familiar living atmosphere that gives those with dementia
security and a feeling of safety, thus creating the feeling of being at
home.
House community
concept – “live-in
kitchen” and
“living.room”
The house community concept is also suitable for larger retirement
and nursing homes. It can minimise the structural deficiencies of large
facilities by implementing activities and addressing the life biography
of the individual residents. This type of offering can also be set up in
accordance with regional particularities, e.g. in a Lower Austrian
facility as “live-in kitchen” (“Kuchl”) or as “living.room” (“Wohn.Zimmer”)
in a facility in Vienna. In order to realise the house community concept,
appropriate staff framework conditions are necessary. In a retirement
and nursing home in Carinthia, Commission 3 found that this model is
also bound to fail completely if there is no assisting staff to implement
it.
Mealtimes and bedtimes are indicators from which the culture of
facilities, i.e. the level of autonomy and individuality, can be derived.
Retirement and nursing homes must also take into consideration to a
greater degree that they are providing a home for people with very
different habits and needs who want to retain their accustomed
Permitting autonomy
and individuality
32
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