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Neil Eastwood presents at the 2018 LASA National Congress. Source: Twitter @StickyNeil

Lessons from LASA National Congress 2018

Aged Care Insite was on the ground in Adelaide this week for the 2018 LASA National Congress. Here’s a quick rundown of some of the presentations.

LASA’s 2018 National Congress Monday program included a seminar on Reframing Dying in Australia, with a focus on how best to address this taboo topic.

Stephen Ginsborg from the Sydney North Primary Health Network spoke of the stigma surrounding death in western society. He said doctors themselves are uncomfortable with the notion of death and that support staff should be included in the dying process long before someone passes, such as staff and the community preparing their goodbyes.

“It can be made less difficult when we have a competent community,” he said, arguing for more education about death literacy, including more understanding about grieving, dying and mourning to better understand care.

Looking forward

LASA chief executive Sean Rooney spoke about the rate of Australia’s rapidly ageing population – with around 2,000 people turning 65 every week and around 1,000 people turning 85 each week.

And with more than one million older Australians accessing services across our aged care system every year, the demand for services is increasing.

“Among this ageing population, we would see great diversity including Indigenous Australians, different cultural and religious groups, LGBTI Australians, those who battle disadvantage in various forms, and those who live in rural and remote areas of our vast nation,” Rooney said.

Global lessons

The ‘Building and Keeping a Care Workforce – Lessons from Around the World’ session investigated how 55 per cent of care staff employed in the aged care services industry are closely linked to those who need care.

“You only get it when you’ve done it,” author of Saving Social Care, Neil Eastwood, said in relation to why those candidates applied for the job.

He said that recruitment in the social work sector is much like any other – mainly through employee referral and word of mouth.

Eastwood said selecting a candidate involved a more nuanced process where you need to know how caring a person is, explaining it was unlike a Seek job application and that it wasn’t a ‘seagulls around the chip’ mentality. He added that only around 8 per cent of people are selected through this process.

And it isn’t just about the recruiters, as he argued candidates are also the customers in that they are willing to invest time and ask a lot of questions about the role.

Ageing well

Desmond Ford, head of programs and business development at COTA SA, spoke about the LGBTIQ People Ageing Well Project, a joint 12-month initiative by COTA SA and the SA Rainbow Advocacy Alliance (SARAA), which was designed to kick-start a consumer-led LGBTIQ movement for older South Australians.

It aimed to engage and empower members of the older LGBTIQ communities throughout the state by giving them a voice and encouraging them to help inform and shape policy and actions that may impact them as they age.

Ford said older LGBTIQ people in SA needed advocating as they aged with access to the mainstream system often proving difficult.

He said themes that emerged from the report surrounded health issues, confidentiality and resources, especially in rural and remote areas.

“How do we connect with people, what are the opportunities to connect? It’s easy to lose connections as we age,” Ford said.

One recommendation was to start a community visitor scheme as well as creating an opportunity for inter-generational storytelling.

He said another way to connect with the mainstream community is through housing, and there needs to be a better range of options like mixed housing.

He also pointed out the challenges faced in navigating the system with friends and family. Ford said common questions asked upon entering aged care are ‘how do we know if a service is LGBTI friendly?’ to understanding the bureaucracy.

“Some people don’t have partners, so they had to hide themselves for a big part of their lives,” he said

The project was funded by the state government and saw close to 200 people participate, including those who identified as LGBTIQ, with 15 consultations held at various locations, including regional centres.

Protecting your reputation

How do you protect the reputation of your aged care organisation in the face of media and public scrutiny?

That’s the question Gail D’Arcy, managing director of The D’Arcy Partnerships, posed to delegates at the LASA Congress.

Takeaway points from her presentation included doing the preparation work early on by identifying risks and fixing what is controllable, checking the facts and making sure the ‘spin’ is cut from your vision.

She said consequences include difficulty in attracting new residents, decrease in staff moral and damage to your reputation as a CEO or care provider.

“The better the communication, the better the business and the better the reputation,” D’Arcy said.

She added that good planning meant being ready – not getting ready when a journalist calls.

“In order to plan, you need to understand the risks and be prepared to change behaviour and culture. It’s the responsibility of everyone in your organisation,” she said.

“This needs to be embedded in your culture so that everyone knows what to do and what action to take.” Examples include being aware of issues like staff training, nursing ratios and background checks.

D’Arcy stressed that internal communications are vital, such as being transparent with staff, encouraging early identification of issues, and observing protocol.

Given the recent Four Corners report and subsequent Royal Commission, D’Arcy said a communications plan – such as having a media spokesperson or drafting statements for contingency scenarios – comes in handy.

However, she said whatever operational plan you have, you must make sure it’s consistent in terms of tone, manner or information.

Staying at home

What does it take for an older person to live at home until death? That’s the theme ECH chief executive David Panter explored in his presentation covering Level 5 HCPs – staying at home until death packages.

He said the aim of the level 5 HCP was to promote self-determination and enable people to have the best life possible as they aged.

“We want to have a system that encourages people to stay at home for as long as possible,” Panter said.

He said little was known about the care and services that can help older people to remain living confidently in the community until death. As a result, ECH commenced the EnRICH (Enabling Responsive and Individual Care at Home) pilot in September 2017.

The model was conceived to rigorously examine the type, quantity, construction and cost of care and services that could support someone at risk of permanent residential care admission to live independently until passing.

“Older Australians prefer to age in place, and the majority of people want that place to be their long-term home in the community; only 1 per cent report a preference for residential aged care,” he said.

“Over 40 per cent of people will require some level of assistance as they age; while formal community-based care and services are delivered into individuals’ homes by the subsidised Home Care Packages (HCP) program, these are not consistently successful in enabling someone to remain at home until death.”

Panter said the model came with additions like short-stay services and rapid response services.

The findings showed that three out of 12 people hospitalised returned home and were able to increase or maintain their social engagement.

Participant and carer network satisfaction was also high, with higher levels of engagement and communication leading to positive response.

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