A leader in aged and community care has urged providers and carers to examine their values and their actions and wrestle with moral and ethical issues to provide the best care.
General Manager, Ageing for the Benevolent Society, Barbara Squires told the Aged and Community Services national community care conference on the Gold Coast that there was frequently a disturbing gap between what care providers say and do.
“There is a dissonance between what we say and what we do,” Ms Squires said. “The Department of Health and Ageing posters talk about older Australians deserving the best care and yet they provide only 1.7 percent indexation to the funding of that care.”
In their own organisations, Ms Squires said care providers often have lofty mission statements and values on their walls but a big gap between those statements and what actually happens when the individual care worker goes into a client’s home.
“Do we walk the talk? Sometimes, especially in larger organisations, there can be a big disconnect between what we say and what happens at the front line. We need to always focus on the impact on older people.”
Ms Squires highlighted a number of moral and ethical challenges facing care providers including staff culture.
“If we don’t treat our own staff with respect, how can we expect them to treat our clients with respect?
“One of the things I am really proud about in our organisation is that our values are clear and we can hold each other accountable to them. We have an open plan office and everyone, including the CEO, is there together. It makes a big impression on new staff.”
She also emphasised the importance of ensuring choice and control for clients within the care relationship.
“There is a certain personality type attracted to caring roles,” she said. “We are ‘helpers’ but we have to be aware that too much helping can cause more harm than good. Research shows that choice and control, even in small amounts, is vital to good health outcomes.”
Pointing to the Humanitas organisation in the Netherlands, Ms Squires said that mission and values did not need to be lofty and complicated.
“Humanitas has three simple core principles: to help the older person be the ‘boss of their own life’; to ‘use it or lose it’; and to have a ‘yes’ culture where yes is the default answer to every question and you take it from there.
“These are challenging things for many of us but we need to think about them and question ourselves and struggle with the moral and ethical dilemmas. The nature of dilemmas is that they do take time and reflection and thought.”
“We need to remind ourselves about what we are really doing and it comes down to ‘whose life is it anyway’? And who decides? There are no black and white answers and it will always be a struggle but it is worth it for the older person.”