SKIN TEAR CONVERSATION STARTERS FOR SUPPORT AT HOME TEAMS
RPA VIRTUAL HOSPITAL WOUND CARE COMMAND CENTRE
EMBEDDING RESTORATIVE PRACTICE FOR INDEPENDENT AGING
FROM THE EDITOR
Welcome to the August 2025 edition of Aged Health , which has a focus on allied health/home care and wound care — and we have some timely insights for you.
In our lead feature, Professor Michelle Barakat-Johnson — named the winner of the 2025 Health Minister’s Award for Nursing Trailblazers — takes us on a tour of the RPA Virtual Hospital Wound Care Command Centre, a pioneering service that connects clinicians (including aged care workers) directly with wound care specialists, no matter where they are. We are also fortunate to have Wounds Australia Life Member Dr Jenny Prentice, who provides some skin tear conversation starters — designed to support anyone caring for aging Australians in any setting, but particularly Support at Home teams.
In the home care space, as 1 November approaches, Dr Claire Gough from Flinders’ Caring Futures Institute — lead author of the Restorative Care Pathway Clinical Guidelines — explains how the rollout of the Support at Home program provides a timely opportunity to embed restorative care into the everyday lives of older Australians, supporting ongoing independence and quality of life.
Then, in our regular series, we spend A Day in the Life of palliative care specialist Regina Huang from Lutheran Services, tour Rendu Towers and Villa Rosalie — Ozcare’s dual tower development — for Design Matters, and are In Conversation with Richard Shieh, Podiatrist at Advance Foot Clinic Podiatry, to learn why mobile podiatry matters more than ever. Plus much more, including case studies and some of the latest research.
Happy reading.
CONTRIBUTORS
Professor Michelle Barakat-Johnson Wound Care and Skin Integrity
The Sydney Local Health District and The University of Sydney
Dr Joseph Brennan, PhD Editor ah@wfmedia.com.au
Dr Claire Gough Physiotherapist and Research Fellow Caring Futures Institute, Flinders University
Dr Jenny Prentice Wound, Skin and Ostomy Consultant Hall & Prior Health and Aged Care Group
Eamon Williams Procurement Specialist OneAdvanced
Advance Foot Clinic Podiatry
HEALING WITHOUT BORDERS: WOUND CARE FOR HOME AND RESIDENTIAL AGED CARE
Wound care is one of the most common and resource-intensive clinical challenges in aged care. Whether it’s a pressure injury, diabetes-related foot ulcer or chronic venous leg ulcer, delays in specialist assessment can lead to deterioration, hospital transfer, and a poorer quality of life for residents and clients.1
Professor MICHELLE BARAKAT-JOHNSON — named the winner of the 2025 Health Minister’s Award for Nursing Trailblazers by Minister for Health and Aged Care Mark Butler — along with the team at RPA Virtual Hospital have been able to close this gap through the RPA Virtual Hospital Wound Care Command Centre, a pioneering service that connects clinicians (including aged-care workers) directly with wound care specialists, no matter where they are.
Michelle takes Aged Health on a tour.
The Command Centre is a practical, scalable way to bring expert wound care to the bedside, or the lounge room, quickly, safely and costeffectively. It gives aged-care teams real-time advice from specialist nurses, supported by digital wound assessment tools and structured clinical pathways, without the wait for an external clinic appointment.
HOW THE CENTRE HELPS RESIDENTIAL AGED CARE AND HOME-BASED SERVICES
1. Faster specialist input, fewer transfers
One of the most tangible benefits is the speed of specialist triage. For a resident
Jacqui Cross, Chief Nursing and Midwifery Officer, NSW Health (right), visits RPA Virtual Hospital.
with a deteriorating wound, an on-demand virtual review can quickly determine who needs urgent escalation and who can be safely managed on site. This prevents unnecessary ambulance transfers and ED presentations.
Economic modelling and early evaluations from the Command Centre have already shown reduced downstream hospital use and measurable system cost savings when wounds are managed earlier in the community.2 For older people, this means less disruption and care in the comfort of familiar surroundings.
2. Building local workforce capacity
Virtual reviews are more than decision-making tools; they are learning opportunities. During each consult, specialist nurses can guide care staff and visiting clinicians through wound assessments, dressing choices and pressure-relief strategies.
Research and pilot projects show that this real-time, case-based education improves confidence and skill among aged-care nurses and personal care workers.3 Over time, these skills translate into better prevention, earlier detection and more effective management of wounds — benefits that multiply across every resident or client in their care.
3. Better continuity across settings
For home care clients, multiple providers may be involved, for example community nurses, GPs and allied health professionals.4,5 Without a centralised record, wound progress can be difficult to track.
The Command Centre’s digital platform (Tissue Analytics)6 standardises wound photography and measurements, ensuring consistent monitoring. Any changes can be identified earlier, and care plans adjusted without the patient leaving home. This is particularly valuable for frail older people or those living in remote locations where travel is both challenging and costly.
4. Faster decision-making for allied health and visiting clinicians
Allied health practitioners, including podiatrists, occupational therapists and physiotherapists, often play critical roles in wound prevention and healing. Because the Wound Care Command Centre is housed within the RPA Virtual Hospital, access to RPA and district services is quick
in isolation, so allied health professionals work closely with clinicians to identify and manage related issues such as cellulitis, lymphoedema and diabetes-related foot ulcers. Allied health practitioners play vital roles in wound prevention and healing.
The Command Centre offers a single pathway for these professionals to obtain wound-specific advice during their visits or call in if they have any concerns about a patient they are caring for. This ensures that mobility plans, footwear choices and pressureredistribution strategies are well aligned with overall wound management goals.
This coordinated approach reduces conflicting recommendations and improves the overall care experience for the client.
Tissue Analytics app — the Command Centre’s digital platform.
The RPA Virtual Hospital Wound Care Command Centre and Skin Integrity Team, Sydney Local Health District.
OTHER INNOVATIONS
The WoundView (COVIU) integrated app study Alongside the Command Centre, there are other exciting advances in virtual wound care for aged care. Michelle is a co-investigator on a separate project led by Associate Professor Georgie Luscombe and Dr Annie Banbury in partnership with Coviu Global and The University of Sydney.
This study is developing a wound app for residential aged care facilities and external wound care providers. The app, which is built into the Coviu telehealth platform and uses consumer-grade devices such as mobile phones, will enable secure wound imaging, documentation and management within care teams, streamlining how clinicians in different locations collaborate on wound care.
This innovation could make virtual wound consultations even more accessible for facilities and home-visiting clinicians who need quick, reliable tools without complex new systems or the need to download an app or purchase cameras or specialist imaging devices.
Michelle Barakat-Johnson, who is a Conjoint Professor of Wound Care and Skin Integrity at The Sydney Local Health District and The University of Sydney, is an award-winning scholar and internationally respected clinical expert in skin integrity, pressure injuries and complex wound care. Michelle has over two decades of experience in clinical and research leadership related to wound care, and specialises in innovative, evidence-based approaches that improve patient outcomes, enhance clinical practices and reduce healthcare costs.
1. Ahmajärvi KM, Isoherranen KM, Pessi TJ, Venermo MA. The impact of diagnostic delay on wound healing — a cohort study in a primary care setting. Int Wound J. 2025;22(5):e70141. doi: 10.1111/iwj.70141
2. Barakat-Johnson M, Newton M, Cayley C, Lai M, Dixie L, Alexander N, Pelusi M, Chan J, Cohen A. Digitising wound care: a cost-consequence analysis of the Wound Care Command Centre™ in Australia. BMC Health Serv Res. 2025;25(1):873. doi: 10.1186/s12913-025-12969-2
3. Rayner JA, Mahoney AM, Fetherstonhaugh D, Cowen S. Models of education for care workers in Australian nursing homes: improving the care of older people. Front Public Health. 2025;13:1584889. doi: 10.3389/fpubh.2025.1584889
4. Norman RE, Gibb M, Dyer A, et al. Improved wound management at lower cost: a sensible goal for Australia. Int Wound J. 2016;13(3):303–316. doi: 10.1111/iwj.12484
5. Australian Government, Department of Health. Report from the Wound Management Working Group. Medicare Benefits Schedule Review Taskforce; June 2020. Accessed 14 August, 2025. https://www.health.gov.au/sites/default/ files/documents/2020/12/report-from-the-woundmanagement-working-group_1.pdf
6. Barakat-Johnson M, Jones A, Burger M, et al. Reshaping wound care: evaluation of an artificial intelligence app to improve wound assessment and management amid the COVID-19 pandemic. Int Wound J. 2022;19(5):1081–1094. doi: 10.1111/ iwj.13755
RPA Virtual Wound Care Command Centre Video
Wound care dietary supplement
Argie Wound Care, developed by Flavour Creations, is claimed to provide essential nutrients that support muscle health and skin integrity, and promote wound healing.
High in energy (2.0 kcal/mL), the product is formulated with 15 g protein and 4.5 g L-Arginine, and is a good source of zinc and vitamin C per serve, which is claimed to aid in the nutritional management of wounds.
Available in two flavours — Green Apple and Orange — the 150 mL, lowvolume product is nutrient-dense and easy to consume, supporting better compliance. It is suitable for individuals aged three years and older.
The product is also low in sodium and potassium, and free from gluten, dairy, nut and soy, making it suitable for most individuals.
The product is Australian made and owned.
Flavour Creations partners with Wounds Australia to raise awareness of the vital role nutrition plays in wound healing. A portion of proceeds from every can of Argie sold will be donated to support Wounds Australia’s research and education initiative.
Flavour Creations
www.flavourcreations.com.au
DESIGN MATTERS
CONTINUUM OF CARE
From retirement living within Rendu Towers to aged care and specialist dementia support in Villa Rosalie, Architectus’s 16- and 21-storey dual tower development for Ozcare offers a continuum of care within one inner-city Brisbane location — allowing residents to adjust the level of care and support needed as they age. Completed in 2024 and boasting four street frontages, the 6180 m2 ‘island’ site enables expansive river and city views to be maximised from both towers and facilitates separate entrances for retirement living and aged care.
photography by Christopher Frederick Jones.
Rendu Towers, envisioned as a vertical retirement village, has 135 residences, including 11 Sky Homes and three Sky Pavilions. It also features a range of communal facilities across an interconnecting level that unites the community of retirees, with Club Rendu featuring a heated swimming pool, club lounge, private dining room, cinema, library, chapel and wellness centre. Designed to embrace Brisbane’s subtropical climate and lifestyle, Rendu Towers features extensive landscaped terraces and expansive liveable balconies, providing residents with yearround access to the outdoors.
... ALLOWING RESIDENTS TO ADJUST THE LEVEL OF CARE AND SUPPORT NEEDED AS THEY AGE.
Villa Rosalie, envisioned as a home-like residential aged care facility, has 120 beds across three floors and includes an entire level dedicated to residents living with dementia. Designed to feel homely and familiar, with clinical support areas concealed, level four features two large, landscaped terraces — offering a vital connection to the outdoors. A high proportion of aged care rooms have private balconies with expansive river views, providing residents with additional accommodation choices.
At Villa Rosalie, a natural material palette is incorporated in the individual rooms, which have home-like features including refrigerators, offering a level of independence and personalisation to help residents feel at home. “It is a privilege to offer residential aged care in a first-class building so close to the Brisbane River,” said Lanna Ramsay, Head of Aged Care at Ozcare. Other Villa Rosalie features include a hair salon and day spa, large function and activity rooms, cinema, chapel and multiple lounge spaces for residents and visiting family members.
A SHIFT IN CARE:
EMBEDDING RESTORATIVE PRACTICE FOR INDEPENDENT AGING
The Restorative Care Pathway Clinical Guidelines are now available to support implementation of the Support at Home program. Developed by the Department of Health, Disability and Ageing in collaboration with Flinders University researchers, these evidencebased guidelines are designed to promote delivery of consistent, high-quality, restorative aged care.
Lead author of the guidelines Dr CLAIRE GOUGH, from Flinders’ Caring Futures Institute, explains how the rollout of the Support at Home program provides a timely opportunity to embed restorative care into the everyday lives of older Australians — supporting ongoing independence and quality of life.
Restorative care encourages a fundamental shift in our approach to care. Rather than doing things for a person — such as making them a cup of tea or a meal — we are challenged to do things with them. When we routinely take over daily tasks, we may unintentionally reduce a person’s capacity to perform tasks when support is not available.
The restorative care approach empowers older people to remain active participants in their own lives. When delivered well, restorative care reduces dependency on services, freeing up professionals and providers to focus on the individual needs of each person. The approach enables a more targeted, person-centred model of care.
The Restorative Care Pathway Clinical Guidelines recommend that restorative care should:
3 “Adopt a person-centred approach to meet the unique needs, preferences and circumstances of every participant.”
3 “Engage a multidisciplinary team (MDT) to support the needs of each participant, their family and support networks.”
3 “Ensure the MDT providing restorative care are educated and equipped with the skills and knowledge to provide comprehensive care for participants at risk of falls, with frailty, sarcopenia and or multimorbidity, dementia, and those who require support with their mental wellbeing, social connections, nutrition and swallowing difficulties.”
3 “Service providers should facilitate regular communication and case conferences among the MDT to ensure optimal outcomes for participants.”
Emphasis original. Australian Government Department of Health and Aged Care. (2025, May 26). Restorative care pathway clinical guidelines. www.health.gov.au/resources/publications/restorative-carepathway-clinical-guidelines
To fully realise the benefits of restorative care, upfront investment in training, service design and team capacity is essential. This approach often requires more time at the outset — for example, supporting someone to dress themselves will naturally take longer than doing it for them. However, this initial time investment leads to significant longterm gains.
It allows carers and health professionals to build meaningful relationships, gain a deeper understanding of each individual’s history and motivations, and fosters trust. By placing the person at the centre of care and empowering them to actively engage in their daily lives, we can strengthen community connections and help to reduce social isolation and loneliness.
To prepare for the Restorative Care Pathway and effectively support the ongoing independence of older people, providers need to shift their thinking from a task-focused model to a person-centred, capacity-building approach. This involves embedding restorative principles into everyday practice through staff training and ongoing interdisciplinary collaboration.
Providers should invest in upskilling their workforce to understand goal-oriented care, motivational strategies and culturally responsive practices. Building strong communication pathways within teams, with clients, support networks and their families, is key, allowing more time for reflection, learning and relationship-building.
DELIVERING RESTORATIVE CARE
Start-up considerations for care providers
1. Establish a Skilled Multidisciplinary Team
2. Invest in education and training
3. Promote person-centred, goaloriented care
4. Integrate ongoing assessment and communication
5. Enable access to supports and appropriate technologies
While the guidelines offer clear direction on what restorative care is — guided by best available evidence — putting these strategies into practice consistently presents challenges, particularly in a sector that often faces workforce shortages and competing demands. However, the effort is worthwhile. By fostering an organisational culture that prioritises doing with rather than doing for, providers can deliver care that not only addresses immediate needs but also supports long-term wellbeing, autonomy and meaningful social connections for older people.
Embracing restorative care has the potential to transform aged care into a more empowering, person-centred experience — where older individuals are supported to live with dignity, purpose and greater independence.
Dr Claire Gough is a physiotherapist and Research Fellow at the Caring Futures Institute, Flinders University, specialising in the integration of health services and policy. She holds a PhD in Clinical Rehabilitation from Flinders University and has extensive experience in musculoskeletal and neurological rehabilitation.
A DAY IN THE LIFE
REGINA HUANG
A PASSION FOR PALLIATIVE CARE
Regina Huang knew from a young age the career path she wanted to take, so began training to be a nurse at 15. “I grew up in Taiwan and instead of a traditional high school I attended a boarding school for nursing attached to a hospital,” Regina said. “Nursing is 100% my passion.”
After graduating from school as an enrolled nurse, she studied to become a registered nurse in Australia, joined Lutheran Services as an aged care registered nurse in 2022 and last year completed a Graduate Certificate in Palliative Care.
To support her desire to provide advanced palliative care, Regina this year began her Masters studies to become a nurse practitioner as part of Lutheran Services’ program, which provides a team of highly skilled nurses across 11 aged care sites in metropolitan and regional Queensland.
Regina developed a keen interest in therapeutic communication during her palliative care studies. “Therapeutic communication establishes connections and encourages open dialogue with strategies that include active listening, compassion and even silence,” she said.
“Conversations around death can be difficult. I wanted to show empathy to residents at the end of life but often didn’t have the right words. I learned that sometimes all you need to do is listen and spend time with the person and their family.”
She gives us insight into how she spends her day:
Regina works as a Floating Care Manager to support periods of staff leave at Lutheran Services sites. As a palliative care specialist, she takes a proactive approach in early conversations around advance care planning, and when a resident is facing end of life, supports them and family to discuss care goals.
There is also a lot of time spent collaborating with the wider health team to manage pain and chronic disease.
“Every morning, I meet members of the team including clinical, kitchen, lifestyle and admin staff to discuss any issues, events or tasks to do,” she said. “After that I start going through progress notes and I’ll see residents who are unwell to ensure they are receiving the best possible care.”
Regina says seeking out quiet moments with residents, families and staff is an important part of her day. “Making time for clinical staff is a priority, to mentor and educate, and I love to catch up with family members. Whenever I see visiting family, I make a point to say hello. It’s the small interactions that often mean the most.
“One day a week I spend time with my mentor to support my nurse practitioner studies. Aged care nursing is rewarding and challenging. You are in a position to make a lot of independent clinical decisions but there’s also a whole collaborative approach.”
Regina Huang with a Lutheran Services aged care resident.
SKIN TEAR CONVERSATION STARTERS
These conversation starters from Wounds Australia Life Member Dr JENNY PRENTICE are designed to support anyone caring for aging Australians in any setting, but particularly Support at Home teams.
Wound Awareness Week (which was held in September) puts chronic wounds — Australia’s hidden epidemic — under the spotlight. It’s not just a chance to start a national conversation about preventing and treating wounds, but also a great opportunity for aged care professionals to upskill in the special needs of older skin.
As skin ages, it becomes weaker, less elastic and more prone to injury and tearing. Skin tears are a costly and common wound type affecting millions around the globe, especially older people. Despite their prevalence, skin tears are largely preventable. Helping your clients understand how to maintain good skin integrity will reduce their risk of skin tears.
There are several factors that increase a person’s risk of experiencing skin tears, and lots of great ways to help your clients improve their skin integrity. These conversation starters will help you explore them.
Conversation starter
SKIN CHECKS
Did you know that skin tears can be tiny, almost too small to notice? Do you check your hands, arms and legs every day or several times a week for any cuts, sun spots, bruising or any other unusual lumps in your skin? Is there anything you are concerned about?
In addition to frequent skin checks, ensure that fingernails and toenails are trimmed regularly, and that the client is wearing properly fitting shoes and clothes that don’t rub and break the skin.
DEXTERITY/ FLEXIBILITY PROBLEMS
Conversation starter
Can you reach every part of your body when bathing? Are there any bits you find it hard to reach?
It can be hard to properly care for skin you can’t see or reach, and easy to miss a small skin tear until it’s too late. Particularly vulnerable areas include between the toes, the underarms, the backs of the thighs and bony areas like shoulder blades. These areas need to be checked regularly.
SKIN CARE
Conversation starter
Did you know that some soaps can cause dryness of the skin?
Using an unscented pH balanced soap free cleanser, having short showers and gently patting your skin dry, rather than rubbing, will help guard against dryness. A pharmacist can help your client choose the right option for their skin.
Conversation starter
REGULAR MOISTURISING
Did you know that moisturising your skin twice a day is really important in helping it stay strong and flexible and less susceptible to injury? How often do you moisturise?
The evidence from research shows that moisturising plays a huge role in keeping our body’s best defence system — our skin — in good working order. Basic, unscented, emollient-based moisturisers, or those with urea and glycerine, or lotions can be found in supermarkets and pharmacies, and online.
— FOR SUPPORT AT HOME TEAMS
Conversation starter
Conversation starter
What have you eaten and drunk in the past 24 hours, and was this typical for you? Are you having any trouble chewing or swallowing?
Healthy skin relies on appropriate nutrition and hydration, which means eating a balanced diet and drinking plenty of water. Without this, skin becomes dry and brittle, and wounds take longer to heal. Issues with chewing and swallowing may prevent older people from eating properly. Some dietary supplements can support skin integrity and improve wound healing — and a pharmacist can advise on its appropriateness. NUTRITION AND
Do you cover up properly in the sun?
Sun exposure can be extra damaging to aging skin, so it’s important that older people use sunscreen and wear protective clothing such as clothing with long sleeves, and hats.
Conversation starter
Can you move around your home easily without tripping or bumping into things? Do you feel stable when standing and walking?
Even gentle bumps can break fragile skin, and trip hazards combined with balance issues associated with aging increase the chances of accidents occurring.
MEDICATIONS
Conversation starter
Which medications have you taken since my last visit, including over-the-counter products like painkillers or allergy medicine?
Certain medications, such as antihistamines, steroids and diuretics, affect skin integrity and make older skin more prone to inflammation and tearing. People on anticoagulants or blood thinners will be prone to increased bleeding from a skin tear.
Conversation starter
SIGHT ISSUES
Can you see clearly?
Good vision is essential to proper skin checks and care, and to ensuring that the home is a safe environment.
FIRST AID FOR SKIN TEARS
Conversation starter
Do you know what to do if you or someone you know develops a skin tear?
The steps to follow are:
1. Apply light pressure over the skin tear with a clean cloth to stop any bleeding.
2. Wash your hands before attending the wound.
3. Flush the wound with clean lukewarm water to remove any dirt or debris.
4. If possible, unfurl any rolled skin and lie flat using a moist cotton bud or pad.
5. Cover the skin tear with a non-stick dressing and gently bandage.
6. Consider visiting a GP or pharmacist for further advice if the skin tear is:
• large or continues to bleed;
• shows signs of infection, which are heat, pain, redness, swelling, odour or pus.
PREVENTING SKIN TEARS
Conversation starter
Do you know how to prevent skin tears?
Along with twice daily skin moisturising, advise your clients to wear long-sleeved shirts and long pants or trousers to protect arms and legs. Also advise clients to remove any clutter or trip hazards in the home.
THERE ARE SEVERAL FACTORS THAT INCREASE A PERSON’S RISK OF EXPERIENCING SKIN TEARS, AND LOTS OF GREAT WAYS TO HELP YOUR CLIENTS IMPROVE THEIR SKIN INTEGRITY. THESE CONVERSATION STARTERS WILL HELP YOU EXPLORE THEM.
WOUND AWARENESS WEEK RESOURCES
On the Wound Awareness Week website (www. woundaware.org), you’ll find factsheets in six languages for consumers, carers and healthcare professionals on everything from the basics of good skin care to sources of support in the community. Plus, free daily webinars for care professionals that cover everything from different wound types to collaborative care teams.
And the International Skin Tear Advisory Panel (www.skintears.org) has a range of resources like the Skin Tear Tool Kit and Risk Assessment Pathway — to guide care professionals in managing this common and impactful wound type.
Dr Jenny Prentice PhD RN STN, Cert., Palliative Care, is a Wound, Skin and Ostomy Consultant at Hall & Prior Health and Aged Care Group in WA. She is the Editor of the World Council of Enterostomal Therapist’s (WCET) WCET Journal and a pioneer in pressure injury research. With over 30 published articles, several books and 22 research projects to her name, Dr Prentice is also celebrated for her dedication to mentorship and patient-centred care.
This is general advice only and specialist/professional advice should always be sought for each circumstance.
RELATIONSHIP-BASED MODEL GETS TO THE HEART OF QUALITY CARE
CASE STUDY
PROBLEM:
A resident who moved into residential care after losing her husband is seeking purpose in her new home.
SOLUTION:
A relationship-based care model that allows residents to become valuable members of the aged care team.
St Vincent’s Care has embedded a relationship-based care model nationwide across its facilities.
Known as the ‘Heartprint’ model, it strengthens personal connections, creates a true sense of community, blurs the lines between residents and workers, and has received national recognition with a nomination in Ageing Australia’s You are ACE! awards, which recognise outstanding achievement, commitment and excellence across the aged care sector.
Take St Vincent’s Care Heathcote in New South Wales — from the moment you arrive, the difference is palpable. Grace Wilson — a 78-year-old resident — is at the reception desk working alongside staff member Jennifer to greet visitors who arrive at the home. Grace, a former office manager, moved into St Vincent’s Care after losing her husband, and was seeking purpose in her new home.
“It’s a natural fit for me and I enjoy doing the work,” Grace said — now staffing the reception desk four days a week. “It makes a difference for new residents and families when they see someone who lives at the home in a front of house role.” Fellow residents also appointed Grace Chair of the Residents’ Advisory Committee, a committee that consults on everything from garden planning to outing ideas.
“Grace is certainly a very valuable member of our team, both as a resident and as a colleague and friend,” Mark Aros, St Vincent’s Care Heathcote Manager, said. “We know that making a contribution to where she lives is important for Grace — it’s important for her mental health and we have plenty of laughs and fun along the way.”
“Quality aged care isn’t just about clinical excellence, it’s about connection,” Ageing Australia CEO Tom Symondson said, saying the Heartprint model is a shining example of the sector’s ongoing commitment to excellence. “The best providers understand this and they’re leading the way in creating places that feel like true homes for residents.”
In Aros’s words: “When residents are empowered to shape their lives here, the whole community thrives.”
Resident Grace Wilson (centre) with her daughter Sheridan Wilson (left) and her colleague Jennifer Dacron from St Vincent’s Care Heathcote.
A DNA-REPAIRING PROTEIN
— COULD IT PREVENT
AGE-RELATED DISEASES?
Protein disulfide isomerase, or PDI, is a naturally occurring protein found in human cells that, researchers have found, acts as a ‘glue’ helping to repair broken DNA — widely accepted as one of the main contributors to aging and the progression of age-related diseases such as Alzheimer’s, motor neuron and Parkinson’s. The protein could have benefits for therapies aimed at boosting the body’s ability to fix its own DNA — a process of repair that becomes less efficient as people age.
“Just like a cut on your skin needs to heal, the DNA in our cells needs constant repair,” neurobiologist Dr Sina Shadfar explained. “Every day, individual cells suffer thousands of tiny hits to their DNA — from both within our own bodies and from environmental stressors like pollution or UV light. Normally, the body responds quickly. But as we age, these repair mechanisms weaken, allowing damage to build up.”
As we age, this DNA damage accumulates and is now widely accepted as a major contributor to age-related diseases. “Brain cells are especially vulnerable,” Shadfar said. “Unlike
skin or blood cells, they don’t divide or renew — so any damage that builds up in them stays. And if the damage isn’t repaired, it can eventually lead to the death of these critical cells.”
Typically found in the outer region of the cell, known as the cytoplasm, PDI helps fold proteins into their proper shapes. But the surprising discovery by Shadfar and his team of researchers at Macquarie University’s Motor Neuron Disease Research Centre — published in open access journal Aging Cell (doi.org/10.1111/acel.70079) — is that PDI can also move into the nucleus, or control centre of the cell. It’s here it can play a vital role in repairing one of the most dangerous types of DNA damage, namely ‘double-strand breaks’.
“Until now, we didn’t know why PDI sometimes appeared in the nucleus,” Shadfar explained. “For the first time, we’ve shown it acts like a glue or catalyst, helping to repair broken DNA in both dividing and nondividing cells.” This glue-like action was demonstrated in the research by stimulating DNA damage in the lab, both in human cancer cells and mouse brain cells. The cells struggled to repair themselves when PDI was removed, while DNA repair improved when PDI was added back in.
Live zebrafish were also tested, where the researchers found that boosting PDI production helped protect the animals from age-related DNA damage. Previously, cancer research has shown that PDI is not always positive — Shadfar likening it to “a double agent”. “In healthy cells,” Shadfar said, “it repairs DNA and helps prevent disease. But in cancer, it gets hijacked — it ends up protecting the tumour instead of the body. That’s why understanding it fully is so important.”
Dr Shadfar, pictured, and the Motor Neuron Disease Research Centre team are using gene therapies, including the same technology used in COVID-19 vaccines, to target aging mechanisms that overlap with those found in motor neuron disease.
Any therapy that modulates PDI, therefore, will need to be precisely targeted to avoid unintended effects, with the next step for the researchers being gene therapy approaches to target aging mechanisms. “This work has the potential to transform how we approach neurodegenerative diseases,” Shadfar said. “We want to intervene earlier — before too much damage is done. Our ultimate goal is to prevent or halt the progression of these devastating conditions.”
This is an important goal given, as Shadfar explains, “[motor neuron disease] deaths have increased by 250% over the past 30 years. Cases of dementia, including Alzheimer’s disease, are projected to more than double by 2041. Parkinson’s disease, now the fastestgrowing neurological disorder, affects over 150,000 Australians — and is increasing at 4% each year.” And that, as Shadfar also points out: “By 2050, one in four Australians will be over 65.”
Ride-hailing app with seniors features
The Uber ride-hailing app has introduced two features across Australia and New Zealand, tailored for seniors: Simple Mode and Senior Account.
Intended for more independent older Australians, Simple Mode is designed to be an easy-to-use interface, with larger text, fewer buttons and easy-to-follow screens. Simple Mode has also been designed to make personalising the app (like adding ‘home’ or doctors to a user’s saved places for quick booking) easy, to help users stay in control.
The Senior Account feature is intended for users who want a little more support from loved ones; it can be set up in Uber’s Family profile, so loved ones can help manage rides and payment options and receive real-time trip updates — all from their own phone. Designed to make the Uber experience easier, more accessible and more supportive of older Australians, the launch of these two features follows 2024 Uber data that found more than a third (36%) of Australians aged 65+ say easy access to transport is a major pain point in their daily lives — one that can impact their independence and wellbeing. Uber Technologies Inc. www.uber.com
VR HEADSET AND A TREADMILL — COULD THIS COMBO CURB FALLS?
Among community-dwelling older people (65 or above), approximately one in three experience at least one fall each year, with most of these being due to trips and slips. In an effort to address this significant public health issue, Dr Yoshiro Okubo — a Neuroscience Research Australia (NeuRA) research fellow — led a study that engaged 56 participants aged 65 years and over and living independently in the community. The study used a VR system and treadmill in order to build ‘obstacle avoidance skills’ that may help older Australians prevent fall risk in real life.
“For this research, we used a virtual reality system and treadmill to train people to avoid obstacles that they may find on a suburban footpath,” Okubo explained. For the study, participants wore an immersive VR head-mounted display and safety harness and walked on a split-belt treadmill in two 8-minute conditions — performed in random order. Participants had to navigate a concrete footpath with slip and trip obstacles, with there also being virtual apples for them to collect along the way.
Importantly for this study, the system was configured so participants could undertake the training with or without physical feedback to obstacle collisions. “The physical feedback was provided by abrupt treadmill belt translations that created momentary balance loss, similar to trips and slips in everyday life,” Okubo said, adding that the study found that this feedback plays a crucial role for older people in learning to avoid an obstacle. Participants also found the VR activity enjoyable and reported that motion sickness was negligible.
Now, researchers at NeuRA’s Falls, Balance and Injury Research Centre plan to trial further environments — such as city streets and bush paths — and use a low-cost VR treadmill system for better clinical feasibility. “We hope this VR obstacle avoidance training will complement existing evidenced-based strength and balance exercises to prevent falls, and associated serious injuries in older people,” Okubo said. “We want to help people build their skills and reduce their risk of falling.” A 2025 paper about the study — ‘Virtual obstacle-avoidance training using daily-life obstacles with physical feedback in older people: a cross-over trial’ — was published in Archives of Gerontology and Geriatrics
DEMENTIA TRAINING APP ADDS PALLIATIVE CARE COURSE
CASE STUDY
PROBLEM:
The peak body for dementia wanted to mark this year’s National Palliative Care Week with a resource that would educate aged, disability and health care workers.
SOLUTION:
Through collaboration with the Fronditha Care Foundation, Dementia Australia added the palliative approach to dementia care course to its Ask Annie app.
workers to its interactive Ask Annie app; the app, which is free to download for both iOS and Android smartphones through the relevant app stores, provides on-the-go dementia training for care workers. The course — ‘A palliative approach to dementia care’ — comprises four key modules that care workers can explore anytime, anywhere, at their own pace, in short lessons on the mobile app.
The course launch coincided with National Palliative Care Week 2025 (11–17 May), with Dementia Australia CEO Professor Tanya Buchanan saying that it aims to maximise quality of life at all stages and educate the dementia workforce on the importance of dignity for people living with dementia.
“Educating the health and aged care workforce about dementia and palliative care will make a critical contribution to improving access to timely and appropriate palliative care for people living with dementia,” Buchanan said. “It is not just about managing and treating physical symptoms, it is also about supporting the emotional, social, cultural and spiritual aspects of a person’s life whilst also supporting their loved ones.
“This course provides workers with insights into palliative care informed from real-life scenarios,” Buchanan added, “highlighting practical tips and skills to empower a compassionate, palliative approach to dementia care, with an additional focus on culturally diverse care.” The course was funded by Fronditha Care Foundation, which focuses on projects that advance delivery of culturally appropriate aged care services for older Australians.
“We collaborated with Dementia Australia, to deliver specialised training with a focus on a palliative approach to dementia care, psychosocial support, assessing and managing symptoms through exploring Greek customs around death and dying,” Spiteri said. “By acknowledging and respecting cultural beliefs and individual preferences and embedding practices across the continuum of care, we can better meet the needs of our elders at this stage of life.”
James Chaousis — a Dementia Australia Dementia Advocate who cared for his wife Linda who received palliative care before she passed away from dementia earlier this year — said compassionate care from care workers made a real difference. “It is important to uphold the core values and preferences of the person living with dementia,” Chaousis said. More information on the Ask Annie app is available at www.dementia.org.au/professionals/professional-development-and-training/ask-annie.
image: Kane Multimedia
RISING TO THE REFORMS: THE VALUE OF SOURCE-TO-CONTRACT SOLUTIONS
Australia’s aged care sector is preparing itself for transformative regulatory, digital and pricing reforms starting 1 November 2025. As a result, aged care providers face unprecedented compliance demands and operational complexities. These sweeping reforms aim to enhance transparency, improve care quality and ensure financial accountability, underscoring the critical need for proactive contract restructuring and stringent supplier compliance management, as EAMON WILLIAMS, Procurement Specialist at OneAdvanced ANZ, explains, making the case for the value of source-tocontract solutions in rising to reform requirements.
The Australian Government’s reform package includes enhanced regulatory oversight, stringent digital recordkeeping standards and revamped pricing models designed to increase transparency and accountability. The Royal Commission into Aged Care Quality and Safety has highlighted numerous systemic shortcomings, prompting these reforms to ensure safer, more reliable and financially accountable aged care services.
Under these reforms, providers will encounter stringent new requirements, including mandatory real-time reporting of supplier performance metrics and increased transparency obligations related to contractual agreements and spending. Providers must ensure all suppliers comply with new ethical, environmental and quality
benchmarks, with severe penalties for noncompliance. This significantly elevates the role of contract governance and demands meticulous supplier relationship management.
CHALLENGES FACING PROVIDERS
Aged care providers commonly encounter complex, multifaceted contracts involving numerous suppliers and contractors. This complexity often leads to poor visibility into contractual obligations, supplier performance and risk exposure. Providers frequently lack robust mechanisms for proactive management, leaving them vulnerable to non-compliance penalties and reputational risks.
Additionally, supplier relationships and contract performance data traditionally exist in disparate, often manual systems, making compliance and supplier risk management cumbersome and prone to errors. The reforms amplify these challenges, demanding integrated, digital solutions capable of realtime monitoring, comprehensive visibility and rapid response to evolving compliance requirements.
SPOTLIGHT ON SOURCE-TO-CONTRACT SOLUTIONS
To navigate these reforms effectively, aged care providers should embrace Contract Lifecycle Management (CLM) and Supplier Management (SM) systems. These sophisticated digital solutions streamline and automate the contracting process, from supplier sourcing to contract execution, compliance monitoring and renewal.
CLM solutions digitise and standardise contract processes, providing centralised control over the contract lifecycle and ensuring clarity and accountability at every stage. Likewise, SM systems enhance transparency and oversight by tracking supplier performance, compliance status and associated risks in real time.
Key benefits of implementing these solutions include:
• Enhanced compliance — automated compliance monitoring and alerts ensure providers remain within regulatory boundaries, significantly reducing the risk of breaches and fines.
• Improved efficiency — digitisation eliminates manual processes, freeing up resources for strategic oversight and decision-making, leading to faster, more accurate contract management.
• Reduced operational risk — real-time visibility into supplier performance and risk exposure allows providers to address issues proactively, safeguarding their operations and reputation.
Real-world examples across Australian aged care highlight the tangible impacts of adopting CLM and SM systems. Providers using these platforms have reported substantial reductions in compliance breaches, significant improvements in contract management efficiency and enhanced capability to address supplier-related issues swiftly.
STRATEGIC ADVANTAGES BEYOND COMPLIANCE
The benefits of CLM and SM solutions extend beyond sheer regulatory compliance. By proactively embracing digital solutions, providers unlock long-term strategic advantages that enhance their competitive positioning and financial health.
Aged care organisations investing in CLM and SM platforms benefit from substantial cost savings through improved supplier negotiations, reduced administrative overheads and enhanced contract utilisation. Digital solutions provide critical data-driven insights, enabling providers to effectively identify trends, forecast supplier performance and optimise contract terms and conditions.
Likewise, proactive management enhances supplier relationships through increased transparency, trust and collaboration. Providers that leverage these solutions become preferred partners, securing advantageous terms and ensuring continuity of high-quality services.
Adopting digital solutions also positions providers effectively for future regulatory changes. With the aged care landscape continuously evolving, those equipped with adaptable, integrated systems are better placed to swiftly and efficiently respond to future reforms, securing a competitive edge in the market.
MEETING COMPLEXITY
The incoming aged care reforms represent a critical juncture for the sector, demanding proactive adaptation from providers. Sourceto-contract solutions are no longer optional but essential tools for successfully navigating these complexities.
By adopting these digital solutions, aged care providers will meet the complex regulatory requirements and harness significant strategic benefits, driving efficiency, reducing operational risk and securing longterm competitive advantages. Ultimately, proactive implementation of these systems will ensure aged care providers are well-prepared, compliant and positioned to thrive in Australia’s
Eamon Williams is Procurement Specialist at OneAdvanced ANZ.
iStock.com/Jacob Wackerhausen
WITH RICHARD SHIEH
WHY MOBILE PODIATRY MATTERS MORE THAN EVER
I’ve had countless conversations with older Australians who say the same thing: “I just want to keep moving”. And it makes sense. Movement means independence. It means being able to hang out the washing, pop to the shop or join family for lunch, without needing to ask for help. What often gets overlooked is how much that independence relies on healthy, pain-free feet. And how hard it can be to care for them as we get older. As a result, podiatry at home is becoming a more common and necessary part of aged care.
PODIATRY IN HOME
CARE
As people get older, caring for their feet often becomes more difficult. Nails thicken and harden, eyesight fades and changes in
strength and coordination make even simple tasks harder. While these changes might seem small, they can lead to infections, ongoing pain and a drop in confidence when moving around.
In my visits, I’ve seen people with deep cuts from trying to cut their own toenails, or infections that have gone unnoticed for months. I’ve had family members say they’re too nervous to help in case they do damage. Podiatrists use sterile tools and know how to work with tricky nails and sensitive skin. We also look out for early signs of other conditions that tend to show up in the lower limbs, like diabetes, high blood pressure, circulation problems and nerve damage.
Being in the home also lets us assess the space. We can spot trip hazards, check all types of footwear (not just what they wore to an appointment) and look at how a person moves around their own environment. We also manage pain in the feet, ankles, knees and legs. A sore foot can quickly become a reason to stay inside. But if we can help reduce that pain, we can support people to stay active and connected to their community. That’s what podiatry in home care is really about.
PODIATRY IN THE BROADER HOMECARE SYSTEM
Podiatrists are part of the allied health team, just like physios and dietitians. We complete a four-year university degree and are registered with Ahpra. But we’re few and far between, especially in regional areas. That shortage means home care providers often find it hard to find podiatrists who can take on new clients. It’s something I see often — providers ready to refer, but no one available to take the job.
The need for podiatry is growing as the population ages. But there’s also a shift in how our work is seen. Where we were once considered ‘nail trimmers’, people now recognise the broader care we provide. GPs and other health professionals are also working more closely with podiatrists to manage fall risks, diabetic care and mobility issues.
The profession itself is evolving, too. Some podiatrists now complete extra training to prescribe certain medications. There’s more collaboration, more crossover with physios and exercise physiologists, and more awareness of what foot health really means in later life.
CHALLENGES AND OPPORTUNITIES
There’s a real risk that demand will soon outpace the number of working podiatrists. Without more graduates entering the field, many people may miss out on the care they need to stay mobile and safe. But with more awareness and support from the government and care providers, there’s a real chance for growth.
Aside from workforce shortages, admin is a major pressure point. The compliance load tied to aged care work is heavy, meaning less time for face-to-face care. It also drives up the cost of each visit. On the other hand, more people now understand what podiatry offers, and there’s a growing appetite to make it part of regular home care planning.
SOME SIMPLE STEPS FORWARD
Good foot care helps people stay steady, comfortable and confident. And that can make a world of difference to someone’s life at home.
Richard Shieh is a qualified and experienced podiatrist at Advance Foot Clinic, holding a Bachelor of Podiatry and a Bachelor of Health Studies from Queensland University of Technology. With a passion for health care and lifelong learning, he also has a diverse healthcare background, with a Diploma in Dental Technology and a Bachelor of Dental Surgery.
ARE WE ON THE CUSP OF LIFE-CHANGING DIABETIC WOUND TREATMENTS?
Diabetes affects 1.7 million Australians — at a cost of $14.6 billion each year — and as Dr Robert Fitridge, a vascular surgeon at Royal Adelaide Hospital and The Queen Elizabeth Hospital, explains: “Diabetic wounds are highly challenging to treat and often fail to heal properly, leaving patients at risk of serious complications.” Now, building on past discoveries, SAHMRI researchers believe they have zeroed in on the mechanism driving diabetic wound healing.
It was in 2016 that Associate Professor Christina Bursill discovered that ‘good cholesterol’, or high-density lipoprotein (HDL), can greatly accelerate the healing of diabetic wounds. The latest discovery — together with recent PhD graduate, Dr Khalia Primer — is that “HDL works by restoring the levels of an important enzyme called PDK4, which plays a critical role in enabling skin cells to generate the energy required for repair”, Bursill said. “PDK4 is essential for wound healing, but in diabetes, its levels are often too low, making it much harder for the skin to regenerate and close wounds.”
By understanding the mechanism behind HDL’s healing effects, more targeted treatments that could transform diabetic wound treatment may follow. “This gives us a much clearer picture of how HDL can be harnessed to enhance the body’s own healing processes,” Primer said. “In future, we could develop therapies that directly target PDK4 or enhance HDL function.”
A particular risk for people with diabetes is that they will develop a diabetes-related foot ulcer (DRFU). DRFUs affect around 50,000 Australians each year, resulting in 5000 amputations, with approximately 34% of people with diabetes developing DRFU during their life — those living with diabetes in rural and remote areas, and First Nations people being disproportionately affected. New discoveries to correct healing are something that Fitridge sees a great need for.
“Even with the best available care, too many wounds remain open for months or even years, increasing the likelihood of infection and amputation,” Fitridge said. “We urgently need better treatments that can heal wounds faster and more reliably. If we’re able to intervene earlier and promote more effective healing, we could potentially prevent thousands of amputations each year and significantly improve outcomes for people living with diabetes.”
Editor: Dr Joseph Brennan, PhD ah@wfmedia.com.au
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