# Presentation: 210717

## Shifting Attitudes in Australian Aged Care

Mike Rungie, CEO 
ACH Group, Adelaide, Australia
April 2007

*Mike Rungie, CEO *
*ACH Group, Adelaide, Australia*
*April 2007*

## Older people simply want to continue to live well and trade on their own solution attempts and processes
Older people have preferences in the way they want services delivered and, in a market driven economy, would probably choose very differently
Older people want services to allow/enable more possibilities than services can ever deliver

- Older people simply want to continue to live well and trade on their own solution attempts and processes
- Older people have preferences in the way they want services delivered and, in a market driven economy, would probably choose very differently
- Older people want services to allow/enable more possibilities than services can ever deliver

## Older people wanted more service interventions positioned upstream and very accessible to enable them to learn and have time to manage their own conditions

## Older people in an elder friendly communities project were not seeking an ever increasing number of services for themselves, wanted responsive services but only when they needed them and were concerned about waiting lists and cancelling the service they didn’t need for fear of missing out

## 60% of ACAT assessed people in hospital are going home via individualised packages of care, including rehabilitation and engagement of the person, family and GP

- 60% of ACAT assessed people in hospital are going home via individualised packages of care, including rehabilitation and engagement of the person, family and GP

## Some services are now joining up on pathways with one service leading to others as needs change, both for better and worse

## Frail older people want to live with hope, but services are unlikely to provide hope.  Services will need to think about what service/habits most enable hope

## The high levels of depression in Nursing Homes are often not diagnosed and treated and little is known about alleviation

**The high levels of depression in Nursing Homes are often not diagnosed and treated and little is known about alleviation**

## Wyatt Holidays provides 800 frail older people holidays each year planned, anticipated and supported by volunteers.  Costs are low and client satisfaction high.  Compare this with the cost, complexity and satisfaction of residential respite.

## The better practice project in South Australia empowers connectors to connect older people to people and activities of mutual interest

## We know that older people prefer to keep and add more people and activity into their lives as a way of safeguarding against abuses but older people know that services tend to reduce people in their lives

## Customer Impact Statements in South Australia and Victoria demonstrate community care is scoring better than even the best residential care in the areas of roles, reputation, participation, relationships, activities and possessions – giving us good information about why people choose an option.

## Considers what life is really like
Engages staff in the dilemma (care is great – Life is not)
Engages all in developing better practice
Uses 5 life dimensions
Right Relationship
Relevant, individualised, strength-based approaches
Valued social roles
Enhancing capacities
Personal safeguards

- Considers what life is really like
- Engages staff in the dilemma (care is great – Life is not)
- Engages all in developing better practice
- Uses 5 life dimensions
- Right Relationship
- Relevant, individualised, strength-based approaches
- Valued social roles
- Enhancing capacities
- Personal safeguards

## Current
60 – 80% Residents in Nursing Homes have Dementia.  Customer Impact Statements reflect challenge.
8% Community Package clients have Dementia
Mental Health numbers very low
Stressing the Health system

Shift 
Awareness, Research, Training, Early Interventions
Community Packages targeting Dementia
Respite Services targeting Dementia
Transition Care 50% Dementia, 30% Mental Health

- _Current_
- 60 – 80% Residents in Nursing Homes have Dementia.  Customer Impact Statements reflect challenge.
- 8% Community Package clients have Dementia
- Mental Health numbers very low
- Stressing the Health system
- _Shift_
- Awareness, Research, Training, Early Interventions
- Community Packages targeting Dementia
- Respite Services targeting Dementia
- Transition Care 50% Dementia, 30% Mental Health

## Australian Aged Care has had a focus on Product Availability and Quality
Expectations are supporting an emerging shift to customer driven service
Single Points of Entry
Short term care
Optimisation
Carer focused
Positive Ageing

- Australian Aged Care has had a focus on Product Availability and Quality
- Expectations are supporting an emerging shift to customer driven service
- Single Points of Entry
- Short term care
- Optimisation
- Carer focused
- Positive Ageing

*Innovations Shifting from Products to Service*

## Nursing Homes:  
	88 places/1000 people > 70 years (shift to High Care)
Community packages: 
	25 places/1000 people > 70 years (shift to Community Packages)
Low level Community Care: 
	focus on local solutions, Community and Volunteers
Housing:
	Re-emergence of affordable housing and Housing Plus services
Health (Hospitals, GPs, Pharmaceutical)
	Shift to Health prevention, Chronic Condition Management, Hospital avoidance
Pension:
	Current use high, compulsory 9% super after 2002

- Nursing Homes:
- 	88 places/1000 people > 70 years (shift to High Care)
- Community packages:
- 	25 places/1000 people > 70 years (shift to Community Packages)
- Low level Community Care:
- 	focus on local solutions, Community and Volunteers
- Housing:
- 	Re-emergence of affordable housing and Housing Plus services
- Health (Hospitals, GPs, Pharmaceutical)
- 	Shift to Health prevention, Chronic Condition Management, Hospital avoidance
- Pension:
- 	Current use high, compulsory 9% super after 2002

***Shifts in the Australian Aged Care Program***

## Departure from traditional notions of old age and family obligations
Desire for independence, control and autonomy
Patterns of housing tenure, lifestyle and family relationships are changing
Flexibility and fluidity
Living alone and loving it
Consumption and lifestyle take precedence
Home as conduit to lifestyle choices
Location and friends prime importance – intentional communities

- Departure from traditional notions of old age and family obligations
- Desire for independence, control and autonomy
- Patterns of housing tenure, lifestyle and family relationships are changing
- Flexibility and fluidity
- Living alone and loving it
- Consumption and lifestyle take precedence
- Home as conduit to lifestyle choices
- Location and friends prime importance – intentional communities

## Yankalilla – More than a Nursing Home

- GP Clinic
- Emergency Retrieval
- Allied Health Centre
- “Hospital” 2 beds
- Teaching and Research
- Respite Cottage
- Short Term Care
- Long Term Care
- Community Care
- Men’s Shed
- Community Meeting
- Volunteers
- Positive Ageing
- Housing Plus Services