What are physical and social environments?
The physical environment refers to the spaces and surroundings where older people live. This includes their houses and the residential aged care facilities. Social environment refers to the people, interactions and relationships and the overall atmosphere that older people encounter and experience in their everyday lives. [1]
How are physical and social environments barriers to rights-based care?
Physical and social environments can become barriers to rights‑based care when they limit older people’s ability to exercise choice, autonomy, dignity and participation in decisions about their lives. [2, 3]
Environmental and structural limitations such as poor design and layout of spaces, shared rooms, lack of private spaces, and surveillance technologies can restrict privacy and personal expression. [2-4] Funding limitations can also affect the quality, design and functionality of residential aged care environments. [3, 5] Read more about funding constraints.
Environmental and structural limitations can contribute to rigid routines, risk-averse or over-protective practices, restrictive practices and negative attitudes, especially toward sexual expressions of people living with dementia (PLWD). [2-4]
Social environment, including organisational culture, staff attitudes, activities, routines and power dynamics, can undermine rights when care is task‑focused and risk‑averse. Rigid routines and activities, workforce constraints such as understaffing and discrimination towards older people, may override their preferences, limiting their participation in decision-making.[2-4]
How are physical and social environments enablers of rights-based care?
The design of the spaces and environments older people live in should consider their rights to meet their physical and social needs. Physical environments that prioritise privacy, dignity and participation support residents’ autonomy, relationships and wellbeing, including sexual expression. Social environments that prioritise well‑trained and adequately staffed workforce that understands and respects residents’ rights and choices, maintain dignity and encourages participation. [2, 3, 5]
Home‑like settings and design approaches that provide private and flexible spaces promote intimacy and sexual expression and enhance independence, safety and privacy. [5] Small household and village‑style models, along with personalised environmental adaptations and assistive technologies, can enhance independence while maintaining privacy. Spaces can include features such as natural light and outdoor access. [3, 5] Read more about personalised lifestyles and environments and right to privacy.
Social environments that support rights‑based care are characterised by a capable and adequately staffed workforce that understands and upholds residents’ rights and choices. Environments with staff that foster respectful and inclusive cultures, supported by effective communication and cultural competence, enable residents to exercise choice and participate in less rigid schedules. Access to community engagement initiatives, including intergenerational programs, further strengthens social connection, inclusion and a sense of belonging. [3, 5]
What can be done?
Promote private and personalised environments
Organisations and aged care leaders:
- Review design and layout of physical spaces. Identify areas that can be improved to enable privacy, sexual expression and a good sense of wellbeing.
- Enhance and personalise environmental features. For example, ensure ample light for environmental safety, provide garden access for those who enjoy outdoor spaces and set up cafes to promote social connection.
The evidence:
- Enhancing privacy requires personalised environmental adaptations. [3]
- Design features such as access to natural light, views of greenery, open‑plan kitchens, shared lounge areas, courtyards and gardens can support resident participation and daily engagement. Village‑style layouts with on‑site amenities, including cafés, shops and expanded outdoor spaces, can further promote social interaction and meaningful engagement. [5]
Provide training on human rights approaches and communicating with older people
Organisations and aged care leaders:
- Provide training on human rights approaches across all levels of care in the organisation.
- Develop and implement targeted communication strategies to strengthen the needs of staff on English language and cultural competency, especially for migrant workers. This will support the active engagement of a culturally diverse workforce.
The evidence:
- Workforce training in human rights, communication and cultural competence enables the delivery of care that supports resident choice and autonomy. [3, 5]
- Improved communication can be supported through English language development programs, especially for migrant workers, and by actively engaging a culturally diverse workforce. [5]
Provide several opportunities for social connection
Organisations and aged care leaders:
- Ensure that there are different options for social and community engagement that meet older people’s needs and interests.
- Build partnerships with different age groups, community groups and seek volunteers to broaden and enrich activity programs. Promote intergenerational programs and assist older and younger people in discovering common interests.
Care teams:
- Take time to know older people in care. Listen, observe and talk to their families to know how to support their best interests.
The evidence:
- Governments and aged care providers should promote the continuation of existing relationships and the development of new connections within the wider community. However, social opportunities need to be tailored to individual needs. [5]
- Well-designed programs can also bring older and younger people together to explore shared interests, exchange knowledge, and build lasting relationships. [5]
Want to learn more?
Refer to Strengthened Aged Care Standard 4 – The environment and Standard 7 – The residential community, for more information about providing human rights-based aged care services in physical environments and residential settings.
ARIIA has developed resources for meaningful lifestyle and social participation activities.
Read Social participation in Australian residential aged care: A human rights perspective to learn how a human rights–based framework can guide governments in addressing older people’s need for social connection in aged care.