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Anglicare Goodhew Gardens (NSW)

Alexander Avenue, Taren Point NSW

Challenging Tradition: Unlocking the DSU

Metropolitan - Residential - 80 beds/Consumers or more

Award descriptors

  • Dementia care
  • Leadership and culture
  • Living environment and/or sustainability

‘Unlocking’ of dementia-secure units (DSU) to improve the quality of life of residents by creating an environment which promotes control and values each individual’s personhood.

About the program

The provision of care for people living with dementia is, and will continue to be, a focus of attention in the Aged Care Sector. There is much documented evidence to guide clinical care decisions and the use of Meaningful Activities and Person Centred Care. Homes also have access to detailed information about making the physical environment appropriate to encourage independence and reduce confusion.

It is, however, time to challenge the assumption that it is necessary and respectful to keep people with dementia in a locked environment. Recommendations about locked dementia specific environments were developed at a time when the profile of aged care residents was different to that of today. Today’s residents are older, frailer and less mobile than even just five years ago. This should be a trigger for the sector to reconsider the need to keep these people ‘locked in’.

The very act of denying personal liberty by keeping someone in a confined space should be challenged. While the sector does adopt the approach that the need for freedom of movement should be balanced with the need for safety, most Homes interpret this by providing a secure unit within the confines of a larger facility. This approach denies people with dementia freedom of movement to access their whole Home environment. This approach has been justified as being more manageable and less confronting for a person with dementia.

The initiative taken by the Home challenges this assumption.

The project took a staged approach which firstly ensured the physiological needs of each individual were met through the use of clinical indicators and individual care conferences; secondly each individual’s personal interests, history and relationships were used to develop a program of meaningful activities which is used to reduce stress and provide meaning in people’s daily routine. Staffing changes were made to ensure appropriately trained Lifestyle Professionals were available to provide Meaningful Activities. While progressive, these stages are not unique in the Industry.

What sets this initiative apart from others in the sector is the unlocking of the dementia secure units within the Home. It is the trifecta of stages in this approach which truly addresses the three components of physical needs, psychological needs and the effect of the built environment.

Analysis of the environment was taken to a new level. Not only were the usual recommendations about furnishings, lighting, contrast etc considered; it was the effect that the locked environment has on the psychology of each individual that was emphasised. Unlocking the DSUs showed people dignity and respect. The positive outcomes for socialisation and reduction of behaviours of frustration and aggression demonstrate clearly that people have appreciated this respect; it has enhanced their quality of life.   

The Home is staffed with a number of third year nursing and occupational therapy students. Exposing these soon-to-be graduates to an environment which truly honours personhood by removing the barriers of restraint will help to shape the future of the Industry in a more respectful and empowering direction.

More information on this program

Mark Aros at or call 0438226211


Friday, 21 December 2018 - 6:23am