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The voice of all aged services Summer 2012 | www.lasa.asn.au

Introducing LASA Chair, Peter Cosgrove

LASA INAUGURAL CONGRESS

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IRT FROM LITTLE THINGS

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EMPLOYER OF CHOICE AWARDS

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EPILEPSY IN LATER LIFE

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LEADING AGE SERVICES AUSTRALIA

Helping older Australians to live well


The voice of all aged services Summer 2012 | www.lasa.asn.au

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44 NATIONAL UPDATE

TECHNOLOGY

SPONSORS

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54 Energy Action

CEO Report Chair Report SA Report NSW Report VIC Report QLD Report WA Report Inaugural LASA Congress Building Awards

PROFILES 29 Peter Cosgrove 32 Morris Miselowski

EDITOR PRODUCTION

Gerard Mansour Jane Murray

LASA Federal Gerard Mansour CEO, Unit 4, 21 Torrens Street Braddon ACT 2612 Tel: (02) 6230 1676 Fax: (02) 6230 7085 Mobile: 0417 518 103 E: gerardm@lasa.asn.au LASA New South Wales/ACT Charles Wurf CEO PO Box 7 Strawberry Hills NSW 2012 Tel: (02) 9212 6922 Fax: (02) 9212 3488 Mobile: 0419 231 056 E: Charles.wurf@nswact.lasa.asn.au

ACIITC Report ACIVA Report IRT – From Little Things A robot that can help your grandma (or you) avoid the nursing home

WORKFORCE 46 Employer of Choice Award – employer 48 Employer of Choice Award – employee 49 Grab the opportunity when you can 52 Presidential Card

GENERAL 57 Review of Latest Government Announcements on Living Longer Living Better (LLLB) 59 Aged Care Tips and Traps – part 4 of series 61 Epilepsy in Later Life 65 Beyondblue 66 SAGE – Study Report 68 ACFA draft recommendations 71 Calendar of Events

LASA Victoria Peter Begg CEO Level 7, 71 Queens Road Melbourne VIC 3004 Tel: (03) 9805-9400 Fax: (03) 9805 9455 Mobile: 0417 562 579 E: peterb@vic.lasa.asn.au

LASA WA Anne Marie Archer CEO Suite 6, 11 Richardson Street, SOUTH PERTH WA 6151 Tel: (08) 9474 9200 Fax: (08) 9474 9300 Mobile: 0437 488 364 E: amarcher@wa.lasa.asn.au

LASA SA Paul Carberry CEO Unit 5, 259 Glen Osmond Road Frewville SA 5063 Tel: (08) 8338 6500 Fax: (08) 8338 6511 Mobile: 0403 809 713 E: ceo@sa.lasa.asn.au

LASA QLD Nick Ryan CEO PO Box 995 Indooroopilly QLD 4068 Tel: (07) 3725 5555 Fax: (07) 3715-8166 Mobile: 0418 881 538 Email: nick.ryan@qld.lasa.asn.au

Adbourne PUBLISHING

Adbourne Publishing PO Box 735 Belgrave, VIC 3160

ADVERTISING Melbourne: Neil Muir (03) 9758 1433 Adelaide: Robert Spowart 0488 390 039 PRODUCTION Sonya Murphy (03) 9758 1436 ADMINISTRATION Robyn Fantin (03) 9758 1431

DISCLAIMER Fusion is the regular publication of Leading Age Services Australia. Unsolicited contributions are welcome but LASA reserves the right to edit, abridge, alter or reject any material. Opinions expressed in Fusion are not necessarily those of LASA and no responsibility is accepted by the Association for statements of fact or opinions expressed in signed contributions. Fusion may be copied in whole for distribution among an organisation’s staff. No part of Fusion may be reproduced in any form without written permission from the article’s author.


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Report from the CEO LASA: Leading Reform, Advancing Industry Gerard Mansour Chief Executive Officer | Leading Age Services Australia

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n the first edition of A number of key committees As we move into 2013 we take another step Fusion I expressed my meet regularly with LASA down the winding path of reform – and the delight in being selected representatives from either voice of a united industry, through LASA, has as the inaugural CEO national office or our state never been more important of Leading Age Services offices. Specified Care and Australia (LASA) and outlined Services has been an area what I saw as the long and of interest to our members, winding road to age care reform. This will be my last piece as, particularly how any new care and service requirements will unexpectedly, I need to return to Melbourne to spend time with be funded. LASA continues to advocate strongly that any new my family. care or service requirements are appropriately funded under ACFI. Even though LASA is such a new organisation I leave with the The LGBTI Health Alliance has facilitated consultation; very clear understanding that the creation of LASA was the right LASA actively sought member input and prepared a response thing to do at the right time; our organisation has hit the ground based on this feedback. Like LGBTI, Minister Butler has also running and our members have already seen clear results. The committed to the development of a CALD strategy by the end of policy agenda of Living Longer Living Better (LLLB) is now moving 2012. LASA again sought member views and incorporated these into the legislative phase with a major revision of the Aged Care into its response. Thank you to those members who provided Act. This presents the industry with a good opportunity to ensure valuable feedback on these areas of special need. quality care provided by a vibrant industry. LASA undertook a national survey in November to gauge We are advised that a draft of the legislation will be put to member responses to ACFA recommendations regarding the House of Representatives in the first sitting period of 2013 accommodation payments and significant refurbishments. LASA (February). LASA has briefed officials in both DOHA and Minister strongly advocated against a single maximum lump sum, instead Butler’s office to assist in the development of the legislation in reiterating our earlier response of a market based approach. the current drafting process. In preparation for the bill’s passage LASA also expressed ongoing concern regarding capital raising through the parliament, LASA will continue to meet with MP’s, for special needs groups, outlining the importance of setting in including Government, Coalition, Independent and Green place block funding models to improve the sustainability of these representatives. vital services as well as undertaking a review of the adequacy of The legislative changes comprise of four key areas being of viability supplements. residential care, home care, governance and administration; other As we move into 2013 we take another step down the winding changes are minor, administrative or consequential. Given much path of reform – and the voice of a united industry, through of the detail is proposed to be contained in the Principles, another LASA, has never been more important. While the government of round of key consultation will be necessary. It is likely that this the day is responsible for progressing its agenda; as an active legislation will be scrutinised through the committee system in and engaged industry it is our duty to continue to influence the both the lower and upper houses. LASA will brief members on the direction of government. I leave LASA confident that we are impacts of the legislative reform at each step and seek feedback perfectly positioned to develop age care reform to ensure that on any proposed amendments. 2013 is shaping up to be a very older Australians indeed live well and that care providers exist busy year within aged care. within a flourishing industry. ■


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Message from the Chair LASA: Strong Foundation, Clear Governance Peter Cosgrove Chair | Leading Age Services Australia

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here can be no doubt Leading Age Services Australia was established at a defining and vital time - just as the Living Longer Living Better major reform process was announced. I am proud of how the organisation has developed in such a short time. Whilst much of the reform process is ahead of us, our LASA foundation is strong and we have established clear and firm governance structures to ensure that not only do we continue to grow, but that we are easily able to reach our members to advise them through the next decade. When deciding upon care options, ordinary Australians do not differentiate between the business structures of aged care providers and neither should we. As we traverse the most significant time in aged care history we can only succeed with a unified voice. Amongst other things this is what attracted me to join LASA as their chair. I was honoured to think that I could assist in the development of Leading Age Services Australia, and we will have a major focus in coming months on the first phase of aged care reform. I consider that I reflect the view of most Australians, I truly respect the work of our aged care sector in meeting the needs of the older Australians in our care. Virtually no one would disagree that older Australians deserve to live well and for those who are frail and vulnerable they deserve special care and to be treated with dignity. These are markers of a progressive and civilised society. Whilst we agree on the fundamentals, we are faced with considerable challenges. We are living longer, the emerging ‘baby-boomer’ generation (where I belong) have expectations of how care will be delivered; our work-force needs to grow and adapt and as always we do this within a geographically disperse nation. Some of our challenges are more difficult than others. Our workforce issues are something that requires ongoing attention. We must value our most precious resource, human capital. The touch of another, or the kind word and gesture make all the difference and it is something I have witnessed first-hand. It is wonderful to live in times where technology is advancing so rapidly. As we saw at the recent LASA Congress, technology will assist us in so many ways. It has the capacity to relieve our workforce from much of the ‘heavy lifting’ and repetitive tasks in providing care, particularly in high needs areas. Technology will also assist us to stay connected. While many of us stay ‘close’ to loved ones via social media, a hand held computer or tablet will

enable a carer to communicate with a client every day, discussing medication issues, and general well-being, even when geography prevents daily physical contact. LASA has demonstrated that while keeping up with rapid advancements in technology it is also leading the way in Canberra, with continued dialogue with the Department of Health and Ageing and Parliamentary leaders, including Minister Mark Butler and shadow Minister Senator Concetta Fierravanti-Wells. Our members have responded enthusiastically to engagement around the revision of the Aged Care Act and I have every confidence that LASA will shape this process in keeping with its core values across 2013. As LASA was formed we developed guiding principles, these assisted our thoughts and goals as we established and will continue to assist our direction into the future. Our prospectus clearly states;

‘‘ ’’ Leading Age Services will advocate for the health, community and accommodation needs of older Australians to help them live well, irrespective of their type of need, or where, or from whom they require services.

”These words assist me and my colleagues in our work with LASA. As we interact with the federal government and bureaucracy we are often faced with a number of competing interests and worthy organisations all advocating for necessary funding. When I come back to those words however it is very simple and I can see a clear path. Our industry must be resourced and supported not simply to exist but to flourish in order to meet the pressing demands in the short and longer term. Just like elsewhere in health there is an expectation from Australians and a clear understanding from our governments and policy makers, that services are universal; aged care is no different. I look forward to working with my LASA board colleagues (who represent a commitment to human care not matched anywhere in the world) in the coming year to continue to advance LASA’s vision to the point that a robust and flourishing industry is simply the norm – to provide high quality accessible aged care. ■


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SOUTH AUSTRALIA REPORT The Magic of Children Paul Carberry Chief Executive Officer | LASA South Australia

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ere in Adelaide we with a parent, during their Some children have taught residents how have a great working holidays. Some students to use computers and the internet, and example of positive who are no longer eligible some residents have taught children how intergenerational for the program continue to play chess interaction, which is producing to visit the residents at tangible and heart-warming results Bupa Morphettville. for everyone involved. The benefits of Forbes Primary School is located in a southern suburb of intergenerational programs such as this have been wellAdelaide. Thirty-one percent of their students have a non-English documented both in Australia and overseas. For the children speaking background, 10% are indigenous, and there is a high involved, enhanced communication skills, greater self-esteem, representation of students from low income families, and of and improved problem-solving abilities, are among the benefits students with special needs. identified. Bupa Care Services operates around 50 residential aged care For the residents, the benefits include social interaction and facilities across four states of Australia. One of them is a 158-bed, stimulation, and greater feelings of value and belonging. high care facility in the Adelaide suburb of Morphettville, about ten Teachers at Forbes Primary report that, prior to the minutes’ drive from Forbes Primary. commencement of the program, the original group of children Within the facility is a 56-bed unit which looks after residents displayed reserved behaviours, low social skills and low living with dementia and, in 2010, the manager of this unit, Robyn confidence levels when reading aloud. After involvement with the Caruso, initiated a program involving the residents of her unit and residents they were more confident, happy and alert, their school the school children. work displayed significant improvement, as did their behaviour and With support from Alzheimer’s Australia, Robyn and a teacher attitude at school. at Forbes Primary established a program of regular weekly visits Staff at Bupa report that, following visits from the children, by children from the school to the residents in Robyn’s unit. residents were more content, settled and happy. Prior to commencing their visits the children receive education In 2011, with Robyn Caruso’s assistance, Forbes Primary about dementia, as well as follow-up sessions after they begin School received a St Vincent de Paul Social Justice Award. The the program. recognition this award has brought has enabled Robyn to improve The children spend a couple of hours per week with residents, community awareness and understanding of dementia through talking or reading together, and teaching each other skills and local and national media. activities. For example, some children have taught residents how This is a great program with benefits all-round, and it to use computers and the internet, and some residents have deserves to be adopted more widely. We intend to work with taught children how to play chess. Robyn Caruso and with Alzheimer’s Australia to document how Strong friendships have been formed between the children, this program has been set up and operated, and to promote who are aged nine to twelve years, and the residents. Such is the its positive value and benefit to other aged care providers strength of these relationships that some children visit residents, and schools. ■


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NEW SOUTH WALES REPORT Into 2013 Charles Wurf Chief Executive Officer | LASA New South Wales

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s we approach the end of 2012, we can allow ourselves a moment to reflect on a year without precedent for our industry. We have experienced enormous change not only in policy direction, but also at an organisational level. Thank you to those throughout New South Wales, and also right around Australia, who worked so hard and with such cooperation to enable Leading Age Services Australia to move from a worthy concept, to such an energetic and strong source of representation for our industry. What now for 2013? There is no doubt that we have tolerated short deadlines and condensed schedules this year in response to changes in policy direction. Both the Federal and New South Wales Governments have presented reforms which will have far reaching consequences, and will for some providers in our industry, directly confront their viability. In 2013 we must not expect the deadlines to be longer or the pace any less. In timeframes we cannot expect generosity from lawmakers; in fact we can expect the opposite. Next year we will have long moved beyond policy announcements and will instead be focused on the detail as governments will seek to enact change through legislation.

The changes announced this year, to be enacted in 2013, will affect our industry for decades. If we are to have change that is economically sound, and socially fair, we must be vigilant and energetic, and we must win the small battles that are likely to take place. Our focus in 2013 must be about the detail. By all means we should look back on 2012 as a year of pace, change, and meeting sometimes ridiculous government deadlines. We can allow ourselves a quick breath at Christmas and recognise the hard work and effort that has taken place at all levels throughout our industry. But we should not look to 2013 as a year to take stock, or a year to consolidate. We need to be hardened by our experiences of 2012. Leading Age Services Australia was born into a climate of change and must and will be at the forefront of ensuring our industry’s viability for many years to come. In 2013 we need to be focussed, we need to have an engaged membership, and we need to challenge and confront government as and where necessary. In 2013 small details will have significant ramifications. ■


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VICTORIA REPORT Positioning for reform success John Begg Chief Executive Officer | Victoria

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here is a high level of energy in our industry at present as we all work hard to stay on top of the government’s Living Longer. Living Better (LLLB) reform. At an operational level I see so many at a management level being drawn back into survival mode; managing their workforce and staying focused on the purpose of our existence an industry, caring for our ageing community. CEO’s, Boards and other leaders within our organisations are grappling with the day to day impacts of this reform and the strategic direction required as we look at the new landscape before us. Many are asking: how do we keep the organisation going and where is all this going to lead to? Go back as far in history as you wish, analyse any industry and observe the subsequent behaviour of the organisations within; you will always find there is something to learn. For me, one of the most valuable lessons is the ability of an organisation to position itself and continue to reposition itself, particularly during periods of significant change and challenges. Some call it adaptation; I simply refer to it as having the smarts to know very specifically what your position is within the market sector you operate in, and do everything you can to dominate it. By way of further understanding this, let me digress slightly and look at the hardware industry. Remember 15 -20 years ago there was a hardware store in every shopping strip; a local store that predominantly dealt with the tradies and the odd ‘Mr Fix It’. Enter the massive shift to a DIY market and the rest you know. The big boys (i.e. Bunnings) got bigger, those in the middle got swallowed up and went out of business and a niche market emerged that specialised in one aspect of hardware (i.e. plumbing, Reece). It’s a simplistic analysis but the same can be said about your local general store, the milk bars. Where are they today? The 24

hour Coles/Woolworths domination has taken its toll and whilst there may be fewer smaller operators, they niche very well. The same can be seen in the coffee shop industry; the newsagency/ stationery industry; the IT industry; in fact, find an industry and analyse where it has been and what’s happening to it now, I bet the smart ones are always repositioning. You may be asking yourself what have these business examples got to do with our industry and caring for our ageing community? Over the past few months I have attended countless workshops, regional and metropolitan meetings, briefing sessions with Ministers and the inaugural LASA National Congress and amongst many observations, anecdotally I have observed the parallels in our industry. What I see is typical business behaviour of any industry when under threat from something as significant as the LLLB reform. Excitingly, I have already seen some organisations repositioning - either in the ‘Major’ player space or moving to become a ‘Niche’ player. However there are still many struggling to understand where they should position themselves. Will they be caught in ‘No-man’s land’? Whether your organisation is large or small; rural or metro; residential or community; private or not-for-profit what’s important here is that you ask this question: can your organisation be all things to all people? Perhaps, as an industry, we have tried to do this in the past. What I am hearing from providers around the nation, and particularly here in Victoria, is that the LLLB reform is not only forcing us to ask this question, it is imposing that we act on it. The history of all industries, and the respective organisations within, will take you some way to finding the answer. Therefore, if you are not already doing so, now is the time to position your organisation for future success. ■


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QUEENSLAND REPORT Nick Ryan Chief Executive Officer | LASA Queensland

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s I reflect on this the final quarter of the year, I very proudly take stock of the number and range of activities and achievements our association has been involved in across a spectrum of age services issues and varied levels. Nationally, LASA Q has continued to inform the LLLB agenda with direct and ongoing input into the reform working groups and committees, particularly across the Residential Care and Community Care age services streams around: • Specified Care and Services • The Aged Care Funding Authority • LGBTI and CALD strategies • Home Care • The Gateway. Working closely with the national office and in conjunction with state colleagues, LASA Q continues to build on this work by informing a national response to DoHA regarding the proposed legislative amendments to the Aged Care Act 1997. As with much of the reform agenda, tight timeframes and lack of specific content and/or detail, has been both frustrating and challenging. Despite these obstacles, LASA Q has worked tirelessly, with the invaluable support and feedback of members, to ensure the age services industry has a voice in the policies and procedures likely to impact us in the future. At times however, even our best efforts to inform and advise government on the critical issues facing our industry and impacting our clients appear to go unheeded. The recent release of the Queensland Government’s recommendations into their review of the Retirement Villages Act 1999 is a clear example of this. Several criticisms of the committee’s recommendations are that they create more red tape, reduce viability for scheme operators, ignore regional and rural service providers and do not consider market forces. This will not dissuade us however from continuing to seize every opportunity to influence and shape the future age services landscape, particularly in this time of unprecedented industry

reform. Not only do we need to do so to guarantee the viability of our industry, but to ensure that it continues to best serve our clients, wherever they are ageing in Australia. It is not just in the policy space that LASA Q is facilitating participative transfers of age services knowledge, experience and skills. In this later quarter of 2012, we have also held a number of meaningful member based events, engaging members and staff alike, and resulting in the exchange of thoughts and concepts that influence both the operational and strategic aspects of age services delivery. These events and training opportunities have included: • Regional Invitations Series – Executive Member strategic workshops in regional Queensland • Consumer Directed Care Forum – Unpacking the new approach to Community Care • Men’s Shed - Safety in the Work Shed seminar • Tri Series Breakfast – Enduring Power of Attorney, Advance Medical Directive and The Adult Guardian • Beyond Blue - Understanding Depression and Anxiety disorders in older people • Certificate III in Home and Community Care - Rockhampton jobseekers. Looking ahead, 2013 has all the hallmarks of another busy and challenging year for the industry, with the impacts of machinery of government changes here in Queensland this year, and a federal government election next year, adding yet another layer of complexity and ambiguity. What I can say with certainty however, is that LASA Q will continue to actively support our members, wherever they are located within the state, and in whatever capacity they require, as part of our strong and ongoing commitment to our ‘Members First’ philosophy. To my team, my national colleagues, our members and the people they serve, I wish you all a very Merry Christmas, and look forward to working with you all in meeting the challenges and harnessing the opportunities that 2013 brings. ■


Leading Aged Care Organisations Back Innovative Pad Recycler In Sydney, December 2012 saw the city’s leading aged care providers back innovative recycler, Relivit in its efforts to bring a new recycling technology to Australia. The patented process reclaims plastic and wood fibre from disposable nappies, continence aids and female hygiene products, collectively known as Absorbent Hygiene Waste (AHW). This allows the waste to be diverted away from increasingly expensive landfill and reduces carbon emissions. The process will also be cheaper than sending this waste to landfill. Sydney alone produces almost 100,000 tonnes of AHW each year. If sent to landfill this waste produces the same amount of greenhouse gases as 37,500 cars travelling 15,000 km per annum. “The formation of the Relivit Founders Club is an important milestone in establishing Australia’s first disposable nappy and continence aid recycling service. Aged care organisations account for more than 10% of Sydney’s AHW. Collecting their waste will allow us to develop a service network that will open up opportunities for councils, childcare centres and households to also recycle this difficult waste stream. This will deliver positive environmental outcomes that will benefit the whole community,” explained Gareth Williamson, Managing Director of Relivit. Relivit’s Founder’s Club membership list reads like a who’s who of Sydney’s leading aged care providers and includes ANGLICARE Chesalon Care, Anglican Retirement Villages (ARV), Baptist Community Services NSW & ACT, Domain Principal Group, Hall and Prior Aged Care, HammondCare, Kennedy Health Care, Southern Cross Care, SummitCare, RSL LifeCare and 16 other aged care providers. Procurement Manager for ARV, Terry James explained, “As well as having a responsibility to provide high quality and cost-effective care, Anglican Retirement Villages has a responsibility towards environmental sustainability. By signing up with Relivit we’re excited to see our pads being

recycled. We understand that more than 95% of this waste will be directed away from landfill, halving the carbon emissions.” Mr Williamson went on. “Relivit understands that aged care providers’ primary focus is on delivering high quality care and that financial resources are carefully directed as a result. To gain their support our service has to deliver savings or be cost neutral at worst. We estimate our service is likely to save Sydney’s aged care sector up to $2 million in the first three years.” Relivit plans to commence operating its first AHW recycling plant in late 2013. The Western Sydney plant will be able to process 25,000 tonnes of AHW each year. It will also receive sanitary waste collected by washroom management providers such as Pink Hygiene Solutions. The reclaimed plastics can be made into outdoor furniture and construction materials, whilst the wood fibre can be reused in making paper, cardboard and pet litter. If you are interested in the service or would like to know more you can contact John Nolan-Neylan, National Sales & Marketing Manager at Relivit on 0450 644 865 or via john.n2@relivit.com.au. Or visit www.relivit.com.au/agedcare

L-R Sarah Christie, Account Manager, Relivit; Samantha Rappolt, Procurement Coordinator – Contracts, ARV; Terry James, Procurement Manager, ARV; and John Nolan-Neylan, National Sales & Marketing Manager, Relivit.


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WESTERN AUSTRALIA REPORT Providers are geing creative in the West Anne Marie Archer Chief Executive Officer | LASA Western Australia

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rts and Health Australia held its 4th Annual Conference, The Art of Good Health and Wellbeing in Perth from 26 to 29 November 2012 and attracted people from around the world who converged on the West’s port city of Fremantle. It was wonderful to see many LASA-WA members attend the conference and also seeing representatives from the St Ives Group being asked to make a presentation about an art exhibition and competition that was held in 2011. Noreen Byrne, General Manager and Kerry Nilan, sales representative from St Ives Retirement Villages, described to the conference attendees their hugely successful art exhibition and competition which showcased St Ives residents’ finest artwork. Combining Noreen’s management skills, Kerry’s creativity and St Ives Director Ray Fitzgerald’s vision, the three set about planning and executing a wonderful art exhibition which many St Ives residents from all over Perth entered, as well as visited.

St Ives Group Art Program managers Kerry Nilan and Noreen Byrne, General Manager of the St Ives Retirement Villages.

The three had never before planned such an event and were amazed at the high calibre of talent that was exhibited, as well as the fantastic public interest that it created. More than 1500 people attended the exhibition that showcased over 300 pieces of artwork, attracting politicians, local government officials and television personalities. The exhibition and competition had great prizes, as well as trophies and certificates presented to participants. The St Ives community holds a treasure of talented artists who took the opportunity of the exhibition to unleash their creativity and showcase their talents to the public. The exhibition not only stimulated the creativity amongst the St Ives community, but also raised funds to upgrade art and craft facilities in the St Ives villages. The Art of Good Health and Wellbeing Conference presented a wonderful opportunity for people involved in the aged care industry to be inspired to utilise arts programs to enhance and enrich the lives of their clients and residents. ■


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LASA Inaugural Conference 28th–31st October 2012 Perth Convention and Exhibition Centre

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t tackled leadership in a changing world, care models of the future, workforce issues including the role of the nurse practitioner and the GP in aged care. It covered systems reform and financing and the ever evolving role of technology in facilities large and small. It was well received by many, applauded by others and there were some who were disappointed but that’s usually the way of all conferences. There were tears in the workshop on putting a ‘Spark of Life’ back into the lives of those with dementia, there was much laughter when Avril Henry enthralled her audience with her latest research into generations X and Y and how aged care employers need to change to attract and keep them in the workforce! There were dozens of commercial stands in the exhibitor’s hall to peruse, to begin building relationships and to contemplate future contact. It was the inaugural LASA conference and it was the ‘coming out show’ for the new aged care association. It provided a platform for the new CEO Gerard Mansour to share his vision for the future as he addressed the delegates. “We (Leading Age Services Australia) are now the largest national provider industry body and representing well over 60 per cent of the industry,” he said. “Importantly, we are the only Association which is committed at its very core, to advocate and represent the entire aged care industry - be that for profit aged care providers, large or small businesses, as well as the breadth of the non-profit


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sector including church and charitable, community organisations and the public sector. “ Gerard went on to say that “My view is that no matter who wins Government next year, we are now in a new decade of reform. The real question we now face is ‘how do we ensure a viable and flourishing industry for all older Australians who will need our care, services and support?’ “While I am passionate about the right of an elected Government to govern, I am equally passionate about our right to contribute as an industry by thought-leadership. There can be no doubt whatsoever, in any industry, that those like us who are at the coal face have so much to contribute to the policy dialogue about industry reform,” he said. Reaction to the content of conference has been mixed, Julia McCarthy, the Director of Operations and Resident Care at Freedom Aged Care in Southern Queensland said she thought LASA’s first conference was very good overall. She said some speakers were much better than others, which is a common observation of how it will be at every conference. Julia found the sessions on aged care reform extremely valuable, particularly hearing about the challenges that other providers face and how they overcome them. “The futuristic and technical focus of conference was great and the Spark of Life really touched my heart! I also got a great deal from presentations that centred on building designs and care models for the future,” she said. Anne Butcher, the General Manager of Aged and Community Care for St Laurence in Victoria said that she got so much from Avril Henry’s presentation.


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“It wasn’t just entertaining; she nailed the attraction and retention indicators for our future workforce. I love the way she constantly researches different generations and their reaction to seeking employment. We will need to be more flexible and innovative if we are to attract and keep younger employees,” said Anne. Anne said she has become more aware of employment advertisements that don’t work, at least that’s according to Ms Henry. She found the sessions on technology and robots interesting, realising that ‘we will need them in the future but that they will never replace the role of real people in the provision of care. I also found the panel discussion on the last day on Aged Care Reform and the detailed discussion on the ‘Living longer, Living Better’ reform package extremely helpful.’


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Gerard Mansour also listed six key decisions which he said, will collectively shape much about the first phase of the aged care journey to June 2014. • Changes to ACFI. In a couple of months the real impact of these changes will become clear. • The decision about ‘significant refurbishment.’ (That decision will be published before this magazine is out.) • Accommodation payments. Government must resist the temptation to take a ‘regulatory’ approach to price setting. It must allow the industry to set accommodation prices, publish those prices openly, and provide and provide funding to support the vulnerable and disadvantaged. • The significant shift to ‘consumer directed care’ in the roll out of the 2012 ACAR for home care packages. • The importance of allowing flexibility for providers to charge additional fees for extra hotel and lifestyle services in residential care. • The wages compact. Conference papers and workshops addressed workforce issues care models, technology and its role into the future to name but a few. As usual delegates and exhibitors enjoyed themselves as much as was humanly possible at both the cocktail party on the first night and then at the gala dinner dance! The final words go to the reluctantly retiring, newly appointed CEO, Gerard Mansour. “There is no doubt that Leading Age Services Australia is up to the exciting challenge given the enormous capability of our membership across Australia. But no industry body can be worth its salt unless its members take the time to give feedback. I urge all members to continue to express their views and thoughts and ideas to their State Associations, their teams, or the LASA Directors. That is an essential and critical part of an effective and vibrant industry body.” Mr Mansour added that, “Over coming years we will continually find one statement comes back to us time and time again – ‘united we stand and divided we fall’ – our policy challenge will continue to be taking the time to consider solutions which meet the needs of our entire industry. If we as an industry do not do that, someone else; typically Government, will make those decisions for us.” “In conclusion I want to share with you my belief that this journey needs to continually be brought back to three key principles: 1. We must shift increasingly to ways in which consumers can have more say, more choice, more empowerment in decision making. 2. Side by side with this increase in consumer engagement is the vital importance of continuing a shift in our funding base towards those who have capacity to pay more being able to do so. 3. We need an ‘aged friendly society’. We must continue in our quest to educate and inform our community about the critical issues of ageing and aged care.” “No one is oblivious to the magnitude of the challenge ahead, but in the end there is a simple principle which must dominate the thoughts of policy makers - without a viable and flourishing aged care industry older Australians will not receive the care and services they need and deserve.” ■


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Winner of the New Standard Building Award, Uniting Care Elanora By Mike Swinson

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he winning entry in the New Standard Building Awards announced at Leading Age Services Australia (LASA) conference in Perth recently is a remarkable model for the future of aged care in Australia and is worth a visit if you ever get the chance. The architects, aged care specialists Calder Flower say that the design incorporates some unique features that optimise efficiency, reduce energy costs and make the building a stunning place to both live and work. Architect Lara Calder said that the long term savings on energy and water consumption will prove to be significant and the building will be an exemplary model for future similar developments. “Sustainable design is not something that aged care readily embraces, they talk about it in terms of maybe some re-cycled rainwater, a grey water reticulation system, solar panels on the roof, but there is a lot more to it and a lot more to this building than just those few features.� The project was built by aged care and seniors living building specialists Grindley Constructions, a company with a long and proud history of work in the sector. Their experience and expertise helps clients to manage risk, reduce uncertainty and meet objectives with complex refurbishment, facility upgrades or new construction.


“Smart buildings these days can and should incorporate design features that take advantage of natural light, airflow and technology so that the outside environment is a part of life inside the building. Computers control double glazed windows that open and shut, letting cool air in or warm air out, daylight stream into the building from all angles. It works so well” she says “that the staff love it, not to mention the residents,” says Lara. “The future of aged care will almost certainly have to embrace the technologies that offer people choice and comfort and no longer deny them connection with the outdoor world.” “Throughout the day residents and staff can see the movement of the sun, the clouds, be a part of storms and wet weather, yet still be comfortable. Lots of natural air movement and it means you don’t need artificial light nearly as much, less air conditioning and so it goes.” A key consultant in this project was John Brodie from Vim Consulting, a specialist in sustainable building design supporting the architects in the design and incorporation of many unique features. From Uniting Care’s perspective the building came in on budget with all the best design and sustainability features in place. At the time of design development in 2008, carbon emissions and high energy costs were not on the radar, not quite; but the project team and the client identified that it would become an issue. That’s proved to be correct, so now the planning is paying off with huge savings in energy by generating its own electricity, saving and re-cycling water. ■


National Update | 25

Winner of the New Extra Service Building Award, Regents Garden By Mike Swinson

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f you had a chance to let your imagination run wild and design an aged care facility that was a ‘bit out of this world,’ Regents Garden facility in Perth, WA just might do it for you. Take a good look at the images here and then if you want to see more, head to their website, www.regentsgarden.com.au/aubin. Regents Garden, in the Perth suburb of Aubin Grove, won in the Building Awards, new extra service category, which judges said was a difficult decision because of the high calibre of all the nominations. “The expansive use of roofing material that allowed diffuse lighting into many of the internal precincts was given high recognition and the internal courtyard/village feel of the main atrium area was considered particularly attractive,” the judges said. The architects of Regents Garden Aubin Grove were charged with creating an innovative and inspiring building that would enhance the experience and quality of life of its residents. The building is designed to encourage residents to interact with each other, their care staff, family and friends… to have them feel excited to be there and nurture a sense of pride of place. The building integrates state of the art equipment, energy-efficient design and the latest research on effective clinical care. A key aim is for residents to always feel ‘it’s their home’ not just their room,


so these zones resemble neighbourhoods, with streetscapes, gardens and individualised mailboxes in front of each room. The neighbourhoods connect to a large fully-enclosed central atrium, which houses the Care Centre ‘hub’ and is suffused with natural light. The new building, the fourth of its type for the Regents Group, includes a café, private banquet hall and movie cinema. Free Wi-Fi is provided for the entire site. Part of the philosophy behind the design is to meet the needs of ‘Baby Boomers,’ whose expectations will be for aged care providers to deliver more from a lifestyle point-of-view. ‘Baby boomers’ have enjoyed a higher standard of living than previous generations and they will expect that standard to be maintained – both for their elderly parents and also for themselves in their later years. These residents will expect single rooms, ensuites, hotel-quality amenities and entertainment. They will also demand value for money. The award application from Regents Gardens says ‘put simply, we are trying to create a facility that people are happy to call their home, where they can experience a quality of life that is even better than they may have experienced before. We want to create a place where our residents well-being and happiness is promoted by a team of professional compassionate staff who provide superior service. We want residents to be able to relax in the knowledge that they are safe and cared for in luxurious surroundings. We want people to come here to live, not die!’ ■


National Update | 27

Winner of the Renovated Extra Service category, Kew Gardens By Mike Swinson

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e provide care that is virtually invisible, it’s there, it’s the core of what we do but because of our built environment, particularly with this new renovation you cannot see it.’ Charmaine Waugh, the CEO of Kew Gardens aged care facility, part of the Australian Aged Care Group announced after their win in the Renovated Extra Service category of LASA’s Building Awards, at the recent conference in Perth. “I have just come back from a trip to Europe and I know that what we are doing here in Kew Gardens is at the cutting edge of aged care facilities from around the world! Awards give us an opportunity to showcase what we do very well and to market that success. We believe that we provide the very best aged care that you have ever seen,” says Charmaine. The extra service renovation at Kew Gardens involved remodelling a number of single rooms into suites, with bedroom, bathroom, kitchen and sitting rooms. The re-built rooms were filled

almost instantly, now there is a waiting list in the facility that boasts 100% occupancy. Charmaine Waugh says, “while the industry has been talking about providing hotel style extra service we actually do it, particularly in the built environment and I think that’s why others are now trying to emulate what we do.” In all aged care facilities, space is at a premium and Charmaine says there is a huge opportunity for some clever individual to come up with a bed that can disappear during the day, reappear at night and allow for the lifting paraphernalia that comes with aged care. “We need someone who can come up with a clever idea so we can get rid of the bed during the day and pull it out at night. Then we have the best of both worlds, a room that can become a sitting room or bedroom at the click of a button. This award is so important to us because it shows we are doing the right thing!” ■


28 | National Update

Winner of the Renovated Standard Facility Building Award Mercy Place, Shepparton, Vic. By Mike Swinson

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he newly renovated Mercy Place in country Shepparton is a home away from home, a place that staff love to work in and residents love to call home. Nicole Malseed, the Services Manager at Mercy Place says the renovation has managed to transform the original facility into a modern, light filled wonderful space. “Not only do residents and staff love it but so do the families and friends of residents. It’s a great place to come and visit, to make tea or coffee to relax and enjoy the spaces. What’s also so good is that the renovation has managed to incorporate the old building into the new one, it all works so well”. Comments like that will be music to the ears of Phillip Templeton, one of the architects involved in the design and construction of the project. “We were asked to provide an extension to an existing facility that would make it iconic to the town and region it serves.

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So we opted for a design that opens up the internal spaces, visually connecting living rooms, dining rooms so that it has a home like feel,” he says. One of the best features of the renovation is the circular kitchenette that is connected to the main meals preparation area that residents can come and go with or without visitors and help themselves. They can choose to eat at a breakfast bar or at a table. They can come and make tea or coffee whenever they choose. The café style doors can open connecting to courtyard gardens with raised beds and fruit trees and scented gardens. Colour has been used to brighten and identify different areas. Power demand has been reduced through skylights and large high windows, solar panels and rainwater tanks formed part of the renovation. The images are worth more than another thousand words! ■


Profiles | 29

Profile of Peter Cosgrove, Chair of Leading Age Services Australia By Mike Swinson

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n his own self depreciating style, General Peter Cosgrove, election in a way almost never seen before in Australia’s the new Chairman of the board of Leading Age Services political history? Australia said in his autobiography, that ‘I am just a kid Peter Cosgrove says it’s all to do with family, with from Paddo in Sydney, who found himself many years personal experiences and of course, the invitation from the later, running like a kangaroo in a spotlight and had to run hard, LASA board. (somewhere, anywhere) in order not “I accepted the role of to get flattened! Chair of the LASA Board,” So are we meant to believe that said General Cosgrove, When I look around these days, beyond the he’s been doing that all his life? “because I have a deep four walls of my own home, I see many elderly Running? Not likely; he has a seated interest in how older Australians who at present are proudly MC for bravery awarded from his Australians are treated as independent, but who all have a higher life time as a platoon commander in they traverse the autumn expectancy than my Mum and Dad and their Vietnam! Peter Cosgrove does not of their lives. I see my job Mum’s and Dad’s did strike me as the sort of bloke who as harvesting the collective would run from conflict, not unless wisdom of the Board of he had assessed all the risks and decided that discretion was the Directors, with a broad range of experience and representing all better part of valour and fighting was more likely to succeed on aged care facility ownerships; to understand the advice of experts, another day at another place. then to put all that to work to meet the challenges and get results.” In a review of General Cosgrove’s book, Anthony Lepere Note those last two words; they are the essence of the man in his own at times acidic way observed that ‘My Story is a himself; ‘get results.’ thoroughly readable account of a soldier’s life, from dormitory “When I look around these days, beyond the four walls of my days at Duntroon, through harrowing experiences in the jungles of own home, I see many elderly Australians who at present are Vietnam, to changing times in the corridors of power. Cosgrove’s proudly independent, but who all have a higher life expectancy concern for the men and women in his charge – one of two great than my Mum and Dad and their Mum’s and Dad’s did. The reality families to whom the volume is dedicated – seems genuine and is that the demographic is growing, the need for support and care deep. His …………. meditations on the deep pity and horror of will also grow, so I see my role in LASA is to support and ensure war are timeless. Cosgrove himself emerges from his prose as that we provide a dignified and supportive future for those people likeable and decent.’ from our decisions makers.” I know from experience that’s the way almost every Australian Anthony Lepere on My Story again; ‘throughout the book, an independence of spirit suffuses Cosgrove’s anecdotes. In his would see him, ‘a decent bloke; a bloke you can trust’ and from clashes with Senate estimates committees and Federal Police Australians there is no higher form of praise. commissioners, Cosgrove is at pains to present himself as So from his leadership roles in the Australian Defence Pinocchio, a puppet perhaps, but one without strings.’ I would add Forces, as Australian of the Year, in North Queensland in the Peter Cosgrove is truly his own man! reconstruction of Tully and Innisfail after cyclone Larry, in East “I think the reverence shown towards elderly people that very Timor, what on earth is he doing launching himself into the much typifies the cultures around us, and I hope underpins the maelstrom of the politics of aged care? This at a time when the approach to aged care funding by the wider Australian community, population ageing tsunami is gathering force and when politicians (even though in this country it is understated) is vital if we are to are sharpening their verbal daggers for the vitriole of the next

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Profiles | 31

afford dignity and amenity to older people. How well we do it is a measure of our capacity as a compassionate community.” Peter Cosgrove has a personal understanding of what it means to look after older family members, as well as another experience that stays with him to this day. Dressed in uniform, complete with slouch hat and TV crew, he was visiting the RSL Lifecare Village in the Northern beaches area of Sydney, where a new wing had been named in his honour; when he came across a new resident, an older bloke who was sitting on his own looking a bit anxious and I said ‘G’day mate, I’m Peter Cosgrove, how are you?’ The man looked at him and said ‘Can you take me home, I don’t like it here!’ It turns out it was either this man’s first or second day in the facility; he had moved from the care of one of his children and he was emotionally vulnerable. The staff hadn’t had a chance yet to settle him into the place, help him meet others and make new friends. “There is the vulnerability of feeling alone and not being able to take care of themselves physically,”says Peter“and there is the other vulnerability of emotional loneliness, that’s why we have to make sure we have wonderful standards of care and compassion in our aged care facilities.” “It struck me like a thunderbolt recently; it’s the reason why I said yes to the Chairman’s role in LASA. I know from personal experience that we have to find that balance between an older persons right to stay at home, despite stairs, slopes, big rambling houses and gardens and our responsibility to get them into care so that their quality of life is as good as it can be in the final months or years.” We don’t have to know the details of the personal anguish experienced by Peter and his family that lies behind that statement, just be aware that Peter knows first-hand how tough the decision can be to try and move someone close to you into care from a home they have lived in and loved, that is full of treasured memories and what do you do if they are stubborn like my Mum and refuse to go? Peter Cosgrove is also a student of human nature, a keen observer of who we are as human beings and how we treat one another. Nowhere is that more apparent than when he has been in Turkey to participate himself in the annual pilgrimage paying homage to the soldiers of Turkey and the diggers from Australia at Gallipoli. Anthony Lepere observes about the General’s description of that visit; ‘Cosgrove tentatively explores the collection of emotions that prompts the annual ‘second invasion’ of Turkey’s Anzac Cove. The young Australians Cosgrove met were: “irreverent and wonderfully affectionate to one another, to the day and to me. I felt in some ways they were channeling the admiration and affection Gallipoli invoked for our ancestors on to me, the nearest bloke they had in a uniform.” “We have taken on a duty and responsibility as the board of LASA to understand government approaches to aged care and the way policy and funding will support those approaches. We want to understand that but equally we want to be involved directly in shaping it. To do that we need to have a really productive partnership between the experts in aged care (most of who reside in the industry) and the governments that hold the policy levers and the funding purse strings.

“That does not mean in that partnership that we will shrink from pointing out when we are not happy with a policy or funding decision, above all what we will be is representative.” “As far as I am concerned, virtually every Australian these days who is approaching the time when they need to think about aged care of some sort, has contributed to this great country and made it what it is today. They deserve dignity, respect and compassion. ‘The American humorist James Thurber observed – that ‘all men should strive to learn before they die, what they are running from, and to, and why.’ I’m sure that in a moment of quiet reflection General Peter Cosgrove would be able to answer that question, probably with a wry smile on his lips. In one of those reflective moments he told the ABC’s Peter Thompson that; “I hope I’m a people person. I hope I really empathise and identify with the people I work with. I hope that’s the case. I think it is. I think over the year’s that’s been noted as something I’m good at. My weakness is that I’ve actually got a pretty short fuse. I’ve managed to keep a real lid on flying off the handle, so to speak, over the years, but I know that I’ve got an Irish temper which I’ve really always got to grab on to.” Board members, bureaucrats and politicians, forewarned is forearmed! Yet it is Lepere’s final observation that is worth including here; “It is not too much to say that General Peter Cosgrove’s professionalism and decency represent an example to which all Australians might aspire.” I for one concur. ■


32 | Profiles

The Future: it’s Your Choice! By Mike Swinson.

A conversation with Futurist Morris Miselowski.

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ith a name like going to morph and evolve Robotic technology that turns lights on and Miselowski, you in the next ten years or so. off at set times, opens and closes curtains, know Morris is of I understand that we will pulls back the doona or blankets, raises Polish decent and always need people to deliver the pillow and bed, there are a myriad of therein lies a fascinating tale, a story care, but technology will play IT developments from around the globe for another day, sometime in the and is already playing an happening as we talk future. increasingly important role. I met Morris at this year’s LASA What will change is the way conference in Perth where he was one of the keynote speakers. we deliver care, the how, what, when, where and why and who we I was drawn to his presentation by his wit, research, knowledge do it to is undergoing huge change and that will continue,” says and his vibrant presentation skills. So what does all that have to do Morris. with aged care? An awful lot I can assure you. “For me,” he said, “it’s not a matter of trying to accurately According to Morris we are in the midst of another industrial predict what might happen, but instead thinking about what is revolution, this one mostly IT based. If you think about it for a likely to occur over the next short time frame and then doing some moment or two, just remember that there are 25 million Australians planning around that. I don’t think there are enough people playing and we have already purchased over 22 million smart phones! in the space of business models for the future, keeping people at Now how much have those little gadgets changed your life and home longer, providing more and more acute care, building and how you live it? employing the technology that allows you to do that. I know some Way back in the dim dark IT ages of 2010, in the early days of are but I think many are not!” this revolution, I detailed an update in the ACAA magazine on the “There are a lot of emerging technologies that are going to remarkable smart phone rollout by Silver Chain in WA: underpin extended life at home,” says Morris. “The Magic Carpet is one, an underlay that can monitor movement and let carers or Last year, one of the most ambitious IT implementation family know when a fall has occurred. Robotic technology that programs in Australia, if not the world, began when Silver turns lights on and off at set times, opens and closes curtains, Chain in WA started rolling out over 2000 smart phones pulls back the doona or blankets, raises the pillow and bed, there throughout its geographically vast organisation. are a myriad of IT developments from around the globe happening The smart phones are being used by a wide range of as we talk.” staff including doctors, enrolled nurses, registered nurses, The LASA Conference also heard of technology (‘Just occupational therapists, care aids and home-help support Checking In’) that exists today; monitoring movement in the home, staff. At any one time there could be over 700 people where and when, to the fridge, outside in the garden, to and from logged on to the database that runs the system. the bathroom, how often, how long. It’s a technology that is really The business’s General Manager of Information helpful for carers and family concerned that Mum or Dad is getting Management, Allan Turner said the next phase will up too much at night, going to the bathroom too much or not using see clinical staff using the smart phones for wound the food in the fridge at all. management, a system that will go live in April this year. “Most of the technology that I see being developed for use The revolution is in full swing and will, if it hasn’t already, in aged care is intuitive, that is, it can learn the activities and become a tsunami as it gathers force and pace, sweeping all movements of the person it is monitoring, so that when something before it, possibly leaving you and your business in tatters if you happens that is outside the norm, alarms can be triggered, people don’t take stock and plan for the future. alerted. In the old industrial revolution everything around us “My presentation was meant to be provocative for those in changed and that’s exactly what’s happening now. Soon we will the aged care industry, showing how the world around us is see virtual walls with changeable visual backgrounds in places


Profiles | 33

like dementia facilities, walls that move to accommodate different roles for the rooms, changing scenes on walls that bring calm and peace to those who are loosing their short term memories. It’s an exciting time to be alive,” says Morris. “We don’t have any choice in whether or not the revolution keeps going; that will happen with or without us. What we can choose, is whether or not we as individuals participate or withdraw, that’s fine. However businesses that withdraw or do not participate will do so at their peril. Take for example the employment of Gen X and Y, you will have to be technology savvy if you want to attract and keep them in your workforce. You have no option and you will need them into the future more and more,” he said. During our conversation, Morris made an observation that really tickled my fancy. He said increasingly people suffer from ‘Cyberchondria.’ Cyberchondria is when you or I head straight for the internet to diagnose our own illnesses or medical conditions without asking health specialists for their opinion or explanation. What he says is really quite scary. It is that the sufferers of this condition once they have self diagnosed vie the web, really believe that they have a detailed understanding of their own health and/or ailments. Those attitudes and beliefs are going to be dropped on the doorstep of aged care providers, by a generation of media and technology savvy baby boomers, who are

prepared to argue the toss and lambast you if you don’t give them what they want. The statistic that reveals just how this technology revolution will be driven by young people is this; this year greater than fifty per cent of the world’s population will be under 30 years of age. How many of them live and breathe with their mobile device attached like an umbilical cord? These revelations of a rapidly changing world give credence to the impetus of change: • It took almost 100 years for landline phones to reach market saturation. • It took just over 20 years for mobile phones to reach market saturation. • It is expected that smart phones will reach that milestone in just ten years. Change keeps going at an increasingly frenetic pace, so the question you face as a executive in an aged care organisation, or any business for that matter is; Am I ready? What do I have to do to ensure the business I am in takes this into account in its planning? Where do I go for assistance if I think we need it? Your smart phone, connected instantly/always to the internet is the short answer, then to your networks of contacts on Facebook or Linkedin! It’s a livin, breathin, a’changin world we live in! ■


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Aged Care Looking Ahead with Technology Suri Ramanathan Chair | Aged Care Industry Information Technology Council (ACIITC)

Report by the Aged Care Industry Information Technology Council (ACIITC)

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ouncil under the auspices of the two Peak Bodies in Aged Care has been in operation for the last 5 years. Over those years we have been able to increasingly impact Government policy and its agencies and have improved our profile in communications with the aged care industry. The year 2012 was a watershed year where we note the following key achievements: • Council sponsored the the highly successful 2012 Information Technology in Aged Care (ITAC2012) in April. The conference was opened by Federal Minster for Communications and the Digital Economy, the Hon Stephen Conroy. Another highlight was the the live telehealth teleconsultation lead by Professor Len Grey. • Commissioned by the Commonwealth Department of Health and Ageing, to undertake the Pathfinder Project to test and prepare for the introduction of the Personally Controlled electronic Health Record (PCEHR). The project included key software vendors and a handful of Providers. • Contributing to and leading the discussion on Telehealth. Along with Indigenous Care Services, Aged Care was the only other sector that was granted incentive payments for equipment and reimbursement for provision of telehealth service in all service locations. Other sectors were restricted to remote and rural only. The initiative for Aged Care even survived the last mid year economic budget cuts. • Bi-weekly free e-newsletter to the Aged Care industry on E-Health, which continues. We will look to a subscriber model in the new year to keep this sustainable, whilst expanding its content. This newsletter includes articles about e-health nationally and globally but also has video interviews of Providers and their Projects. Video in a bi-weekly newsletter, a first in Aged Care. Given the above and the other activities over the years, including the facilitating to bring about the formation of a Technology Vendors Association (ACIVA), embarking on Cloud Services in Aged Care when this type of service to reduce total cost of ownership to our sector was virtually non-existent (but now has spawned a fledgling industry by others entering the market), and significantly increasing the profile of electronic medication

management for Aged Care with policy makers and lastly our major and many contributions to shaping e-health has been our contribution over the years. With this in place we look forward to 2013 with the following initiatives : 1. We will continue to drive technology in aged Care. Our Industry needs a Technology Roadmap to support the business solutions available to our Providers to continue to evolve its service offerings to our clients. Council will develop a sector wide strategic plan early in the new year. 2. Council will bring together early in the new year a number of industry leaders with the object of developing an aged care industry information technology roadmap. We plan this to be a blueprint for the sector to work with and evolve regularly. It will also be a focal point when we have wider aged care policy discussions, as technology as an enabler, with Government and its agencies. 3. We will constitute the first ever Forum for Chief Information Officers in Aged Care and plan to evolve this to be a national body and voice of information technology professionals in Aged Care. The first CIO’s Forum will be late February. 4. We will disseminate Pathfinder PCEHR Project Lessons Learned with Software Vendors in late January and then with the sector at ITAC in May. 5. We will crystallise industry thoughts on being more Consumer Centric leveraging technology as our contribution to Aged Care Reform, our theme for ITAC 2013. 6. We will contribute to various Government Policy initiatives including Aged Care Gateway as well as continuing to drive telehealth and move to telemedicine. 7. We have created a Home Care IT Group to bring together the focus in enabling technology to not only Providers but also to consumers. This is on top of all the other initiatives already in place. Every member of your ACIITC is active in leading an initiative and subcommittees to drive the programs. We look forward to a busy 2013 and increasingly we seek that each of you participate in contributing to shaping Aged Care as the sector moves forward in its evolution. ■


36 | Technology


38 | Technology

The 2012 ACIVA Report Card – PCEHR & HI Dr Caroline Lee – ACIVA President

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he Aged Care Information Technology Vendor Association (ACIVA) has worked diligently this year to keep aged care (community and residential) in the sights of the National e-health Transition Authority (NEHTA) and the Department of Health & Ageing (DOHA). Through the efforts of members attending numerous NEHTA industry technology and clinical forums, the industry was recognised and awarded significant e-health status via the Aged Care Vendor Panel. Due to the support of the Aged Care Industry Information Technology Council (ACIITC), the aged care Pathfinder Project was conducted with three ACIVA members. 2013 will provide the industry with numerous resources regarding the Personally Controlled Electronic Health Record (PCEHR) and the Health Identifier Service (HI Service). This means that aged care is now part of the new era of health information connectivity, enabling care and nursing staff to obtain vital information about the clinical and medical needs of residents and clients which they otherwise would not have easy access to. Access to information in the PCEHR regarding residents and clients past medical history will be strictly managed to ensure Privacy needs and requirements are supported but those with the relevant access will be able to, for the first time, access past and vital records to aid effective decision making. But aged care organisations will need to apply for their HPIO’s (Healthcare Provider Identifier – Organisation) and employ a health professional with a registered HPI-I (Healthcare Provider Identifier-Individual ) before any Provider can access Personally Controlled Electronic Health Records (PCEHR) of any resident/ client who has provided consent to do so. Accessing a PCEHR requires an organisation to have a compliant software program that has been approved to access

the Health Identifier Service to upload or download healthcare documents. The HPI-O of an organisation will be recorded on any document that it uploads to a resident/client’s PCEHR. If other health professionals/healthcare providers have uploaded healthcare reports and an organisation wishes to download a document from the PCEHR, the HPI-O must also be sent to the PCEHR as an audit trail. When applying for a HPI-O, an organisation must determine if they wish to use only one number across their organisation as the audit trail number or if it would be more appropriate to have each facility/business unit to have their own HPI-O. There are two organisation types that the HI Service recognises: • A seed organisation - a legal entity within Australia which provides or controls the delivery of healthcare services; or • A network organisation – which is linked to, and provides services to the seed organisation. There is an “Organisation Type Classification Reference Guide” available on the Medicare website that will aid an organisation to determine the best method to use: http://www.medicareaustralia.gov.au/provider/health-identifier/ index.jsp#N1007B This access wouldn’t be possible if it wasn’t for the hard work of the numerous residential and community aged care software vendors and suppliers – many of whom are ACIVA members. As National President of ACIVA, I wish to thank all members for their support over 2012 and encourage the industry to continue to support the committed software vendors and suppliers that have made this and numerous other services and access possible over the past years. ■


Technology | 41

From Lile Things........ Rod Young | Advocacy & Policy Consultant | IRT

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he past year has been an extremely busy time for Wollongong-based IRT Group. In a whirlwind end to 2012, the aged care and lifestyle community operator committed to spending more than $200 million in retirement villages and aged-care centres on the eastern seaboard over the next four years and won a raft of local and national awards IRT Chief executive said responding to an ageing population was one of the great challenges aged care providers faced. “Our model of operations is different to that of a developer as we build a community that we then stay and operate,” said Ms Nieves Murray. “We remain committed to the community for many years to come – our oldest community is 40 this year – and making them sustainable, relevant and inclusive is an ongoing focus.” And the efforts are not going unnoticed, with IRT winning several categories at the Origin Energy 2012 Illawarra Business Awards for Business of the Year; Business Leader of the Year – Nieves Murray; Excellence in Community Service; and Excellence in Workplace Health and Safety. And for the third year in a row, IRT has taken out three top honours in The Australian Business Awards 2012 for Enterprise, Environmental Sustainability and Recommended Employer. Having worked in aged care since 1985, Ms Murray has taken IRT from its Wollongong and South Coast base into the Canberra and Queensland markets with more to come. IRT Group’s mulit-million dollar spend includes the purchase of three communities (home to over four hundred residents) on Queensland’s Sunshine Coast, as well the planned construction of more than 320 lifestyle villas and apartments tailored for over 50’s and seniors on the eastern seaboard.

“Almost 40 per cent of the population on the Sunshine Coast is aged over 50 and there will be a greater demand for age-appropriate accommodation as the population expands,” Ms Murray said. “But the Queensland acquisition follows our 2009 expansion into the Canberra market. Both regions require age-appropriate accommodation.” In Canberra, IRT Group constructed the award winning IRT Kangara Waters right near Calvary Hospital, the University of Canberra, Bruce Stadium and the Belconnen Shopping District, however, Murray said the community at IRT Kangara Waters in Belconnen offers much more than a convenient location. “When downsizing, people want to live within five-to-ten kilometres of their existing homes so they can keep in contact with established social networks,” Ms Murray said. “They don’t want to and nor should they have to live where land is cheap but services and shops scarce. People want to be a part of a community, and this is an important consideration in the development of retirement villages”. IRT is currently planning an expansion of its IRT Howard Court development in Wollongong’s CBD. The seven-storey development currently has 77 apartments, and will more than double in size with a new tower less than 100 metres from Wollongong City Council Chambers. “We are sourcing community input right at the beginning – at the planning stage,” Ms Murray said. “The current building is almost 20 years old and is still serving its purpose well – in fact there is massive demand for that site from the market. Our talks within the community will create an accessible facility, allowing people to stay in their homes for as long as practical, while integrating into the surrounding area.” ■


Congratulations to Electrolux Laundry Systems Best in Test – Uses less power and water than other Washer Extractors The Danish Energy Association invited 5 leading suppliers Electrolux, Ipso, Meile, Primus and Schutless to participate in the consumption data study. The Association then staged the independent testing of commercial Washer Extractors from the five suppliers in accordance with established industry standards and these are the results: The Electrolux machine uses: tMFTTQPXFSDPOTVNQUJPOUIBOUIFBWFSBHF tMFTTXBUFSDPOTVNQUJPOUIBUUIFBWFSBHF The test examined independently verified and uniform consumption and performance data in accordance with EN IEC 60445 – the basis for European energy marking systems for domestic washing machines. The Electrolux machine tested was the W465H Economy Washer Extractor, examined on two program settings Wash (3A03) and Economy (3A01). All other suppliers submitted a like sized machine for testing. Its official – the Electrolux machines consume less water and power than other leading brands.

Measuring water consumption

Energy Consumption test

Water consumption per kilo was measured at various different wash temperatures form 30oC to 60oC without a pre-wash, these are the test results*

Denmark is one of the countries that have taken the lead in energy savings and addressing the issue of CO2 emissions. The Danish Government has adopted a long term vision in order to meet their set targets.

Test results Average water consumption Ipso 16.4 per kg clothing.

Test results Average energy consumption in kWh per kg of clothing.

Ipso 0.264

The Energy consumption test was conducted in a similar fashion as the water consumption test, i.e.: washing cotton fabric at various temperatures from 30oC to 60oC without a pre-wash, the results speak for themselves* Electrolux environmental considerations don’t stop with water and energy efficient machines ….. All Electrolux commercial laundry products are manufactured to ISO14001 Environmental Management Standard that incorporates materials composition, environmental impact during manufacturing process, recycling, packaging, distribution and environmental safety.

Electrolux (Performance) 14.3

Primus 13.5

Schulthess 12.3

AVERAGE

Miele 11.8

AVERAGE Primus 0.178 Schulthess 0.176 Electrolux (Performance) 0.169

BEST IN B TEST BEST IN TEST

Miele 0.149 Electrolux (Economy) 0.145

Electrolux (Economy) 8.3

*The factors are based on an analysis contained in the “Energy Saving in the Public Sector Project” (Nov 2007).(– small font, italic)

*These test results can all be found at www.faellesvaskeri.dk

Electrolux Laundry Systems can not only provide you with the most efficient, user-friendly and environmentally friendly machines but with 6 full time technicians and a large network of associated services agents they can maintain and support your investment. The service line is open for business 24/7, 365 days a year. Along with professional service and support is a huge local spare parts holding, free design and consultancy service, accreditation advice and all the ancillaries necessary to ensure your laundry works to its optimum and is OH&S compliant. All this and the confidence that you are dealing with a recognised global company not a Distributor.

With Utility prices on the rise talk to the leading manufacturer of easy to use, innovative, energy and water efficient laundry systems.

888 or visit on www.electrolux.com/professional CallCall for 1300 a free550 consultation on 1300 546 Australia wide to find948 out more orour visitwebsite our website at www.electrolux.com/laundrysystems .


44 | Technology

A robot that can help your grandma (or you) avoid the nursing home

T

wo major trends could open the door to robotic care givers that help senior citizens stay in their homes longer. First, robots are getting more people friendly. And second: people are getting more robot friendly. As baby boomers age and retire, they’ll be confronted with a really tough choice: Pony up for extremely expensive assistedcare or full-care facilities or stay at home and rely on family or outside help as needed. Ask any ageing person their preference, and you’ll see that the “age in home” option is the winner both in economic and psychological terms. The AARP estimates that 84 percent of respondents want to remain in their homes. The good news is that, relatively soon, it looks like there will be tech options — including in-home robots — that can help them stay put. The technology is getting more adaptable and more affordable. Rethink Robotics sells Baxter, an industrial robot, for $22,000 now and, with the advent of a new software development kit, Baxter could be adapted for new markets. Rethink’s CTO and founder Rodney Brooks hopes that geriatric care will be one of them.

“I think absolutely elder care is going to be an incredible pull on automation technology, because people want to stay in their homes longer, and the demographics is much more older people. This, by the way, is true in China now too. You know, a young Chinese person now has two parents and four grandparents who don’t have anyone else but that person.” So there’s going to be a real pull for how technology lets people be independent longer. And I’m hoping that someone will come up with some provocative things with Baxter for that.”

Research: Older Americans are receptive to robotic help Technology is one thing. The willingness to use it is another. And new research out of Georgia Tech shows that acceptance of inhome robot help among older people may be growing. Researcher Cory-Ann Smarr, a PhD candidate in Engineering Psychology at the school, said a survey of 21 people between the ages of 65 and 93, showed them open to using robots for some tasks — but also very picky about which tasks those would be.

Barb Darrow


Technology | 45

Willow Garage’s Personal Robot 2 with two friends.

“They were fine with a robot reminding them to take their medications but not so fine about a robot telling them what medications to take,” Smarr told me in a recent interview. Most of the respondents — who were shown a video of the Willow Garage PR-2 robot performing jobs — seemed pretty tech savvy already. Most were proficient users of cell phones, recordable and programmable devices like thermostats and coffee makers. Most (71.4 percent) said they used a computer so these respondents were not tech neophytes and may not be typical of older seniors in the broader population. Recent Pew Research on smartphone ownership found that just 11 percent of adults over the age of 65 have smartphones, compared to 34 percent of those aged 50 to 64 year. Still, it’s interesting that they did not shoot down the notion of a robot helper. While there’s been talk of robots in the home for decades — Roomba helped blaze the trail — there’s really nothing out there that looks like a robotic butler or maid. But given the economics of ageing, the option of staying in a home that’s paid for versus selling that home to pay for facility living is undoubtedly attractive. Since assisted care facilities can cost anywhere from $1,500 to $5,000 per month, the notion of buying a $22,000 robot — assisted at times by human helpers — might not be beyond the pale. And more people will face that choice than ever. The most recent U.S. census data shows that the percentage of Americans over the age of 62 grew 21.1 percent between 2000 and 2010 — the second fastest growing demographic after the 45 to 64 year age group which grew 31.5 percent in that period. And, the AARP estimates that the number of US adults over the age of 65 will nearly double in the next 20 years. Companies that can build adaptable and affordable robots to fill this growing need could be big, big winners going forward. ■


46 | Workforce

Employer of Choice Award Springfield Gardens, part of the Padman Group By Mike Swinson

T

his is a good news story in an industry sector that has to cope with more than its fair share of negative media attention. Flexible rostering and policies that allow children of staff to play an active role at the Padman Group’s Springfield Gardens facility are among reasons the South Australian provider has taken out this year’s employer of choice award from Leading Age Services Australia (LASA). Springfields Residential Care won in the employer-nominated category and was one of six employer and building awards announced at LASA’s national congress in Perth recently. LASA CEO Gerard Mansour said it was nice to have a good news story when much of the focus in aged care was on meeting the challenges. “Springfields demonstrated that with a changing population profile, it needed to adapt its workplace culture to reflect the needs of its local community to ensure an attractive and engaging place for current and future staff,” the LASA judgement said. Diane Jones, Springfield Gardens Director of Nursing said the management team focus on making the workplace a happy place to and from that flow many other benefits. ‘We have less absenteeism, fewer incidents and accidents and low levels of sick leave. Residents also see our staff as people, with families and there is a lot of interaction between them.’ Staff turnover is low; training is encouraged with flexible rostering. Some staff even choose their shifts to suit individual and family needs; children of staff are welcome at the facility, some are involved in after school volunteer work. There is also a range of staff social activities including a social club, footy tipping, and theme days. Says Diane Jones ‘I try to encourage cultural diversity, recognising and celebrating the wide range of cultural backgrounds of our staff. It empowers people and lifts self confidence. Our next function is a Harmony and Food festival, with staff dressing up in their traditional costumes and we provide a big range of food from those cultures. It will be fun!’ ■

Winner of Employer Category - Springfields Residential Care

Runner Up of Employer Category - Nationwide Health & Aged Care Services


48 | Workforce

Winner of the Employer of the Year/Employee Nomination By Mike Swinson

I

n the employee-nominated category the employer of choice award went to Bethanie Kingsley in WA in recognition of their culture demonstrating open communication. The award recognises a work culture that focuses on friendliness and staff happiness! It is a combination of efforts by both staff and residents that according to Maya Krayneva creates an atmosphere of love, care, support and laughter. Simple but creative initiatives are regularly being organised at the site e.g. Kingsley Christmas Tree or “Tree of Belonging” where all staff and residents are being represented on the tree by putting up their own personal Christmas decoration. Monthly surveys of the residents reveal they enjoy the care and support they receive. Staff are also being supported to work flexible hours, to help meet family needs, reduce stress and establish an effective work-life balance. At Bethanie team culture is important and supported. Regular detailed staff surveys are used for feedback and innovative ideas. As with the other winner in this category, staff feel valued, listened to and respected, they are free to bring forward opinions and suggestions, and are encouraged to approach supervisors with issues and concerns. They know they will be heard and their opinions respected. An indication of the effectiveness of the workplace culture is staff turnover; at Bethanie it is low! Management use few agency staff, leave is covered by existing staff, that means staff levels are not being kept to absolute minimums. In addition staff are encouraged to continue their education and develop their career paths and in many cases the cost of that is met by Bethanie. The runner up award in that same category went to Hall & Prior as the result of a nomination initiated by employee Mr Kraig Hoogland, who began as an executive chef in 2001 and was recently appointed to the role of operations manager. Mr Kraig has received much support from his employer including a university scholarship to undertake an MBA. “The judges were impressed with the preparedness of the employer to support the growth and development of staff internally as well as reward the staff member through internal promotion,” it said in a LASA statement. ■

Winner Employee category - Bethanie Kingsle

Runner Up of Employee Category - Hall and Prior


Workforce | 49

Grabbing an Opportunity When You Can! By Mike Swinson with Associate Professor Rosemary Saunders from the University of Western Australia and Chris How from the Bethanie Group.

Engaging Older Australians in Onsite Health Professional Learning

T

he things you discover in the concurrent sessions of conferences like the recent Leading Age Services Australia (LASA) Conference in Perth are at times, quite extraordinary. Sometimes it’s a matter of choosing one session from another when you actually want to attend both. It was at one of those sessions where I listened to Associate Professor Rosemary Saunders and Assistant Professor Helen Dugmore from the University of WA and Chris How from the Bethanie Group talking

about engaging older Australians in onsite health professional learning, or as I put it ‘Grabbing an Opportunity when you see it!’ This is a story about taking advantage of an opportunity but also seeing outside the square, then bringing the opportunity and the idea to life. Here is Associate Professor Rosemary Saunders. “Nursing academics at UWA had a previous working relationship with the Bethanie Group as clinical nurse consultants and we were aware that Bethanie had a part of a nursing home


50 | Workforce

that had been vacant for three years, so we approached them about the possibility of creating a new clinical learning environment facility within their aged care setting.” “We applied for funding through Health Force Work Australia to undertake a capital works refurbishment, and to allow us to purchase equipment.” The location of the facility is on the ground floor of a building that has an aged care hostel above it and is also near another facility that has 35 residents and there are independent living units also in the same area for people over 65. The reason why this was identified as a valuable learning space is that students could participate in their learning activities while mixing with older residents of either the independent living units or the aged care hostel. “It certainly helps those students begin to understand firsthand the needs of older people. It’s a hands on, live aged care teaching space!” UWA has leased the building space from the Bethanie Group for five years. This teaching facility is in the Northern Perth suburb of Joondanna, about 15 kilometres from the campus of UWA or about twenty minutes from the Perth CBD by bus. “There is another unique aspect to this project,” said Rosemary, “that we have older residents participating in the learning process, with students. The students involved range from those doing nursing, those doing Podiatric Medicine and medical

students will be involved next year. We also bring enrolled nursing students here who are doing their study through the Central Institute of Technology and nursing students from the West Coast Institute of Training.” The nursing students from UWA are all doing a Masters Graduate entry to practice program, that is a two year course and they attend courses at Bethanie for one day a week. A new course was developed called concept based learning, and it includes teaching in the hostel environment, with residents. Developing skills like communication, interviewing, and assessment. In the second semester of their first year they also work closely with residents who actually come down to the ground floor to interact with the students. Chris How from the Bethanie Group says the close collaboration with both tertiary and VET sectors was and still is phenomenal. “As an outcome we now have a vibrant energetic space for learning for all levels of nursing, care workers, allied health and in the future medicine. All of the students get a very real interactive environment that exposes them to the true complexities and joys of working in aged care. In my view it is starting to make aged care ‘sexy’ – that is a real career opportunity for these students.” When the students are at the Bethanie facility they use iPads that can access the electronic health record of every resident that they are working with, it is as real a learning environment as you can get.


Workforce | 51

“In WA we do not yet have electronic health records in the acute sector, so this gives them a unique insight into what it means to work with that technology. The podiatric medicine students have established a clinic which services residents and others in the nearby community,” said Rosemary. This model is all about engaging consumers, who happen to be older Australians. So when the decision was made to begin this project community conversations were held with staff, residents and family members, to see what they thought of the idea. They raised issues that others hadn’t thought of that needed to be addressed. From that a reference group was formed, consisting of six residents, the managers of the hostel and the independent living units, the project director and a student. The reference group have been instrumental in guiding the project and came up with an idea that they wanted to provide direct feedback to students as part of their learning process. Things like ‘do students introduce themselves, do they explain procedures, do they provide privacy by using curtains and do they listen to my concerns! Feedback from both residents involved and the students supports that. • The residents are very helpful - sometimes they remind us of things we need to do like checking the ID band prior to performing procedure. • I thought it would be good for me to participate in something about which I knew nothing. It would give me an interest instead of sitting in my unit and falling asleep!

“I feel quite humbled by the detailed feedback that residents provide about the students and it makes a big difference to the effectiveness of the learning process. The learning process is also strengthened by the relationships and friendships that are formed over a period of a year. It’s remarkable what you see happen between students and residents,” says Rosemary. There are benefits for Bethanie staff from both the interaction with students and from professional development courses. “We are in the midst of conducting a physical assessment course for registered nurses, and we have residents participating directly in that course. “A survey of our students has revealed that 47% have said they would now consider working in aged care and we think that comes from a realisation of the importance of the work they provide in that sector, as well as realising that there are great opportunities ,” said Rosemary. “This is such a rich learning environment that I hope more Universities and teaching institutions can partner effectively as we have with aged care providers, as there are huge advantages from those partnerships, for students, staff and residents,” says Rosemary. Chris How has the last word! “The totally unexpected outcome of the project is the positive wellness and self esteem aspects that have been observed in the hostel and Independent Living Unit residents involved. These residents have a new lease on life with a sense of purpose by being able to positively engage in the teaching of students.” ■


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General | 53

A fully managed Loyalty Benefits Program allowing you to do what you do best The EAE program has been designed to improve employee morale, loyalty, productivity & retention and maximise staff satisfaction, while minimising management’s administration of the Program. The Program includes: • Access to a dynamic, easy-to-use online shopping centre offering fantastic discounted products and services from Australia’s most trusted brands • A suite of induction materials and employer information kits designed to maximise engagement and promote your organisation as an employer of choice • Monthly reporting • An online administration module for managing employee access to the program • Regular communication, including monthly updates, special offers and competitions • Quick and easy to join up and enrol your employees • Ability to customise website and marketing collateral to include your organisation’s branding • Suitable for organisations of all sizes Our key focus is providing a range of products that offer ‘real’ benefits to employees with Best Rate pricing across a number of different product segments. • Fashion, Accessories, Gift & Toys • Cosmetics, Health & Wellbeing • Travel, Entertainment, Food & Beverage • Home, Garden & Auto • Communication & Technology • Finance & Insurance E-News Fortnightly electronic Newsletters are used to communicate & promote offerings to all employees and eligible nominated friends and family members who have registered expression of interest for the EAE Offerings. Posters Poster promotions are used to build awareness to eligible employees to participate in the EAE Loyalty Benefit Program. This ensures that all employees are aware that the organisation has a Loyalty Benefit Program in place. EAE Website All eligible employees and nominated friends and family members will have access to EAE Offerings on the EAE website once issued with an individual access code. For full details, contact Suzanne Leech on 1300 552 147 suzanne@eae.com.au


54 | Sponsors

Incorrect energy bills cost Australian businesses thousands Energy Action leading the charge to help businesses understand energy costs

W

ith all their jargon, technical information and complex calculations, energy bills can be confusing and difficult to understand for Australian businesses. Because of this, many discrepancies between what organisations should be paying and what they’re actually paying go undetected. Sometimes the difference may only be a few dollars, but in many cases it can be hundreds or even thousands of dollars. Furthermore, more than half of Australian businesses (55 per cent) wrongly believe their energy contracts are not “contestable” (or able to be negotiated). Many businesses sit back and remain on the same contract, and some may not even be aware they are on high default rates. It is therefore more vital than ever for Australian businesses to understand the content of their bills. Correcting overcharges can save Australian businesses a significant amount on their energy bills. Likewise those being undercharged can identify the discrepancies early in their contract and rectify them, avoiding hefty surprise additions to bills later down the line. Energy Action analysed bills submitted for bill validation via their contract management and monitoring services over a 3 month period. They found that: • 1 in 5 bills (21 per cent) were incorrect in some way • on average, 13 per cent of users are overcharged and 8 per cent undercharged • overcharges amounted to more than $74,000 • the most common reason for an overcharge was incorrect ‘line loss’ charges (loss factors represent energy lost in the electricity network during transport). Valerie Duncan, CEO of Energy Action said: “Many businesses are worried about the rising cost in energy and the introduction of the carbon tax. But there are many other charges that could potentially be reduced if actively monitored. Having an independent energy management company assess that you are on the right network tariff for example can, in some cases, result in significant savings. “Businesses wouldn’t pay a phone bill without checking its accuracy, and energy bills should be no different. But the reality is that a lot of energy bills are paid without ever being validated. Checking an energy bill is virtually impossible without expert help however. Energy Action’s Activ8 service provides energy monitoring and bill validation services to help Australian

businesses check they are not being charged incorrectly as unlocking these savings is not a simple task for a business to tackle on their own.”

What makes up energy charges on a bill? An energy bill is made up of several different charges. Energy itself makes up just under half (around 45 per cent) of the total. The charges that make up the remainder of an energy bill include: network, market, environmental and service related charges. • Network charges cover costs involved in the transporting of electricity from generators, across the transmission and distribution networks to a site. These charges are reviewed and adjusted annually. • Market charges are fees which are paid to the Australian Energy Market Operator (AEMO) to operate and maintain the National Electricity Market (NEM). • Environmental charges are costs associated with complying with State and Federal schemes which are aimed at promoting efficient use of energy, reducing greenhouse gas and funding renewable energy generation. • Other service related charges are fixed fees which typically cover costs associated with electricity retailing such as service charges and retailer fees. This section may also include additional metering fees that may be associated with metering or monitoring services.

What should businesses be doing? 1. Get to know your bill: To help Australian businesses better understand their energy bills Energy Action has launched an online guide: http://www. energyaction.com.au/australian-energy-market/get-to-knowyour-bill.html 2. Check your charges Get an expert to check bills. It can be difficult to know whether bills are correct without understanding how charges are calculated. Often you may require additional information and consumption data related to time of use from a metering agent. Many bill issues therefore cannot be rectified directly with your energy supplier and will need the expert help of a reputable energy management company who can independently check charges are correct and advise on where savings could be made.


Are you sick of rising energy bills ey on lls at your aged care facility?

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Even if your contract isn’t due to expire, we can still help!

2XUĂ€DJVKLSVHUYLFHWKHAustralian Energy Exchange, allows energy suppliers to competitively bid against one another over DUHYHUVHDXFWLRQWRVXSSO\\RXUIDFLOLW\ÂśVHQHUJ\ÂąZLWKDEHVWÂżW contract secured in around 15 minutes. Note: Energy Action do not ask you to move from your current retailer, the choice to move is always yours! As a special offer to LASA members, we have waived the registration fee (usually $450.00) for use of the Australian Energy Exchange.

This means your aged care facility has no fees to pay, only savings to be made!

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56 | Sponsors

3. Review network tariffs An energy management company can advise if you’re eligible for a better value network tariff. As network charges make up a sizable part of an organisation’s energy bills, switching tariffs can, in some cases, result in significant savings. Energy Action highlighted potential savings for its Activ8 customers in Victoria of more than $1.2 million, with average savings of $5,800 and several being well in excess of $20,000 per annum. 4. Think about use Using electricity in the off peak period is not necessarily the best way to save money. Electricity companies look at peak usage and keep enough energy back to cover this level at all times (so there is always enough energy available). Using large amounts of energy in a short period of time means the electricity company will need to supply the highest amount you use all day – resulting in much higher demand and capacity charges. It is often better to spread use across the day. 5. Identify opportunities for energy efficiency Ultimately, the best way to reduce bill costs is to reduce consumption. Educating staff on ways to reduce electricity use and creating an energy policy are good ways to lower a business’s energy footprint. Upgrading lights can also be a cost effective option to reduce consumption. Some businesses may even be able to produce their own energy with expert guidance. Cogeneration can reduce organisations carbon footprint by up to 30 per cent. There are also many schemes and grants available to help businesses implement energy efficient improvements.

Valerie Duncan added “Checking your bill is just the first step in making cost savings. Most organisations can also find other quickwin efficiencies and organisations spending more than $20,000 per annum should consider securing future energy rates by negotiating a forward contract. Businesses should also be looking at ways they can become more energy efficient in the long-term to bring down costs and help the environment.” To discuss this opportunity further and have a free electricity (or gas) bill health check, contact Peter Naylor at Energy Action today! As a special offer to LASA members, we have waived the registration fee (usually $450.00) for use of the Australian Energy Exchange. This means your aged care facility has no fees to pay, only savings to be made! Even if your contract isn’t due to expire, we can still help! Phone: (03) 98225244 (ext 2002) Mobile: 0451 039 350 Email: peternaylor@energyaction.com.au Or go online: www.energyaction.com.au ABOUT ENERGY ACTION Energy Action is Australia’s leading independent energy management Company, offering comprehensive buying and management services aimed at reducing energy usage and saving businesses money. The company’s flagship service, the Australian Energy Exchange, allows energy suppliers to competitively bid against one another to supply an organisation’s energy – with a best fit contract secured in around 15 minutes. This unique platform has secured energy contracts in excess of $5 billion and delivered millions of dollars’ worth of savings for Australian organisations.


General | 57

Review of Latest Government Announcements on Living Longer Living Beer (LLLB) James Underwood | Director | James Underwood & Associates Pty Ltd

Overview: It is very good to see more certainty around bonds and fees in aged care following the release of: • The Aged Care Financing Authority (ACFA) Draft Guidelines on Accommodation Payments and Equivalence of Lump Sum and Periodic Payments (Oct 2012); and • Implementing Living Longer Living Better (LLLB): Overview of Proposed Changes to the Aged Care Act 1997 and Related Legislation (Nov 2012). This increased certainty should give a boost to the building of aged care places in Australia. It must be noted, however, that residential aged care occupancy rates have dropped greatly over the last decade (from 96.0% in 2003 to 92.8% in 2012) and the sector may have to be careful what it wishes for! A major increase in the numbers of residential care places would likely drive occupancy rates down further and challenge operating margins.

These people are effectively cross-subsidised by higher bond payers as the accommodation offered is usually identical. This group of “small bond” lump sum payers is not referred to in LLLB plans. Declining occupancy levels may mean providers are more willing to accept otherwise uneconomic capital amounts, but some specific legislative mention should be made of this group.

The $500,000 Lump Sum It is very pleasing to see a realistic figure chosen that will work for most providers. Few providers are in areas where they expend more than $500,000 per place on land, buildings, holding costs and set-up costs. Few currently charge more than $500,000. High cost areas in Sydney, Melbourne, Queensland, Canberra and Perth – with high land prices and multi-level buildings – will need higher bonds. So, too, will providers who offer suites or other enhanced accommodation. Hopefully, arrangements for approval of bonds higher than $500,000 will be fairly simple. We expect many providers will offer at least some suites across their services as the market segments further. The use of the MPIR to change a lump sum into a periodic payment appears to be a generally fair plan except for regions with lower average bond levels (see Accommodation Charge Rules vs Periodic Payment Rules, below)

Accommodation Charge Rules vs Periodic Payment Rules An area I don’t understand yet is how the old accommodation charge means test is going to mesh with the new periodic payment calculation. Department examples were provided in early May 2012 when LLLB presentations were held around the country. These examples show calculation of a post 1 Jul 2014 accommodation payment of $18,200 p.a. on assets of $144,500. This calculation was using the accommodation charge asset test that we use now. • Current accommodation charge means test Assets of $109,641 - $41,500 = $68,141/2080 = $32.76/day max accom charge • LLLB Accommodation payment test (per DoHA PowerPoint presentation in May 2012) Assets of $144,500 - $41,500=$103,000/2080 = $49.52/day accom payment However, using the ACFA advice of Oct 2012, this would be calculated as follows: • Assets of $144,500 - $41,500 = $103,000 lump sum or, at resident option: A periodic payment of $103,000 x 7.62%(MPIR) = $7848.60 p.a. or $21.50/day We will need to see some different arrangements proposed by ACFA for persons with lower assets or, using the draft ACFA test, new “lower asset” customers may pay considerably less than under the current accommodation charge means test. A surprising outcome!

The Small Lump Sum Many persons can only pay a small lump sum (or periodic payment).

Loss of retentions Retentions continue to be banned from 1 Jul 2014. No good purpose is served by this ban.

Specific areas are reviewed as follows:


58 | General

The retention amount – currently $3,876 p.a. – is a very important capital income component in regions where lower house prices prevail. For example, in Toowoomba, many houses sell for less than $240,000. A $200,000 bond is as much as most services receive. Invested in the bank at 5% p.a., this gives a provider a capital income of $10,000 p.a., plus a retention, to a total of c.$14,000 p.a. From 1 Jul 2014, Toowoomba and similar regional providers will get c.$4,000 p.a. less in capital income for new residents unless house prices suddenly jump by a lot more than CPI! This seems very counter-productive. Home Care Providers The large expansion of funded home care provided for in LLLB is very positive and helps meet consumer expectations. It is difficult, however, to gauge the impact on new customers of the co-payment (“care fee”) arrangements. A part-pensioner could be asked to pay up to an extra $5,000 p.a. (or $96.15 p.w) in care fee. Added to the weekly fee of, currently, $62.30, this means they would pay up to $158.45 pw. As many CACPs provide no more than 4.5 “hands-on” hours p.w, this may mean it costs $35/hr for provision of cleaning, ADLs and/or social support. Many part-pensioners may find this too expensive and not enter the program. A non-pensioner – with a care fee of up to $10,000 p.a. to a total fee of $254.61 pw –

would appear very unlikely to accept a CACP or an intermediate package. The current $62.30pw fee is too high for many full pensioners to afford and compares poorly to the cost of fairly similar HACC services. Accordingly, some specific LLLB requirements or guidelines regarding fee discounting for full pensioners may also be helpful. ■


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Aged Care Tips and Traps Rachel Lane, Principal, Aged Care Gurus

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n the last edition of the LASA Fusion magazine we looked at Retirement Villages, the motivations for people to move to a retirement village and the different forms of legal and financial arrangements that can apply. It is not uncommon for people to mistake retirement villages for aged care. While the amount that you pay on entry to a retirement village may be similar to the amount of accommodation bond payable to enter aged care that is really where the similarities start and end. In this edition, the last in our 4 part series, we are going to look at Residential Aged Care Facilities, the different financial arrangements that can apply. Residential Aged Care is like Neapolitan ice cream – there are 3 flavours – Low care, High Care and Extra Services. Each has a different financial arrangement and it is possible to find more than one, and sometimes all three under the same roof. Adding to the complexity is the fact that within 2 of these types of care (low care and high care) the facility needs to keep a mix of residents; standard, fully supported and partially supported. The mix of residents will impact on the funding of the facility. From a resident’s point of view, one financial arrangement may work better for them than another. The choices you make about the type of care you receive and how to fund the cost can have wide ranging effects and consideration needs to be given to your ability to access the care you want, the effect on pension entitlement, cash flow, tax, your ability to afford care in the longer term and the amount of money left to your estate. The financial arrangements that currently apply to Residential Aged Care are: • Low Care Accommodation Bond + Daily Care Fee + Income Tested Fee • High Care Daily Care Fee + Accommodation Charge + Income Tested Fee • Extra Services Accommodation Bond + Daily Care Fee + Extra Service Fee + Income Tested Fee Residents whose assets are below the minimum assets amount (currently $41,500) don’t pay an accommodation bond or accommodation charge, while those with assets above this threshold but below the upper threshold (currently $109,640.80) pay a calculated amount. Many people believe that if you don’t

have any money, you won’t get in to an aged care facility. This is simply not true. Due to the need to keep a mix of residents, an aged care facility may require a resident that is financially disadvantaged to maintain their funding levels. Of course, an aged care facility doesn’t have to accept any resident or any financial arrangement. The accommodation bond is probably the most misunderstood of the financial arrangements. Confusion about how much to pay and how much you get back is often related to other arrangements, such as retirement villages. The accommodation bond you pay to an aged care facility is guaranteed by the government. The maximum amount that is deducted from the bond, known as the retention fee, is currently $323 per month capped at 5 years. Importantly, the accommodation bond is an exempt asset for the calculation of pension entitlement, and the amount that you pay and the way in which you pay it can affect your pension, your assessment of the former home (and any rent received) and the amount of income tested fee you can be asked to pay. Some residents have found it valuable to negotiate an accommodation bond with the aged care facility. Negotiating the right amount of accommodation bond can create a triple benefit: a discount on aged care fees, an increase in pension and a reduction in the income tested fee. If the type of care you are accessing is standard high care, then you can’t pay an accommodation bond, you will need to pay an accommodation charge instead. The maximum accommodation charge is currently $32.76 per day and applies to people with assessable assets above $109,640.80. While it may seem better to pay a daily charge instead of a bond, you need to consider it in light of your own circumstances. If you are a full pensioner the daily care fee and accommodation charge can give you a cost of care that is nearly 140% of your pension. If your intention is to sell your former home, then payment of a bond can assist in reducing the amount of assessable assets and the amount of income you are considered to earn. However, if your intention is to keep and rent your former home then the accommodation charge may be a simple arrangement that enables you to claim an asset and income exemption while producing the money you need to cover the cost of care.


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While the income tested fee applies in each type of care, it is a fee that many aged care facilities don’t discuss and many residents are not aware of. The main reason for this is that the income tested fee is calculated after the resident moves in and is specific to that resident. A number of factors will influence how much income tested fee a resident pays, including their pension entitlement, the type of care they have moved to, the amount of accommodation bond or charge they have paid, the assets they use to pay their bond and the way in which they pay it and whether they have retained or sold their former home the amount of income tested fee will vary. The amount that the resident is initially advised they will need to pay can also vary during the period of their stay, based on changes in their income levels. Full means-tested pensioners don’t pay an income tested. The calculation for determining how much a resident can pay is 41.67c per dollar of income above the threshold, for a standard resident (single) the threshold is $892.10 per fortnight. The maximum income tested fee is capped at the cost of care or $68.65 per day. Residents need to be aware that the choices they make about the type of care they access and the way in which they fund it can have wide ranging effects, including on the cost of care itself! Aged care choices are complex. The right decisions will depend on the residents’ own financial circumstances and objectives. ■


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Epilepsy in later life

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diagnosis of epilepsy brings different challenges in the later years. In this article Epilepsy Action Australia explore the top concerns, and how older people can minimise the impact of epilepsy and maintain their quality of life. Many people believe epilepsy is something you’re born with. In fact, while epilepsy can begin at any time from birth through to old age, it is actually more likely to develop in later life. Although many people are diagnosed before age 20, in over 65’s epilepsy is the third most common neurological disorder after dementia and stroke. However doctors have only recently begun to realise just how frequently epilepsy occurs in older people. With the population living longer, only very young children are more affected by seizures than this age group.

Difficulties with diagnosis Epilepsy can be a complex condition, and because it is not always easy to diagnose in seniors, subsequent treatment can be delayed.

Diagnosis is harder Multiple medical conditions in older people can mask the true problem. Also, at an age when dementia is more wide spread and memory function is declining, obtaining a clear history of a seizurelike event can be very challenging. Seizures can be less obvious than in younger people and are easier to overlook. If a 20-year-old blacked out for a few minutes and forgot what just happened, it would seem strange. Whereas an older person may dismiss the episode as fading memory or just getting older. Seizures might be mistaken for other health conditions such as transient ischemic attacks (TIA), fainting, blood pressure problems, cardiac events, migraines, vertigo (dizziness with sensation of movement) or panic attacks. Conversely, common health conditions – such as fainting, cardiac conditions and TIAs – can be misdiagnosed as seizures. Confused states that might be a seizure or its aftermath may also be caused by dementia, serious illness or psychiatric illness, medication, high fever (for example, from infections) or dehydration.

Signs to look for Older people who have repeated brief events of loss of memory, behaviour changes, language changes, loss of awareness or consciousness, tremor, sensory changes or numbness, should see a doctor to determine whether they are having seizures.

Epilepsy should be considered whenever there are periodic events or ‘funny turns’. Diagnosis is important because undetected epileptic seizures in older people can cause problems and pose a safety concern. Good observation, documentation and a description of an event is an important key to diagnosis, but this may not always be available, especially if the person is living alone, or there are no witnesses.

What causes epilepsy at this age? Epilepsy is a condition with many possible causes or no known cause. When epilepsy begins later in life, a reason can usually be identified. Anything that causes brain damage or scarring – such as illness, trauma, or lack of blood or oxygen – can lead to seizures. In this age group: • Stroke is the most frequent cause of seizures, which affect up to 15% of stroke survivors. The larger the stroke, the higher the risk. Sometimes seizures are the first sign of a stroke. • Some medications such as antidepressants and major tranquillisers can reduce the brain’s seizure threshold (the point at which increased electrical activity in the brain will result in a seizure). Herbal medicines may also provoke seizures. • Seizures can be triggered by blocked arteries, heart disease and any other disorders that limit supply of blood or oxygen to the brain, or trauma causing head injuries or brain haemorrhage. • Up to 16% of people with Alzheimer’s disease can have seizures. • Other seizure causes include diabetes, kidney or liver failure, serious infections, brain tumours and chronic alcohol abuse.

Seizure types Partial seizures are the seizure type generally experienced by seniors. Most commonly these are complex partial seizures, which may appear as confusion, odd behaviour or memory lapses – episodes which the person can’t clearly recall. As they are more subtle than tonic-clonic (or convulsive) seizures, they may not be recognised as epilepsy and as mentioned above can sometimes be attributed to ageing or other medical conditions. Overall, there are two main categories of seizures: partial and generalised. In partial seizures, seizure activity is limited to one or more small areas of the brain. This may only alter awareness or consciousness, usually causing confusion and a change in behaviour.


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Generalised seizures occur in both sides of the brain at once and consciousness is normally lost immediately. The most recognised generalised seizure is a tonic-clonic seizure. Partial seizures can also lead into a (secondary) generalised seizure, so it is possible to have more than one seizure type.

Management Epilepsy is normally managed by a healthy lifestyle combined with medication that aims to stop the seizures with the least possible unwanted effects. Older people generally respond well to epilepsy treatment. Up to 80% of seniors who develop epilepsy can be expected to become seizure-free when they begin taking antiepileptic drugs (AEDs).1 The decision to start AED treatment is based on a number of factors including the risk of seizures recurring, consequences for the person if they have any further seizures, potential unwanted effects of AEDs and ultimately, the person’s views and choice.2

Medication side-effects People over age 65 are often more sensitive to medications and unwanted effects. Hence a low dose may be all that is needed. The reason for this sensitivity is that as our body ages, so do all our organs – including the liver and kidneys, which help process drugs. Their reduced function means lower doses may be needed to stop drug levels becoming toxic and causing significant unwanted effects.

Side-effects are less common with a lower medication dose. They include tiredness, unsteadiness, tremor, visual disturbances, mood or behaviour changes, depression or stomach upsets. The problem can often be reduced or prevented by adjusting the dose or changing medications. This shouldn’t be done without consulting the doctor as adjusting medications without medical advice can trigger more severe seizures which could be lifethreatening. Sometimes, as with seizures themselves, unwanted effects of AEDs – in particular, changes in alertness, memory, concentration, balance and coordination – are missed and put down to ageing. Further, AEDs and daily medications for other health conditions may affect (or ‘interact’ with) each other, with undesirable consequences. It is estimated that approximately 60-70% of people over age 60 take prescription medications. As such, these drug interactions are a frequent concern. Outpatients in one study of older adults with seizures in the US were taking an average of seven medications at one time, and up to 13 drugs each year. The fact that many of these drugs are processed by the liver increases the

Figure 1. Summary of common unwanted effects reported with antiepileptic drugs in older people. Source: www.epilepsy.com


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possibility for drug interactions (in this case, the AEDs that are not processed by the liver may be tolerated better).3 Doctors need to know all the medicines a person is on – both prescription and over-the-counter – so they don’t prescribe drugs that will mix poorly.

• • •

Lifestyle issues Seizures can affect older people, physically and psychologically, in ways that are potentially more debilitating than for younger age groups, decreasing quality of life. Some struggle, for example, to accept and adjust to epilepsy. There are a number of reasons for these impacts: • Potential injuries. During seizures, older people are particularly vulnerable to injuries such as spinal or head injury, fractures, burns, cuts and abrasions, or a car accident, and a fall is more likely to result in a fracture. • Stigma. The stigma associated with a diagnosis of epilepsy can be particularly hard to deal with at this age, and for some people, worse than having seizures. Epilepsy was a condition that was rarely spoken about in previous generations, giving rise to misinformation about the condition. • The post-seizure (post-ictal) phase in seniors is generally more prolonged than in younger age groups. Although a seizure may only last a minute or two, recovery can sometimes take several hours to a day or two. • Anxiety. Fear of seizures or injury such as falling in public, along with longer recovery times, may contribute to people deciding to isolate themselves. As such, anxiety can significantly diminish physical and emotional wellbeing and needs addressing as soon as possible. • Forgetfulness, poor concentration, memory lapses and mental confusion can be problems for some older people on medication.

• •

Other medical conditions often make the situation more difficult. Problems with drugs mixing poorly and unwanted medication side-effects are common. Loss of a driver’s licence can increase the likelihood of social isolation. People who have seizures may not be legally eligible to drive in their state or territory, and need to check with the doctor and follow transport authority guidelines about driving. Isolation and depression. The unpredictable nature of seizures can lead to social withdrawal. Seizures in this age group are more likely to dent people’s confidence so they restrict social activities and connections, eventually becoming lonely and depressed. Safety. Many older people live alone and safety can be a concern, especially if seizures are not well-controlled. Loss of confidence. Reduced independence can result in premature admission to nursing homes and residential care facilities.3

What to do? There are many practical steps to help minimise the impact of the condition in later life. 1. Limiting medication side-effects. Check with the doctor and chemist about possible side-effects and whether medications for different conditions can be taken together. Regularly reviewing medication with the doctor may help. 2. Recovering after seizures. If confusion and tiredness are prolonged, it is important to rest and seek support from family, friends or neighbours. 3. Addressing memory problems. These are common among people with epilepsy of all ages. Epilepsy Action Australia holds free memory workshops explaining how memory works and teaching strategies for remembering everything from shopping


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lists to daily appointments. Call 1300 37 45 37 to check the date of the next memory workshop closest to where you live. 4. Remembering medication. Simple techniques include using a pillbox or an alarm clock, or having medications with meals. On request, the chemist will also put the pills into a tray pack marked with the day and time they need to be taken. 5. Reducing the chance of falls, fractures or injury. To reduce the likelihood of injury during seizures, sensible and relevant safety measures are necessary. These may include: • Avoiding using a ladder • Choosing a low bed • Standing well back from the road or platform edge when waiting for a bus or train • Using rubber-backed mats to make bathroom floors less hazardous • Living in accommodation without stairs 6. Avoiding social isolation and depression. While the possibility of seizures can make a person want to stay home, it is important to keep in touch with family, friends and community groups. Participating in activities and maintaining interests also helps. Consider telling other people about your epilepsy and what to do for your seizures, as this can increase your confidence in social situations. Call Epilepsy Action Australia on 1300 37 45 37 to find out about our seizure firstaid training for individuals, families and within the community. Talk to your doctor if feelings of depression continue.

7. Getting around without a driver’s licence. It is possible to remain active and mobile without driving. Check the public transport options in your area. Ask social services, and local council and community groups about travel assistance you are eligible for. Friends and family may also be able to drive you to shops and appointments. 8. Living alone safely. If seizures are not well-controlled, ask Epilepsy Action Australia about fall detectors, identification bracelets and pendants which can automatically alert emergency services and family or friends in case of a seizure. 9. Lifestyle adjustments. Adequate sleep, a good diet, stresscontrol, limiting alcohol, exercising, and continuing activities you enjoy often helps in seizure management. Epilepsy Action Australia provides education and support to individuals and organizations caring for, or working with people with Epilepsy. For more information please visit us at www. epilepsy.org.au/online-academy, email us at academy@epilepsy. org.au or phone 1300 37 45 37.

References 1

Brodie MJ, Kwan P; Epilepsy in elderly people. BMJ. 2005 Dec 3;331(7528):1317-22. http://www.bmj.com/cgi/content/ full/331/7528/1317#REF25

2

http://jppr.shpa.org.au/lib/pdf/gt/kilpatrick200206.pdf Management of

3

www.epilepsy.com

Epilepsy in Older People. Kilpatrick and Lowe. Geriatric Therapeutics.


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At-risk older people to receive more support from carers

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lder people in residential care or who require significant assistance to stay at home are twice as likely to develop depression and anxiety as the general population. This disturbing statistic, along with the limited mental health training offered to aged care workers, has seen beyondblue create a ground breaking new program to improve aged care students’ understanding of depression and anxiety in older people. Registered Training Organisations (RTOs) across Australia are being urged to use Making a difference: Understanding depression and anxiety in older people in their aged care courses to help students recognise if older clients are experiencing depression or anxiety. Research from the National Ageing Research Institute reveals almost 35 per cent of older people in residential care will experience depression, while around 30 per cent of older people living in the community, but requiring significant assistance to remain at home, will also experience it. These rates are at least double the general population risk. The rates of anxiety disorders in these groups are believed to be much higher than the community average of 26 per cent, but have not been confirmed. beyondblue CEO Kate Carnell AO said it is vital aged care staff are taught how to recognise depression and anxiety in older people because these conditions reduce an older persons’ quality of life. She said the new training program would enable RTOs to deliver content on depression and anxiety in older people as part of Certificate III in Aged Care and Home or Community Care, courses that most people wishing to work in the aged care sector complete. “It is terrible that the cumulative effect of numerous risk factors including illness and isolation means older Australians are particularly vulnerable to depression and anxiety,” she said. “But this new training program means students will receive an excellent grounding in the signs and symptoms of depression and anxiety when they enter the aged care workforce. The community must do

everything it can to ensure the good mental health of older people and we believe this will help significantly.” Making a difference: Understanding depression and anxiety in older people builds upon beyondblue’s Professional Education to Aged Care (PEAC) Program, which is aimed at improving the aged care workforce’s understanding of depression and anxiety disorders in older people. beyondblue is asking RTOs to apply for the new program through the beyondblue website. It is the first time beyondblue has provided material for accredited training courses and has taken two years to develop. The program, which is free for eligible RTOs, will consist of student workbooks, facilitator guides, DVD clips and a podcast. For more information or to register go the older persons’ page on the beyondblue website www.beyond or email agedcare@ beyond blue.org.au ■


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SAGE Study Tour Beryl Raufer Chief Operating Officer | Villa Maria

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n 17 September this year I left Melbourne to participate in the 2012 SAGE Tour of Belgium, Luxembourg and Germany and the IAHSA Conference in Malta. This was an unexpected but incredibly exciting opportunity for me to explore the aged care sector in Europe and to gain knowledge and insight of how it operates in that environment. The Tour itself included 6 facilities in Belgium, Luxembourg and Germany which were involved in the delivery of both the residential area of aged care and community care. The facilities visited were WoonZorgZone Wervik and Senior Plaza, Willbroek in Brussels, Konviksgaart – Residence Grande-Duchesse Joesphine – Charlotte operated by Sodexo in Luxembourg and InHaus 2, FraunhoferGesellschaft (In-Haus Innovation Center) and ALPHA GmbH operated by Sozialwerk St. George.V. and Haus am Sandberg, Multicultural Senior Center in Germany. In the short space of this article it is impossible for me to give details of every facility and organization visited so I will concentrate on one which impressed me the most. The first was the WoonZorgZone (Housing Care Zone) in Wervik which operates an integrated service delivery model, encompassing residential aged care for the frail elderly, community domestic and nursing care, a community centre and housing options. It also provides a community centre and affordable housing options. The photo on the right shows the community centre and some of the independent living apartments. Wervik is a small town (population around 7,000) which has in recent times suffered high unemployment, compared to the national average and relocation trend which has seen younger residents leaving town for large centres. The net result of this is a population increasing in average age and frailty and a net decline in available informal care. As we have seen in Australia, the overwhelming desire of people as they age is to stay in their familiar home environment for as long as possible. Living in a rest home is not desired.

The WoonZorgZone is centred on the St John’s Hospital which incorporates the residential facility for frail aged and contains the call centre for dealing with the in-home services and support. Services provided include personal care, nursing services and home domestic services and maintenance services as well as transport services. It is referred to as a full service residential area. A key premise of the organisation is that someone requiring nursing care can be reached within 10mins of a call being made. This has meant that an operating zone of approximately 750m radius around the hub or a circle 1.5 km across is the effective limit of the size of this service. Another of the key features of the full service zone is the pedestrian circle around the town. This is in essence an aged friendly walking route that goes past key shopping and other services within the town. The whole route has been reviewed for aged friendly grades and traffic conflict.


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This concept obviously works in an environment which is defined in area and would lend itself to small regional towns or defined suburbs. The benefits for me of the Tour were found in the exposure to new ideas and different ways of doing things, but also in the validation that what we are doing in Australia is something we can be proud of. An opportunity for people from Europe, the

USA and other countries to visit here and see our services, facilities and programs through something like a SAGE Tour would be most beneficial and promote even greater exchange of ideas. I can’t speak highly enough of the value to me both in knowledge and networking that SAGE has provided me with. I have already followed up with many of the fantastic contacts I made with other participants. ■


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Aged Care Financing Authority (ACFA) - Dra Recommendations Rachel Lane, Principal, Aged Care Gurus

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he Aged Care Financing Authority (ACFA) was established in August to provide advice to the government on pricing and financing issues across the aged care sector. It recently released its draft recommendations on accommodation payments. The recommendations relate to residents who enter permanent residential aged care after 1 July 2014 and include: • A single maximum amount of lump sum accommodation bond, or equivalent periodic payment, to be set by the Minister at the 95th percentile of all bonds for the most recently available year of data. On current data this would be around $500,000; • Residents will be able to lodge a complaint for unreasonable pricing below the maximum amount which will be evaluated based on set criteria such as quality, location, construction cost and other relevant factors. If the price was found to be unreasonable the provider would need to adjust their pricing; • Aged Care Providers can apply to the government for approval of a higher price. Guidelines will be developed around

applications for higher pricing with criteria to include: quality, location, construction cost and other relevant factors; • The equivalent periodic payment will be calculated as it is currently for low care and extra service residents, using the Maximum Permissible Interest Rate (MPIR); and • Aged Care Providers will need to publish the price (or prices) of their accommodation bonds and periodic payments on the internet and in information given to prospective residents. Providers will be encouraged to commence this from 1 July 2013, on a voluntary basis. The recommendations noted that the removal of retention and the need for providers to insure bonds was likely to inflate prices, it also noted that the “cooling off period” should be a 28 day period and re-named the “choice of payment method period” to better reflect its objectives. No mention was made of the minimum assets amount, or the capping of accommodation bonds and their equivalent based on the resident’s assessable assets. The rules that allow residents to keep and rent their former home with


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asset and income exemptions applying were also not discussed, although we believe all of these will be maintained. So what are the potential impacts on facilities and residents? The cost of care for residents is likely to go up. Aged Care Facilities will need to be aware of a resident’s capacity to pay their market price accommodation bond prior to them moving in, as an unexpected capping of the accommodation bond at the resident’s capacity to pay is likely to mean a bond (or daily equivalent payment) that is less than market price with no ability to crosssubsidise with a resident paying greater than the market price. Based on the current MPIR, a resident who chooses to pay the equivalent periodic payment of $500,000 will need to pay $104.38 per day/$38,100 per year as an accommodation payment. When

we consider: most residents are pensioners (part or full), the full age pension is currently $20,087 per year, the current income test for Age Pension (single) reduces entitlement at 50c per dollar of income above $3,952 per year and the care co-contribution will be assessed on assets above $41,500 and income above $22,543 it is unlikely this will be an affordable method of payment. Residents who sell their home to pay an accommodation bond will need to give careful consideration to the impact on their pension entitlement and ongoing cost of care. Payment of an accommodation bond that is less than the sale proceeds from the home is likely to result in a reduction in pension and an increase in the care co-contribution. Conversely residents who use both the sale proceeds from their home plus assets outside the home are likely to increase their pension entitlement and reduce their liability to pay a care co-contribution. Residents who can use assets outside the home while retaining and renting the home are likely to be in the most favoured position. Clearly residents and their families will need expert advice to determine how much to pay, the way in which to pay and the knock-on effects to pension, tax, the cost of care, cash flow and their estate planning wishes. This was recognised in the Living Longer, Living Better Report which stated “Consumers will be encouraged to access financial advice about their aged care costs from qualified advisors with expertise in aged care financing”. We couldn’t agree more. ■


The Bidet Shop Testimonial: Late in November of last year I fell and shattered my right elbow. The elbow was operated on and the result is that I now have a Titanium elbow joint with 2 plates and numerous screws holding everything together and I am now unable to fully extend my right arm and have found I am now unable to reach many things including the clothes line. I am even unable to reach my own behind, so I invested in a bottom wiper but it was a waste of money, then I found a different type and bought it. It was better designed but it still wasn’t satisfactory for what it had been designed for. In June of this year I ordered a Bidet BA 13BE, I was given the name and contact number of a plumber and electrician whom the Bidet Shop recommended for Contact The BIDET SHOP’s friendly staff the installation. Two days later the boxed Bidet was delivered to my front door. today on 1800 243 387 (free call) That same day I had the power point installed and the following morning the or view online at www.thebidetshop.com.au plumber came and installed the Bidet. Since the Bidet ’s installation I now have my independence back as I don’t require any assistance with my toileting. I just wish that Bidet’s were installed in the disabled toilets at the clubs etc. as it would allow me and others similarly disabled to have a morning, afternoon or day out and not have to ask their carer/husband/wife to assist them when they need to use the disabled restrooms. It would just make these outings so much more comfortable for all concerned. It would also allow us to be able to get out on our own and just enjoy the day independently. I am so happy with the Bidet and would recommend it to anyone who has a loss of mobility, or an inability to be able to wipe their own behind. The warm seat, warm water and warm air make the whole experience delightfully, quite luxurious. Thank you, I am yours sincerely, Mrs M. Humphrey


Calendar of Events | 71

2013 Calendar of Events 24-26 February

20–23 March

14-26 April 2013

22nd Annual Tri-State Conference

Queensland Age Services Conference

SAGE Study Tour- China plus Singapore

Albury Entertainment Centre T: 03-9805 9400 E: events@vic.lasa.asn.au

Jupiters Hotel, Gold Coast T: 07 3725 5555 W: www.qld.lasa.asn.au/events E: events@qld.lasa.asn.au

E: jmartin@agedcare.org.au W: www.sagetours.com.au

1 & 2 May

30 & 31 May

18–23 May

ITAC 2013

LASA NSW-ACT Congress

Crown Conference Centre Melbourne Contact: Jane Murray T: 08-8981 5119 W: www.itac2013.com.au E: itac2013@jayscorpevents.com.au

The Westin, Sydney E: cynthia.oyoung@nswact.lasa.asn.au W: www.nswact.lasa.asn.au/events/ congress

International Council of Nurses (ICN) 25th Quadrennial Congress Melbourne, Australia For more information please visit www.acn.edu.au or www.icn.ch

July

5-7 August

3–6 September

NIMAC Conference 2013

LASA 2nd Annual Congress

12th Australian Palliative Care Conference

Sydney Convention Centre Consec - Conference Managers T: 02-6251 0675 E: lasa@consec.com.au

National Convention Centre, Canberra W: www.palliativecare.org.au

Jupiters Hotel Gold Coast T: 07-3725 5555 E: events@qld.lasa.asn.au W: www.qld.lasa.asn.au/events


72 | Product News

TECO Australia introduces Bar Fridges to its Range Following its successes in supplying Split System and Window Wall Air Conditioners, and LED/LCD TV’s to Mining Camp Accommodation and Common Area Portable Building Units, Student Accommodation areas and Hotel/Motel Rooms, TECO have introduced a range of Bar Fridges specifically designed to cater for the hospitality industry. Engineered to Perform with Super Quiet operation, Stylish Design, Internal Light, Glass Shelving and handy Drink Can Dispenser in the 117Ltr Freestanding or Under Bench Bar Fridge is suitable for medium

to large rooms, and to cater for Student Accommodation and smaller Hotel/Motel Rooms, that require a small fridge for guest convenience, TECO have also introduced a 50Ltr Bench Top Bar Fridge. To complement this range, TECO Australia will introduce over the coming months, Vertical Freezers, Chest Freezers and Frost free Refrigerators with Multi Flow Control ranging from 215Ltr to 410Ltr.

For more information visit www.teco.com.au

Australian College of Nursing (ACN) will host the International Council of Nurses (ICN) 25th Quadrennial Congress in Melbourne, Australia. Titled Equity and Access to Health Care the conference will be held from 18 – 23 May 2013. It is anticipated the ICN Congress will bring together approximately 3000 to 5000 nursing delegates from across the globe and will present a great opportunity for all nurses to expand their knowledge and expertise within an international nursing context. The ICN Congress will feature many dynamic speakers including Her Royal Highness Princess Muna Al-Hussein, who will deliver the keynote address, and Anne Marie Rafferty, who will present the Virginia Henderson lecture. It will also feature a Student Nurses Assembly and the Florence Nightingale International Foundation Luncheon in support of the Girl Child Education Fund. For more information please visit www.acn.edu.au or www.icn.ch

Health Metrics Health Metrics Pty Ltd purchased the assets of WeCare Australia Pty Ltd. The acquisition adds dozens of customers and thousands of residential care beds to the Health Metrics stable. This transaction extends Health Metrics’ market share within the aged care vertical. “This acquisition is a key part of our multi-pronged strategy”, said Steven Strange, CEO of Health Metrics. “This is good for our bottom line and our growth but more importantly it’s very good for the WeCare customers and staff. The customers now have a road map that will future proof their current investments. We will continue to support and enhance the WeCare system”, added Steven. All existing WeCare customers will be contacted individually as part of the integration process. For any further enquiries regarding this press release please contact Steven Strange directly at sstrange@healthmetrics.com.au

Safety Link is a national ISO accredited 24-hour Personal Alarm Call Response Service that links clients with family, friends or emergency services in times of need. The service is designed for people who may be at risk due to age, ill-health or a disability and comprises of a pendant button, an alarm connected to the existing telephone system, and the highly trained staff at the Safety Link Monitoring Centre. When the personal pendant is pressed, it sends a radio signal to the alarm unit, which in turn rings the response centre. When an alarm call is received at the response centre, one of Safety Link’s fully trained monitoring staff will attempt to make telephone contact with the client to establish the appropriate action to take. If contact cannot be made with the client, the monitor will telephone the client’s nominated ‘contacts’ who may be a family member or neighbour to check on the client’s well- being. Should a contact not be available a 24-hour emergency service will be called.

Safety Link prides itself on helping maintain clients’ independence and recognises its successes are due to the dedicated friendly employees who provide a personal and caring service to its clients. Safety Link is now pleased to offer assistance to Carers looking after people who may be at risk of self- harm or injury (for example people with dementia or a disability). Safety Link offers affordable wireless and easy to use solutions giving peace of mind for Carers yet with the utmost care for safety. Carers in their own home or in a residential support service choose the best equipment for their situation. Carers or families will be able to safely monitor the movement of the person via doors, floor and chair sensors and GPS monitoring to minimise risk. Safety Link can also provide seizure sensors ideal for monitoring someone with epilepsy (ideal for sleeping or sitting) so Carers or family members can feel reassured about the persons safety. 1800 813 617 http://www.safetylink.org.au



LASA Fusion Summer 2012