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Quality of life is difficult to measure, but essential to aged care

In an aged care facility quality of life is about freedom, engagement with others, and having a connection to values, says international expert.

A staff member of the Arts Health Institute was conducting a survey with the residents living in a memory unit.

Sitting with a resident as they conducted the one-on-one surveys, the staff member asked, “What else can be done to make your life here more satisfying?”

The resident paused to think.

“I don’t really know,” he replied, “but could you just sit with me a while longer?”

Stephen Lundin, international expert on workplace moral, culture and productivity, recounts this story to illustrate quality of life, something he says is difficult to measure, but at the essence of good aged care.

Dr Stephen Lundin. Photo: Nicola Ward

Dr Stephen Lundin. Photo: Nicola Ward

When quality of care is discussed it usually involves fairly clinical criteria reflecting a medical model, says Dr Lundin. He acknowledges that clinical criteria are important, but says quality of life is critical, largely due to the vulnerability of the residents.

“In an aged care facility quality of life is about freedom, engagement with others, and having a connection to values and favourite activities. But for staff to really know a person who can’t summarise their life, they need to be truly present and to discover things about them through conversation, family and visitors, and by paying attention,” says Dr Lundin.

Dr Lundin, author of the best-selling FISH! A Remarkable Way to Boost Morale and Improve Performance was speaking to Australian Ageing Agenda ahead of his participation in the Aged and Community Services NSW & ACT state conference in May.

He is best-known for the “FISH Philosophy,” which focuses on “who we are” while we work, and how our values, attitudes and interactions shape the workplace culture.

His philosophy encourages people to approach work playfully, to be present, focus on serving others, and be more conscious of our attitudes.

What makes a workplace satisfying is partly influenced by how much people enjoy the work and partly by how much they enjoy the feel of the place, Dr Lundin says. “Some places have a toxic feel while others are welcoming and warm. The feel of a place, or the culture, is created moment by moment as workers choose how they will show up at work.”

Dr Lundin acknowledges that aged care organisations and staff have been through a lot of change, as reforms have been implemented, over which they had little control. “It is true the sheer amount of change is tiring,” he says.

But, aged care workers have a choice in how they show up for work, he says.

“Why not create a palace of hospitality amidst the chaos? Why not co-create a place that is playful so that coming to work is joyful even if the actual job is not? We create our own workplace culture; why not make it a fully human and playful place?”

Dr Lundin encourages workers to put aside a focus on the negative and build a work environment where “you look forward to entering each work day because it is like a healthy home.”

The ACS NSW & ACT state conference runs from 4 to 5 May at Dolton House, Sydney.

Want to have your say on this story? Comment below. Send us your news and tip-offs to editorial@australianageingagenda.com.au 

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7 Responses to Quality of life is difficult to measure, but essential to aged care

  1. Illana Gaye Halliday February 12, 2016 at 1:38 pm #

    We are so excited to have Steve Lundin MC our conference and run a pre-conference workshop on applying FISH in aged care. His FISH principles are a perfect match for what we all want to achieve with CDC.

  2. Jason February 12, 2016 at 1:47 pm #

    We have found the Eden Alternative model to be a very effective way for transforming culture and implementing person centred care. Culture change needs a framework to deliver the outcomes. Too often services go straight to the model implementation without first working on the paradigm shifts from task/institution to person focus. Then the model, be it Montessori, spark of life etc become ineffective and non sustainable. Change culture first then bring in the interventions then you will see sustained quality of life outcomes.

  3. Maggie Haertsch February 12, 2016 at 10:41 pm #

    It is terrific that Steve will be back in Australia and fabulous to know that he will be at ACS Conference in May. He is a passionate change agent in aged care and an inspiring workshop leader not to be missed. If an organisation wishes to have a workshop with the “Big Tuna” (as he is affectionately known) and can’t make it to ACS, I can help organise one with Steve just contact the Arts Health Institute.

  4. Dave February 15, 2016 at 10:48 pm #

    …The asymmetrical power relationship implicit in the FISH philosophy aligns perfectly with reduced staffing and no RN coverage.

    Another vile lesson from the powerful to the powerless… You can’t do anything about the changes we make to your workplace so just choose to have a good attitude about it.

    Please come back Anthony Robbins, all is forgiven.

  5. Brenton February 16, 2016 at 5:38 pm #

    This is not rocket science. You can call it whatever you want but is it so difficult and complex to treat people in a dignified and respectful manner? With all due respect to Dr Lundin you are talking about a model of interacting and engaging with people that should be common sense. If it isn’t we need to ask ourselves why?

    Regardless of whether its FISH philosophy, or Eden, or Montessori is dependent upon sufficient resources to successfully implement it in the first place. When you have 2 staff to 40 residents with complex care needs what type of culture do you think its going to be? Of course it’s toxic. People are stressed and worried that Mrs Smith in room 34 has been waiting for over an hour to go to the toilet. They’re worried that if Mr Jones triggers his sensor mat by the time anyone can get to him he will be on the floor with a broken hip.

    Why this stuff is considered so ground breaking and revolutionary in the first place is completely beyond me. While I support all of these approaches I think it is sad reflection on our society that we need them in the first place. You need to have training on how to be compassionate and caring?? Absolutely disagree that culture change needs a ‘framework’. Cultural change requires people in power to instil values in their workforce that are consistent with upholding human rights. Once again very easy to talk the talk with altruistic mission statements when in reality your residents are left sitting in their own faeces while they eat fish fingers and party pies. Large parts of this sector are in a state of absolute denial and deflect away from the real issues through singing the praises of the latest feel good catch phrase.

    When my children are in Aged Care I couldn’t care less what idealistic philosophy the organisation pretends to prescribe to. I want them to receive quality care where they are treated like human beings and not treated as though they are still five when they are 85. If you are a CEO of an aged care organisation ask yourself would you be happy to live in one of your own facilities? If you answer yes then maybe you could do an undercover boss exercise and go an do just that for a week. Reality is a bitter pill to swallow and delusion the perfect antidote!

  6. Carolanne Barkla February 21, 2016 at 4:19 pm #

    Culture in any organisation will determine service delivery. Every organization looking to continuous quality improvement and creating a great culture should look to the FISH Philosophy.
    The FISH philosophy has been the most adopted organizational program of all time. Having Dr Lundin from the USA coming to Adelaide on 28 April 2016 to specifically present ‘ FISH! To improve competitive edge: Why aged care needs FISH Philosophy’ is a not to be missed opportunity!
    Check out the program: http://www.agedcommunity.asn.au

  7. Stella Martin February 22, 2016 at 7:38 pm #

    Philosophise, strategise and organise all you want; if you aint got no staff you aint got no care.

    Funny how its always management personnel that gush so effusively about this motivational malarkey. A culture of continuous improvement…hooray! (Yawn)

    Fair conditions, reasonable workload and a provider that doesn’t try to operate on the smell of an oily rag will determine workplace culture. Fairytales about mice, cheese, penguins and fish make accountants feel good when they cut staff numbers.

    Nice challenge, Brendon. Undercover boss in their own facility…but I doubt we’d find a CEO that brave.

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