Restorative care approaches need to be extended into residential aged care, allowing some residents the potential to return home, says a leading academic.
Michael Fine, Adjunct Professor at Macquarie University’s Department of Sociology, said models of aged care needed to reflect that understandings of ageing had shifted away from that of ageing as a period of deterioration, towards one of opportunity and possibility.
“We need to be shaping our aged care services away from this very negative, terminal decline model, towards a much more restorative approach,” Professor Fine told Australian Ageing Agenda.
Professor Fine, speaking ahead of his presentation at the AAG & ACS regional conference this week, said that there was potential for residential care facilities to operate as long-term rehabilitation facilities, and with greater emphasis on social aspects of care.
For example, a residential aged care facility could operate three streams: permanent residents, residents who are part of a rehabilitation program, and day care facilities, which could provide seniors in the community with access to services such as physiotherapy.
Further, Professor Fine said if consumer directed care and consumer choice were extended into residential care, there was the potential that residents would choose care that reoriented them back into their own homes.
“The crucial thing is that we start to get older people themselves involved in much more of the planning of things. I think we consult them too far too late and far too little,” he said.
A more fluid model of care that would allow people to move in and out of residential settings may also potentially free up the number of available vacancies, said Professor Fine, allowing consumers’ a greater diversity of choice in where they are cared for.
While Professor Fine acknowledged that not everyone in a residential aged care facility could be rehabilitated, it was wrong to presume that residents could not make functional gains.
Among residents living with dementia, research had shown reablement approaches, including that of music, exercise and social engagement programs, reduced dependency and slowed the onset of symptoms. These were also often cost effective to run, he said.
“The scope for improvement really lies in that social sphere, and that’s the cheap side. It’s quite cheap and it reaps incredible rewards,” said Professor Fine.
There were also potential cost benefits to a restorative approach in residential care in that clinical staff such as nurses could move into more consultative roles, rather than be required to be on-hand at all times, he said.
Residents returning home: one provider’s success
One aged care provider that has already moved towards embedding reablement has successfully supported three of its residents to return home in the past 18 months after they made functional gains.
Ozcare’s Noosa Head facility has adopted a model of care that encouraged residents to maintain their independence wherever possible, according to facility manager Carmel Morgan.
“It’s about health and wellness; we help our residents focus on their ability to do things for themselves,” she said.
Former resident John Pigeon moved into Ozcare Noosa Heads two years ago after he was diagnosed with Alzheimer’s disease and his wife Anthea found it difficult to manage his care.
On admission, staff worked to get to know John as an individual and established his strengths. From there, they helped John and his family establish goals – including being able to return home.
Staff assisted John with his nutrition and medications, and encouraged his involvement in activity programs. They worked with him to improve his functionality, such as having a shower on his own, getting John get to a point where his wife felt she could manage caring for him again on her own.
For more on reablement and restorative care across aged care, the Active Ageing Conference 2016 on 4 August in Sydney will have the latest evidence and practice. Click here for more information
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