Human connection

In mid-July aged care residents from different Melbourne homes got together for a city tour. But instead of jumping on a bus, they gathered in their respective common rooms to interact with each other and the outside community via a teleconference system and 80-inch screens.

The residents and homes are taking part in a digitally enabled social inclusion pilot being delivered under National Centre for Healthy Ageing’s Living Labs program.

“The idea is to use the video-conferencing technology to bring them together for some enjoyable activities,” National Centre for Healthy Ageing director Professor Velandai Srikanth tells Australian Ageing Agenda.

At the initiative’s launch at Carrum Downs Aged Care Home activities included a live tour of the Old Treasury Building with the guide engaging participants in questions and a quiz on what they learned.

“It then emerged that one of the residents used to work in the building and go for walks around the city at lunchtime and grab a coffee here or lunch there and meet friends; the kind of things that evoked enjoyable memories. But also the tour engaged them in knowing about things they’re curious about,” says Srikanth.

“It was fun watching the residents, listening, engaging and jumping in to answer the quiz, and then they had a lot to talk about at the end amongst themselves.”

The initiative is the pilot and launch of the “Ciao!” Program in Australia, which NCHA is delivering in partnership with Monash University – where the centre is based – public health service Peninsula Health, and the Amplifon Foundation.

The program is based on Amplifon Foundation’s successful “Ciao!” Program – which, like the name suggests, comes from Italy. It was launched there in 2020 – at the height of the pandemic to address residents’ prolonged isolation, facilitate ongoing connection with families, and provide entertainment and recreation.

It has since supported residents in more than 230 aged care homes in Italy and Portugal.

The program aims to improve aged care residents’ experience through interactive technology-based activities within and across homes, says Srikanth.

“It starts to break down that relative passive engagement in activities that we often see and, even though well-meaning, the kind of passive activities that they are exposed to.”

Also at the launch, an experienced person took residents and other participants through gentle-seated exercises for yoga.

“It was enjoyable to watch them have fun with it rather than just do some exercises,” says Srikanth. “You can do a range of things with it that not just show people places or things but engage them between themselves and engage them across facilities.”

Other ideas include following the journey of a guide dog puppy in training, virtual travel and therapeutic gardening.

“Imagine if we could connect people internationally to countries where they had people of their background, or even places of their background to go and look at. That would be fantastic,” says Srikanth.

The latter, he says, is among several new ideas being discussed for the Australian version of the program. Still in the early stages of development, a certainty is the involvement of residents, family members and care home staff in its design.

“At the National Centre for Healthy Ageing any project or programs that we devise, the essential piece is creating that in concert with the people that are involved.”

And residents wish to have input, the recent report collating the results of the last two annual experience surveys shows.

“They should include us in the decision-making, some of us have good ideas for improving our experience,” says one resident.

On a positive note, providers are improving when it comes to how much residents have a say in their activities. In fact, the Residents’ Experience Survey Report – which combines and compares results from 2022 and 2023 – reveals this was the most improved area across the period.

The annual 14-question survey captures the views of 20 per cent of residents from 99 per cent of homes across three areas. Around 37,400 residents from over 2,620 homes participated in both 2022 and 2023.

It shows 87 per cent of residents report having a say in their daily activities always (64 per cent) or most of the time (23 per cent) in 2023. That’s up from 80 per cent in 2022 with a particular improvement in those reporting always having a say (52 per cent).

Positive comments from survey participants include:

“I love the activities, I participate in everything as much as possible.”

But there is also room for improvement.

More daily activities is the most frequent request in response to the question: What is one thing you would suggest as an improvement at this service?

Comments calling for more and improved quality of activities include:

• “More intellectually stimulating activities, I’m bored too much of the time”
• “More activities that are mixing, socialising, games”
• “Entertainment is needed on the weekends”
• “We need more activities… nothing for us to do here but sit in front of the TV”.

More intellectually stimulating, sociable and engaging is exactly what the NCHA is aiming for with the Ciao! Program. It’s one of around 20 projects the Living Labs teams are involved in to improve the everyday quality of life of older people.

“Innovations or services that we create are intended to be done in a way that we can rigorously measure what happens, so we know what works and what doesn’t work,” says Srikanth.

In common across programs is the lab’s focus on experience and wellbeing. Why? It’s obvious, says Srikanth.

“If I were to go into residential aged care, one of the key things that I’d be thinking about is, will I be able to enjoy my stay there in the last few years of my life?”

There’s also a lot of evidence to its value. Including the royal commission, which pointed out the care experience is critical for people, and many who contributed to the inquiry who talked about the need for social connection and engagement as well as care quality, he says.

“When we set out to invest in our programs, we engaged with community to work out what priorities would be important for them, and social connection was way and above many other things, so it became an important part of our programs to make sure that we address that.”

Many NCHA projects are close to generating some novel information, so “watch this space,” says Srikanth. Of the early learnings “people connection” is the most important, he says.

“Face-to-face and human connection is high on their lists. Technology helps if that cannot be done easily, and technology helps in group activities like in the “Ciao!” Program,” Srikanth tells AAA. “One of the important pieces that we’re trying to work out is intergenerational connection.”

A NCHA Living Labs project exploring this involves building an intergenerational activity playground for primary school students. The idea is for kids to attend in a play and learning environment involving science and technology pieces and older adults engaging with them, says Srikanth.

“There’s learning for kids [and] engagement and purpose for older adults,” he says. “One of the key parts of Blue Zones across the world – where healthy longevity is touted as being successful – is the connection piece. And it’s not just connection between your own generation, but connection across and with purpose.”

Also exploring meaningful intergenerational connections is South Australian aged care provider Helping Hand. Its aged care home in Golden Grove has teamed up with neighbouring high school Gleeson College to pair 20 seniors with 20 likeminded students to pilot a program of weekly meet ups.

“We got the student profiles about their likes, dislikes, lifestyle and things like that. Then the team at Golden Grove matched them for interests with the residents that were being involved,” says Melinda Richardson, Helping Hand’s executive manager of residential services.

“For instance, a lad and an older fella were matched because of their love of music and they both played instruments,” Richardson tells AAA.

That budding young musician is Alex. He’s been bonding over music with Jeff (pictured together above) and reports a “very positive” experience.

“I remember the buzz in the room at the beginning of the first visit, everyone not too sure what to expect, but it proved to be a success quickly after some awkward and funny ice breakers and introductions,” he says.

These activities were about building relationships and mutual learning that transcends age

Sally Parson

Since then, two groups of residents and students have been meeting weekly to get to know and learn from each other.

Born of a desire to foster meaningful connections across generations, the initiative has flourished in ways beyond expectations, says Sally Parson, personal learning plan coordinator at Gleeson College.

“Each session was carefully planned around themes such as getting to know each other, sharing games, exploring technology and reminiscing through photos. These activities were about building relationships and mutual learning that transcends age,” she says.

It has been a success with participants from both sides engaging with and showing an understanding of their intergenerational partner, says Richardson.

The program – which builds on Helping Hand’s intergenerational program involving little kids and their parents – ran throughout the second term of the school year and it’s continuing for the third and fourth terms. Next on the agenda is fine-tuning the model for expansion and exploring how to transition out of the school program into something ongoing so the connections are not lost.

“We’re keen to grow this and get this across all of our care homes,” says Richardson. The initiative runs within the existing lifestyle program and budget, making it highly doable, she adds. 

“The key is to have a college or a school that’s willing to work with you, that absolutely makes the commitment and can see the value for their students,” Richardson tells AAA.

Similarly, providers need to prepare well and have a good model, she says.

“Once you start you can’t stop; it’s part of a school curriculum. You can’t have it fail halfway through because it’s hard to start again and people lose confidence. You’ve got to be all in and make sure that you’ve set it up well for success.”

Asking effective questions, taking ownership of the customer’s enquiry and acting upon the customer’s unique cues are the traits of the top performing customer contact centres.

That’s according to the SenseCX Best Practice Quality Assurance Aged Care Sector Benchmark Report from customer experience specialist CBSA.

The aged care sector’s overall performance ranks in the top half of the nine sectors evaluated. But there are several key areas of customer service requiring improvement, says CBSA account director Tony Williams.

“It’s very encouraging to see aged care provider phone centre staff we evaluated outperform most sectors,” Williams tells Australian Ageing Agenda.

“That said, there’s certainly ample room for providers to make it easier for customers to interact. Staff need to put customers at ease by demonstrating stronger ownership of issues. Simply saying ‘I’ll be able to help you with that right now’ immediately reassures customers and builds confidence and trust that they’ll be looked after,” he says.

Rankings are based on 13,348 assessments of 244 organisations conducted between 1st July 2023 and 30th June 2024. This includes 160 assessments of eight aged care organisations. Those making the top five – in order – are:

1. BlueCare
2. Bethanie
3. Bolton Clarke
4. Calvary
5. St Vincent’s Care.

The other providers assessed – in alphabetical order – are Anglicare, Arcare Aged Care and Regis Aged Care.

On areas needing improvement, Williams says aged care phone centre staff can do better at anticipating customers’ needs and proactively offering information.

“For example, providing advice and information that customers didn’t ask for but is nevertheless useful can really influence the customer’s experience,” he says.

Staff also need to make customers feel more positive about the interaction.

“Experiences which feel personal, caring and understanding are vital in the aged care sector, but few providers’ contact centre teams do this well… It’s essential to build instant rapport and simply using the customer’s name is an excellent way to build a relationship,” says Williams.

“Another important area call handlers need to improve is managing customers’ expectations. They need to give their full attention, listen actively, and confirm their understanding of what the customer needs. Staff need to be prepared to address uncertainties around things like timescales by providing honest reasons to customers.”

Concluding calls is a big area in need of a boost for aged care staff – who perform below every other sector CSBA evaluates.

“Providing clear summaries back to customers, checking their understanding and ensuring they can ask any additional questions are important to get right,” says Williams.

Under-investing in customer service is incredibly short-sighted, says Williams.

“Managing customer experiences demands targeted frontline training backed-up with monitoring to ensure agents consistently demonstrate behaviours that will drive excellent customer service.”

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