Community Care Review Spring 2019 - Cover Story

Spring 2019

Australia’s magazine on home and community-based care and support

Eden in Oz & NZ Changing the narrative of ageing

This issue: IN FOCUS

ASSISTIVE TECHNOLOGY

PROFILE

SOFTWARE APPLICATION

CLINICAL

EDUCATION

Indigenous aged care Digital revolution

Parkinson’s disease

Pressure wound care

Dementia’s top crusader Scope of practice

cover story

Growing old at our own risk We live in world of compliance and control, and nowhere is this more apparent than in the aged care sector. Risk-taking can be important – even during one’s twilight years.

By CAROLINE RICHES.

L

ife is risky business, from the moment we are born to our last day on earth. There are two ways to manage risk, it seems: avoid it, or consider it and carry on.

Risk could be slowly killing the most vulnerable people in our society. When elderly or disabled people are denied the freedom to go out or perform everyday tasks, when they’re unnecessarily drugged while in care, or when they’re not allowed any time alone, risk takes the blame. In the community care and aged care sectors, the topic of risk has never been more controversial.

When American author Leo F Buscaglia said “the person who risks nothing does nothing, has nothing, is nothing, and becomes nothing,” he could have been talking about toddlers, teenagers or those seeing out their life. “He may avoid suffering and sorrow,” said Buscaglia, “but he simply cannot learn and feel and change and grow and love and live”.

Older people should have the same chance to grow and love and live as anyone. Recent research has agreed that a client-centric model in community and aged care is the best way to allow this. But while many agree on the approach, not everyone understands what it means and few providers are putting it into practice.

Global organisation The Eden Alternative has been providing culture change education and consulting services to the aged care, community care and disability services industry in Australia since 2003.

The philosophy works around 10 principles that blame the bulk of suffering among older people on loneliness, helplessness and boredom. It believes a loving relationship with people, plants and animals can combat loneliness; creating opportunities and empowerment are the antidote to helplessness; and variety, spontaneity and meaningful activities help counteract boredom and preserve the human spirit.

Clinical care must always be in place to allow people to function without pain, say the principles. But medical treatment should be the servant of genuine human care, never its master.

Dr Allen Power

Dr Bill Thomas

Jill Vitale-Aussem

TRANSFORMING CARE Sally Hopkins, Executive Director at The Eden Alternative in Australia, New Zealand and Southeast Asia, has been passionate SPONSORED FEATURE

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SPRING 2019

about transforming care for a decade. Risk taking is a part of this, but she believes aged care and community care models are risk-averse to their detriment because of compliance requirements.

“The institutional model reaffirms that as we age, we are at risk of hurting ourselves,” she says. “That we can’t be trusted to make our own decisions. That we can’t do anything for ourselves anymore.

“We want - and need - to change that tragedy narrative on ageing.”

People love to look after themselves, help others and do home duties, but these things are impossible if you’re unable to move, she says. “They’ve been taken away from people and it’s about giving them the opportunity to give back.”

Through face-to-face and experiential classroom education, Eden teaches care providers how to transform the communities in which they live and work to improve the wellbeing of both the elderly and their carers.

“The biggest resource we have are the residents or clients and they are the ones who are the least empowered and have least voice,” says Hopkins. “Even homes or centres and carers who claim to be very person-centric are still trying to control the outcome. But we have to give the car keys and the steering wheel to the person who is immediately impacted by the decisions we make.”

Hopkins believes elders should be able to give back as much as possible given their abilities, and that these should never be underestimated.

cover story She offers the example of an elderly man in Queensland who a year ago couldn’t walk and wanted to regain strength in his legs. He went to a physio and now walks 2.3km every day to his local shops. He is in regular contact with his local member and is a local fundraiser.

“He is so involved, he’s doing things that are meaningful for him and he’s also trying to improve the lives of other people. For example, he has campaigned for a better crossing with a traffic light on the busy road outside his home.

“His carers have supported and enabled him to achieve his own goals - it’s not interfering, it’s enhancing.”

NEW QUALITY STANDARDS The new Quality Standards, which came into effect on July 1, seem to well reflect Eden’s definition of good aged care support. The eight standards are about improving safety, health and wellbeing though consumer dignity and choice; ongoing assessment; personal care; supporting daily living; and providing the right service environment, among others.

“These new standards force people into the world of risk and the Eden Alternative dovetails beautifully into these new standards,” says Hopkins. “The people who have implemented Eden processes are already ahead of the game.”

Adopting Eden’s principles should make the day of a carer easier and the life of the resident or client, more fulfilling, she adds.

Take personal care like washing someone or helping them get dressed. “Every time you have an interaction with someone, don’t do it in silence, have a conversation with them. Do your job in an active way that supports the person to do more for themselves, which will give you more time.”

We need to personalise these intimate situations, she says.

“It’s all about assigning specific carers to people and building a relationship with that person. How do you truly provide the care someone wants if you don’t know them?”

EMBRACING CULTURAL CHANGE The game-changing element of allowing risk has inspired Eden’s first conference since 2006, Living a Full Life is Risky Business, to take place in Brisbane in October.

Staging the conference is, in itself, a risk, says Hopkins.

“Many believe that they’re providing acceptable services, but this just isn’t the case. The institutional model sees ageing as a negative risk and I want to bring people together to challenge this view.”

The secret to a successful, fulfilling life in our risky world, she says, is about enhancing the upside risks (a risky action that might create a more positive meaningful experience) and identifying and minimising downside risks (which can result in negative experiences).

The conference will unite people from all over the world, giving them the opportunity to share their stories and embrace the journey of cultural change. There will be workshops on personal transformation and teachings on how to organise the right environment to create a new culture, with information on Australia’s new Quality Standards and how they can work with Eden’s principles.

Conference attendees will also revel in the emotive guidance of around 30 speakers from different parts of the world, including three inspirational leaders in their field.

Dr Bill Thomas set up The Eden Alternative in 1996 when he was a doctor in a nursing home. A lady living there told him that she was really, really lonely and he realised he couldn’t find a prescription for her. He has since built a reputation as one of the most eclectic and creative thinkers in medicine and has been named by The Wall Street Journal as one of the top ten Americans shaping ageing.

“We want - and need - to change that tragedy narrative on ageing” – Sally Hopkins

Among his many achievements including two decades living off the grid and running a mixed power farming operation - Dr Thomas has set up the Green House Project, which explores radical new aged care models, founded influential multiauthor blogging platform ChangingAging. org, and created Minka, a high-tech startup that blends robotic manufacturing tools and community building strategies to create MAGIC - Multi Ability, Multigenerational Inclusive Communities. Dr Thomas was also noted by US News and World Report for his “startling common-sense ideas and his ability to persuade others to take a risk”.

The other keynote speaker, Dr Allen Power, has a 20-year history of working in culture change in aged care and specialises in dementia and the desegregation of people with the condition. He is an internist, a geriatrician, an educator and an author. One of his books, Dementia Beyond Drugs: Changing the Culture of Care, was named a 2010 Book of the Year by the American Journal of Nursing.

Eden’s President and CEO Jill VitaleAussem, an international speaker on culture, leadership and ageism and author of Disrupting the Status Quo of Senior Living: A Mindshift, will conduct a workshop on ageism. She’ll discuss the importance of changing our language when we talk about older people - in birthday cards, in the media and in everyday life.

“Our speakers are recognised internationally as innovators and risk takers,” says Hopkins. “They challenge the status quo; they want to do it differently.”

Allowing a culture of risk in a home care, aged care or community care setting takes perseverance. Often it’s about taking apart and repackaging the normal way of doing things. The executive team of the service provider must be committed to training all staff, and then it’s about placing the maximum possible decision-making authority into the hands of elders or those closest to them.

When a home or a community centre is making the 10 Eden principles work, they are able to receive recognition on the Eden Registry. This shows they are encouraging those in their care to really give back and take risks.

As one of the principles states, “human growth should never be separated from human life”. n For more information on Eden in Oz and NZ Conference, visit www.edeninoznzconference.com.

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