Two days of solutions for better aged care

Fresh, solutions-focused, positive and different. This sums up the overall feedback Australian Ageing Agenda heard at Facing the Future: Aged Care 2030 and Beyond – the inaugural conference of Aged Care Research & Industry Innovation Australia.

With imagery from the 1960s futuristic television program The Jetsons – which was set in 2062 – there was energy and optimism in the air at the sold-out event. There was laughter, too, as MC Jean Kittson – a performer and writer – entertained and informed with stories of her experiences as a carer for her parents.

The two-day conference held at Adelaide Oval on the traditional lands of the Kaurna people drew more than 350 delegates hungry for ideas to help them create a better future. They left with plenty of thanks to the 18 keynote speakers and 19 Think Tank presenters – many of whom prescribed collaboration as a key part of the solutions to building a better future for Australia’s aged care sector.

It was the Think Tanks – three concurrent sessions each day – that presented the most-talked-about challenge of the event: how to choose one when wanting to attend all three.

On day one, and after much consideration, it was the session on Embracing Diversity for Positive Ageing for AAA. It did not disappoint.

There, Professor Briony Dow – director of National Ageing Research Institute – discussed cultural diversity in aged care and the implications for older people, providers and the workforce. She talked about a diverse older population that is changing and a culturally diverse workforce, and the challenges of racism and discrimination that comes with it. Among the solutions is cultural competency, Dr Dow said.

Cultural competency is “not just about language and interpretation – it’s about having systems that underpin the care. So organisational culture, regulatory framework, staff training, rostering, translation and interpretation services as well. All the resources that enable care providers to work effectively in cross-cultural situations,” Dr Dow told delegates.

Already experienced in this area, Fronditha Care chief executive officer Faye Spiteri shared how a bilingual and bicultural workforce was at the core of their model serving the Greek communities of Victoria and Newcastle. Their initiatives include a language-learning program for non-Greek speaking staff.

Elsewhere, on the conference’s theme of positive ageing, LGBTIQ+ Health policy and research lead Michael Frommer talked about the need for aged care services to respond to diverse people’s past and traumatic experiences of care and other areas of life.

The standout talk and images for this session came from Sarah Brown – the CEO of Purple House, which provides culturally safe dialysis through remote clinics and mobile dialysis units, aged care and support across remote Australia.

As previously reported, this Western Desert Nganampa Walytja Palyantjaku Tjutaku Aboriginal Community Controlled organisation has an all-Indigenous board of directors – 12 Pintupi people from the Western Desert.

“So for us … it’s all about being on Country. However we manage to get people back to Country for however long, but keeping that connection,” Ms Brown told the packed room. She showed beautiful images of people, country and art – and talked about how quality meant different things to different people.

We saw a bed outside on the red dirt and under the blue sky; people cooking and eating their favourite dish – kangaroo tail. Purple House director and dialysis recipient – Irene –could be seen sitting outside raising a cup of tea to the camera, watched by a dog.

“It also obviously raises issues about how there’s a diversity in the priorities for people, and then the aged care royal commission and accreditation standards and all that stuff needs to have a focus on safety and quality. But quality is different things for different people. Some people will look at that [photo] and look at the dog and the rubbish and the state of the house. We say it’s Irene back home where she needs to be to pass on cultural heritage,” Ms Brown said.

While feeling a little smug that the right choice was made – as agreed by others in the session – a bit of FOMO crept in. Discussion at afternoon tea revealed other delegates seemed equally pleased with their choices to attend the other Think Tank sessions on Solutions for Mental Health and Wellbeing and Social Isolation and Person-centred Living for Dementia respectively. Calls for the recordings of the other sessions could be heard throughout the room.

Elsewhere on day one, Minister for Aged Care Anika Wells said innovative ideas and solutions would support the government and the sector to co-design positive ageing approaches so older people could live meaningful lives and safe high-quality aged care was available when needed. “I’m committed to fostering innovation in the sector so it’s more agile and needs based,” Ms Wells told the audience via recorded video presentation.

Later, trend analyst and futurist Bernard Salt dazzled delegates with numbers and graphs. He set the scene by talking about the aged care “freight train heading straight towards us unless we are fully and well prepared”.

To help delegates prepare he painted a picture with Census and other data of the aged care workforce and older people and how they are changing and affected by change. When it comes to migration, the three fastest-growing feeder countries are India, the Philippines and Nepal.

“In 2016, the largest non-English speaking language on the Australian continent was Mandarin. Today it is Punjabi, or Hindi, or Urdu. This is your worker base. You need to connect with the worker base of the next five or six years. You need to understand these languages and cultures, the Filipino community, the Tagalog language,” Mr Salt told delegates. “Then the Nepalese – and this is particularly the case through New South Wales, less so through other states. And I understand that the Nepalese have a particular growth in the aged care industry as well.”

Perhaps his most poignant message, though, was from the data showing anxiety and depression increase exponentially for people in their seventies, eighties and beyond – because of social isolation, and following the death of a partner, he suggested. But the national Census also shows that spirituality becomes more important later in life, Mr Salt said.

As part of its remit to ensure every Australian has the right aged care system to deliver better outcomes for older people, Interim Inspector-General of Aged Care Ian Yates told delegates his office wants to hear from stakeholders about what’s going well, what’s not and what’s worth trying. “And we want to hear about what people would like to do as well,” he told delegates.

Talking to AAA on the sidelines of the event, Mr Yates shared some early feedback about what people are interested in the Office of the Inspector-General of Aged Care pursuing.

“We’ve had some people encourage us to do, what you might call shorter term, limited, or boundaried [work], where it might be possible to have some significant impact in the short term,” Mr Yates told AAA. “But we’ve also had other people say, here’s an opportunity to start thinking about tackling some of those system-wide systemic issues, what we call today, the baked-in issues. And I think we need a balance between those.” (See AAA next week for more on this story.)

Also appearing on day one was international speaker Susan Ryan – CEO of The Greenhouse Project, which has 384 homes in 33 states across the United States and a model based on homelike settings and “deep-knowing relationships” between care givers and care recipients. “By the end of this year, we should hit number 400,” she told delegates.

Ms Ryan shared their learnings and the critical success factors. “Well, the first thing I would say is all about your data; it drives decisions,” Ms Ryan told the room. Other success factors include effective stakeholder relationships, positive language, learning as a process rather than an event, and leaders who create the vision needed. She also stressed that providers cannot do it alone, in silos or with half effort.

“You can’t half jump. This is a quote by a colleague of mine … and she says, ‘You’ve got to fully connect, you can’t tweak on the edges. You have to fully transform and fully commit. You’ve got to really go all in and to really make change happen.’”

Day one finished with a laugh-out-loud “On the Couch” session on how to live a meaningful life and positive ageing. Host Ms Kittson was joined in conversation with swimming champion and Australian Olympian Dawn Fraser; author, ABC chair and media professional Ita Buttrose; and Equity Trust grant program manager Susie Meagher.

They talked about the value of exercise and meaningful activities and Ms Fraser drew laughter from the room when she shared her secret for feeling young. “I’m 86 this year and so I feel 68. I always turn my age around. When people ask me my age and I say I’m 68 and they say ‘Oh you don’t look that’,” she told delegates.

On her wish for the sector’s future, Ms Fraser said she would like to see people supported to stay in their own homes instead of having to go into an aged care facility. Ms Meagher talked about the need to unlock capital and get investors to understand the challenges.

From Ms Buttrose came a call to stamp out the negative stereotypes around ageing and focus on the positives. “We really want to try and fight those and say to people, ‘Look, if you’re lucky, you get to be old, not everybody makes it. And if I use Dawn’s example – if you’re 68, well then, I am 18,” she said in return for more laughter.

In the evening, delegates came back together for the conference dinner to sip champagne, partake in a session of laughing yoga and be entertained by musician and songwriter Russell Morris – and a balloon floating in time to the music that, as Mr Morris noted, appeared to move around like a ghost.

Elsewhere during the evening, ARIIA made two key announcements – one to launch a new ideas incubator and another to name the latest winner of ARIIA grants.

Day two

Back bright and early, the buzz in the air, vibrant conversations, networking and discussion continued on day two.

It included international speaker Professor Alex Mihailidis, the scientific director of AGE-WELL in Canada, whom AAA spoke to in the lead up to the event. “Technology is not a silver bullet,” was his takeaway message for delegates. “It is one tool in a toolbelt of many different types of interventions [that] has to be usable by everyone involved in the care of a specific older person.”

Elsewhere, Professor David Brown from the University of Technology Sydney Ageing Research Collaborative talked about the importance of collaboration and coopetition as the pathway to financial security in Australia’s aged care sector – and drew laughter for his slides despite the far-from-funny topic.

Assuring the audience that coopetition was a real word, he said it was where competing organisations cooperated to come up with a solution and was behind the success of other industries, including the Australian cotton industry.

“We need to work together on this. Systemic systematic problems need systemic or systematic innovation, this cannot be done by any of us individually; it cannot be done by policymakers, it cannot be done by firms, it cannot be done by researchers, it cannot be done by consultants, it cannot be done by us as individuals, but it can be done by all of us when we actually work together on a problem,” Mr Brown told his audience.

Activist, author and thought leader Ashton Applewhite appeared by live video to implore delegates to work together to tackle ageism, sexism and racism.

Speaking next – Wiradjuri and Kamilaroi man, and ABC international affairs editor, Stan Grant. Ageism, he said, was an issue of the western world but one that doesn’t exist everywhere – including in his Aboriginal culture, which instead has Elders.

A professional storyteller, Mr Grant shared his story and the story of his ancestors to a captivated audience. He talked about bringing two Australias together to make a home for both older people and Elders. Mr Grant’s takeaway message was that ageing and death is not something to feared but rather something to be embraced by our Elders.

Also on day two, Professor Yun-Hee Jeon inspired delegates with the score of research projects and successful implementations she has been involved in over 20 years focusing on dementia and person-centred care. That includes a proven reablement model for people in the community, which is now being followed up with a similar study for aged care residents.

Among her key messages, Professor Jeon said the successful knowledge translation of person-centred care started with managerial leadership and support.

The conference also provided an opportunity to hear from four ARIIA grant recipients on the stage about their projects – and what they hoped to achieve – and government representatives about driving innovation. AAA also spoke with several other grant recipients among the delegates about their projects underway.

A second round of Think Tank sessions tackled workforce, innovation for end-of-life and palliative care, and dignity of risk in the community, respectively. Again FOMO guided a tough decision for delegates to make.

In the workforce session, Sharon Walsh – director of volunteer services at Bendigo Health – noted the event coincided with National Volunteers Week and called out to the volunteers in the room to say “thank you”. She said that volunteering was a health matter and that volunteers were a key part of workforce solutions.

“There’s opportunity through volunteering, using volunteering as a pathway to not only create a level of sustainability for volunteering, but to also encourage and enhance our future workforce,” she told delegates.

The day finished with a panel discussion led by Ms Kittson that included Apollo Care Alliance CEO Stephen Besci talking about his aged care organisation’s innovative model. His description of a private company with a purpose to acquire not-for-profit homes in regional areas to keep them open, drew applause.

“The results in two-and-a-half years, we’ve saved seven nursing homes from closing. We’ve got a bunch more coming,” he said. Mr Besci finished with a call to action for all stakeholders, and a suggestion for ARIIA’s next conference to facilitate the sector’s next steps.

“If we go back to the theme for the last two days, collaboration was used a lot, and that leadership that pushes the boundaries. So if you want this to get off and go in the right direction, number one, all the stakeholders need to come together and be aligned,” he said. “And if you were to ask me, the next conference that ARIIA holds – and sorry about this, Sue – is getting all the stakeholders together to do that next step.”

He was referring to ARIIA research and workforce lead Professor Sue Gordon, who thanked Mr Besci and while noting she was “standing between you and a drink now” shared some trivia from The Jetsons before closing.

“Did you know that George Jetson’s birthday was the 31st of July 2022?” she said, before thanking all the speakers and the ARIIA team for making the event so great.

“But finally, the people that I want to thank is all of you. You have come here with generosity and openness. I just thank you for your contribution.”

As delegates, speakers and organisers mingled with old colleagues and new contacts and enjoyed farewell drinks and canapes, there was talk of favourite sessions, ideas to take back to colleagues, and the next event. AAA understands discussions are already underway at ARIIA about a second conference.

Main image: MC Jean Kittson at the inaugural ARIIA conference at the Adelaide Oval

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