Aged Care Insite April/May 2013

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Information about Aged Care Insite April/May 2013
Health & Medicine

Published on March 10, 2014

Author: papaRACSi


Issue 76 April–May 2013 Positive ageing guide  Exercise  Diet  Sleep and more ... Quality care: Attracting the best workforce See page 18

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contents EDITOR Amie Larter (02) 9936 8610 Journalist Aileen Macalintal production manager Cj Malgo (02) 9936 8772 Jason Walker (02) 9936 8643 Graphic Design Ryan Salcedo National SALES manager Luke Bear (02) 9936 8703 SUBSCRIPTION INQUIRIES (02) 9936 8666 PUBLISHED BY APN Educational Media (ACN 010 655 446) PO Box 488 Darlinghurst, NSW 1300 ISSN 1836-1501 PUBLISHER’S NOTE © Copyright. No part of this publication can be used or reproduced in any format without express permission in writing from APN Educational Media. The mention of a product or service, person or company in this publication, does not indicate the publisher’s endorsement. The views expressed in this publication do not necessarily represent the opinion of the publisher, its agents, company officers or employees. 26 33 18 SUBEDITOR 38 Food safety concerns news 04 Unconventional approach Understanding the guidelines 40 Keep moving WA leaders’ future proof their sector Why exercise is vital 06 Mental health crisis 42 Muscle wastage Carers at risk of suicide New research offers possible solution 10 A person-centred approach New customer focused practice model unveiled clinical focus 44 Wound care management 11 The science of sleep Old-age sleep myths busted 12 Macular degeneration More than just a burden to sufferers 13 Living in silence Elderly avoid addressing hearing concerns 42 Victorian research breakthrough 48 Training required Benefits for carers dealing with dementia at home 14 Connecting seniors workforce 50 Opinion: Michael Fine 16 IT brainstorm 52 Stress less Social media platform bundles technology Consumer care forecast New forum promotes care improvements Managing workplace demands 54 Hitting the mark policy & reform 18 Recruitment issues The evolution of community care How to build a skilled workforce 56 22 Bid to improve wages Government’s $1.2 billion plan 24 Opinion: Kevin Rocks Compact not a long-term plan 26 NDIS shortfall? Bupa celebrates staff success 59 Answering changing needs 29 Positive ageing plan New aged care facility unveiled The impact of boomers on the industry technology 60 Opinion: Stuart Hope construction & design 33 A rise in demand Keeping meal times social Book tells HammondCare’s story 57 Night of living legends Celebrating living longer How the bill will affect over 65s practical living 36 Eat and meet community 56 Faith in action 58 Birthday bash Incorporating technology at home The aged care building boom Audited 9,215 as at Sept 2012 Knowledge must be increased 46 Cancer drug key to HIV 63 Data security 63 The dangers of hacking 66 Watching over the elderly New product identifies falls April–May 2013 | 3

news Futureproofing aged care L-R: Young Leaders Program participants Louise Forster (far left) and Joshua Hawes, (far right) flank Chris Hall, CEO of MercyCare (second left) and Dr Nicky Howe, CEO of Southcare S outhcare in partnership with MercyCare and Baptistcare are leading a new project to foster and promote the involvement of young leaders in the aged care industry. The project involves a four-month leadership program aimed at getting young participants ‘board ready’ for an organisation, as well as a series of six ‘unconventional conventions’ facilitating talks on how the industry can support more young leaders to join aged care organisations. “We are aiming to diversify the talent and knowledge of our board of directors and this includes engaging the perspective of Generation Y leaders,” said Dr Nicky Howe, CEO of Southcare CEO. “Young leaders can bring a renewed energy to the directors’ table while also showcasing a different understanding on areas such as social media, employee engagement and community volunteering.” Young leader Elizabeth Oliver, senior occupational therapist for Catholic Homes Inc agrees. “Young people are comfortable with technology, which offers the industry new and exciting ways of improving the lives of seniors, staying abreast of current events and promoting reminiscence. “ … Many senior staff members are much more risk-averse, which can stifle 4 | April–May 2013 creativity and innovation. “Young people bring fresh ideas, and are prepared to try ideas in new ways rather than thinking ‘we have tried that in the past and it didn’t work’.” Oliver said that the aged care industry is not really seen as ‘sexy’, with young leaders often drawn to areas that offer substantially higher salaries, such as mining. She believes that there is often a lack In developing a new generation of young leaders, Western Australia’s aged care leaders are taking steps to ensure the future of the sector. By Amie Larter of career path and access to personal development for young people in the aged care industry, so talented people move on. “Organisations need to embrace young leaders, as they are the future of aged care,” she said “It is a challenging industry and one that needs all hands on deck to foster and sustain change.” Howe hopes that the ‘unconventions’ will inspire a shift in thinking about the contribution that young people can make to boards and committees, as well as raise awareness about what attributes, skills and knowledge young people can bring to the sector. From the young leader’s perspective, Oliver believes this is an excellent opportunity to be engaged by inspiring business leaders and board members – gaining insight into a side of business she has never had the opportunity to witness. “I have worked for three large aged care providers over the years, and in all that time I have only met two board members in passing – boards to me have been like a secret service,” she said. “I joined this course to become informed as to how boards make decisions so that I can frame my proposals in a way that ensures their chance of success,” said Oliver. n Southcare CEO Nicky Howe believes young leaders offer the opportunity to develop: • Diversity of board membership: Age, gender, cultural background and sexual orientation. Diversity of membership can reduce ‘group think’. • Workforce planning strategies: Young leaders can offer valuable insights into the development of strategies to attract and retain young talent in organisations. • Board succession plans: With 29 per cent of boards in Australia made up of people over the aged of 60 years, it is a business imperative that we recruit young leaders onto our boards. • Service delivery models: The grandparent/ grandchild relationship is special, and through this relationship young leaders offer unique insights into what matters to seniors. • Board “behaviour effectiveness” guide: Research into board behavioural dynamics (social and psychological processes occurring between directors and between the board and management) highlights a number of cases of how ‘knowledge’ either the ignorant director or the know-it-all director can have negative consequences. • Social media stakeholder engagement strategies: Leverage the organisation’s business via a new medium.

Puppies behind gastro outbreaks Sexuality and dementia resource • Health officials have called for the banning of dogs within aged care facilities following two gastro outbreaks in a nursing home in Canberra last year. • Griffith University researcher Dr Cindy Jones has produced the first education resource for managing the issue of sexual expression among people with dementia. A four-month old puppy, the likely cause of the outbreaks, was removed from the home, and a panel of experts established to investigate warned that is should be banned from the home until it was a year old and deemed suitable for an aged care environment. Puppies are known to carry campylobacter gastroenteritis, a significant health risk to the elderly, according to the report. Sexualities and Dementia: Education Resource for Health Professionals aims to increase awareness of intimacy, sexualities and sexual behaviours specific to people with dementia. Based on national and international literature and research, the resource serves as a guide on how carers can better support them. It is also the country’s first e-learning resource that tackles issues faced by non-heterosexual people with dementia, including those who identify as lesbian, gay, bisexual, transgender and intersex (LGBTI). Stroke survivor numbers to double in 20 years • The National Stroke Foundation believes that the number of stroke survivors in Australia is set nearly double in 20 years, unless the government agrees to address the issue of funding for the nation’s second biggest killer. Stroke Foundation chief executive Erin Lalor believes that their calls for funding to reduce the amount of avoidable death and disability caused by stroke have fallen on deaf ears for too long. Over 420,000 people were living with in Australia in 2012 – an increase on the previous estimate of 350,000. Two thirds of those survivors were dependent on another person for daily needs. “This is a frightening level of growth and a figure that does not even include those carers who will have to give up paid work,” Lalor said. inbrief news Research group goes international • Research Australia has formed an international alliance with three other health research advocacy groups in America, Sweden and Canada. The four organisations – Research Australia, Research! America, Research Canada and Research Sweden – will collaborate to leverage expertise, advancements and approaches in health and medical research advocacy. Elizabeth Foley, Research Australia CEO, said that the collaboration will enable the organisation to learn from its key partners on how to best overcome hurdles faced in each respective country in the health and medical industries. The alliance will be evaluated after two years. April–May 2013 | 5

news Carer suicide link More than a quarter of carers have contemplated taking their own lives. By Aileen Macalintal O ne out of four people who provide care for a family member with dementia have contemplated suicide more than once last year, according to a Griffith University research. “We have known for a long time that caring for a person with dementia can lead to depression, anxiety, and poor physical health. These are all risk factors for suicide, but no one had ever asked carers whether they think about suicide,” said Dr Siobhan O’Dwyer. O’Dwyer, a research fellow from Griffith’s Research Centre for Clinical and Community Practice Innovation, led the study. The report, published in the International Journal of Geriatric Psychiatry, also found that one-third of those carers said they would likely attempt suicide in the future. Most of the approximately 300,000 Australians who have dementia are cared for by spouses or adult children in their own communities, rather than in nursing homes. About 200,000 Australians are currently caring for a person with dementia and some 6 | April–May 2013 of these spend more than 40 hours per week of feeding, dressing, showering and toileting. Researchers spoke to a sample group of 120 Australian and US carers. With the feedback and the data provided, carers were found to have contemplated suicide at a rate eight times that of the general population. “Carers who had contemplated suicide had higher levels of depression, anxiety, and hopelessness. They were also less satisfied with the support they were receiving from family or friends and made greater use of dysfunctional coping strategies. “They also reported more severe symptoms of dementia in the person they were caring for and said that they reacted more strongly to those symptoms. This information isn’t causal, but it does give us a sense of some of the factors that might place carers at risk.” O’Dwyer said the findings reflect what is happening in the community and provide a basis for future research. “Although more research is required to confirm this finding, there are clear implications for policy and clinical practice in terms of identifying and supporting significant number of carers who are already contemplating suicide,” the study concluded. Kate Carnell, CEO of national depression initiative Beyondblue, said being fully aware of the risk of the job may help carers emotionally prepare. She said carers need to talk with people around them to receive support from family and friends. There are also groups and organisations, such as Beyondblue, that offer counselling services. Carers Australia said they are aware that the population of carers is aging and is frequently experiencing disability and other health conditions. In particular, carers are also at risk of mental health disorders. They said caring has been shown to cause depression, fatigue, anxiety, sleep interruptions and stress-related conditions. “Caring for a person with dementia can bring both rewards and challenges. While carers can feel proud of the care that they provide for 24 hours each day, we know that they are often managing very difficult, challenging and sometimes distressing behaviours,” they said. Carnell said, “These things are further impacted by the demands of the caring role, which for each carer is different. “The important thing is that they get the assistance and support that they need.” n Carers Australia provides shortterm counseling and emotional and psychological support services for carers. For carer-specific support, call Carer Supports & Services toll-free on 1800 242 636.

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advertorial Who are Australia’s outstanding contributors to T he search for Australia’s top contributors to aged care has begun, with nominations now open for the 2013 HESTA Aged Care Awards. HESTA is recognising those people and organisations who demonstrate excellence, leadership and dedication in the aged care sector. The winners of the HESTA Aged Care Awards share in $30,000 of prize money, generously provided by long-term HESTA awards sponsor, ME Bank. HESTA CEO Anne-Marie Corboy said the awards are an opportunity to recognise the important contribution those working in aged care make in improving the lives of older Australians. “Like many other countries around the world, Australia has an ageing society with many people now living well into their 80s and even 90s,” she said. “The ageing of our population poses new challenges for health care and places increasing demands on existing aged care services and social supports. “Aged care professionals provide a wide range of services, from keeping older people healthy and living independently, to preventing and managing illness and providing high-level care to the frail. “People working in this sector also provide a great deal of emotional support to older people and deliver vital services in a compassionate manner, helping maintain their dignity and independence for as long 8 | April–May 2013 as possible.” There are three award categories — Individual, Organisation and Team — which acknowledge the breadth of services being provided to older Australians. The Individual Award recognises exceptional service by an individual who has significantly changed and improved the quality of service provision to older Australians. The Organisation Award recognises an outstanding contribution by an organisation, through the development and/or provision of high-quality care using technology to develop efficiencies and enhance the wellbeing of those in their care. The Team Award recognises health teams that have used collaboration and innovation to deliver better health outcomes for older Australians. ME Bank CEO Jamie McPhee said, “We’re proud to continue our support of the HESTA Awards program, recognising the tireless contribution of individuals and organisations in the health and community services sector.” Ms Corboy encouraged people to nominate an outstanding individual, team or organisation they admired as soon as possible. “If you know a dedicated aged care professional who is making a difference to the lives of older people, nominate them now,” she said. “These awards are an opportunity to acknowledge and reward the care and compassionate support aged care workers provide to the elderly in their home, or in a residential care setting.” Finalists of the aged care awards will be announced on 16 July, 2013, with interstate finalists flown to Sydney for the awards dinner on 4 August, 2013. HESTA is one of Australia’s largest super funds, with more than 750,000 members and $21 billion in assets. More people in health and community services choose HESTA for their super. Nominations are open until Friday 31 May, 2013. To make a nomination before Friday 31 May 2013 or to find out more about the HESTA Aged Care Awards, visit Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL No.235249 Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321.

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news Community care ‘my way’ Presenting the new 7-step approach to aged care case management. By Amie Larter M ajor community care provider, Care Connect, has launched a new service delivery model – My Life, My Choice, My Way. Senator Mitch Fifield (shadow minister for Disabilities, Carers and the Voluntary Sector) launched the new service stating that the model was something that government could learn from. “We want all Australians to feel empowered, we want their lives to be the best that they can be,” he said. “And My Life, My Choice, My Way is going to help make that possible for many thousands of Australians.” Replacing the more traditional case-management model, Care Connect has implemented a 7-step approach built around person-centred practice and focused on having the client in control of their own aged care journey. “I think moving into the aged care sector, we all face it with a degree of trepidation and uncertainty – we know it to be complex,” said Paul Ostrowski, CEO of Care Connect. “But by taking this approach with time people will feel far more in control ... It translates it into everyday language.” Two years in the making, the company drew upon national and international best-practice research to create the model, which was trialled in Victoria throughout 2012. The research confirmed that people who have more control over their funding and can lead the decision making process more were more likely to have stronger health outcomes. “It is very much a facilitation model as opposed to a management model. The client can involve anybody who is important in their life it might be their friends, neighbours, other carers and we help through a discussion which is the client is encouraged to lead – help them build their plan for their future.” 10 | April–May 2013 Ostrowski said that the biggest trap staff in the sector fall into is thinking that they are already 100 per cent focused on the client. Before the trial, 100 per cent of staff at Care Connect believed they were person-centred; however at the end of the pilot, 90 per cent said that wasn’t actually the case. “We have a far greater understanding of person-centred care now,” he said. “We have invested very heavily in the model, firstly getting an external consultancy to take a good hard look at our practice, and then completely turning our approach on its head. “It is an important journey for all organisations to go through – I would encourage other organisations to look at the model that Care Connect has put in place and see what they can learn from it.” n

news Debunking sleep myths For older adults, while more sleep would be great, less sleep is unthinkable. By Aileen Macalintal I t is a common belief that sleep problems or less hours of sleep is just part of getting old. But this is just one of the myths exposed on World Sleep Day. Professor David Hillman, president of Sleep Health Foundation, said about 50 per cent of older adults report difficulty sleeping. “It is quite common to meet people who have attributed symptoms of sleep apnoea to ‘getting older.’” He said pointing old age as the cause for sleep problems is a myth. Common problems with sleep are associated with poor health outcomes, he said. For example, sleep apnoea is associated with increased motor vehicle and work-related accident risk, hypertension, heart disease, depression and metabolic disorders such as diabetes. “Elderly people need about the same length of sleep as younger adults,” he said. But they may spend more time in bed getting sleep, due to disturbances such as body aches and pains. Professor Shantha Rajaratnam, president of Australasian Sleep Association said, “Poor sleep in older people is most likely related to conditions that accompany getting older such as significant medical and psychiatric conditions, specific sleep disorders, increased use of medication and changes in circadian sleep-wake cycles.” Some sleep disorders, such as insomnia and obstructive sleep apnoea, are more common in the elderly, Rajaratnam said, but with diagnosis and specialty care, these issues can be treated. Sleep problems should and can be prevented, according to Hillman. “Sleep, like diet and exercise, is a key to healthy living. Inadequate sleep adversely affects thought processing, decision making, vigilance, reaction times and mood. These are all ingredients in a happy, healthy life. Productivity, safety and wellbeing suffer as do other aspects of quality of life,” he said. “Apart from its restorative function, sleep is also a time where there is a lot of information processing going on: memories are consolidated, lessons drawn from the day’s experiences and redundant material edited out. Problems are worked on,” he said. “Hence the brain is busy in ways that are different to wakefulness but essential to optimal wakeful function.” Hillman said everyone should think about their sleep habits because sleep is an important health investment regardless of age. And habits cultivated at a young age stay with us forever. Adult sleep requirements become reasonably stable from early 20s onwards, unlike when one is much younger, which is when 9 to 12 hours of sleep is needed. The average adult sleep needed is around 8 hours a night. Hillman said some need more while others need less. Most know their own personal requirement from experience. “If you try to get away with less on a regular basis you will function suboptimally. Decision making, ability to think through problems, reaction times and mood all suffer when there is insufficient sleep,” said Hillman. n April–May 2013 | 11

news Vision loss affects carers as well as sufferers Depression rates are high among carers of those with vision loss as a result of age-related macular degeneration. By Amie Larter D epression rates among those caring for someone with vision loss from age-related macular degeneration is triple those seen in the Australian population over 65 years. “We know that it is a very challenging task for a carer looking after someone with low vision because there is a constant worry about accidents and falls – it is the relentless nature of having to have patience, understanding and the continuous need to stay positive,” said Julie Heraghty, CEO of the foundation. Heraghty said that assisting with everyday tasks including getting dressed, cooking, finances and attending regular doctors meetings are regular responsibilities experienced by carers. “The golden years are not too golden for many of those diagnosed with wet AMD and those who care for them,” she said. Results revealed that over half of carers believe the disease has had a negative impact on their life, while 38 per cent had felt frustrated and 28 per cent had experienced sadness. Of the carers, two thirds were contending with their own chronic conditions – arthritis, heart disease, cancer – and one in ten carers reported that there was no one to look after them if they were unwell. Heraghty suggests this could be attributed to the fact in most cases it’s a spouse looking after the person with AMD. “To paint a picture, we have got two people trying to live on their own, to maintain independence and quality of life. One has vision loss and may have another chronic disease. The other person – the husband or wife may also have arthritis or a heart condition and is doing all the caring. “This really creates a challenging situation.” Wet AMD is characterised by a sudden loss of vision caused by abnormal blood vessels growing in the retina. It is the more severe form of the disease, with the dry form resulting in only gradual loss of central vision. In Australia there are currently over 1 million people that have evidence of macular degeneration. Of this figure 167,000 had late stage macular degeneration which included 57,000 with the dry form and 110,000 with wet AMD. Associate professor Alex Hunyor, retinal specialist at Sydney Eye Hospital and Macquarie University says early detection is vital to managing the growing figures of the condition. “We now have treatment for the wet form – so if people have just started losing their vision we can stop them from losing anymore. We can often keep them driving a car, reading – quite independent,” he said. 12 | April–May 2013 “But if they delay presenting until they have lost vision, even though we may be able to recover a little bit, we are not gaining nearly as much from them in terms of how they will be in three to five years’ time.” Increased awareness of the condition is also crucial in detecting the disease earlier. Hunyor suggests that it’s important for medical professionals to be able to understand the symptoms of macular degeneration. “If they are describing problems with central vision – blurry patches or a crooked appearance to straight lines, they are very characteristic symptoms of macular disease. “To work out what the macular problem is they just need to have their eyes tested by a specialist.” n

news Sounding out silence S eniors can spend up to seven years in “silence” before seeking help for loss of hearing, said audiologist Jawan Haydar from National Hearing Care. “We estimate seniors are waiting on average about seven years from the time they first experience symptoms of hearing loss to when they finally book an appointment at a local clinic. That’s seven years of missing out on conversations with your children and grandchildren,” Haydar said. Approximately three million Australians are suffering some form of hearing loss and this is expected to increase with an ageing population. Hearing loss hits seniors the worst, with many of them suspected to be undiagnosed. Three out of four people aged over 70 years are likely to experience some form of hearing loss, which can affect their quality of life. “Since hearing loss is gradual and subtle, many people don’t even realise they’re losing their hearing. Sufferers tend to blame their partner and family members with phrases like ‘stop mumbling!’” Haydar said. Signs of hearing loss include ringing in the ears (“tinnitus”), too loud or slurred speech, trouble hearing consonants, and perceived mumbling of women and children, whose high frequencies are not heard. Complaints about loud TV may also be a sign. Seniors are advised to be even more careful once they start having symptoms. They often ignore problems with hearing because noises do not seem so loud, making their condition worse. “It is so important seniors stay on top of their health by undertaking hearing checks once every two years. We see a lot of people’s lives change after realising they’re experiencing hearing loss and do something about it, such as wearing a hearing device,” said Haydar. National Hearing Care offers free hearing checks and many seniors are eligible for subsidised hearing devices. n April–May 2013 | 13

news Internet a rich tapestry for seniors The social media platform, Tapestry, has launched in Australia, with plans to connect seniors to their loved ones. By Aileen Macalintal S ince the first trial last year, there are more than 450 users of the platform, which bundles technologies like email, Facebook and Google+ into the one account for ease of use. Signing up takes about 20 seconds. Founder Andrew Dowling said Tapestry is easy to use, bringing a set of online services together into one simple interface. Its features include photo-sharing capabilities, simplified e-mail and web browsing, standard applications such as a clock and weather, as well as a simple application launcher to explore apps available on an Android tablet device. Tapestry has already won several awards including Commercialisation Australia Skills and Knowledge grant, Commercialisation Australia Experienced Executive grant, and the 2012 National iAward for Innovation. Asked whether users would be intimidated by this technology, Dowling said they received a lot of questions like this when they started out, particularly from potential investors. “So one of our first goals was to prove that the product could overcome these concerns,” he said. They began with a trial in cooperation with Wesley Retirement Living, where half of the participants had never used the internet before. “To our delight, it was actually this group which ended up being most enthusiastic about Tapestry, with all of them signing up as permanent users after the trial. We think 14 | April–May 2013

news the reason for this was how much work we had put into making the product easy and accessible for all users, no matter how comfortable they are with technology,” he said. Andrew Dowling “The tablet doesn’t require any pre-existing knowledge of computers in order to be able to use it, for example. Navigation is very intuitive and clearly displayed in a large font to make it easy to use.” One Tapestry member, Sydney resident Ruth Moore, 83, said staying in contact with her family has been surprisingly easy. “I used to have a computer a few years ago, but I think Tapestry is much better for my requirements,” Moore said. “It gives me exactly what I want – contact with my family, photos, information on the internet, and weather updates.” “I’d never used the internet prior to using Tapestry. It’s been a revelation to me. I used to see internet addresses in magazines and television, but I could never do anything about it. Now I know exactly what to do.” Ruth said she loved it, but the great thing is her family liked it too. “To be honest, I believe my 23-year old granddaughter from Tasmania is the most impressed. She can’t believe that her Nan is using the internet, let alone Facebook!” Dowling and his team are looking forward to releasing features for the iPad, iPhone and Android phones. They are also working on more controls over data sharing from Facebook, as well as features that can be useful in retirement and aged care communities. “Tapestry was conceived from the very beginning as a company that could help address the real needs of a large number of people in our community, needs that aren’t currently being met by today’s technologies,” Dowling said. He said aside from complexity, people are concerned about privacy, security and the constant change in everything. Some were worried over security and privacy on the Internet, so the team designed safety into the system from the ground up. “It’s a closed community that can’t be accessed from the outside,” he said, unlike Facebook. “We’re very excited about what Tapestry is creating. It has the potential to not only improve the quality of life for many seniors, but challenge the way the aged care industry delivers its services,” he said. “Although the fastest-growing demographic in Australia is seniors over the age of seventy, one in ten seniors say that they often, or always, feel lonely.” Dowling said it is even more shocking that males over 80 have the highest suicide rate in developed countries. “The good news is that technology can play a role in helping address some of these issues,” he said. “Research shows that simply using the internet to connect to the outside world reduces the incidence of depression in seniors by up to 20 per cent.” With Tapestry, family members may connect with and care for their senior relatives, which is why it has received strong interest from providers in the aged care sector looking for innovative ways to deliver services to seniors. n April–May 2013 | 15

news CIOs brainstorm to help health professionals A group of Australians look at using technology to improve the provision of care. By Aileen Macalintal i nteractive video games and smart phones could be used to help improve the health of rural Australians, according to CIOs. A series of forums, the CIO Solution Roundtable, is underway among chief information officers nationwide, with the first forum brainstorming ways to modernise healthcare among mostly ageing rural Australians and change the way patients participate in their own care. The first forum tackled the problems of rural healthcare. Games and smart phones are among the ideas that came up. “If we improve the communications between companies that develop, market and integrate healthcare technology, then this will drive innovation in the industry and deliver better solutions,” said roundtable convenor Dr Brendan Lovelock, the health industry practice lead at Cisco Australia. Since a number of elements interplay to improve the connectivity between those involved in healthcare delivery, Lovelock said the forum did not just focus on one area of technology. “It is hoped ... we will develop more innovative ways of addressing the challenges faced by rural healthcare providers and their patients,” he said. The potential of interactive media and game development industries will be tapped to deliver “a more engaging and purposeful experience for the user”, Lovelock said. This meant exploring opportunities to engage healthcare professionals and patients through smart phones and tablets, as well as personal measurement technologies to make information easily accessible. “Creating devices which are sympathetic to the physical challenges confronting many elderly patients is one aspect but creating software applications which have features appropriate to their healthcare needs is another important requirement. “If you make technology relevant to elderly patients and support them appropriately, then they will use it. “Also, the user of this technology is often not the elderly person, but the carers and healthcare providers who support those patients,” he said. “The group decided that we should focus on improving the connectivity between acute care, primary care (GPs), allied healthcare providers and the patient. “We would look to reconvene a broad group including those members of the games and interactive media industries, plus the device development industries, to look at gaps in connectivity.” Another goal was to build an evidencebased approach that could address hospital overcrowding. If more patients were well-connected to relevant information and with their care providers, overcrowding in emergency rooms might be avoided. Lovelock said rural health care faced multiple challenges, including an increase in chronic disease due to an ageing population, a shortage of skilled workers, and a healthcare process challenged by long distance. “Addressing these issues requires the innovative and efficient use of our precious rural health care resources and the better coordination of care delivery in the country.” With healthcare information technology, new models will be developed to overcome many barriers, and put workers and patients in better control of chronic conditions. “It allows better connectedness between care providers, improved coordination of the care process and enabling the right care resources to be delivered when and where required.” The CIO Solution Roundtable grew from the Partnering for Healthcare Innovation conference last year in conjunction with the Medical Software Industry Association. “The opportunity is to drive innovation by bringing together the smartest people from large and small companies in the industry to share their knowledge and catalyse innovation in healthcare solution design.” n Wendy Moyle with Gerry 16 | April–May 2013

calendar 2013 APRIL • ACN Nursing and Health Expo VIC 21 April Melbourne Convention and Exhibition Centre, Victoria • ACN Nursing and Health Expo QLD 28 April Brisbane Convention and Exhibition Centre, Queensland MAY • Understanding & Implementing Your ACFI QLD 1 May Brisbane Broncos Leagues Club, Brisbane understanding_ACFI • ITAC 2013 Information Technology in Aged Care 1–2 May Crown Conference Centre, Melbourne • Effective Care Plans & Case Conferencing QLD 2 May Brisbane Broncos Leagues Club, Queensland care_plans_and_case_conferencing • Spark of Life International Master Course 5–24 May Perth, Western Australia • ACSWA 2013 Conference 9–10 May Crown Metropolitan, Perth • 4th International Society of Advance Care Planning and End of Life Care Conference 9–11 May Melbourne Convention and Exhibition Centre, Victoria • 3rd Biennial National Falls Prevention Summit 16–17 May Stamford Plaza Brisbane • The International Council of Nurses (ICN) 25th Quadrennial Congress 18–23 May Melbourne, Australia • Understanding & Implementing Your ACFI VIC 20 May Melbourne, Victoria understanding_ACFI • Alzheimer’s Australia 15th national • Effective Care Plans & Case • Alzheimer’s Australia - The Tiles of • Spinal Health Week conference 14–17 May Hotel Grand Chancellor, Hobart, Tasmania Life - Colouring the Future 14–17 May Hotel Grand Chancellor, Hobart, Tasmania • ATSA Daily Living Expo 15–16 May Rosehill Gardens Racecourse, Sydney Conferencing QLD 21 May Melbourne, Victoria care_plans_and_case_conferencing 21 – 27 May Nationwide • 13th Annual Hospital in the Home Conference 23-24 May Novotel Melbourne on Collins • LASA NSW-ACT Congress 2013 30 May The Westin, Sydney April–May 2013 | 17

policy & reform Ageing is a growth industry As the population ages, the emphasis for policymakers must return to attracting professionals back to the industry. By Louis White I f there is one consistent with Australia’s population is that we are all growing older and that the elderly are outstripping the young. Advances in medical technology increase the life expectancy of people in developed countries, while an abundance of artificial food, poor diet and exposure to unnatural radiation is reducing fertility. According to the Australian Bureau of Statistics, our median age has increased by 4.7 years in the past two decades from 32.7 years as at June 30, 1992 to 37.4 years as at June 30, 2012. From June 30 1992 to June 30 2012, the proportion of people aged 65 and over increased from 11.5 per cent to 14.2 per cent. During the same period, the proportion of population aged 85 years and over has more than doubled from 0.9 per cent to 1.9 per cent of the total population. Conversely, the proportion aged under 15 years has decreased from 21.8 per cent to 18.8 per cent. The most alarming statistic revealed by the ABS is that in the 12 months to June 30, 2012, the number of people aged 65 years and over in Australia increased by 134,700 people, representing a 4.4 per cent increase. Over the next several decades, population ageing is projected to have significant implications for Australia in many spheres including health, labour force participation, housing and demand for skilled labour. Australia needs to build a skilled and dedicated workforce to care for our ageing population. For far too long, aged workers on all fronts have been underpaid and forced in some instances to work in non-conducive conditions. But we can no longer ignore this vital sector. The recruitment within is vitally important and governments and private enterprise need to address areas such as poor pay and conditions, lack of career structure and inflexibility in order for our aged care to be properly handled. After all, we are all getting old and will some day require the help of others. “Some fundamental shifts are required in our thinking of the needs of older Australians,” says Patrick Reid, chief executive officer of Leading Age Services Australia. Patrick Reid 18 | April–May 2013 Emma Pilcher “Our politicians need to acknowledge the ‘real cost’ of both providing care and also the costs to society when care is denied to people. When this happens we are able to attribute the rightful value to our workforce. Politicians often wax lyrical about the importance of age services, but the shortfall in funding does not suggest a genuine desire to meet the actual needs of older Australians. “Innovation around how the workforce operates, how it is incentivised, their roles and responsibilities, job satisfaction and clear pathways for personal and professional growth all need to be considered when considering workforce growth. Not only do we need to consider new entrants to the sector but we also need to consider how we optimise the performance of existing employees and retain those workers in the industry longer.” LASA is one of the few organisations in the sector that represents all industry participants with its focus on being an influential and representative force for providers of aged services across Australia. Reid is adamant that while salary is one issue there are many other issues in the sector that need to be addressed to make it more attractive to current and future employees. “Material benefits are always important in the context of remuneration for effort and salary is a significant issue as our workforce undertakes an important and demanding role, their salary needs to acknowledge this,” Reid says. “However, material benefit is only one aspect of the mix, nonmaterial benefits need to be weighted effectively such as training, promotion prospects, work climate, leadership, content and context of work and of course relative responsibility for work area. “Flexibility and innovative work practices are often known to be more important than salary, but in our industry I think a combination of both is required that will allow an encouragement of productivity to reduce operational and clinical costs that can be reinvested in the workforce and their advancement.” Reid is vocal in his criticism of “spurious red tape” within the industry that is a barrier for many people wanting to work in the sector. “It has a huge impact on the daily workload and efficiency of an aged service worker,” he says. “LASA supports and acknowledges that a level of regulation is required for high quality care, but this need not be at the expense of ‘administrivia’. Processes can however be streamlined with improvements made to reduce compliance that does not have a positive impact on clients care or accommodation quality and safety.” KinCare, which provides a variety of aged care services in

policy & reform homes throughout most states of Australia, believe that a complete overhaul of how working in aged care services is perceived is needed to make the industry more attractive. “The sector needs to be promoted more from a grass roots level and needs to be identified as an occupation right from high school and throughout university,” Emma Pilcher, human resources manager, KinCare, says. “There needs to be awareness in the community that the aged care sector is the second largest growing industry in Australia behind mining and resources. “Incentives in the forms of education discounts and support with practical work placements through study, funding towards initiatives like Care Careers to promote further access to the jobs that interest people across all areas of health.” Pilcher believes promoting the sector as a speciality would be a good move to encourage future work participants. “Yes, why not?” she says. “It will be a focus for all Australians in five to 10 years from now. “Private enterprise needs to further invest into ensuring that there is going to be equity across the industry and assisting to raise the minimum wages and making the industry more attractive from an lifestyle occupation perspective. “Private enterprise should be interested in ensuring that the future workforce are trained and supported so thus this decreasing future potential problems and further strains on the state and federal governments as the baby boomer generation need more and more care options.” Pilcher states that the pay level, restricted access to education and training along with lack of clarity between in-home care, residential and facility care as barriers to working in the industry but believes anyone considering a career in the sector will be rewarded. “The future will be bright, attractive, and connected with technology and very fulfilling because of the nature of the work and the ‘giving back to the community’ that comes with being a home care worker.” One of the problems associated with salary with working in the aged care sector are the education requirements. April–May 2013 | 19

policy & reform According to Education 4 Life, an individual’s minimum education required to enter the aged care industry is a competency based Certificate III in Aged Care or Certificate III in Health Service Assistant. This can be achieved over a varying period of six weeks through to 12 months maximum traineeship depending on the registered training organisation’s delivery model. These direct care staff make up the majority – 75 per cent – of care providers in all residential aged care facilities. “An individual’s employment is based on the attainment of these competencybased qualifications, which do not have a requirement for achieving any ongoing professional development,” says Michael Maher, E4L’s chief executive officer. E4L specialises in using education to help aged care providers build teams. The company specialises in improving the current skills of staff members along with teaching them new skills. The company was established in 2009, and uses peer group education sessions to facilitate team building. “We need to empower workers in the industry from all levels to feel that their jobs are ‘important and valued’ by the consumers and general public,” 20 | April–May 2013 Maher says. “The reporting of sensational negative issues within the industry mars public perception and the knowledge of ‘inner workings’ of the industry. The champions and stalwarts are never acknowledged at a local or even facility level to the degree that workers are able to feel pride in their efforts. “In health, aged care is the not-so-sexy sibling. It does not have the work status as working in an ER or something similar in the hospital, nor does it have the same pay rates, therefore it struggles to keep its existing workers. The government needs to offer incentives for existing workers to stay in the industry.” Maher is a believer in that the government should provide education funding so that existing workers can access fully funded professional development courses. Another idea would be to provide incentives for workers to upskill themselves. He is also believes that working in the aged care sector should be seen as a specialty. “In the same way one would not want a ER nurse covering a shift in the maternity ward, you would not want them covering a shift in RACF either. Aged care is a specialty area for all direct care roles. It is very different from working in a hospital. “If it was seen as a specialty and treated with more respect, it would attract a more professional worker.” One area that could provide a boon for recruitment and long-term stability is seeking more mothers in the aged care workforce. JustMums Recruitment, started by mother-of-two Rachel Perkins, has undertaken many recruitment assignments in the aged care sector and sees more than a few issues. “The aged sector is low paying, unglamorous and crippled with the perception of high staff turnover, significant staff shortages, poor work culture, low staff morale and heavy workloads,” Perkins says. “Whilst challenging, we need to work on the image of the industry in order to attract talent to the workforce. “At JustMums Recruitment we believe that a career in the aged care sector can be a wonderful career choice for return to work mothers (parents) as it offers job security and the flexibility to work around an individual’s family/ home commitments. “There are not many other industries that provide this, so for our candidates it can be

policy & reform incredibly appealing and an easy ‘sell’. For this reason, we are prioritising a partnership with training organisations and employers within this sector to create real and rewarding job opportunities for our mums. “I believe that more work should be done with students nearing their secondary schooling to promote the sector to a younger demographic and for them to consider a career in the aged care sector as professionally rewarding and exciting.” Perkins also believes governments around the country have a key role to play. “Increased funding, a national and standardised approach to service delivery and model of care, and monitoring and reporting to regulate training within the aged care sector are ongoing areas that the government needs to focus on,” she says. “We have an unemployment rate of above five per cent in this country and I believe that their needs to be an emphasis placed on strategically directing those that are currently unemployed into direct employment within the aged care sector. “This will increase our participation rate, add much needed skills and resources to the sector and decrease our reliance on the use of candidates from overseas and skilled migration. The economic and financial benefits could then be re-directed as funding back into the sector.” The aged care sector will only grow in numbers on all fronts with each passing day. Time for Australians on all levels to start working together to address the pressing needs of the aged care workforce sector before it is too late. n April–May 2013 | 21

policy & reform Government’s billion-dollar bid to boost aged care wages While Labor’s plan to boost pay draws criticism from the Coalition and LASA, the ANF welcomes the Aged Care Workforce Compact. By Amie Larter T he federal government has announced a $1.2 billion injection into the pocket of minimum wage aged care nursing and care staff, in a bid to provide more rewarding careers and conditions for Australia’s 350,000-strong aged care workforce. The Aged Care Workforce Compact, an agreement between the government, union and employers, will see significant wage increases for aged care nurses, care workers and other professionals in the industry. Starting in July, workers who are currently paid the award rate and who sign an enterprise agreement with an approved provider could see a wage increase of up to 30 per cent over four years. “We know that most Australians who pursue a career in aged care do it for much more than the financial reward, but pay rises of that level are a big incentive to work in this growing industry,” said minister for ageing Mark Butler, at the launch of the Compact. “A better paid, better skilled and better trained workforce will underpin a more responsive system that provides older Australians with quality care, when and where they need it.” The Australian Nursing Federation welcomed the announcement, and called on the opposition to commit to the compact if it wins in September. “We have begun addressing the wages issue through the workforce Compact; we must now address other issues like staffing levels and skills mix,’’ said ANF Federal Secretary Lee Thomas. “It is imperative that the aged care sector is seen as a viable and exciting place of employment so that as a community we are all assured that the highest quality care is being delivered.” However, the Coalition remains strongly committed to its fouryear Aged Care Provider Agreement announced in 2010 – what they describe as a “game changer” for the sector. “With only 40 per cent of providers operating in the black, many providers will be unable to pay the wage increase and meet the associated on-costs,” said shadow minister for ageing and mental health senator Concetta Fierravanti-Wells. “These cost pressures will further erode their viability, especially smaller providers in regional and rural areas.” Fierravanti-Wells described the compact as nothing more than a union-driven industrial process dressed up as administrative change. “Minister Butler’s compact has failed its principal objective to find a sustainable agreement with the aged care sector on workforce issues.” 22 | April–May 2013 Top L-R: Mark Butler, Senator Concetta Fierravanti-Wells Bottom L-R: Lee Thomas, Patrick Reid There were mixed levels of support from aged care bodies and providers, many looking long-terms to matters of staff retention and quality. Leading Age Services Australia CEO Patrick Reid said that the compact “tinkers at the edges”, and doesn’t address the real issues faced by the industry. “The compact will not address the huge shortage of age services workers and may in fact worsen recruitment and retention in rural and remote providers,” he told Aged Care Insite. “This pay rise is from existing funding and has been taken from existing care budgets, with an expectation that providers who have had their funding reduced find further money from their own resources to fund this industrial action dressed as administrative changes. Reid believes that fundamental shifts are required in our thinking of the needs of older Australians, and that politicians need to acknowledge the ‘real cost’ of providing care. “Already, every 73 minutes another Australian is denied aged care,” he said. “Where will they go? To family members if they are lucky, to overstretched community services and homeless refuges if they are without family. “Family members and charities will continue to pay for the failure of government to meet demand in aged services.” n

They said ? what Ian Yates, CEO COTA Yates said it was heartening to see the government move in this direction, as older people’s experience with aged care was dependent on the quality and number of staff available. “One of the biggest concerns older people have about aged care is that staff are underpaid and overworked and don’t have enough time to spend with them; or haven’t been adequately trained. “Aged care nurses don’t get paid on par with colleagues in mainstream hospitals even if they have the same qualifications. They fill just as critical a role.” Stephen Kobelke, CEO Aged and Community Services WA Kobelke opposes the redirection of funding instead of a “much needed” injection of new funds. He said that as a matter of principle, ACSWA doesn’t support a framework that diminishes funding to providers in order to channel funds to supplement wage increases. “Taking money from consumer entitlement to channel to staff wages is inappropriate, particularly in a consumer-focused environment. “This decision will have significant impacts on the sustainability of providers and the level of care delivered to the frailest and most vulnerable members of our community.” Martin Laverty, CEO of Catholic Health Australia Laverty said it was not clear how many aged care services would take up the new compact, as it will suit some providers, and not suit others. “It would be unfortunate if some aged care staff miss out on pay increases or receive policy & reform smaller increases as a result,” he said. “They deserve higher wages with those in line with the health sector. This will only happen when the government adopts a funding system for aged care that supports fair and competitive wages ...” Lucy Morris, Chairperson of Baptist Care Australia Morris posed the question: Who is the real winner in the federal government’s pay rise announcement? Probably the federal government and the unions, not employees or the older Australians seeking aged support services, she said. “Older Australians should be feeling shortchanged as the apparent increase in wages comes out of money originally intended for direct care. It was deducted at the start of the 2012-13 financial year, and the care arrangements will feel the impact for years to come.” Professor John G Kelly, ACSA CEO ACSA said that the Compact will create significant difficulties for providers in regional and remote Australia as well as standalone urban providers. “The redirection of $1.2 billion from aged care subsidies into wage increases is another case of robbing Peter to pay Paul,” he said. “The capacity of small, independent, regional and rural providers to implement the requirements and cope with the administrative burden causes us concern. “It will be up to each and every provider now to undertake an analysis of their capacity to participate in this process.” Ara Cresswell, CEO of Carers Australia Cresswell believes that anything which addresses the shortage of a properly trained aged care workforce is a welcome step. “The shortage of trained aged care workers to provide personal care to people in their own homes or residential facilities is a perennial source of anxiety to family carers. This shortage can largely be attributed to poor wages and conditions. “Many family carers have relayed that they are very hesitant to take up respite opportunities because they do not have confidence in an under-resourced system.” n April–May 2013 | 23

policy & reform Why the compact? The federal government’s Aged Care Workforce Compact promised increased wages for aged care workers. Kevin Rocks fears that this is an election promise that will ultimately disappoint. 24 | April–May 2013 o ne of the things I’ve learnt over the many years I’ve worked in aged care is that it is a vocation and not a career for those with money on their minds. However, there is no doubt that our aged care staff deserve to be paid better wages for the honourable work they do, as a sense of achievement alone does not attract and retain qualified staff. The $1.2 billion funding plan announced by the Labor government this March pledges to lift wages for approximately 300,000 Australian aged care workers next year. While many of the details are not yet clear, the compact appears to work under the condition that individual providers enter an enterprise bargaining agreement with their staff. The terms of the agreement are likely to give unions a new way to recruit members and drive pay negotiations. The Aged Care Workforce Compact is an apparent attempt to lift wage standards in aged care, but the devil lies in the detail. The government has not specified where this funding package will come from, and upon closer inspection appears to merely redistribute funds by sleight of hand from other parts of the aged care budget. From an aged care provider perspective, it is difficult not to be cynical of the government’s decision to only offer individual workplace agreements and no federal awards. It remains unclear whether the government truly believes that individual aged care providers have the financial capacity to sign up to an accord where they must also make significant financial contributions, particularly in sight of further cut-backs in government subsidies, which are currently running at $1.8 billion. Government funding contracts should not require an industrial outcome, and this initiative appears to be a union-driven process, disguised as aged care reform. The government’s announcement will place much pressure on employers to increase wages, however, with 40 per cent of providers currently operating at loss, we will only know how many of them will realistically be able to afford to sign the agreement and receive the additional funding once all details of the compact are announced. The use of individual workplace agreements will see some providers access additional funding and others not. Ultimately, the compact can be expected to have an impact on the individual aged care provider’s ability to attract and retain quality staff.

policy & reform Furthermore, the government has not outlined a clear time frame for the funding roll-out or duration. As such, it does not provide a sustainable road map for consistent pay increases for the industry. As it stands, this federal spending package is a short-term solution with little benefit in the long run. It is likely that in a couple of years, very few aged care employees will find more money in their pockets as a result of this initiative. The government must provide a funding model that enables providers to have appropriate staff levels, and ensures we have the capacity to consistently increase wages. If the government provided the required funding to be distributed across the system, the aged care workforce would be attained now and for the future. A sustainable wage program will be crucial when we consider that the aged care workforce needs to triple over the coming decades to meet the growing demand of a rapidly ageing population. Aged care providers are already under pressure to increase staff numbers and balance skills in line with the Ageing in Place policy introduced by the Labor government’s Living Longer, Living Better reforms. Aged care providers must focus their efforts on attracting talented staff who are able to work in a variety of care levels. The division between low and high care previously gave employers an indication of the required resources. Managing staff effectively in a less defined environment will become an additional challenge aged care providers must face. At Holy Family Services, the transition to an all high care environment is already in place. We know that high care residents typically require more attention, and we have put significant effort into training existing staff to be able to provide this additional level of care. We have also hired extra staff with experience working with specific conditions, such as dementia, and are closely monitoring how each wing of our facility is resourced. Having worked in aged care for over 30 years, I know that the most vital ingredient in the quality of the care our residents receive is dedicated and talented staff. As a result, Holy Family Services already pays higher wages than recommended within the confines of the current funding model. We also reward members of our staff who have worked with us for five, 10 or even 20 years by organising recognition ceremonies. In order to continue to improve wages, provide training and hire the additional staff demanded by the Living Longer, Living Better reforms, we need genuine budgeting reforms. Cutting funds from one end of the budget to fill a gap on the other will not solve issues long-term. It will take much more than rebadged money to improve wages and attract more people to the sector. Aged care workers are the heart and soul of our industry and they deserve an honest approach to their remuneration. n In an uncertain recruitment market, Kevin Rocks recommends six steps to attract and retain great staff: • Company values: Employers must have genuine values that are not just words on the wall. Although it might sometimes be difficult to live by them, they are the foundation that enables us to deliver quality care to our residents • Reward good work: Rewarding excellent performance is one of the most important things employers need to focus on to retain great employees. Holy Family

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