Restorative care must be default approach

Many people in the community have pre-existing perceptions of what ageing looks like, keynote speaker Associate Professor at Bond University Justin Keogh told the Positive Ageing Summit’s day 1 audience, but holistic ageing aims to make it a more positive experience by increasing strength, mobility and maintaining independence.

Exercise science has changed significantly since the 1990s – when resistance training was considered something just for bodybuilders, he said. Extensive research has since been done on the benefits for older people, but there is still work to do in getting providers to implement evidence-based programs that support positive ageing through exercise and reablement.

Across the world, the literature shows that resistance training and exercise are crucial to ageing well, said Dr Keogh, and research has also shown that consumers would largely prefer an exercise prescription over more medication.

“As youngsters, that aerobic sort of activity, just running around in the playground is great – sets you up for life quite nicely. But as we start to reach middle and early older age, that aerobic exercise needs to be supplemented by progressive resistance training,” he added, emphasising that progressive training by nature needs to become harder for progress to be made.

“And as we get older and mobility starts to be compromised and also balance, gait training becomes highly important as well.”

Implementing these types of programs may be easy, said Clayton Church Homes chief executive officer Jo Boylan – who has been implementing exercise programs to promote positive ageing for the past 25 years – but they are difficult to maintain.

“For Australia to win this race against disparity and rehabilitation and ageing, and regardless of the lack of depth to reablement in the new standards… aged care providers will need to set up restorative care and rehabilitation as the initial default response to each older person’s presenting needs,” she said.

Ms Boylan acknowledged that this is a big ask for providers, but that it is also a human right to have equal access to high-quality care.

“Not only is it a human right to have equal access to good quality care and services, we also need to prepare for an ageing population,” she said.

“Dismantle the barriers to healthy ageing, tackle systemic ageism, re-design and set up the systems, the structures, the policies and procedures for a whole of system change.”

Ms Boylan told an attentive audience of sector leaders that the target should be moving the individual to a “maintaining phase” not just the recovery pathway. She also reminded them that while multidisciplinary care teams are important, recovery must be led by registered nurses.

“The key is the RN. Every day that RN is reading the progress notes and scanning and looking for decline, for falls, for refusal of care, for reduced food, fluid intake, isolation, lack of engagement. These issues can be the start to reduced health outcomes,” she said.

More than exercise

For a truly holistic approach to positive ageing however, Food Solutions Diet Consultants national dietetic manager Yvonne Feeley reminded the audience that creating social opportunities through exercise and nutrition-based tasks are equally as crucial to a person’s wellbeing – especially in home care.

An important part of implementing this is educating staff on what they need to look for, or simple things they can do to boost wellness, such as bringing lunch to a home visit and eating with their home care client.

“Talk to them about finding out what it is that the older person wants and then please try and get everybody out of their home. We really need to get everybody out and about with everybody, where they can actually share eating in a social environment as we would,” she said. 

“Food is everybody’s business. Whether it’s a carer, whether it’s the dietitian, whether it’s the physio, if there’s exercise programs, then we need to have some encouragement.”

“We need to get better coordination, better communication between everybody that cares for those particular people in their home,” Ms Feeley added.

Speaking on the same panel, Plena Healthcare executive general manager of customer growth and strategy Jason Skennerton agreed that reablement and wellness services such as allied health are often an afterthought and should instead be seen as the building blocks – especially when it comes to home care and consumer understanding of allied health.

“I think there’s a really significant knowledge gap in terms of the aged care population, in terms of what the service is actually for and what it should be used for. We see that at the moment whereby we talk to consumers about health-promoting activities, exercise physiology, physiotherapy, and a really common response that we hear back from people is, ‘oh, I’m okay right now. I don’t have any pain. I haven’t had a fall,’ that’s great, let’s keep it that way,” he said.

“We really don’t want to be seen as a reactive service that is responding to a clinical incident and coming in after the fact.”

Ms Feeley and Mr Skennerton were joined on the panel by Dr Robert Mulllins, Plena Healthcare national podiatry manager. Professional practice advisor aged care at Occupational Therapy Australia, Christina Wyatt, moderated.

PAS day 1 highlights

Positive Ageing Summit is an initiative of Australian Ageing Agenda and Community Care Review – read our coverage of the event here and find out more on the Positive Ageing Summit 2025 website