hello2019@wearehuddle.com

wearehuddle.com

+61 3 8376 7575 HUDDLE CASE STUDIES 2019 • MELBOURNE, SYDNEY

Mapping the aged care journey to better support customers and families through the final stages of life with Arcare.

Case study.

Desired outcomes • Customer experience

• New Value Creation

• Service innovation

Tools used • An experience map.

• A report that guided the Arcare team through the research:

• Nine core insights to direct future work and innovation in an evidence based way

• Five design principles to guide decision-making

• A set of key opportunity areas to take specific action on

• A step by step guide to using all the tools and taking action

Brief/Challenge Arcare wanted to know how people wanted to feel, and what they wanted to know, during the Aged Care journey so that they could better attract potential residents and care for both residents and their families in the journey.

The challenge—How can we understand what the experience of residents and their families is like now and where it falls short so we can design experiences that better meet their needs during exploration of aged care and through their time with us?

Our approach We set out to understand what the current experience of aged care at Arcare is like, so that Arcare could make decisions and changes grounded in knowing what will meet people’s needs.

We approached our research with deep face-to-face interviews with residents and online research with their loved ones. Our contextual based enquiry working with residents and influences allowed us to understand what it was like to be them and what it felt like to go through the aged care journey with Arcare.

During the synthesis and analysis phase of our research Huddle hosted an Ideation workshop for senior leaders of Arcare’s management team, where we co-designed possible solutions to the findings we had uncovered. This session was invaluable to support the Arcare team in understanding and implementing the research within their organisation.

The real problem (what we discovered through research) We discovered the aged care journey can be lonely, it’s a journey of shared grief, and that love fuels that journey. We also discovered the loved ones of the residents were not only supporting them through the experience, but they too were customers of Arcare, for the entire experience. This insight created a new journey of two experiences parallel to each other within the research, not just the resident journey with elements of the families experience. The experience of the families needed to be supported by Arcare, just as much as the experience of the resident in entering and exiting aged care.

Outcome Ageing, seeking care and death are universal experiences and every particular experience of those is unique. Clients and their families bring their entire lives to this journey. Their life experience, their cultural context, their family dynamics, their spirituality and their beliefs all shape their individual journey.

Our research helped Arcare understand what deep needs and drivers people coming into aged care have, and how they could be applied broadly across their customers. The tools we created have helped Arcare leaders and staff at all levels make changes and decisions that really deliver care and peace of mind in every action and interaction.

The work enabled Arcare to proactively create great experiences for older Australians and their families to support them at a challenging time in their lives.

39 ✔ The bond was released within 14 days.

1 ✔ Being prepared gave me a massive head start when the accident happened.

2 ✔ I loved the food at my hospital. ✘ The facility for rehabilitation

was horrendous.

3.1 ✘ The preparation was hell on earth.

3.2 ✘ I was only given five days notice to get out of the hospital and find an aged care home.

4 ✔ We support each other. ✘ I can’t get anyone in my

family to agree. ✘ Why won’t my family help me?

5 ✔ Myagedcare.gov.au is a massive help.

✘ It is all so confusing. ✘ It is very time consuming. ✘ The ACAT assessment was

very stressful for my loved one.

6 ✘ I can’t do the assessments on my own.

7 ✔ The broker makes it so easy.

8 ✔ The website is clear and helpful. ✔ Phone calls are great for

personal contact. ✔ We have friends at Arcare

who are very happy. ✘ Anyone can say anything

in a brochure or website.

9 ✔ I know clients and staff from when I visited friends at a home.

10.1 ✔ I can talk to clients to get their perspective.

✔ A site tour is so valuable to us. It is great to look around and get a personal feel.

✔ The staff member is so friendly. ✔ I can see that the clients have

a choice of where they eat. ✔ The staff are so friendly and warm. ✔ The staff are very happy to help. ✔ The residence feels more like

a hotel than a typical aged care home.

✔ The residence is so clean and new.

✔ It has a lovely garden for clients to enjoy.

✘ I didn’t see any clients. ✘ I visited a non Arcare residence

and all they talked about was cost. ✘ Some non Arcare residences were

very institutional. ✘ They told me a room was available

and it was devastating to find out the room wasn’t suitable.

✘ I can’t really judge the activities on a printed list.

✘ The residence is sterile and like no one lives there.

10.2 ✔ The residence is beautiful and smells nice.

✔ It is nice and clean. ✘ I can’t really see any clients. ✘ They brushed me off because

I didn’t have any money.

11 ✘ My loved one couldn’t visit. ✘ My loved one wouldn’t view

any material. ✘ I don’t know if my loved one

will like it.

12 ✘ I have no idea what it’s going to be like.

13 ✔ I get to try this out.

14 ✔ The manager is really supportive and compassionate.

✔ The manager is caring and negotiable.

✔ The application was processed in days.

✔ It was seamless and professional.

✔ They made one-on-one time and we finished it in a single day.

✘ At times it is really hard to get through to the manager.

✘ Paperwork is a pain to fill out.

15 ✔ They recommended a financial advisor.

✘ Everything with finances is hard for me.

16 ✘ They pressured me to sign the contract.

17.1 ✘ Organising the little things is so stressful.

17.2 ✔ There isn’t enough room for the things I love.

18.1 ✘ Co-ordinating my loved one’s arrival was chaotic.

✘ We arrived and there was no-one to greet us.

✘ We almost ran out of time to meet the cut-off.

18.2 ✘ I didn’t get any introductions. ✘ I was upset, but who could I

talk to? ✘ I feel so overwhelmed. ✘ Handing over my medicine felt

like I was handing over control.

19 ✘ I had no idea it could be so traumatic.

✘ I had to leave because my loved one was so upset.

20.1 ✔ The manager is kind and compassionate to me.

✔ The staff are going above and beyond to help us.

✔ They settled my mother despite her being difficult.

✔ The nurses’ calmness is very reassuring.

✔ They helped me be clear and on the process.

✔ The nurse took time to answer my questions.

✔ Many staff dropped in to say hello. ✘ They couldn’t settle mum. ✘ They didn’t give me support

and comfort. ✘ They didn’t tell me this happens

all the time. ✘ They are asking the same

questions that were asked previously.

20.2 ✔ They make me feel like a queen. ✔ I feel that whatever I want, they

will do.

21 ✔ The private dining is a nice touch. ✘ Lunch in the dining was too soon

for my loved one. ✘ The lunch food is not a very

high standard.

22 ✘ I don’t know if I can stay and I can’t feel at home.

✘ I don’t know what to bring.

37 ✔ They supported me emotionally and shared their love for my loved one.

✘ We needed more support. ✘ The staff seemed inexperienced in

supporting a grieving family.

38 ✔ The staff were quietly attentive. ✘ I felt my parent (a client) was left alone

when my other parent (also a client) was in palliative care.

✘ I felt my parent (a client) could have used some counseling when their partner (also a client) was in palliative care.

✘ Some of the staff weren’t familiar with my loved one.

✘ The staff seemed inexperienced in dealing with a dying patient.

✘ We had to ask the staff several times for adequate pain relief.

23 ✔ I love the special days. ✔ The events are so professional.

For Oktoberfest they decked out the room.

✘ Everyday is the same here.

24 ✔ Dealing with head office is easy. ✘ We pay fee for facilities even though

we don’t use them. ✘ I worry about running out of money

at the end for my loved one. ✘ We pay for foxtel, alcohol and

internet when it is irrelevent for our loved one.

25.1 ✔ I sleep well knowing my loved one has settled.

✘ I wish I had not visited as my loved one is so unhappy.

25.2 ✔ I love my Saturday and Sunday’s when the kids come.

✘ I can’t ask my family for more. ✘ I feel like I put pressure on my family. ✘ My family is so far away.

26.1 ✔ It’s the little things like a quick pop in to say hello.

✔ My loved one tells me she loves it. ✔ Staff are so friendly and supportive

of my loved one. ✔ They always have a smile on

their faces. ✔ They encourage my loved one

to be independent. ✔ They are always so patient,

respectful and inclusive of my loved one.

✔ They treat my loved one like a king or queen.

✘ The staff aren’t responding to my loved one’s pain.

✘ The staff are mean. They told my loved one to wear a diaper instead of getting up in the night to go to the toilet.

✘ The staff are so clinical and not empathetic.

✘ The staff treat my loved one like a child.

✘ There aren’t enough staff to get my loved one up for meals.

✘ It can take quite a while for a staff member to come.

✘ Some staff are resistant to making extra effort.

✘ Some staff don’t know how to support my loved one’s disability.

26.2 ✔ The staff are caring and beautiful. ✔ The staff are sincere with me. ✔ I like that the staff are happy to help. ✔ The staff go above and beyond.

One did my hair, another brought in a phone book.

✔ The staff help me choose my clothes.

✔ The manager helped me with my personal affairs.

✔ The staff were very happy to fix my issue.

✘ Many of the staff can’t clearly communicate. They are hard to understand.

✘ The staff don’t listen to me ✘ Some staff are very office like. ✘ I don’t know the staff’s names. ✘ Some staff don’t know

my capabilities. ✘ I am left until last because I am easy

to deal with. ✘ The new staff member no longer

invites me. ✘ They are understaffed. I have to wait

long periods. ✘ I don’t think the students and carers

have enough expertise. ✘ The new manager isn’t as willing

to help.

✘ Extra travel is so expensive. ✘ I raised an issue, but feel like

nothing’s happened. ✘ The staff didn’t do enough about

the theft. ✘ I don’t know who can help me.

26.3 ✔ I feel like I know the staff quite well. ✔ They know my name and show

compassion for us. ✔ They always give me honest

information and I appreciate that. ✔ They care and make an effort when

I have personal difficulties. ✔ The staff showed they wanted to

help and explained how things work. ✔ I like that the staff keep me informed ✔ The managers keep me informed. ✔ I speak up if I’m not happy and feel

I am respectfully heard. ✔ The staff are always good to deal

with on issues and happy to help. ✔ I like being informed by phone.

✘ The nurse spoke aggressively to me. ✘ I don’t know their names and they

haven’t introduced themselves. ✘ I want to know more about my loved

one’s health. ✘ They should have case reviews. ✘ There is not a lot of communication

unless I ask. ✘ I am happy to check-in for updates,

however sometimes I can’t find anyone to give me info.

✘ They tell me there is a shortage of staff.

✘ I worry about the repercussions if I complain.

✘ The manual form for feedback is a pain.

✘ Things I have mentioned have slipped back quickly.

✘ I haven’t met the manager. ✘ They don’t need to call as often. ✘ I panic when they call.

27 ✔ I can see a doctor whenever I want. ✘ I’ve hardly seen a doctor.

28 ✘ The hairdresser cuts everyone’s hair the same.

✘ Not sure when I have an appointment.

✘ How do I pay?

27.1 ✔ It’s nice to be able to sit in the fresh air.

✔ Her room is very room with a large en suite.

✔ I have great chats with the barista. ✔ I enjoy spending time with my loved

one in the coffee shop. ✔ It is fun to interact with

other clients. ✔ The private dining room is wonderful

as it is hard for my loved one to travel.

✔ Getting to know other families helps us look out for each other.

✔ I feel part of the community. ✔ I feel at home at Arcare. ✘ I wish my loved was more active

and participated more. ✘ All I ask is for my loved one

to have a buddy.

27.2 ✔ The coffee shop helps me meet others.

✔ I like a different places to eat. ✘ I don’t want to associate with

the old people. ✘ Certain cliques dominate the

common rooms and the TVs.

28 ✔ It’s a great change to get out. ✔ I like going to the supermarket. ✔ Visiting the shops is a highlight

of my week. ✘ There is not enough room

on the bus. ✘ My partner struggles with outings. ✘ I can’t go because of my walker.

✘ I spend hundreds of dollars a month on taxis.

29.1 ✘ The bus is unable to accommodate my loved one.

✘ There are no activities the loved one is interested in.

29.2 ✔ The staff come and ask me to attend.

✔ The range of activities is great. ✔ Activities help me meet other people. ✘ The staff don’t come and ask me to

participate anymore. ✘ There is nothing happening

on weekends. ✘ The current range of activities is a

bit boring.

30 ✔ I could change my room to be close to my friends.

✔ I like that I can see the street from my room.

✔ I love my garden.

✔ The bird feeder makes it feel like home.

✘ I find it depressing that there isn’t enough space.

✘ The hardest thing to accept is that there is only one room.

✘ Everything is ‘hard’ here. The floors, the walls, the rooms.

✘ I can’t forget my home.

31 ✔ I love my fridge. It has all the things I like.

✘ I don’t have enough choice. ✘ Where are my eggs? ✘ Food is not to my liking. ✘ The food makes me feel sick to

look at. ✘ The food in the first week was great,

now it is uneatable.

32 ✔ I was introduced to my close friend at the dinner table.

✔ I like the conversation at the dinner table.

✘ I introduced myself to everyone and no-one turned their head.

✘ I was placed next to people I couldn’t communicate with.

✘ Dinner is too early. ✘ Having to watch others eat

makes me sick.

33 ✔ I love when my retirement village friends visit.

✘ All my friends are gone. ✘ Only one close friend left who

I can talk to. ✘ I get no visitors.

34 ✔ My friends help me through tough times.

✔ The staff are good at getting people with the same mindset together.

✘ It’s hard to make friends here. I don’t want to force myself on other people.

✘ The staff could do more to help us meet each other.

✘ I can only meet people at dinner. ✘ I find it hard to get through

the cliques. ✘ The class levels create a bad feeling.

People get snobby.

35 ✔ The things I like to do are possible here.

✔ My iPhone is my window to the world.

✔ The ipad is my source of knowledge and info.

✘ If I could get back to my hobbies that would be good.

✘ I love the Internet however no longer have access.

✘ They don’t know what I like to do. ✘ There is no one here to help with

my device.

36 ✘ When someone dies they don’t tell you.

A home away from homeThe Arcare aged care experience map

About this projectIn late 2018 and early 2019 Huddle and Arcare worked together to discover what the current experience is for Arcare clients and influencers so as to create better more meaningful experiences in the future. We used a human-centred design approach to understand deep needs.Our objective is to provide Arcare with practical, actionable insights and opportunities derived from customer research to connect you with what customers need and the ways in which you can design to meet those needs. We discovered key drivers for experience, insights around what really matters, areas for improvement and developed some Design Principles to guide future work.

The colour orange represents the client. Figures wearing orange are the client.Text in orange is a quote or point of view of a client.An orange line is a client journey.

The colour violet represents Arcare.Figures wearing violet are the Arcare people.Violet shading represents an Arcare residence.

Experience Drivers

L Understand my love for familyThe driving force for influencers and for many of the clients we spoke with, is undeniably the love they have for one another and the sense of care and familial duty they feel towards one another. They want to do the right thing by one another and to ease the burden for each other.

T Trust me so I can trust you Care of another human is a big deal. Clients and influencers need to trust Arcare to feel secure in their choices and confident of care. Customers go into the relationship with some suspicion, and trust is built over time through small and repeated actions rather than grand gestures.

CA Show me you care for meClients come to Arcare primarily because they need care. They know that their daily life is no longer possible without care, or their families know they need care.

V Show me you value meTo be seen and valued as a unique human is important to your customers. This applies equally for clients and influencers. No one wants to be seen a generic customer.

K Be clear and knowledgeable with meIn aged care having facts, as distinct from rumour or media claims, is important. Knowledge provides clarity on what’s possible and helps influencers, and to a lesser degree clients navigate a path.

SUSupport us through thisAged care is a baffling system for most. Customers value support and guidance. Practical and emotional support make the process feel less onerous and provide reassurance and certainty. They don’t want to feel alone in this big life change.

S Help me feel secureThe desire to know they have done the right thing is a key motivator for customers at the early stage of the relationship and to a lesser extent, later during the relationship.

CO Connect with me Both Influencers and clients tell us they value real human connection. They need help at all stages of this aged care experience and the help they value most comes with human relationships.

F Maintain my freedomCustomers told us that they believed independence and choice to be important elements for a positive aged care experience. Having a strong sense of still being able to do things matters. When independence and capability reduces choices and freedom, the little things increase in magnitude. For clients this is about their freedom to act and make choices. For influencers this is about regaining some of the freedom that the burden of care reduced.

Touchpoints

An Arcare residence Arcare website

Arcare marketing collateral Email from Arcare

Arcare brochure Phone

Friends and family Medical professionals

Professional services (e.g. broker or financial advisor)

WWW

Government Arcare carer

Key

How to read an experience mapOur Experience map has a number of components. Here’s how to understand and use them:

Phased experience: The phased experiences are the main stages of the journey for both clients and influencers. This is essentially linear and begins for both prior to investigating or discovering information about Aged Care in general and Arcare specifically. The phases are: The Lead-up to needing care, Exploration, Join (includes decision and application), Day One, Early Days, Ongoing, Final Days, and Exit.

Experience Drivers: Experience drivers describe the core desired experience of your clients and influencers. They reflect their motivations at different points along the journey. These experience drivers enable you to connect with the behaviours of clients and influencers so you can design with them in mind, helping you meet their needs effectively.

Narrative: The combination of actions, thoughts, and feelings for clients and influencers, these include:

Doing—this shows what influencers or clients are doing.Thinking—this shows how people are connecting at a cognitive level. It’s rational and grounded in the brain. Knowing this helps you create experiences that meet their needs for knowledge.Feeling—this shows how people are responding emotionally to the situation. It’s grounded in the gut or the heart. Knowing this help you empathise with your clients and influencers reducing the likelihood of unsatisfactory experiences.

Touchpoints: These are the main people, technology or places clients and influencers are interacting with at a point in time.

Pain and Delight points: These represent specific points at which something either causes pain and distress or happiness and delight.

The colour teal represents the influencer.Figures wearing teal are the client.Text in teal is a quote or point of view of a client.A teal line is an influencer journey.

Solid lines represent the pathways through the experience for the clients (in orange) and influencers (in teal).

Faded lines represents the additional actions of certain clients or influencers within the experience.

Solid lines with arrows represent sections of the experience that are non linear and repeat within the experience phase.

This is a future thought

Future thoughts highlight opportunities that support the needs of clients and influencers at key moments in the experience.

SU

SU

PREPARING FOR DEATHClients do the administration and logistics for their funeral and death. Most complete key administrative tasks well in advance including a will, POA and DNR. They have clear thoughts and desires for the funeral and the time after death. Some want fanfare and others don’t want fuss, a number don’t care.Most have discussed their wishes for the time after their death with their families.

Death of anotherClients experience the death of others at the residence.For some these days are very bad days. They notice that Arcare doesn’t always make them aware of another’s passing.

PERSONAL HOBBIESClients pursue their own hobbies.Many clients fulfill their needs through self organised tasks or activities. They thrive in the sense of purpose it creates. Many clients wish they had some way to reconnect with activities they once loved.

Arriving and settling at the residenceClients arrive at Arcare on their own or with their family and get to know the residence. Some arrive via ambulance. Others arrive with their loved ones. For many the first day feels traumatic and is a blur. They can feel disorientated and overwhelmed. They feel the loss of control and independence that some had anticipated previously.Those not there of their own free will react most strongly and negatively. They can feel trapped and hate the experience.

Selecting possessionsClients choose what to bring with them.For some clients this is an unpleasant experience. It’s a reminder of loss and those things that cannot remain in their immediate possession.

RespiteWhile respite can be mandated, some clients choose respite to trial a residence, or give their family a break. Others plan a short stay and choose to remain. They feel more comfortable trialling a residence without having to make more permanent decisions.

Visiting a short list.Some clients visit a short list of aged care residences. Others review marketing material. Some want to visit a shortlist prepared by their family. Other trust their family’s judgement and don’t visit at all, and instead view a brochure or webpage.

Finding quality aged care providersClients talk to friends and draw on their network’s experiences. Many clients are familiar with aged care residences and use those experiences as reference points. Where they don’t have personal experiences, they strongly value people they trust. Proximity to a key family member is a critical need, however some also have specific room requirements.

Completing assessmentsClients complete any assessments organised by their family.

A significant event catalyses their journey into aged care.For some it is a shock. A medical event that dramatically affects their ability to care for themselves.For others it has been a slow decline. A reduction of capability capped by a serious accident.

Preparing for death Many influencers do the administration and logistics for their loved one’s passing with their loved one.They discuss their loved one’s preferences for palliative care location, resuscitation and funerals. Some of these discussions have occurred well before their loved ones move into aged care.Many have completed questionnaires with Arcare and feel confident and clear of the arrangements that are in place.Some believe Arcare may not be aware of end of life wishes as the influencers have not been asked about this. For some, the desire for their loved one to remain in the residence during palliative care may not be known.

Visiting more frequentlyInfluencers visit more frequently in the early days.They want to help their loved one settle in.

A significant event catalyses the loved one’s journey into aged care.For some it’s a surprise, the last of many falls they didn’t know about. For others it has been a gradual decline. Many silently grieve for their loved one’s decline in health.

Making a decisionInfluencers decide their loved one needs to go into care or medical staff make the decision for them.Influencers worry and want their loved one to be cared for and safe. They feel responsible to help but can’t care for them in either their home or their loved one’s home. For some, the burden has simply become too great. Grief continues as they worry about the reaction, and question whether they are doing the right thing.

Preparing for aged careInfluencers prepare for their loved one to enter aged care.Many don’t know anything about aged care and are uncertain about where to start. Myagedcare.gov.au proves to be a useful guiding light. However, confusion and stress is common as they navigate the information and complete the ACAT and Centrelink assessments. For many this time is all consuming.

Working with friends and familyInfluencers are not the only one this transition affects.Some take comfort in the support of their family. Others are frustrated by the lack of help or an inability to agree. Those without support feel isolated and alone.

Researching aged care providersInfluencers explore different aged care providers, looking for the best fit.For all involved this is a big responsibility. They want to be certain of the care and hopeful for their loved-one’s happiness. They highly value the options of people and professionals they know and trust.For many, proximity is a foundational need and it is common for them to have noticed residences in their area.The internet is an important resource as they review websites for residence look and feel, services, availability and cost. Phone calls help them get a personal feel and greater clarification.Time pressure continues. Visiting residences

Influencers visit residences to understand the care and the liveability.

Choosing a residenceInfluencers, with their loved one or on their behalf, choose the residence they hope best suits.They are happy that their loved one will be getting the care they need. There is relief and achievement that a decision has been made. However, they feel anxious and worry about their decision. They don’t know if their loved one will like it there. They question if they are doing the right thing and worry about reactions.Those with support find great comfort in a shared decision.

Choosing a residenceSome clients choose the residence with their family, others have no involvement. For many the selection of the particular residence doesn’t appear to provoke many new emotions. They continue to grieve this transition, however most accept their need for care and support.

RespiteWhile respite can be mandated, some influencers choose it as a voluntary step in the transition.They use it to ease their loved one into the idea of aged care living. Some believe respite is a good opportunity to see how their loved one will like it.

Applying with ArcareInfluencers apply for their loved ones to stay with Arcare.Influencers highly value the speed and ease of the application process. They feel supported when staff personally help them with the application and feel grateful for the care given around a difficult decision.The securing of a place elevates relief and a sense of achievement for some. For many the uncertainty remains.

Arriving and spending time at the residenceInfluencers arrive with, or meet their loved one at Arcare. They spend time together.Feelings are mixed. Some are expecting difficulty and unhappiness from their loved one. Others don’t know what to expect or are hoping for the best.Influencers just want the arrival to run smoothly.

Loved OneInfluencers arrive with, or meet their loved one at Arcare. They spend time at the residence.The loved one’s reaction varies. Some loved ones are unhappy, whilst others are subdued. Influencers feel surprised and traumatised by unexpected levels of distress.

FamilySome clients spend time with their family.Some hide their feelings from family to avoid worrying them. Others express their unhappiness directly to those closest to them.

LeaveInfluencers leave the residence at the end of day one.Many influencers leave feeling upset and exhausted. Others feel guilty and uncertain as to whether they have done the right thing. Many feel relieved that their loved one will get the care they need.

Visiting ArcareInfluencers visit their loved one at Arcare.They want to spend time with their loved one.Influencers continue to use their experiences to evaluate and validate the residence over time. With validation of care, influencers’ desire for happiness for their loved one (socialisation and participation) becomes an increasing priority.

Spending time with loved oneInfluencers wish to spend time with their loved one during the final days.Many have strong preferences for the experience surrounding the final days of their loved one. Most want their loved one to experience a pain free death. Some wish for their loved one to be surrounded by family and friends, they fear their loved one passing alone. Others have very individual and specific desires. Many have not discussed these desires with their loved ones. Often they believe such a discussion will be traumatic.They expect to feel sad, desolate and helpless. Some anticipate they will be in denial.

DeathInfluencers need care at their loved one’s death.They will grieve. Some will feel relief in their loved one’s finding peace. Many will seek out time alone, and privacy, patience and understanding is appreciated.

Death AdministrationInfluencers organise the funeral and finalise Arcare administration.They want Arcare to talk them through the steps. They expect help with paperwork and administration to reduce stress. Some hope for support with funeral arrangements too.Payments and refunds are expected to be prompt and easy. Some worry about being rushed to remove their loved ones belongings whilst still grieving. They wish for Arcare to be compassionate and understanding.

Getting paid supportSome influencers seek out paid professionals to support their research.They simply can’t do this alone or don’t have the time. A broker helps them simplify the process and their decision.

Pre-emptive researchSome influencers pre-empt that their loved one may soon need care.They notice that it is more difficult for their loved one to manage, and begin gathering options for the future. Early discussions and completion of assessments can be tough, however they find it helpful in the long run.

Validating options Some influencers attempt to validate their choices with their loved one.Some loved ones will visit a shortlist of residences prepared by the influencer, whilst others simply view websites and brochures. A loved one’s lack of desire, mobility, or awareness of the pending transition sometimes prevents any validation taking place.

PriceInfluencers care about price, however it’s not the main consideration.For some, price is daunting and down right scary, however even then it is not the main concern. Price, however does create uncertainty around whether they can afford the room.

Preparing financesInfluencers prepare the finances for the transition.The financial aspect can be daunting. Some already have accountants and financial planners. For those who don’t, they feel the recommendations from Arcare are extremely helpful.

Completing the contractInfluencers complete the contract.Many will complete the contract on their own.Some will engage with lawyers or trusted friends or family to review.

Preparing for the moveInfluencers manage lots of “Life Admin” for their loved one.For many the sale of their loved one’s assets is another responsibility. Whether selling or moving, the things to organise can create a sense of pressure.

Move from RespiteSome clients change from respite to permanent care in the early days. They find that the care and living at the residence is to their liking.Some feel they’ve had the opportunity to overcome any fears about the residence and staff, discovering the friendliness and care is authentic and ongoing. For those that want to stay, the uncertainty of whether they are able to can be very distressing.The transition to permanent can also be saddening as some grapple with the idea that this is their new life, and struggle about which possessions to move in.

Declining healthClients wish to go peacefully, however vary in their desires for the final moments. They want it to be pain free. Some wish for it to be on their own terms. Some are ready to go now. Thoughts and plans about the final days are mixed. There are those who refuse to think about it, whilst others are curious.Some have specific desires and preferences. They may desire family to be close, or wish to die alone. Others want closure with family. Often these desires are informed by past positive or conversely traumatic experiences around death. Those with specific desires and preferences often haven’t communicated it to many people. Some believe it will be too traumatic to discuss with their loved ones.

Time in a medical facilitySome clients spend time in a hospital and/or rehab.For many this can be an unpleasant experience. Some leave hospital or rehab feeling that any other place would be better. Others are pleasantly surprised by the care, liveability and connection within the facility.

Making a decision Clients make a decision to go into care or the decision is made for them by family or medical staff. They grieve this new life stage and the pending encroachment on their independence. Many accept that they need care as they no longer feel confident or able to cope on their own. Despite acceptance, some feel sad as they never wanted to end up in a ‘home’. Others resist the transition, believing they don’t require the support. Feelings of being a burden on loved ones can be a factor in the decision. Getting help from family

Clients get help from their family. Some clients are simply unable to prepare on their own. Others seek support, where available, and trust their families to prepare the assessment, look for options and make the final decision.

Pre-emptive planningSome clients receive and act on advice to plan ahead.

Recognise here that clients have varying emotional states, don’t exert pressure or make things harder.

This is a good time to be gentle with potential clients, recognise they will present with a huge variety in readiness.

Be on the lookout for ways to encourage clients and influencers to align on expectations and reduce knowledge gaps.

Consider content that helps families have conversations about aged care.

Think about how you can support potential clients to know what to look for in care.

Consider how to put potential clients in touch with others who can offer assurance.

Consider how to give access to current client stories and voices.

Because trust is so important, think about how to help existing clients talk to their friends about Arcare.

Significant event

OUTINGS AND EXTERNAL TRIPSClients leave the residence.External trips are important to those clients who are able. They provide a nice change and break up the days and weeks. For many, these trips help them engage in additional activities that are individually important. They also enable clients to acquire and bring back items that are important to them day to day such as food, magazines and craft materials.

“ I feel the weight of this moment.”

LOVED ONEInfluencers spend time with their loved one.Their loved one’s emotional state significantly impacts how they feel. They wonder how their loved one is going to be today. When their loved one is happy, influencers feel content. When their loved one is unhappy, they feel worried, sad, and powerless. Influencers also grieve as their loved one’s hope and health declines over time.

SPACESInfluencers spend time with their loved one in their room and in communal spaces.There are those that find the room pleasant, however many prefer to get their loved one out of the room as they believe their loved one will be happier when outside the room. The coffee shop is an outing that supports some influencers’ desires to create socialisation and participation opportunities. Some influencers enjoy the common spaces themselves as these support interaction with other clients and their families. This interaction helps them feel part of the community. Conversely, others prefer more private spaces such as the courtyards and dining rooms.

ACTIVITIESInfluencers attend activities with their loved one.They believe their loved ones will be happier when active and social. Some feel worried that the activities don’t suit their loved one’s interests.

ROOMClients spend significant time in their room.The room is a central point for clients. It is the place from which they experience much of their day. They can make this space their own as they establish roots and a sense of home in their new environment. Here they pursue personally important activities and hobbies, such as knitting, gardening, crosswords, listening to radio, or watching TV. If the space or location isn’t right they will often move to find the right environment and setting. Be it close to friends, a room with a view, or away from dining areas.

FOODClients eat, however many aren’t happy.Food and eating gives shape to clients’ days. However, there are very few who are satisfied with the experience. Whilst some feel certain elements meet their needs, others criticise these same elements. Many clients criticise the quality and the consistency (day to day and over time). Some feel it has declined significantly since they first arrived. All feel that choice is important. However when one option is consistently of a particular ethnicity, they feel it’s not a real choice. Clients also feel really strongly about eggs and many want them more frequently. Early dinners are also found to be undesirable. They feel current platforms for voicing their concerns fall on deaf ears so they often give up.

DININGSome clients dine in the dining room. Others choose to dine alone in their room.The dining room is a polarising experience for clients. Some are content with their table and enjoy socialising with other clients. Others feel disheartened and disappointed with the table allocation. They believe they can’t socialise at their table. A negative first experience in the dining room often sets strong future expectations and some refuse to return. Certain clients struggle with the dining environment, they think the eating habits for clients are unappetising or disruptive.

SOCIALISING INTERNALLYClients socialise with other Arcare clients.They interact with other clients, however many feel that don’t have close friends. There are those who believe it is hard to make friends and want the staff to do more to help them do this. There are many who describe themselves as loners and feel content with time on their own. However, these same clients flourish when seeing their old friends. Those with active social lives feel happy and connected. They like that these connections keep them active during good times and support them during bad times. Some clients describe cliques (social and class based) that stand in the way of connection between themselves and others.

FAMILYClients spend time with family members.For most, the residence location was chosen due to proximity to key family members. Family visits are often a highlight of their day or week. For many these days are their happiest. Those that receive few visits are saddened by this. Families also play an important role in providing additional support. They help the client handle their affairs, help them day-to-day and take them to a variety of appointments. Clients feel they are a burden to their families when asking for help.

STAFFClients interact with staff.Clients want to be building real connections with staff. They would like staff to recognise them as a whole person, including who they are as an individual and what their physical and emotional needs are. High levels of service are also expected. Closeness between the staff and clients has a shadow side. Some clients are aware of negative operational factors that undermine their perception of care (e.g. staff shortages). There are also those that feel they get service last because they are accommodating.

Supported by ArcareInfluencers want communication and support.They want prompt and clear advice when their loved one’s time is near. They expect support and comfort during this difficult time and reassurance is important to them. Some want space and privacy and others worry that staff’s familiarity (and potential numbness) with death might impact their ability to sympathise and provide support.

Cared for by staffInfluencers want expert and personal care for their loved one.They expect staff to be attentive to their loved one’s needs and to treat them with dignity. They appreciate when staff with personal relationships go above and beyond.

SU

SPACESClients use spaces other than their room in the residence. Some utilise the lounges and like that staff set TVs to display major events, like tennis.Others avoid common areas because they don’t enjoy being around high care clients. They can find it depressing and don’t want to associate with them.Those who visit the coffee shop feel it adds variety to their day. For them it provides an opportunity to be social.

ROUTINEClients settle and fall into a routine.Most, and even those resistant to being in the residence, feel the care they are getting is great and are grateful. For some this accompanies a sense of relief for both themselves or their partner. However, many feel that everyday is the same. Lack of milestones and markers for internal commitments and appointments make it hard for them to differentiate days and weeks. Special days (a break from the routine) and events bring great joy and variety.

STAFFInfluencers observe staff interactions.They want to see staff building relationships with clients. Influencers think... ‘Are the staff friendly and caring? Are they personally connecting with my loved one?’ They want to see staff treating their loved one as a whole person. They consider... ‘Do staff understand my loved one’s emotional and physical needs? Do they treat them with dignity and respect and recognise their individuality and independence?’ They want to see a high level of service. They assess... ‘Do the staff have expertise, Are they happy and positive? Are they attentive and prompt?’

MANAGING FINANCESInfluencers manage their loved one’s finances.For many it is automated or low touch and they generally enjoy the ease of this interaction. When contacting head office they like the clarity and support provided.

ACTIVITIESClients participate in activities arranged by the residence.Many clients partake in one or more activities offered by the residence. The type of activity varies according to capability and preference, however exercise is common. They feel it helps them keep busy, be social and happier.Invitations to participate in activities help some feel included. However, when this stops or barriers exist they can feel excluded. Many clients like having the choice, though they don’t want to actively engage. Some don’t participate because of barriers in physical capability, whilst others don’t love what’s on offer.

EXTERNAL FRIENDSClients socialise with external friends.Many clients feel they have few or even no external friends left. Most make and receive phone calls to friends who are both near and far and some receive visits, though mobility and proximity impacts visitation significantly. Clients who lived locally prior to moving to Arcare often receive more frequent social visits from their community.

SpacesInfluencers spend time in different spaces at the residence.They spend time in their loved one’s room.Some have lunch in private dining rooms, whilst others eat in common areas. These moments for connection feel nice, however they care most about whether their loved one is settling or will settle.

StaffInfluencers engage directly with staff and observe interactions with their loved oneDuring a difficult day they appreciate support and comfort. They feel assured when clarity about the present moment and future is provided. They want to feel secure that the care matches expectations. Are staff being personal? How are carers interacting and helping my loved one? Do carers go above and beyond? Influencers get disappointed when expectations set during interviews don’t match the arrival experience.

SpacesClients spend time in different spaces, however they spend most time in their room.Some tour around the facility, others do not. Introduction to other clients also varies. Few value the tour on this day. The room becomes a central point for the day and some stay in there for the remainder. Others venture out for either private dining with family or in the dining room with others.

StaffClients interact with staff as they settle in.Some are suspicious about the true intentions of staff. They aren’t sure about whether the friendliness and kindness they see are fake to secure their placement. For others, staff attentiveness makes them feel valued and a great sign for the care to come.

Lead-up Exploration Join Day 1 Early Days Ongoing Final Days Exit

Think about how your website supports the influencer to get a “feel” for a residence and answers their questions.

Take into account that at this point many influencers do not know what exactly they are looking for. Offer guidance, expertise and reassurance.

Help influencers know what to look out for.

Think about how to give a visit experience and how to help a client know what to look out for..even if they can’t visit in person. Explore temporary respite as a less onerous decison.

Look for the best way to instil trust and confidence.

A visit is a time to ask questions to understand need as well as to answer questions.

Consider content that feels real…not staged.

Understand that respite can be seen as a smaller and less onerous choice.

Think about highlighting the relative ease of taking up respite care to support people making a big decision.

Consider how to help clients choose belongings and let go of possessions not coming with them.

Think about how you can make moving and locating possessions as easy as possible so clients do not feel they need to ask for help.

Consider ways to accommodate belongings and possessions that have meaning beyond their room.

Know how the client may respond on Day One and work to make the experience as good as it can be for them.

Think about the role you play in building trust at this stage.

Consider the spaces that will be most helpful for a client on this day.

Think about how your website easily creates a path for this planning stage.

Consider having a range of partners to refer people to via phone to make this stage easy.

Recognise in discussions that price matters and can constrain choice, but that is not the most important consideration at this stage.

Think about how to easily talk about price and value on the website.

Consider how your marketing material can meet needs for security and clarity.

During construction of new residences think about how to become trusted advisors in the community for those who are at early planning stages.

Consider how you will convey an honest full sense of life at the residence on a tour. Think about how best to meet needs by asking questions. Consider how you can you make tours available to as many as possible.

Think about how you can work with current clients to convey the experience of living in Arcare.

Consider ways of helping clients become familiar with the residence prior to moving if they have not visited.

Look at ways to make the respite experience flexible and easy to get.

Use respite as a chance to understand and help set expectations of care and happiness.

Bear in mind that this is the implementation of a decision. Keep the process easy so the hard emotions can be dealt with.

Recognise the conflicting thoughts and feelings influencers may be feeling at this stage.

This is a time to make sure you know expectations and help set them so the day goes smoothly.

Think about how you can create the best individual experience here. Work to eliminate surprise.

Consider how to help clients choose belongings and let go of possessions not coming with them.

Think about how you can identify any worries and concerns and help build confidence and trust.

Recognise that clients transitioning from respite to permanent care have varying emotional states. Look for opportunities to support them.

Think about how you could capture, maintain and act upon clients’ specific food preferences.

Consider how to support clients who prefer a later dinner.

Look for ways you could create a visible process for continous food improvement.

Understand that eggs are critical and explore ways to serve them more frequently.

Consider how you can create flexibility in the food you serve to support greater choice.

This is a time to check back in to foster trust.

Consider how you can build security and clarity by meeting expectations and helping set or re-set them.

Look at ways to identify room preferences early in the journey and help clients find a space that matches their needs.

Think about how you can help clients put down roots and convert their room into a home.

Recognise that the first dining moments are critical and carefully plan these first experiences.

Look for ways to bring together like-minded and similarly capable people together.

Look for ways to identify a client’s ‘people’ or ‘tribe’ early so that you help facilitate new connections.

Consider how to remove or reduce the pockets of ‘us and them’ that fracture community.

Think about how you can support and create direct connection between like-minded people.

Consider how staff can bring to life the key pillars of care in their interactions with clients.

Think about how can empower choice and freedom for clients.

Support staff to create authentic and open relationships with boundaries.

Here, be mindful that an influencer needs clear and succinct information to help them in a timely way.

Think about how best to support clients who need help getting assesments.

Resist pressuring people at this stage recognising the magnitude of their choice and need to advise or support.

Think about ways in which you can make this easy and support influencers at a busy time. Don’t make things harder for them!

Understand that influencers will be starting to look for different experiences now, as their need to validate care is met.

Look for opportunities to help them align expectations with their loved one.

Think about how you could equip influencers with the knowledge to cognitively and emotionally deal with the changes in their loved one.

Look for opportunities to create greater quality interaction between clients and influencers.

Recognise that influencers and clients have differing views of a good life. Seek out opportunities to create alignment.

Think about how you can support clients with their affairs to reduce pressure on family relationships.

Think about how you can surface and support client’s personal hobbies. How might you help them overcome or find workarounds to physical restrictions?

Consider how you can find new avenues for independence to help clients find greater satisfaction day to day.

Think about how you could lower the barriers to outings and trips.

Look for ways to provide access to the outside world and desireable items when clients have mobility barriers.

Think about how you can support clients to have sensitive conversations with their influencers.

Look for opportunities to reduce stress by helping align expectations and surfacing desires. Think about how to connect clients with those who can help them.

Consider how best to act and communicate when a client passes.

Think about how best to emotionally support clients on these difficult days.

Consider how to best help clients emotionally and cognitively prepare for the final days.

Understanding that often final day preferences haven’t been shared, consider how best to facilitate these discussions with clients.

Consider content that supports influencers to have sensitive conversations with their loved one.

Look for opportunities to reduce stress by helping align expectations and surfacing desires. Think about how to connect influencers with others who can help.

Consider content that helps influencers prepare for final days and moments emotionally themselves.

Consider how best to help each particular family. Look for ways for all service and care to be flexible and unobtrusive.

This is a time to allow space and look for ways to delay administrative issues.

Consider ways to offer personalised support that involves connecting the influencer with others.

Look for ways to assure influencers of support at this time so they have security and clarity at earlier stages.

Be clear about what Arcare can help with and make it easy to get that help. Leverage off the trusted relationship that has built over time to reduce the administrative burden.

GOING ON TRIPSInfluencers go on external trips with their loved one.

“Please don’t rush me.”

“ My head is ready but my heart may never be.”

“ I don’t want any fuss.”

“ Such a sad day.”

“ This is my new life now.”

“ Where is my home, now?”

“ Is it clean? Is it new? Does it smell good?”

“Please no more paperwork.”

“ I like it but will they?”

“ Are they friendly? Does it seem like a good place to live?”

“ I don’t know what I don’t know.”

“ Every day is the same.”“It’s a big day.”

Think about the role your spaces play in supporting or disrupting community.

Consider how great meaningful connection can be created.

Think about how you can create variety and new milestones in clients’ days and weeks.

Consider how you can capture existing opportunities for delight that already exist in a client’s week.

Think about how the three key pillars of care manifest in all actions and interactions within the residence?

Look for opportunities to support influencers to be clear about bills and charges and to enable easy solutions.

Think about how you can nurture a strong local community to enhance the social life of clients when they enter Arcare.

Consider how you enable and encourage socialisation for those with few or far friends.

Names are really important. Think about how everyone can know one anothers’ name.

INFLU

ENC

ER EXPERIENC

EC

LIENT EXPERIEN

CE

PAIN AN

D D

ELIGH

T POIN

TS

CA

CA

CA

CA

CA

CA

CA

CA

CA

CA

CA

V

VV

V

V

V

V

V

V

CO

CO

CO

CO

CO

K

K

K

K

K

K

K

K

K

K

K

K

KK

K

K

KK

K

K

K

L

L

L

L

L

L

L

F

F

F

F

F

F

F

F

F

FS

S

S

S

S

S

S

SS

S

S

SS

S

T

T

T

T

T

T

T

T

T

T

TT

SU

SU

SU

SU

SU

SU

SU

SU

SU

CA VCO L F T

Influencers interact with staff They feel good when they have rapport and familiarity with staff. They want to feel heard and personally supported.Influencers feel secure when staff keep them updated about their loved one’s progress. Many will actively seek out carers to get feedback. They like being included in their loved one’s care and appreciate honesty and openness. However too much information about operational challenges, such as staff shortages, creates worry. There are those that don’t speak up to staff about concerns due to fears of retribution for their loved one.Think about how you can help influencers build relationships with staff that are authentic and open.

Consider how information is shared and exchanged so that influencers feel they deeply understand their loved one’s wellbeing.

SU

SU

1

2

3.2

3.1

6

7

4

5

8

9

10.1

11

10.2

12

13

14

15

16

17.1

17.2

18.1

18.2

19

22

25.1

25.2

26.2

26.3

27

29

29

30

31

32

34

36

37

38

39

27

23

26.124

33

20.1 21

20.2

Arcare sought to understand and improve the experience for customers and their families entering and exiting aged care.