Personalised lifestyles and environments

What are personalised lifestyles and environments?

Personalised lifestyles and environments are activities and spaces designed and managed according to the preferences of older people. This means adapting activities and physical spaces to each person’s needs, preferences, identity, and rights. Personalising lifestyles and environments promote autonomy, privacy, dignity, freedom of movement, and meaningful social connections.  They also support safety by enabling independence and avoiding unnecessary restrictions. [1-7] 

Personalising lifestyle means involving older people in decisions about what they want or prefer doing, and where they want to live. Supporting them to connect with others who share their interests, and to engage in meaningful everyday activities, helps create a lifestyle that feels personal, familiar and fulfilling. [7, 8]

Personalising environments in residential settings means furnishing rooms with personal belongings, allowing pets and companion animals, and creating spaces that reflect the person’s identity and preferences. These approaches help maintain familiarity and comfort while keeping the environment safe. [9-12]

Personalising home care settings focuses on maintaining a safe, clean and well-maintained environment suited to the needs of older people.[13]

Why does this matter for rights-based care?

A rights-based approach to personalised lifestyles and environments prioritises dignity, self-determination, and choice, even when risk is present and residents need high levels of support. [4, 5, 8] Focusing too much on risks can reduce personalisation.

Environmental or physical design that supports individuality, dignity and privacy typically includes: 

• Smaller, homelike settings such as village-style and household models
• Private and semi-private spaces that genuinely protect privacy
• Access to outdoor areas, natural light, greenery and animals and, 
• Dementia-enabling spaces such as areas with minimal noise, clear signages, good lighting and simple layout, that reduce stress triggers. [9, 14, 15]

Personalised environments support autonomy by having open and semi-open spaces, allowing residents to move freely rather than keeping them in locked wards as a risk control measure. [4, 5, 16] In the case of people living with dementia (PLWD), having access to semi-open spaces and enclosed gardens provides freedom of movement and lessens agitation. [5, 16] Read more about dementia-friendly environment here.

Personalised lifestyles and environments allow residents to follow their own routines and activities and move freely rather than following rigid schedules. This approach improves quality of life, strengthens autonomy and can reduce reliance on psychotropic medications. [1, 5-7, 15]

Personalisation depends on staff capability, leadership support and available resources. [9, 16] Staff need training on person-centred, rights-informed, and privacy-respecting care. Managers play a key role in providing ethical oversight and ensuring adequate staffing levels and mix of people with different skills to avoid care that is mainly focused on task completion at the expense of person-centred care. [1, 4, 14, 17] 

The New Aged Care Act requires residential aged care facilities to support residents’ connection with animals. However, the legislation provides little practical guidance, creating challenges for providers around safety, liability, and implementation. Excluding companion animals often reflects the priorities of the organisation in avoiding risk rather than residents’ autonomy and wellbeing. [10, 11] 

Personalisation requires supportive governance and adherence to regulations. Refer to Strengthened Aged Care Standard 4 – The Environment for more information about providing human rights-based aged care services in a physical environment that is safe, supportive and that meets the needs of older people. 

Want to learn more?

• Read about how activities and living environments support the autonomy of older people in residential care in this article. 
• Read about the principles of human-centred design in aged care in this article. 
• The Australian Government describes how care should be responsibly delivered in older people’s homes and other settings in these resources: 

1. Services delivered in the individual's home
2. Services delivered other than in the individual's home

What can be done?

Person-centred activities 

Care teams:

• Support older people to make choices about everyday routines such as choosing when to wake up, eat preferred meals, or have a shower. 
• Encourage older people to continue their hobbies such as knitting or gardening.
• Encourage older people to take part in meaningful lifestyle and social participation activities. 

The evidence:

• Nursing managers thought it was important for residents to continue their individual routines, even when they lived in long-term care settings. [1]
• Offering choices in everyday activities and routines builds trusting relationships between nurses and residents. [6]

Person-centred environmental design 

Organisations:

• Create small, homelike spaces rather than large institutional areas. 
• Ensure private or semi‑private areas for personal time.
• Ensure access to outdoor spaces and greenery views. 
• Use design features that help PLWD, such as clear signage, less noise and uncluttered pathways. 

Care teams and family members:

• Use bedding, cushions or decorations that the older person prefers.
• Display photos, artwork, books or treasured objects.
• Arrange furniture to suit personal comfort and mobility.
• Encourage older people to spend time outdoors and enjoy natural light.

The evidence:

• The construction of new nursing homes needs to adhere to specific building guidelines about structural design to promote a dementia‐enabling environment; refurbishment of existing homes must also adhere to such guidelines. [4] 
• Facilities should adopt person-centred environmental design to protect privacy and dignity. Practical implications include tailored caring environmental modifications, investment in caregiver education, and strategic use of assistive technologies. [14]
• Small household models housing about a dozen residents enable person-centred care. They need to have ample natural light, outdoor greenery views, open-plan kitchens, lounge areas, courtyards and vegetable gardens that the residents can tend to. [18] 
• One way to personalise residents' bedrooms was to use furniture, ornaments, and photographs from their own home. [9]
• Facilities should adopt person-centred environmental design to protect privacy and dignity. [14]
• Physical environmental components (e.g., animals, plants, natural elements) offer many opportunities to incorporate meaningful activities into daily care practices. Residents can move more freely and have more control over their daily life than in traditional residential care, as they can participate in outdoor, domestic, work-related, and other activities. [15]

Policies promoting personalisation

Organisations:

• Embed person-centred care and personalisation in policies. Staff and services should be required to uphold dignity, autonomy and self-determination in all care decisions.
• Ensure that policies:

1. Recognise cultural identity, language, spirituality and personal history in care planning. Read the diversity theme here. 
2. Involve older people in planning their daily routines, activities and living arrangements
3. Support freedom of movement and avoid blanket restrictions
4. Support access to pets, companion animals or animal‑assisted activities, and
5. Promote social connection through community visits, interest groups, and cultural events.

The evidence:

• The lack of meaningful activities and inadequate community connection opportunities needs to be addressed. [17] 
• Care homes should reconsider blanket exclusions of animals and recognise residents’ needs. Reframing the concept of ’family‘ to include companion animals could support more rights-respecting aged care environments. [10]

Staff training

Organisations:

• Provide ongoing training about personalising lifestyles and care for older people.

Care teams:

• Seek training on finding ways to support residents in personalising their routines, activities and their spaces using respectful communication practices.

The evidence:

• Investment in staff training is needed to support communication and practices that respect privacy. [14]